RESUMEN
OBJECTIVE: The objective of this pilot project was to evaluate a model of care that consisted of a community pharmacist and registered nurse collaborating in a primary care clinic to improve guideline-directed therapy. SETTING: A regional grocery chain pharmacy partnered with a primary care clinic associated with a large academic medical center. PRACTICE INNOVATION: A community pharmacist was granted access to the electronic medical record and paired with a registered nurse care manager at a primary care office. EVALUATION: Forty-one patients were included and assessed for diabetes guidelines directed care. The pharmacist completed chart reviews and sent recommendations to a registered nurse care manager and the patient's primary care provider. The nurse facilitated lab orders, discussed the pharmacist's recommendations, and scheduled appointments as necessary for the patient. RESULTS: This intervention resulted in initial improvement in glycemic control followed by a decline at 3 months. Surrogate markers for prevention of micro- and macrovascular complications improved at 3 months. Optimization of medications for glycemic control and complication prevention also improved. CONCLUSION: The collaboration between a community pharmacist and primary care clinic led to improved adherence to guideline-directed diabetes care. Access to electronic medical records was necessary for pharmacist recommendations and communication. Pharmacist involvement in clinical recommendations at a primary care clinic in addition to standard duties at a community pharmacy may further improve care for patients with diabetes and requires further evaluation.