Pharmacist-led group medical appointment model in type 2 diabetes

Tracey H. Taveira, VA Medical Center
Peter D. Friedmann, VA Medical Center
Lisa B. Cohen, VA Medical Center
Andrea G. Dooley, VA Medical Center
Sameed Ahmed M. Khatana, VA Medical Center
Paul A. Pirraglia, VA Medical Center
Wen Chih Wu, VA Medical Center


Purpose The purpose of this study was to assess whether the VA-MEDIC (Veterans Affairs Multi-disciplinary Education and Diabetes Intervention for Cardiac risk reduction), a pharmacist-led group medical visit program, could improve achievement of target goals in hypertension, hyperglycemia, hyperlipidemia, and tobacco use in patients with type 2 diabetes compared to usual care. Methods This was a randomized controlled trial of VA-MEDIC intervention in addition to usual care versus usual care alone in diabetic patients to reduce cardiac risk factors. VA-MEDIC consisted of a 40- to 60-minute educational component by nurse, nutritionist, physical therapist, or pharmacist followed by pharmacist-led behavioral and pharmacological interventions over 4 weekly sessions. Measures The attainment of target goals in hemoglobin A1C (A1C), blood pressure, fasting lipids, and tobacco use recommended by the American Diabetes Association. Results Of 118 participants, 109 completed the study. VA-MEDIC (n = 58) participants were younger and had greater tobacco use at baseline than usual care but were similar in other cardiovascular risk factors. After 4 months, a greater proportion of VA-MEDIC participants versus controls achieved an A1C of less than 7% and a systolic blood pressure less than 130 mm Hg. No significant change was found in lipid control or tobacco use between the 2 study arms. Conclusion Pharmacist-led group medical visits are feasible and efficacious for improving cardiac risk factors. © 2010 The Author(s).