A study on diabetic patients by the University at Buffalo School of Pharmacy and Pharmaceutical Sciences identified cost savings with improvements in a key indicator of glucose control in diabetes patients, the hemoglobin A1C measurement. The A1C provides a three-month average of the amount of excess glucose in the blood. Higher A1Cs indicate that a patient is at higher risk for developing long-term complications associated with diabetes, such as kidney disease or vision problems.

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Published last spring in the Journal of the American Pharmacists Association, the UB study of 50 patients with Type 2 diabetes demonstrated that in just six months clinical pharmacists, in collaboration with primary care providers, were able to significantly reduce patients’ A1C levels.

In the UB study, patients’ A1C levels were reduced by an average of 1.1 percent, from an average of 8.5 percent to 7.4 percent, one year after being enrolled in the program, while also improving the overall metabolic profile.

“Our results show that enhancing the patient’s access to care through collaborative physician-pharmacist relationships can yield lower blood glucose levels, improve the overall metabolic profile and reduce costs to the payer,” says Erin Slazak, PharmD, UB clinical assistant professor of pharmacy practice and board certified pharmacotherapy specialist.

These clinical improvements occurred while monthly costs per patient went down by approximately $212, around $2,500 per year, even though there were nominal increases in the cost of medications prescribed.

The key to success?

“Patients had unlimited access to pharmacists throughout the year,” says Slazak.

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Patients referred to the UB program had been identified by their primary care providers as having difficulty controlling their blood sugar. Slazak notes that it was not uncommon to see patients with glucose levels as high as 400 mg/dl (normal levels are below 100 mg/dl).

The UB pharmacists spent an initial one-hour appointment with each patient, where they worked up detailed health records covering dietary information and all medications and disease conditions, and then reviewed them with each patient.

After that, patients could call or make appointments with pharmacists at will.

“We did extensive education with patients about how to manage their conditions,” says Slazak. “In many cases, we were instrumental in getting them to start insulin. There is a lot of resistance to that, and not just because it’s an injection.”

For patients in the initial stages of administering insulin, she says it was common to be contacted once every few days. The pharmacists then made suggestions to physicians about changes in medications, dosages or lifestyle that might be beneficial to their patients.

That kind of individualized attention is far from the norm for diabetic patients.

“Nationwide, the standard of care is that the primary care provider manages diabetes alone,” says Slazak. “Pharmacists typically do not have direct involvement.”

That is partly because some states, including New York, have not yet approved collaborative practice agreements between physicians and pharmacists. In the Buffalo study, for example, physicians were required to review pharmacists’ recommendations and approve all interventions first. Completion of the review process and approval occurred in only half of the cases, potentially limiting the overall benefit to the patient.

“We know there’s a long-term clinical and economic benefit to pharmacists working directly with patients and we think that can continue to grow,” says Scott V. Monte, PharmD, UB clinical assistant professor of pharmacy practice and director of Diabetes and Cardiovascular Research, CPL Associates, LLC, in Buffalo. “Pharmacists can help achieve better outcomes if given the chance.”

The study was conducted through MedSense™, part of the Pharmacotherapy Research Initiative, a collaborative effort between Lifetime Health Medical Group and UB, to study how pharmacists impact patient care. MedSense™ is one of many program sites that are part of the UB Pharmacotherapy Research Initiative in the School of Pharmacy and Pharmaceutical Sciences, which was established to study how pharmacy medication management can improve the health of patients while cutting costs through patient-centered pharmacotherapy.

In addition to Slazak and Monte, other co-authors on the paper include Nicole Paolini Albanese, PharmD, UB clinical assistant professor; Martin Adelman, PhD, chief information officer at CPL Associates, LLC; Gauri Rao, a student in the UB School of Pharmacy and Pharmaceutical Sciences, and Joseph A. Paladino, PharmD, UB professor of pharmacy and director of outcomes research at CPL Associates, LLC.

The program is jointly funded by Lifetime Health Medical Group and the UB School of Pharmacy and Pharmaceutical Sciences.

