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class="c-sortpagination"><div class="c-sort"><div class="o-input__droplist1"><label for="c-sort1">Sort By:</label><select name="sort" id="c-sort1" form="facetForm"><option selected="" value="rel">Relevance</option><option value="a-title">A-Z By Title</option><option value="z-title">Z-A By Title</option><option value="a-author">A-Z By Author</option><option value="z-author">Z-A By Author</option><option value="asc">Date Ascending</option><option value="desc">Date Descending</option></select></div><div class="o-input__droplist1 c-sort__page-input"><label for="c-sort2">Show:</label><select name="rows" id="c-sort2" form="facetForm"><option selected="" value="10">10</option><option value="20">20</option></select></div></div><input type="hidden" name="start" form="facetForm" value="0"/><nav class="c-pagination"><ul><li><a href="" aria-label="you are on result set 1" class="c-pagination__item--current">1</a></li><li><a href="" aria-label="go to result set 2" class="c-pagination__item">2</a></li></ul></nav></div><section class="c-scholworks"><div class="c-scholworks__main-column"><ul class="c-scholworks__tag-list"><li class="c-scholworks__tag-article">Article</li><li class="c-scholworks__tag-peer">Peer Reviewed</li></ul><div><h3 class="c-scholworks__heading"><a href="/uc/item/3pw7g37r"><div class="c-clientmarkup">Pharmacokinetics and pharmacodynamics of insulin analogs in special populations with type 2 diabetes mellitus</div></a></h3></div><div class="c-authorlist"><ul class="c-authorlist__list"><li class="c-authorlist__begin"><a href="/search/?q=author%3AMorello%2C%20Candis%20M">Morello, Candis M</a> </li></ul></div><div class="c-scholworks__publication"><a href="/uc/ucsd_postprints">UC San Diego Previously Published Works</a> (2011)</div><div class="c-scholworks__abstract"><div class="c-clientmarkup"><h3>Introduction</h3>The goal of insulin therapy in patients with either type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) is to match as closely as possible normal physiologic insulin secretion to control fasting and postprandial plasma glucose. Modifications of the insulin molecule have resulted in two long-acting insulin analogs (glargine and detemir) and three rapid-acting insulins (aspart, lispro, and glulisine) with improved pharmacokinetic/pharmacodynamic (PK/PD) profiles. These agents can be used together in basal-bolus therapy to more closely mimic physiologic insulin secretion patterns.<h3>Methods</h3>This study reviews effects of the multiple demographic and clinical parameters in the insulin analogs glargine, detemir, lispro, aspart, and glulisine in patients with T2DM. A search was conducted on PubMed for each major topic considered (effects of injection site, age, race/ethnicity, obesity, renal or hepatic dysfunction, pregnancy, exercise, drug interactions) using the topic words and name of each type of insulin analog. Information was also obtained from the prescribing information for each insulin analog.<h3>Results</h3>The PK/PD profiles for insulin analogs may be influenced by many variables including age, weight, and hepatic and renal function. However, these variables do not have equivalent effects on all long-acting or rapid-acting insulin analogs.<h3>Conclusion</h3>Rapid-acting and long-acting insulin analogs represent major advances in treatment for patients with T2DM who require insulin therapy. However, there are potentially important PK and PD differences between the two long-acting agents and among the three rapid-acting insulin analogs, which should be considered when designing treatment regimens for special patient groups.