Type 2 Diabetes Medication Use Potentially Boosted by Pharmacist Involvement in Care

A greater proportion of patients received guideline-directed medical therapy for type 2 diabetes mellitus after being seen by a pharmacist-led care clinic as opposed to a primary care clinic alone, prompting researchers to conclude there is a significant potential benefit of pharmacist involvement in diabetes management. Investigators presented their findings at the 2022 ASHP Summer Meetings.

“Despite…updated recommendations, SGLT2 inhibitors and GLP-1 receptor agonists remain underutilized. Pharmacists play an important role in the initiation of these medications due to their extensive knowledge about medication appropriateness, medication safety, and insurance coverage,” said Katherine E Harte, PharmD, of Rhode Island Hospital, lead author of the study.

Researchers conducted a retrospective, single-center, cohort study of 2670 adult patients treated for type 2 diabetes mellitus at a primary care clinic from January 2020 through June 2021. Patients were seen by nonpharmacist providers within a primary care clinic, or by a pharmacist-led diabetes clinic within the primary care clinic.

Patients were excluded if they had hemoglobin A1c <6.5% or estimated glomerular filtration rate <30mL/min/1.73 m² at baseline; were pregnant, breastfeeding, on dialysis, or allergic to an SGLT2 inhibitor or GLP-1 receptor agonist; were prescribed one of these agents before the study began; or had a “history of type 1 diabetes mellitus, multiple endocrine neoplasia syndrome type 2, gastroparesis, bariatric surgery, or a personal or family history of medullary thyroid carcinoma.”

SGLT-2 inhibitors and GLP-1 receptor agonists were utilized at a rate of 23% (610/2670) in the group only seen by the primary care clinic. This rate rose to 53% (229/433) among patients who were also seen by the pharmacist-led diabetes clinic.

“The results of this study indicate that there is a large potential benefit of pharmacist-driven collaborative practice diabetes management on uptake of newer guideline-directed medications in patients with [type 2 diabetes mellitus],” researchers concluded.

Reference:
Harte KE. Impact of pharmacist management on SGLT2 inhibitor and GLP-1 receptor agonist utilization in patients with type 2 diabetes mellitus. Poster presented at: 2022 ASHP Summer Meetings; June 11-15, 2022; Phoenix, AZ. Accessed June 21, 2022.