Tuesday, July 16, 2024

Impact of Collaborative Care Model on Economic Outcomes in Diabetes Management

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The increasing economic burden of diabetes management necessitates innovative approaches. A recent study has explored the effectiveness of an interprofessional collaborative care model involving family physicians and community pharmacists within a pharmacy chain. The research focused on individuals with uncontrolled type 2 diabetes and polypharmacy, assessing whether such a model could alleviate the economic strain associated with the condition.

This multi-center, parallel arm, open-label, randomized controlled trial aimed to compare the economic outcomes of patients receiving collaborative care from community pharmacists with those receiving usual care. Participants included individuals with uncontrolled type 2 diabetes (HbA1c > 7.0%) and on at least five chronic medications. Those lacking baseline economic data were excluded. Direct medical costs were derived from the institution’s financial records, while indirect costs were assessed through self-reported income and productivity loss, utilizing the Work Productivity Activity Impairment Global Health questionnaire.

Study Methodology

The study included 175 participants, with 70 in the intervention group and 105 in the control group. The mean age of the participants was 66.9 years, and most were male and of Chinese ethnicity. Direct medical costs and productivity loss were analyzed using generalized linear models with log link function and gamma distribution. The primary focus was on changes in these costs over six months.

Key Findings

Results indicated that the intervention group experienced a more significant reduction in direct medical costs compared to the control group. Specifically, the intervention group saw a decrease of US$70.51, whereas the control group observed a reduction of US$47.66, with a statistically significant difference (p

Practical Implications

– Collaborative care involving community pharmacists can significantly reduce direct medical costs for diabetes management.
– Medication costs are a critical factor in economic outcomes, emphasizing the need for effective medication management.
– No notable differences in productivity loss suggest that indirect costs might require alternative interventions.

The study concludes that implementing a split-shared care model with community pharmacists can mitigate the economic burden of managing uncontrolled type 2 diabetes and polypharmacy. This approach could be a viable strategy for healthcare systems aiming to reduce costs while maintaining patient care quality.

Original Article: BMC Health Serv Res. 2024 Jun 22;24(1):760. doi: 10.1186/s12913-024-11199-2.

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