Pharmacists Improve Care of Diabetics While Cutting Costs, Research Shows is a post from: Pharmacy in jobs, news, schools

The Massachusetts College of Pharmacy and Health Sciences has banned students, faculty, and staff from covering their faces on its three campuses in an effort to ensure public safety, a college spokesman said yesterday.

Pharmacy school bars covering of the face is a post from: Pharmacy in jobs, news, schools

“It’s not my decision,” Thorp said in a meeting with News & Record editorial writers last March.

Thorp said he would be happy to help UNCG gather information toward its goal.

“The question whether UNCG is the right place for a second school of pharmacy and whether the state needs one — those are things that need to be decided by President Bowles and Chancellor Brady,” he said later, referring to UNCG leader Linda Brady and UNC system President Erskine Bowles.

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What that precisely meant was unclear. But it did not appear to be a ringing endorsement.

When pressed about opinions on his campus, Thorp was equally nimble, if uninformative. “Well, you know universities are places where there are lots of opinions,” he said. “There is certainly some skepticism about it but there are some other people who think it makes sense.”

In any event, he said, it wasn’t their decision to make, either.

(He was a lot more forthcoming about Tar Heel basketball.)

But being opposed to a new pharmacy school “isn’t part of the UNC culture,” Thorp said, reassuringly.

That was then.

That was before UNC-CH began pursuing its own plans for a satellite pharmacy school at UNC-Asheville. This would not be a full-fledged school like the one envisioned for Greensboro, where as many as 100 students would enroll. But it would involve up to 40 students and would compete for funding at a time when state money is hard to come by.

As of now, there are three schools of pharmacy in North Carolina: the lone public one in Chapel Hill and private ones at Campbell and Wingate universities.

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A major premise in its long-range plans to establish a school, say UNCG officials, is the acute shortage of pharmacists in the state. Their proposal cites a 2008 report by the Pharmacy Manpower Project that ranked North Carolina and Wisconsin as the two states with the most serious shortages of pharmacists.

Some UNC-CH officials counter that the shortage isn’t as great now as it was thought to be before because of the recession.

Why then, the need for another program in Asheville?

And recessions do eventually end. The pharmacy school is a much longer-term proposition.

UNC-CH’s timing also is, well, suspicious. UNCG’s plan has been on the table for months. The Chapel Hill plan was either a well-kept secret or a late development.

Brady said Thursday that she learned of the Chapel Hill proposal at the end of September. “My sense is it had not been in the works very long,” she said.

There may be no calling dibs in these matters, but shouldn’t Chapel Hill at least have touched bases with UNCG as a professional courtesy?

“People have different approaches,” Brady said.

Even so, she added, “I personally don’t view the Chapel Hill concept as a competitor. It’s very different from what we’re proposing here.”

UNCG would offer the professional-level and graduate degrees, including doctorates, and include a significant research component.

She said UNCG’s provost, David Perrin, interim UNC-CH vice chancellor and provost Bruce Carney and the UNC system’s vice president for academic affairs, Alan Mabe, will meet within the next two weeks to discuss the two proposals.

“I don’t think it’s helpful for us to be competitors,” she said. “Sometimes that’s the case, but it would be good for the two institutions to sit down and talk about the two plans and the state’s needs.”

No offense to Asheville, but the arguments for a school here are compelling: the economic impact; backing from the Moses Cone Health System and influential local foundations; the impact on downtown, if it should be built there; synergy in research with the N.C. A&T/UNCG Joint School of Nanoscience and Nanoengineering.

“Our argument is not only an educational argument,” Brady said. “It’s an economic development argument.”

The Asheville initiative definitely would cost considerably less up front. But UNCG expects a return of as much as $28 for every dollar invested, including between $5 million and $6 million a year in sponsored research and $6.5 million in annual tuition revenue.

For her part, UNCG’s Brady was clearly expecting statesmanship to trump turf concerns.

“The first chancellor to call me following my appointment here was Holden Thorp,” she said.

Can UNCG and UNC-CH meet in middle on pharmacy schools? by Allen Johnson is a post from: Pharmacy in jobs, news, schools