</div></div><div class="c-scholworks__media"><ul class="c-medialist"></ul></div></div><div class="c-scholworks__ancillary"><a class="c-scholworks__thumbnail" href="/uc/item/3pw7g37r"><img src="/cms-assets/fce3f1e18d15d2087506c17fceeeaddc24e56669dafdef300ca840c2fd1290bf" alt="Cover page: Pharmacokinetics and pharmacodynamics of insulin analogs in special populations with type 2 diabetes mellitus"/></a><a href="https://creativecommons.org/licenses/by-nc/4.0/" class="c-scholworks__license"><img class="c-lazyimage" data-src="/images/cc-by-nc-small.svg" alt="Creative Commons 'BY-NC' version 4.0 license"/></a></div></section><section class="c-scholworks"><div class="c-scholworks__main-column"><ul class="c-scholworks__tag-list"><li class="c-scholworks__tag-article">Article</li><li class="c-scholworks__tag-peer">Peer Reviewed</li></ul><div><h3 class="c-scholworks__heading"><a href="/uc/item/2dg1663g"><div class="c-clientmarkup">Predictive Modeling of Factors Influencing Adherence to SGLT-2 Inhibitors in Ambulatory Care: Insights from Prescription Claims Data Analysis.</div></a></h3></div><div class="c-authorlist"><ul class="c-authorlist__list"><li class="c-authorlist__begin"><a href="/search/?q=author%3AKhartabil%2C%20Nadia">Khartabil, Nadia</a>; </li><li><a href="/search/?q=author%3AMacedo%2C%20Etienne">Macedo, Etienne</a>; </li><li class="c-authorlist__end"><a href="/search/?q=author%3AMorello%2C%20Candis">Morello, Candis</a> </li></ul></div><div class="c-scholworks__publication"><a href="/uc/ucsd_postprints">UC San Diego Previously Published Works</a> (2024)</div><div class="c-scholworks__abstract"><div class="c-clientmarkup">Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are novel oral anti-hyperglycemic drugs that demonstrate cardiovascular and metabolic benefits for patients with type 2 diabetes (T2D), heart failure (HF), and chronic kidney disease (CKD). There is limited knowledge of real-world data to predict adherence to SGLT-2i in an ambulatory setting. The study aims to predict SGLT-2i adherence in patients with T2D and/or HF and/or CKD by building a prediction model using electronic prescription claims data presented within EPIC datasets. This is a retrospective study of 174 adult patients prescribed SGLT-2i at UC San Diego Health ambulatory pharmacies between 1 January 2020 to 30 April 2021. Adherence was measured by the proportion of days covered (PDC). R packages were used to identify regression and non-linear regression predictive models to predict adherence. Age, gender, race/ethnicity, hemoglobin A1c, and insurance plan were included in the model. Diabetes control based on hemoglobin A1c (HbA1c) and the glomerular filtration rate (GFR) was also evaluated using Welch t-test with a p-value of 0.05. The best predictive model for measuring adherence was the simple decision tree. It had the highest area under the curve (AUC) of 74% and accuracy of 82%. The model accounted for 21 variables with the main node predictors, including glycated hemoglobin, age, gender, and insurance plan payment amount. The adherence rate was inversely proportional to HbA1c and directly proportional to the plan payment amount. As for secondary outcomes, HbA1c values from baseline till 90 days post-treatment duration were consistently higher in the non-compliant group: 7.4% vs. 9.6%, p < 0.001 for the PDC ≥ 0.80 and PDC < 0.80, respectively. Baseline eGFR was 55.18 mL/min/1.73m2 vs. 54.23 mL/min/m2 at 90 days. The mean eGFR at the end of the study (minimum of 90 days of treatment) was statistically different between the groups: 53.1 vs. 59.6 mL/min/1.73 m2, p < 0.001 for the PDC ≥ 0.80 and PDC < 0.80, respectively. Adherence predictive models will help clinicians to tailor regimens based on non-adherence risk scores.</div></div><div class="c-scholworks__media"><ul class="c-medialist"></ul></div></div><div class="c-scholworks__ancillary"><a class="c-scholworks__thumbnail" href="/uc/item/2dg1663g"><img src="/cms-assets/0b997bd26608625a832f331760aa64c1e7786ed16ec6d495a299bd73f278e9ac" alt="Cover page: Predictive Modeling of Factors Influencing Adherence to SGLT-2 Inhibitors in Ambulatory Care: Insights from Prescription Claims Data Analysis."