Assessment of a Community Pharmacist Remote Monitoring Service in Patients Using Continuous Glucose Monitors (CGMs)

Cody Beldon; Kelly Rogers; Ashley Johnson; Rachel Schneider; Lauren Stinson; Stacey Frede; Katelyn Johnson

doi:10.1016/j.japh.2024.102106

Assessment of a Community Pharmacist Remote Monitoring Service in Patients Using Continuous Glucose Monitors (CGMs)

J Am Pharm Assoc (2003). 2024 Apr 23:102106. doi: 10.1016/j.japh.2024.102106. Online ahead of print.

Authors

Cody Beldon¹, Kelly Rogers², Ashley Johnson³, Rachel Schneider⁴, Lauren Stinson², Stacey Frede⁵, Katelyn Johnson⁶

Affiliations

¹ PGY-2 Community-Based Pharmacy Administration and Leadership Resident, Kroger Health and the University of Cincinnati College of Pharmacy, Cincinnati, OH; at the time of the study: PGY-1 Community-Based Pharmacy Resident, Kroger Health and the University of Cincinnati College of Pharmacy, Cincinnati, OH.
² Pharmacist, Kroger Health, Cincinnati, OH.
³ PGY1 Community-Based Pharmacy Residency Program Director, Kroger Health, Cincinnati, OH.
⁴ Pharmacist, Kroger Health, Cincinnati, OH; at the time of study: PGY2 Community-Based Pharmacy Administration and Leadership Resident, Kroger Health and the University of Cincinnati College of Pharmacy, Cincinnati, OH.
⁵ Manager, Clinical Program Development, Kroger Health, Cincinnati, OH.
⁶ Assistant Professor, Division of Pharmacy Practice and Administrative Sciences and PGY1/2 Community-Based Pharmacy Administration and Leadership Residency Program Director, College of Pharmacy, University of Cincinnati, Cincinnati, OH. Electronic address: katelyn.johnson@uc.edu.

PMID: 38663533
DOI: 10.1016/j.japh.2024.102106

Abstract

Background: Diabetes is the eighth leading cause of death and has a substantial impact on the United States (U.S.) health care system. Recent changes to major insurance formularies allow for increased access to continuous glucose monitors (CGM). Community pharmacists routinely assist and educate patients about diabetes care, including usage of CGM.

Objectives: The purpose of this study was to evaluate the clinical impact of a community pharmacist remote CGM monitoring service on patients' glycemic metrics. Patient completion of comprehensive diabetes standards of care and pharmacist interventions and recommendations were assessed as secondary objectives.

Methods: This study was a prospective, feasibility study conducted at two pharmacies within one regional division of a large community pharmacy chain between November 2022 and June 2023. A pharmacist conducted patient enrollment visits and remotely monitored CGM glycemic metrics via cloud-based platforms per the study protocol. CGM glycemic metrics were evaluated for each patient three months pre- and post-study enrollment, including time above range (TAR), time in range (TIR), time below range (TBR), glucose management indicator (GMI), average glucose, CGM utilization rate, and glucose variability. Metrics were evaluated for statistical significance using the Wilcoxon signed-rank test and descriptive statistics.

Results: Pharmacists enrolled 36 patients in this study with 20 patients completing the full three-month study period per protocol. There was a statistically significant improvement in three of eight glycemic metrics (very high TAR, TIR, and average glucose). Specifically, TIR had the largest improvement from 61.8% pre-enrollment to 69.9% (p < 0.006) post-enrollment. All other pertinent glycemic metrics displayed improvements but were not statistically significant.

Conclusion: The results demonstrate clinically and statistically significant improvements in several glycemic metrics for patients who participated in the community pharmacist-led remote CGM monitoring service, which may result in improved diabetes control and fewer long-term diabetes-related health complications.