Abstract Body (Do not enter title and authors here): Background
There are significant disparities in the care of patients from minority racial/ethnic groups with diabetes and hypertension. We deployed a pharmacy-led approach, paired with population health support, within a tertiary academic medical center to identify high-risk Hispanic, Black, and Asian patients and target these gaps in diabetes and cardiovascular care utilizing clinical pharmacists to actively manage, monitor, and titrate anti-diabetic and anti-hypertensive pharmacotherapy.
Research Question
Our aim was to describe this pharmacist-led initiative and determine feasibility and impact on HbA1c and blood pressure (BP) outcomes.
Methods
This program identified and prioritized self-identified Black, Hispanic, and Asian patients based on a diagnosis of T2DM, most recent A1c value, presence of ASCVD, and hypertension. Once identified, a pharmacist sought the patient’s medical provider’s permission to engage the patient in pharmacist-driven medication management. This management included initiation and titration of anti-diabetic and anti-hypertensive medications, as appropriate. In addition to clinical management, the pharmacy team would investigate benefits for covered agents, complete prior authorizations, assess and monitor medication adherence and persistence to ensure patients’ ongoing access and compliance with medication therapy. This study is a retrospective review of patient outcomes from the start of the program in October 2022 to March 2025. Primary outcomes of this study include HbA1c values and BP values before and after management by the pharmacy program. Descriptive statistics were utilized for outcome analysis.
Results
During the study period, 335 patients have been enrolled. This population included 204 (61%) Black, 108 (32%) Hispanic, and 23 (7%) Asian patients. The average HbA1c was reduced by 0.54%, average systolic BP was reduced by 15.3 mmHg, and average diastolic BP was reduced by 8.9 mmHg over the 30 month study period. Patients who began the program with an HbA1c >9 (n=148) had an average HbA1c reduction of 1.3%. In patients with ASCVD (n=127), there was a 71% relative increase in patients on GLP1 and SGLT2i agents after pharmacist intervention. There was an average of 5 encounters with a pharmacist per patient
Conclusion
In this study a pharmacist-led, population health based intervention resulted in clinically significant, long-term improvements in HbA1cs and BPs in Black, Hispanic, and Asian patients.