/></a><a href="https://creativecommons.org/licenses/by/4.0/" class="c-scholworks__license"><img class="c-lazyimage" data-src="/images/cc-by-small.svg" alt="Creative Commons 'BY' version 4.0 license"/></a></div></section><section class="c-scholworks"><div class="c-scholworks__main-column"><ul class="c-scholworks__tag-list"><li class="c-scholworks__tag-article">Article</li><li class="c-scholworks__tag-peer">Peer Reviewed</li></ul><div><h3 class="c-scholworks__heading"><a href="/uc/item/2qx4v5qh"><div class="c-clientmarkup">Effectiveness of Providing Video Podcasts to Pharmacy Students in a Self-Study Pharmaceutical Calculations Module</div></a></h3></div><div class="c-authorlist"><ul class="c-authorlist__list"><li class="c-authorlist__begin"><a href="/search/?q=author%3AMnatzaganian%2C%20Christina%20L">Mnatzaganian, Christina L</a>; </li><li><a href="/search/?q=author%3ASingh%2C%20Renu%20F">Singh, Renu F</a>; </li><li><a href="/search/?q=author%3ABest%2C%20Brookie%20M">Best, Brookie M</a>; </li><li class="c-authorlist__end"><a href="/search/?q=author%3AMorello%2C%20Candis%20M">Morello, Candis M</a> </li></ul></div><div class="c-scholworks__publication"><a href="/uc/ucsd_postprints">UC San Diego Previously Published Works</a> (2020)</div><div class="c-scholworks__media"><ul class="c-medialist"></ul></div></div><div class="c-scholworks__ancillary"><a class="c-scholworks__thumbnail" href="/uc/item/2qx4v5qh"><img src="/cms-assets/6f769e0dfc98f405857f953eb4d9ae88149514c1e79e36a8c0ea8c15c0f36563" alt="Cover page: Effectiveness of Providing Video Podcasts to Pharmacy Students in a Self-Study Pharmaceutical Calculations Module"/></a></div></section><section class="c-scholworks"><div class="c-scholworks__main-column"><ul class="c-scholworks__tag-list"><li class="c-scholworks__tag-article">Article</li><li class="c-scholworks__tag-peer">Peer Reviewed</li></ul><div><h3 class="c-scholworks__heading"><a href="/uc/item/4g36m77p"><div class="c-clientmarkup">Longitudinal Effects on Metabolic Biomarkers in Veterans 12 Months Following Discharge from Pharmacist-Provided Diabetes Care: A Retrospective Cohort Study.</div></a></h3></div><div class="c-authorlist"><ul class="c-authorlist__list"><li class="c-authorlist__begin"><a href="/search/?q=author%3AMorello%2C%20Candis">Morello, Candis</a>; </li><li><a href="/search/?q=author%3ALai%2C%20Lytia">Lai, Lytia</a>; </li><li><a href="/search/?q=author%3AChen%2C%20Claire">Chen, Claire</a>; </li><li><a href="/search/?q=author%3ALeung%2C%20Chui">Leung, Chui</a>; </li><li><a href="/search/?q=author%3AHirsch%2C%20Jan">Hirsch, Jan</a>; </li><li class="c-authorlist__end"><a href="/search/?q=author%3ABounthavong%2C%20Mark">Bounthavong, Mark</a> </li></ul></div><div class="c-scholworks__publication"><a href="/uc/ucsd_postprints">UC San Diego Previously Published Works</a> (2022)</div><div class="c-scholworks__abstract"><div class="c-clientmarkup">Clinical pharmacist interventions have resulted in optimized diabetes control in complex patients; however, there are no studies examining the durability of achieved outcomes after patients discontinued being seen by the pharmacist. A pharmacist-led comprehensive medication management (CMM) Diabetes Intensive Medication Management (DIMM) “tune up” clinic provided the opportunity to evaluate long-term glycemic control outcomes following clinical discharge. This study used a retrospective cohort study design with a matched primary care provider (PCP) comparison group. Outcomes were compared between the groups at several post-discharge intervals (6, 9, and 12 months) using independent t tests and chi-square tests, where appropriate. DIMM-managed patients achieved an average HbA1c reduction of 3% upon discharge, and maintained an average HbA1c concentration that was significantly lower than PCP-managed patients at 6 months (p < 0.001) and 9 months (p = 0.009) post-discharge. Although DIMM-managed patients had lower HbA1c than PCP-managed patients at 12 months post-discharge, the difference was not significant (p = 0.105). Similar findings were noted for average FPG and LDL across the study time points. No differences in average HDL levels were reported across the time points. A significantly larger proportion of DIMM-managed patients maintained HbA1c < 8% compared to PCP-managed patients at 6 months (67.5% versus 47.2%, p = 0.001) and 9 months (62.6% versus 40.6%, p = 0.040) post-discharge; DIMM-managed patients had a larger, but non-significant, proportion of goal retention compared to PCP-managed patients at 12 months (56.9% versus 47.2%, p = 0.126) post-discharge. Similarly, a significantly larger proportion of DIMM-managed patients sustained HbA1c < 9% compared to PCP-managed patients at 6 months (87.8% versus 66.7%, p < 0.001) and 9 months (82.1% versus 68.3%, p = 0.012) post-discharge; however, there was no significant difference at 12 months. The attenuation of the DIMM-managed metabolic biomarkers suggests that an additional follow-up visit or touchpoint may be helpful. The personalized care of the DIMM “tune up” approach was successful in achieving sustained glycemic control for up to 9 months. Outcomes can help inform future long-term result durability evaluations.