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Freudenberg DL, Covington LP, Young RB, et al. Impact of a Pharmacist-Driven Protocol to Improve Guideline-Concordant Prescribing of Diabetes Medications in Patients With Atherosclerotic Cardiovascular Disease: A Pilot Study. J Pharm Pract. 2020;897190020958245doi: 10.1177/0897190020958245.
Freudenberg, D. L., Covington, L. P., Young, R. B., Lopez, N. D., Patel, M. V., & MacLaughlin, E. J. (2020). Impact of a Pharmacist-Driven Protocol to Improve Guideline-Concordant Prescribing of Diabetes Medications in Patients With Atherosclerotic Cardiovascular Disease: A Pilot Study. Journal of pharmacy practice, 897190020958245. https://doi.org/10.1177/0897190020958245
Freudenberg, Dakota L, et al. "Impact of a Pharmacist-Driven Protocol to Improve Guideline-Concordant Prescribing of Diabetes Medications in Patients With Atherosclerotic Cardiovascular Disease: A Pilot Study." Journal of pharmacy practice vol. (2020): 897190020958245. doi: https://doi.org/10.1177/0897190020958245
Freudenberg DL, Covington LP, Young RB, Lopez ND, Patel MV, MacLaughlin EJ. Impact of a Pharmacist-Driven Protocol to Improve Guideline-Concordant Prescribing of Diabetes Medications in Patients With Atherosclerotic Cardiovascular Disease: A Pilot Study. J Pharm Pract. 2020 Sep 17;897190020958245. doi: 10.1177/0897190020958245. Epub 2020 Sep 17. PMID: 32938319.
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J Pharm Pract. 2020 Sep 17;897190020958245. doi: 10.1177/0897190020958245. Epub 2020 Sep 17.

Impact of a Pharmacist-Driven Protocol to Improve Guideline-Concordant Prescribing of Diabetes Medications in Patients With Atherosclerotic Cardiovascular Disease: A Pilot Study.

Journal of pharmacy practice

Dakota L Freudenberg, Les P Covington, Rodney B Young, Nicole D Lopez, Miti V Patel, Eric J MacLaughlin

Affiliations

  1. Texas Tech University Health Sciences Center Jerry H. Hodge School of Pharmacy, Amarillo, TX, USA.
  2. Texas Tech University Health Sciences Center School of Medicine, Amarillo, TX, USA.

PMID: 32938319 DOI: 10.1177/0897190020958245

Abstract

PURPOSE: To determine whether a pharmacist-driven protocol improves guideline-concordant prescribing of diabetes medications in patients with atherosclerotic cardiovascular disease (ASCVD).

METHODS: A retrospective pre- and post-intervention study was conducted at a university-based family medicine clinic. A pharmacist-driven protocol was implemented which involved the creation of an algorithm recommending specific diabetes medications in patients with ASCVD. An in-service presentation reviewing the algorithm and process for referral of eligible patients to an appointment with a clinical pharmacist was delivered to providers. Clinical pharmacist appointments focus was on improving diabetes management and initiating cardiovascular risk-reducing medications if appropriate.

RESULTS: A total of 234 patients were screened, and 108 met inclusion criteria. Upon completion of patient outreach, 34% were scheduled with a pharmacist. Forty-three percent of patients (16 of 37) attended the appointment. Of those, 31% were initiated on an evidence-based regimen indicated for diabetes and ASCVD. In comparing pre- to post-implementation of the pharmacist-driven protocol, the rate of guideline-concordant prescribing increased by 48% (3.8% to 5.6%).

CONCLUSION: Implementation of a pharmacist-driven protocol can increase guideline-concordant prescribing. However, further exploration of patient- and system-level barriers is necessary to implement such a program more broadly.

Keywords: cardiovascular disease; diabetes; family medicine; pharmacist-driven protocol; pharmacotherapy

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