Involvement of Community Pharmacists in Complex Care Plans for Diabetic Patients, a Pilot Study

Diabetes Clinical Trial

Official title:

A Collaborative Care Model for Chronic Disease Management in Diabetes - Involvement of Community Pharmacists in Complex Care Plans, a Pilot Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02399332
• Other study ID #: REB15-0673
• Status: Completed
• Phase: N/A
• Start date: March 2016
• Est. completion date: December 2017

Study information

• Verified date: May 2019
• Source: University of Calgary
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This project is an initiative to bring physicians, nurses, community pharmacists and patients together in collaborative planning in the management of diabetes, which aligns with the collaborative, team based aspects of family medicine as a community based discipline. Alberta funds both physicians and community pharmacists to complete a comprehensive assessment and plan for patients with qualifying medical conditions. Our research hypothesis is that a collaborative approach between healthcare providers involved in delivering care will improve individual patient outcomes with the primary outcome being improved glycemic control. Health care utilization and medication adherence will also be assessed. This project will compare the results of comprehensive annual health care plans implemented over a period of twelve months with or without involvement from community pharmacists. It is hypothesized that involvement of community pharmacists and their collaboration with physicians will lead to improved outcomes.

Description:

Research question: Does involvement of a community pharmacist in formulating and following a complex care plan for diabetic patients in conjunction with the patient's clinical team (physician and chronic disease management nurse) improve outcomes including glycemic control, health care utilization and medication adherence.

Hypothesis: Collaborative complex care planning for diabetic patients with the primary care physician, chronic disease management nurse and community pharmacist leads to improvement in patient health outcomes, decreases hospital visits and visits to family physician and emergency room and improves medication adherence.

Aim of the study: The aim of this study is to serve as a pilot in exploring if collaborative care provided by physicians, chronic disease nurse and community pharmacists in formulating and following complex care plans leads to better clinical outcomes when compared to care plans that are formulated and followed in isolation by the physician and chronic disease nurse. This study would be the basis for a future in depth project comparing outcomes of care plans completed in isolation by the pharmacists or physicians with those created in a collaborative environment. Our long-term objectives are improvement in patient outcomes, reduction in health care expenditure as well as preventing duplication and potential discordance of comprehensive care plans.

Methodology

Patients and study design: This is a single centre prospective case control pilot study.

A cohort of 25 eligible diabetic patients at the South Health Campus Family Medicine Teaching Clinic (an outpatient academic family medicine clinic in Calgary, Alberta) will be studied and compared against a group of 25 control diabetic patients. The intervention would be involvement of patient's community pharmacist with their clinical team in formulating the complex care plan and following up with the patient on a monthly basis. The control is a set of patients who have complex care plans completed by their clinical team with no coordination with the pharmacist.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 16
• Est. completion date: December 2017
• Est. primary completion date: December 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Age = 18

• Patients who have diabetes with HbA1C over target (>7) and who qualify for a complex care plan completion.

Exclusion Criteria:

• Pregnancy

• Unwilling to participate/provide written consent

• Unable or unwilling to participate in planned follow-ups

Related Conditions & MeSH terms

• Diabetes

Intervention

Other:
• Community pharmacist involvement
Collaborative involvement of the community pharmacists in formulating and following complex care plans

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
University of Calgary

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in HbA1C from baseline at one year		1 year
Secondary	Change in systolic BP from baseline at one year		1 year
Secondary	Change in diastolic BP from baseline at one year		1 year
Secondary	Change in Low Density Lipoprotein (LDL) from baseline at one year		1 year
Secondary	Change in weight from baseline at one year		1 year
Secondary	Change in BMI from baseline at one year		1 year
Secondary	Change in hospital admissions from baseline at one year		1 year
Secondary	Change in family physician visits from baseline at one year		1 year
Secondary	Change in emergency room visits from baseline at one year		1 year
Secondary	Change in medication adherence from baseline at one year		1 year