SMBG in a diabetes education program improves T2D outcomes. This study was done to evaluate if use of SMBG taught by clinical pharmacists or Certified diabetes educators improved A1C compared to diabetes classes and medication review in HRM. A pretest-posttest format was used. Subjects (n=807) were referred by providers from 5 federally qualified health centers and a practice group.
HEDIS measures collected included: A1C, BP, FPG, BMI, total cholesterol (TC), LDL-C, HDL-C, and TGs. Subjects received a validated knowledge test initially, 3 months after taking a diabetes class and at study end. A psychosocial inventory was collected initially and at study end. This multi-component model was a four-arm study comparing Diabetes Classes (DC), Pharmacist Medication Management (MTM), Pattern Management (PM) using a glucose meter data management system, and control subjects who did not participate (Ctl). Subjects had at least two interventions prior to assignment to PM. 258 subjects attended the diabetes classes, 71 in the MTM arm, 44 in the PM arm, and 138 Ctls. 296 were lost due to incomplete and/or lost data. Demographics revealed 77% in the 20-64 years old range, 21% in the >65 age group, and 16% in the <20 age group, with 65% female subjects. The mix was 86% non-Hispanic black and 13% non-Hispanic white. 60% of subjects were on Medicare/Medicaid, 30% employer-insured, and 16% uninsured. Mean A1C levels in the DC group decreased from 7.93 to 7.60, 8.06 to 7.32 in the MTM group, 7.70 to 7.28 in the PM group, while Ctls increased from 7.00 to 7.36. The PM group had the greatest mean changes in multiple measures including BMI, BP, FP, TC, and TG. The MTM group had the greatest improvement in A1C.
Conclusions: The PM group had the largest changes in overall measures of T2D control. There was increased diabetes knowledge and reduced ER visits. Thus, in HRM using PM from SMBG, the improvements suggested better monitoring of multiple metrics of relevance in T2D control.
I. Myers: None.