</div></div><div class="c-scholworks__media"><ul class="c-medialist"></ul></div></div><div class="c-scholworks__ancillary"><a class="c-scholworks__thumbnail" href="/uc/item/4g36m77p"><img src="/cms-assets/491b9581c1d5225a6f950b751d1d737c838938477d76463a5d89e23b674e8538" alt="Cover page: Longitudinal Effects on Metabolic Biomarkers in Veterans 12 Months Following Discharge from Pharmacist-Provided Diabetes Care: A Retrospective Cohort Study."/></a><a href="https://creativecommons.org/licenses/by/4.0/" class="c-scholworks__license"><img class="c-lazyimage" data-src="/images/cc-by-small.svg" alt="Creative Commons 'BY' version 4.0 license"/></a></div></section><section class="c-scholworks"><div class="c-scholworks__main-column"><ul class="c-scholworks__tag-list"><li class="c-scholworks__tag-article">Article</li><li class="c-scholworks__tag-peer">Peer Reviewed</li></ul><div><h3 class="c-scholworks__heading"><a href="/uc/item/9rc045x8"><div class="c-clientmarkup">A Systematic Approach to Providing COVID-19 Vaccinations in the Community by Student Pharmacists</div></a></h3></div><div class="c-authorlist"><ul class="c-authorlist__list"><li class="c-authorlist__begin"><a href="/search/?q=author%3ALuli%2C%20Alex%20J">Luli, Alex J</a>; </li><li><a href="/search/?q=author%3AMorello%2C%20Candis%20M">Morello, Candis M</a>; </li><li><a href="/search/?q=author%3ALorentz%2C%20Sarah%20M">Lorentz, Sarah M</a>; </li><li><a href="/search/?q=author%3ABounthavong%2C%20Mark">Bounthavong, Mark</a>; </li><li><a href="/search/?q=author%3ABrandl%2C%20Katharina">Brandl, Katharina</a>; </li><li class="c-authorlist__end"><a href="/search/?q=author%3AHart%2C%20Laura%20A">Hart, Laura A</a> </li></ul></div><div class="c-scholworks__publication"><a href="/uc/ucsd_postprints">UC San Diego Previously Published Works</a> (2022)</div><div class="c-scholworks__abstract"><div class="c-clientmarkup">Doctor of Pharmacy (PharmD) students and faculty at University of California, San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences (SSPPS) were highly motivated to support local and regional COVID-19 vaccination efforts, which began in January 2021. A system was created to streamline requests for SSPPS volunteers, maximize opportunities for student learning and engagement, and ensure adherence to pharmacy practice standards and laws in the process of assisting with vaccination efforts in the community. An existing model for approving student organized events was modified to fit additional needs for COVID-19 vaccination efforts by SSPPS students and faculty. For each event, students completed a standardized form containing event details including location, date, time, pharmacist preceptors, and duties. All requests were screened by designated SSPPS faculty to ensure student safety, availability, and feasibility. After each event, students and faculty completed a unique online form designed to track volunteer hours. Students received course credit for volunteering and completing a standardized self-reflection. Comments from students' reflections (<i>n</i> = 74) were analyzed to identify common challenges. Between 11 January 2021 and 31 May 2021, SSPPS faculty and students volunteered for 245 shifts, totaling 1346 h. Students encountered several logistical challenges, such as availability of vaccines. The system utilized allowed for SSPPS students and faculty to play an integral role in COVID-19 vaccination efforts throughout the region.