Improving Quality of Care in Diabetes Through a Comprehensive Pharmacist-Based Disease Management Program

In the U.S., a large percentage of patients with diabetes receive less than optimal care (1). The use of pharmacists, nurse practitioners, and multidisciplinary teams in a variety of settings have led to improvements in disease control in patients with diabetes and other chronic diseases (2–14). This report describes the utility of a pharmacist-run disease management program in improving the care of predominately indigent, Spanish-speaking patients with diabetes and common comorbid conditions. The study was conducted at El Rio Health Center, which is a federally qualified health center located in Tucson, Arizona. The patient population is comprised mostly of indigent, Spanish-speaking, and sometimes transient patients with primarily type 2 diabetes. The program was implemented in August 2001, using a residency-trained, bilingual PharmD as the provider for patients referred to the pharmacist-based diabetes service by staff physicians. The pharmacist served as the primary care provider for the patients’ diabetes and comorbid conditions, hypertension, and hyperlipidemia. Using medical staff–approved collaborative practice agreements, the pharmacist provided appropriate diagnostic, educational, and therapeutic management services, including prescribing medication and ordering laboratory tests. The collaborative practice agreements were based on national …