Background: Multidisciplinary primary care models incorporating pharmacists have emerged to improve glycemic control in patients with uncontrolled type 2 diabetes mellitus (T2DM). Healthcare Effectiveness Data and Information Set (HEDIS) measures establish quality benchmarks for comprehensive diabetes care and guide reimbursement. Large-scale research on the effect of pharmacist interventions to improve these quality measures in primary care remains limited.

Objective: To evaluate the effectiveness of a pharmacist-physician collaborative care (PPCC) model on comprehensive diabetes care quality measure achievement compared with standard care (SC).

Methods: This retrospective cohort study included adults aged 18 to 75 years with uncontrolled T2DM receiving care in primary care clinics at a community-based health system in Virginia from July 1, 2018, to December 31, 2019. Patients were in one of 2 groups: (1) the intervention group (PPCC), where embedded pharmacists provided diabetes management under a collaborative practice agreement, and (2) the comparator group receiving SC in clinics without pharmacists. The SC group was created via 1:2 propensity score matching. Generalized linear mixed models assessed the association between group and quality measure achievement. Primary outcomes included glycated hemoglobin (hemoglobin A1c) (≤9%, ≤8%, ≤7%) and blood pressure control (<140/90 mm Hg), per the last recorded value in 2019.

Results: The sample (N = 1,293) had a mean age of 57 years, was 56% female, and 45% each White and Black. The PPCC group (n = 431) was more likely to achieve A1c control compared with the SC group (n = 862) (A1c <9%: odds ratio [OR] = 3.68, 95% CI = 2.31-5.84; A1c <8%: OR = 3.53, 95% CI = 2.12-5.89; A1c <7%: OR = 4.61, 95% CI = 2.48-8.56; all P < 0.01). Similarly, the PPCC group was more likely to achieve blood pressure control less than 140/90 mm Hg (OR = 1.49, 95% CI = 1.01-2.22; P = 0.04).

Conclusions: Patients in the PPCC group were more likely to meet comprehensive diabetes care quality measures compared with SC. These results underscore the value of pharmacists in diabetes management in primary care and their contribution to value-based care.

背景： 多学科初级保健模式中纳入了药剂师，以改善未受控制的2型糖尿病患者（T2DM）的血糖控制。Healthcare Effectiveness Data and Information Set (HEDIS) 指标为全面的糖尿病护理质量设立了基准，并指导报销标准。然而，在初级保健领域中，关于药剂师干预对这些质量指标影响的大规模研究仍然有限。

目的： 评估药师-医师协作护理（PPCC）模式与标准护理相比在全面糖尿病质量管理中的有效性。

方法： 这项回顾性队列研究包括2018年7月1日至2019年12月31日期间，在弗吉尼亚州社区基础医疗系统初级保健诊所接受治疗的年龄在18至75岁之间且T2DM未受控制的成人患者。患者分为两个组：（1）干预组（PPCC），嵌入式药剂师根据协作实践协议提供糖尿病管理；（2）无药剂师的诊所中的标准护理比较组，通过1:2倾向评分匹配创建。广义线性混合模型评估了组别和质量指标实现之间的关联。主要结果包括糖化血红蛋白（HbA1c）（≤9%，≤8%，≤7%）以及按2019年最后一次记录值低于140/90毫米汞柱的血压控制。

结果： 样本量为N = 1,293，平均年龄57岁，女性占56%，白人和黑人各占45%。与标准护理组（n = 862）相比，PPCC组（n = 431）实现糖化血红蛋白控制的可能性更大（HbA1c

结论： 与标准护理相比，PPCC组患者更可能达到全面糖尿病质量管理指标。这些结果强调了药剂师在初级保健中对糖尿病管理的价值及其对于基于价值的医疗模式的贡献。