</div></div><div class="c-scholworks__media"><ul class="c-medialist"></ul></div></div><div class="c-scholworks__ancillary"><a class="c-scholworks__thumbnail" href="/uc/item/9rc045x8"><img src="/cms-assets/cbff14e84a329cbaba0d8596e4de51a4860c42678d188ba92124557c6a27c425" alt="Cover page: A Systematic Approach to Providing COVID-19 Vaccinations in the Community by Student Pharmacists"/></a><a href="https://creativecommons.org/licenses/by/4.0/" class="c-scholworks__license"><img class="c-lazyimage" data-src="/images/cc-by-small.svg" alt="Creative Commons 'BY' version 4.0 license"/></a></div></section><section class="c-scholworks"><div class="c-scholworks__main-column"><ul class="c-scholworks__tag-list"><li class="c-scholworks__tag-article">Article</li><li class="c-scholworks__tag-peer">Peer Reviewed</li></ul><div><h3 class="c-scholworks__heading"><a href="/uc/item/5vr3b2jq"><div class="c-clientmarkup">Impact of a First-Year Student Pharmacist Diabetes Self-Care Education Program</div></a></h3></div><div class="c-authorlist"><ul class="c-authorlist__list"><li class="c-authorlist__begin"><a href="/search/?q=author%3AMorello%2C%20Candis%20M">Morello, Candis M</a>; </li><li><a href="/search/?q=author%3ANeighbors%2C%20Melissa">Neighbors, Melissa</a>; </li><li><a href="/search/?q=author%3ALuu%2C%20Linda">Luu, Linda</a>; </li><li><a href="/search/?q=author%3AKobayashi%2C%20Shawna">Kobayashi, Shawna</a>; </li><li><a href="/search/?q=author%3AMutrux%2C%20Brandon">Mutrux, Brandon</a>; </li><li class="c-authorlist__end"><a href="/search/?q=author%3ABest%2C%20Brookie%20M">Best, Brookie M</a> </li></ul></div><div class="c-scholworks__publication"><a href="/uc/ucsd_postprints">UC San Diego Previously Published Works</a> (2013)</div><div class="c-scholworks__abstract"><div class="c-clientmarkup"><h3>Objective</h3>To evaluate the effectiveness of a first-year diabetes self-care education program by measuring student pharmacists' confidence and knowledge retention, and the clinical applicability of the skills learned.<h3>Design</h3>Integrated into a Pharmacy Practice Course, a 9-hour program consisting of lectures, a home glucose monitor assignment, and active-learning workshops was completed by 2 cohorts of first-year student pharmacists. Three survey instruments were developed and administered to the student pharmacists prior to the program, immediately after the program, and 9 months after the program to assess confidence, knowledge retention, and the clinical applicability of the knowledge and skills learned.<h3>Assessment</h3>In cohort 1, 54 student pharmacists (response rate 90%) perceived that their confidence and ability improved significantly (increased by 88% and 110%, respectively, from baseline, p<0.001). Overall knowledge of diabetes increased as well as indicated by a 40% increase in test scores (p<0.001). About two-thirds of student pharmacists used their training to assist patients with diabetes within 9 months of completing the program. Findings in cohort 2 mirrored those observed with cohort 1, indicating good generalizability.<h3>Conclusions</h3>An innovative first-year diabetes self-care education program significantly improved student pharmacists' knowledge and confidence in providing diabetes self-care education, and the majority immediately used their leaned skills to assist diabetes patients and caregivers. Training first-year student pharmacists in diabetes care so they are prepared to use these skills as early as their first year of pharmacy school may be an effective approach to increasing the number of providers available to counsel and care for this expanding patient population.</div></div><div class="c-scholworks__media"><ul class="c-medialist"></ul></div></div></section><section class="c-scholworks"><div class="c-scholworks__main-column"><ul class="c-scholworks__tag-list"><li class="c-scholworks__tag-article">Article</li><li class="c-scholworks__tag-peer">Peer Reviewed</li></ul><div><h3 class="c-scholworks__heading"><a href="/uc/item/56z8s87v"><div class="c-clientmarkup">Waterpipe smoking among health sciences university students in Iran: perceptions, practices and patterns of use.