Involvement of Community Pharmacists in Complex Care Plans for Diabetic Patients, a Pilot Study

Research question: Does involvement of a community pharmacist in formulating and following a complex care plan for diabetic patients in conjunction with the patient's clinical team (physician and chronic disease management nurse) improve outcomes including glycemic control, health care utilization and medication adherence.

Hypothesis: Collaborative complex care planning for diabetic patients with the primary care physician, chronic disease management nurse and community pharmacist leads to improvement in patient health outcomes, decreases hospital visits and visits to family physician and emergency room and improves medication adherence.

Aim of the study: The aim of this study is to serve as a pilot in exploring if collaborative care provided by physicians, chronic disease nurse and community pharmacists in formulating and following complex care plans leads to better clinical outcomes when compared to care plans that are formulated and followed in isolation by the physician and chronic disease nurse. This study would be the basis for a future in depth project comparing outcomes of care plans completed in isolation by the pharmacists or physicians with those created in a collaborative environment. Our long-term objectives are improvement in patient outcomes, reduction in health care expenditure as well as preventing duplication and potential discordance of comprehensive care plans.

Methodology

Patients and study design: This is a single centre prospective case control pilot study.

A cohort of 25 eligible diabetic patients at the South Health Campus Family Medicine Teaching Clinic (an outpatient academic family medicine clinic in Calgary, Alberta) will be studied and compared against a group of 25 control diabetic patients. The intervention would be involvement of patient's community pharmacist with their clinical team in formulating the complex care plan and following up with the patient on a monthly basis. The control is a set of patients who have complex care plans completed by their clinical team with no coordination with the pharmacist.

Inclusion criteria

• Age ≥ 18
• Patients who have diabetes with HbA1C over target (>7) and who qualify for a complex care plan completion.

Exclusion criteria

• Pregnancy
• Unwilling to participate/provide written consent
• Unable or unwilling to participate in planned follow-ups