Introduction and Objective: Beginning in 2026, hospitals must report severe hyperglycemia as a quality measure to CMS. This study evaluated a pharmacy-led stewardship service to improve hyperglycemia management and glycemic control in an acute care facility, aiming to enhance outcomes and meet CMS standards. Methods: Outcomes were compared between November 2024 (pre) and November 2025 (post). Eligible patients had diabetes, received antihyperglycemic agents, or had ≥1 blood glucose ≥200 mg/dL. Patients were excluded if admitted 24 hours or initial glucose 600 mg/dL. A dedicated pharmacist worked 5 days/week, 8 hours/day, monitoring and intervening to maintain target glucose levels. The primary outcome was the difference in severe hyperglycemia hospital day ratio, defined as days with ≥1 blood glucose 300 mg/dL within 10 days of admission. Secondary outcomes included mean days of euglycemia (no events), hyperglycemia, severe hyperglycemia, and hypoglycemia (counting a full day if ≥1 event occurred), and provider acceptance rate. Chi-square tests analyzed the primary outcome and acceptance rate, while unpaired t-tests analyzed remaining secondary outcomes. Significance was set at p ≤ 0.05. Results: Of 382 patients screened, 212 were included with similar baseline characteristics. The post-intervention group had lower severe hyperglycemia days (6.95% vs. 9.41%, p = 0.18), more euglycemic days (2.82 ± 3.54 vs. 1.83 ± 2.68, p 0.001), fewer hyperglycemic days (2.54 ± 4.20 vs. 6.64 ± 4.30, p 0.0001), and no change in hypoglycemic days (p = 0.79). Provider acceptance for pharmacy interventions was lower post-intervention (83% vs. 92%, p = 0.26), but overall increased by 2.76-fold, from 25 to 69. Conclusion: The pharmacist-led glycemic stewardship service improved glycemic control and may enhance CMS quality measures. These findings support service expansion in acute care settings, with potential benefits to improve patient outcomes and CMS metrics. Further studies are needed to confirm long-term effects. Disclosure M. Watler: None. D.C. Beltran: None. C.J. Gonzalez Hernandez: None. L. Cabrera Ricabal: None.
WATLER et al. (Fri,) studied this question.