</div></a></h3></div><div class="c-authorlist"><ul class="c-authorlist__list"><li class="c-authorlist__begin"><a href="/search/?q=author%3AGhafouri%2C%20Nasim">Ghafouri, Nasim</a>; </li><li><a href="/search/?q=author%3AHirsch%2C%20Jan%20D">Hirsch, Jan D</a>; </li><li><a href="/search/?q=author%3AHeydari%2C%20Gholamreza">Heydari, Gholamreza</a>; </li><li><a href="/search/?q=author%3AMorello%2C%20Candis%20M">Morello, Candis M</a>; </li><li><a href="/search/?q=author%3AKuo%2C%20Grace%20M">Kuo, Grace M</a>; </li><li class="c-authorlist__end"><a href="/search/?q=author%3ASingh%2C%20Renu%20F">Singh, Renu F</a> </li></ul></div><div class="c-scholworks__publication"><a href="/uc/ucsd_postprints">UC San Diego Previously Published Works</a> (2011)</div><div class="c-scholworks__abstract"><div class="c-clientmarkup">Abstract Background In recent years waterpipe smoking has become a popular practice amongst young adults in eastern Mediterranean countries, including Iran. The aim of this study was to assess waterpipe smoking perceptions and practices among first-year health sciences university students in Iran and to identify factors associated with the initiation and maintenance of waterpipe use in this population. Results Out of 371 first-year health sciences students surveyed, 358 eight students completed a self-administered questionnaire in the classrooms describing their use and perceptions towards waterpipe smoking. Two hundred and ninety six responders met study inclusion criteria. Waterpipe smoking was common among first-year health sciences university students, with 51% of students indicating they were current waterpipe smokers. Women were smoking waterpipes almost as frequently as men (48% versus 52%, respectively). The majority of waterpipe smokers (75.5%) indicated that the fun and social aspect of waterpipe use was the main motivating factor for them to continue smoking. Of waterpipe smokers, 55.3% were occasional smokers, using waterpipes once a month or less, while 44.7% were frequent smokers, using waterpipes more than once a month. A large number of frequent waterpipe smokers perceived that waterpipe smoking was a healthier way to use tobacco (40.6%) while only 20.6% thought it was addictive. Compared to occasional smokers, significantly more frequent smokers reported waterpipe smoking was relaxing (62.5% vs. 26.2%, p = 0.002), energizing (48.5% vs. 11.4%, p = 0.001), a part of their culture (58.8% vs. 34.1%, p = 0.04), and the healthiest way to use tobacco (40.6% vs. 11.1%, p = 0.005). Conclusions Social and recreational use of waterpipes is widespread among first-year health sciences university students in Iran. Women and men were almost equally likely to be current waterpipe users. Public health initiatives to combat the increasing use of waterpipes among university students in Iran must consider the equal gender distribution and its perception by many waterpipe smokers as being a healthier and non-addictive way to use tobacco.</div></div><div class="c-scholworks__media"><ul class="c-medialist"><li class="c-medialist__other">2 supplemental files</li></ul></div></div><div class="c-scholworks__ancillary"><a class="c-scholworks__thumbnail" href="/uc/item/56z8s87v"><img src="/cms-assets/7f353400127e306a5379308a353ee5a51dd164af40cbcb514693e5cc51bab13d" alt="Cover page: Waterpipe smoking among health sciences university students in Iran: perceptions, practices and patterns of use."/></a></div></section><section class="c-scholworks"><div class="c-scholworks__main-column"><ul class="c-scholworks__tag-list"><li class="c-scholworks__tag-article">Article</li><li class="c-scholworks__tag-peer">Peer Reviewed</li></ul><div><h3 class="c-scholworks__heading"><a href="/uc/item/7j6358rq"><div class="c-clientmarkup">Evaluation of a short, interactive diabetes self-management program by pharmacists for type 2 diabetes</div></a></h3></div><div class="c-authorlist"><ul class="c-authorlist__list"><li class="c-authorlist__begin"><a href="/search/?q=author%3ASingh%2C%20Renu%20F">Singh, Renu F</a>; </li><li><a href="/search/?q=author%3AKelly%2C%20Panteha">Kelly, Panteha</a>; </li><li><a href="/search/?q=author%3ATam%2C%20Alexander">Tam, Alexander</a>; </li><li><a href="/search/?q=author%3ABronner%2C%20Jason">Bronner, Jason</a>; </li><li><a href="/search/?q=author%3AMorello%2C%20Candis%20M">Morello, Candis M</a>; </li><li class="c-authorlist__end"><a href="/search/?q=author%3AHirsch%2C%20Jan%20D">Hirsch, Jan D</a> </li></ul></div><div class="c-scholworks__publication"><a href="/uc/ucsd_postprints">UC San Diego Previously Published Works</a> (2018)</div><div class="c-scholworks__abstract"><div class="c-clientmarkup"><h3>Objective</h3>Numerous barriers prevent patients with type 2 diabetes (T2D) from completing a diabetes self-management program. We investigated whether patients with T2D exhibited improved clinical outcomes after attending a relatively short, interactive diabetes self-management program conducted by pharmacist diabetes educators, compared to a physician's usual care.