Objective: To evaluate the effects of digital diabetic care and pilot-test the healthcare ecosystem with retail pharmacists as the care provider.

Methods: We managed to build a digital healthcare ecosystem that engages diabetic patients and pharmacists with a cloud engine that operates 5 different algorithms for diabetic care support. A set of glucose tele-monitor and an App was installed in the drug stores and pharmacists provided personalized interventions to the walk-in patients according to the onsite glucose tests and the supporting App contents generated by the cloud engine in real-time. Between Jun 6th 2015 and Dec 26th 2017, we served a total of 283,938 patients in 4,035 pharmacies in 183 cities, and 14,609 of them were selected in this analysis following 4 inclusion criteria: 1) the baseline fasting blood glucose (FBG) or random blood glucose (RBG) were diabetic, 2) the intervention duration was ≥ 1 month, 3) the number of received diabetic care was ≥ 3 times, and 4) the baseline characteristics were complete. Among them, 11,131 received FBG tests, 4,731 had RBG tests and 1,253 had both.

Results: FBG and RBG were reduced on average by 0.8 mM (baseline: 9.1 ± 2.2 mM, last time: 8.3 ± 2.2 mM, n=11,131, P< 0.001) and 3.2 mM (baseline: 14.5 ± 3.2 mM, last time: 11.3 ± 4.0 mM, n= 4,731, P<0.001), respectively. The diabetes control rates were improved with 3,165 patients of the FBG population (28%) and 2,545 patients of the RBG population (54%) returning to normal. The greatest glycemic control effect took place following the initial intervention with the reduction of FBG by 11% and RBG by 18%. Nonlinear fitting using compound function identified descending glucose reduction to time: FBG, y = 1.122x-1/3 + 7.970; RBG, y = 2.927x-1-0.003x + 11.070.

Conclusion: Retail pharmacists equipped with digital tools can effectively control diabetes and are valuable resources to help streamline the process of community healthcare delivery.

Disclosure

J. Cao: None. Y. Li: None. W. Wang: None. Z. Wang: None. D. Li: None. H. Zhang: None. K. Liu: None.

© 2018 by the American Diabetes Association.
2018
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.