<h3>Results</h3>We retrospectively analyzed the data of adults with T2D who attended a diabetes self-management program (≥ 1 group meeting or individual appointment followed by a telephone interview from a pharmacist diabetes educator between May 2010 and Dec. 2012; n = 513) and compared their outcomes with those of T2D patients who received only their physician's usual care (n = 857). Each patient's A1C was assessed at baseline, 3 months, and 6 months post-intervention. The mean [SD] reduction in A1C percentage points in the T2D patients was significantly greater in the diabetes self-management program group compared to the physician's usual care group at both 3 months (- 0.8% [1.5] vs. - 0.2% [0.9], p < 0.001) and 6 months post-intervention (- 0.6% [1.3] vs. - 0.2% [1.1], p < 0.001). T2D patients significantly improved their glycemic control within 3-6 months of attending the diabetes self-management program compared to patients who only received their physician's usual care.</div></div><div class="c-scholworks__media"><ul class="c-medialist"></ul></div></div><div class="c-scholworks__ancillary"><a class="c-scholworks__thumbnail" href="/uc/item/7j6358rq"><img src="/cms-assets/4512b4e05774501e17eb71a2f61be02cbbb56f4f211a1efceb238e2c8d42cb97" alt="Cover page: Evaluation of a short, interactive diabetes self-management program by pharmacists for type 2 diabetes"/></a><a href="https://creativecommons.org/licenses/by/4.0/" class="c-scholworks__license"><img class="c-lazyimage" data-src="/images/cc-by-small.svg" alt="Creative Commons 'BY' version 4.0 license"/></a></div></section><section class="c-scholworks"><div class="c-scholworks__main-column"><ul class="c-scholworks__tag-list"><li class="c-scholworks__tag-article">Article</li><li class="c-scholworks__tag-peer">Peer Reviewed</li></ul><div><h3 class="c-scholworks__heading"><a href="/uc/item/4zn3f81t"><div class="c-clientmarkup">Transferring Key Success Factors from Ambulatory Care into the Community Pharmacy in the United States.</div></a></h3></div><div class="c-authorlist"><ul class="c-authorlist__list"><li class="c-authorlist__begin"><a href="/search/?q=author%3ALuli%2C%20Alex%20J">Luli, Alex J</a>; </li><li><a href="/search/?q=author%3AAwdishu%2C%20Linda">Awdishu, Linda</a>; </li><li><a href="/search/?q=author%3AHirsch%2C%20Jan%20D">Hirsch, Jan D</a>; </li><li><a href="/search/?q=author%3AWatanabe%2C%20Jonathan%20H">Watanabe, Jonathan H</a>; </li><li><a href="/search/?q=author%3ABounthavong%2C%20Mark">Bounthavong, Mark</a>; </li><li class="c-authorlist__end"><a href="/search/?q=author%3AMorello%2C%20Candis%20M">Morello, Candis M</a> </li></ul></div><div class="c-scholworks__publication"><a href="/uc/uci_postprints">UC Irvine Previously Published Works</a> (2021)</div><div class="c-scholworks__abstract"><div class="c-clientmarkup">In the United States, pharmacists' scope of practice continues to expand, with increasing opportunities for pharmacists in all practice settings to enhance health in society. In ambulatory care, pharmacists remain integral members on the healthcare team and have demonstrated positive impacts on patient care. Sharing similar characteristics as pharmacists in the community setting, a deeper look into common elements of a successful ambulatory care practice that can be applied in the community pharmacy setting is warranted. Key success factors identified from ambulatory care include (1) maximizing a pharmacist's unique knowledge base and skill set, (2) forming collaborations with physicians and other providers, (3) demonstrating outcomes and value, and (4) maintaining sustainability. Opportunities exist for pharmacists in the community setting to utilize these success factors when developing, implementing, and/or expanding direct patient care services that improve accessibility to quality care and population health.</div></div><div class="c-scholworks__media"><ul class="c-medialist"></ul></div></div><div class="c-scholworks__ancillary"><a class="c-scholworks__thumbnail" href="/uc/item/4zn3f81t"><img src="/cms-assets/928a25c3868641578c250941803149d12ebe20dd4c084e3074a930238837f26d" alt="Cover page: Transferring Key Success Factors from Ambulatory Care into the Community Pharmacy in the United States."/></a><a href="https://creativecommons.org/licenses/by/4.0/" class="c-scholworks__license"><img class="c-lazyimage" data-src="/images/cc-by-small.svg" alt="Creative Commons 'BY' version 4.0 license"/></a></div></section><section class="c-scholworks"><div class="c-scholworks__main-column"><ul class="c-scholworks__tag-list"><li class="c-scholworks__tag-article">Article</li><li class="c-scholworks__tag-peer">Peer Reviewed</li></ul><div><h3 class="c-scholworks__heading"><a href="/uc/item/42z7k5tp"><div class="c-clientmarkup">Estimated Cost-Effectiveness, Cost Benefit, and Risk Reduction Associated with an Endocrinologist-Pharmacist Diabetes Intense Medical Management Tune-Up Clinic.</div></a></h3></div><div class="c-authorlist"><ul class="c-authorlist__list"><li class="c-authorlist__begin"><a href="/search/?q=author%3AHirsch%2C%20Jan">Hirsch, Jan</a>; </li><li><a href="/search/?q=author%3AArjmand%2C%20Anisa">Arjmand, Anisa</a>; </li><li><a href="/search/?q=author%3AHa%2C%20David">Ha, David</a>; </li><li><a href="/search/?q=author%3AZimmerman%2C%20Andrew">Zimmerman, Andrew</a>; </li><li><a href="/search/?q=author%3AOurth%2C%20Heather">Ourth, Heather</a>; </li><li><a href="/search/?q=author%3AMorreale%2C%20Anthony">Morreale, Anthony</a>; </li><li><a href="/search/?q=author%3AEdelman%2C%20Steven">Edelman, Steven</a>; </li><li><a href="/search/?q=author%3AMorello%2C%20Candis">Morello, Candis</a>; </li><li><a href="/search/?q=author%3ACadiz%2C%20Christine">Cadiz, Christine</a>; </li><li class="c-authorlist__end"><a href="/search/?q=author%3ABounthavong%2C%20Mark">Bounthavong, Mark</a> </li></ul></div><div class="c-scholworks__publication"><a href="/uc/ucsd_postprints">UC San Diego Previously Published Works</a> (2017)</div><div class="c-scholworks__abstract"><div class="c-clientmarkup">BACKGROUND: In 2012 U.S. diabetes costs were estimated to be $245 billion, with $176 billion related to direct diabetes treatment and associated complications. Although a few studies have reported positive glycemic and economic benefits for diabetes patients treated under primary care physician (PCP)-pharmacist collaborative practice models, no studies have evaluated the cost-effectiveness of an endocrinologist-pharmacist collaborative practice model treating complex diabetes patients versus usual PCP care for similar patients. OBJECTIVE: To estimate the cost-effectiveness and cost benefit of a collaborative endocrinologist-pharmacist Diabetes Intense Medical Management (DIMM) Tune-Up clinic for complex diabetes patients versus usual PCP care from 3 perspectives (clinic, health system, payer) and time frames. METHODS: Data from a retrospective cohort study of adult patients with type 2 diabetes mellitus (T2DM) and glycosylated hemoglobin A1c (A1c) ≥ 8% who were referred to the DIMM clinic at the Veterans Affairs San Diego Health System were used for cost analyses against a comparator group of PCP patients meeting the same criteria. The DIMM clinic took more time with patients, compared with usual PCP visits. It provided personalized care in three 60-minute visits over 6 months, combining medication therapy management with patient-specific diabetes education, to achieve A1c treatment goals before discharge back to the PCP. Data for DIMM versus PCP patients were used to evaluate cost-effectiveness and cost benefit. Analyses included incremental cost-effectiveness ratios (ICERs) at 6 months, 3-year estimated total medical costs avoided and return on investment (ROI), absolute risk reduction of complications, resultant medical costs, and quality-adjusted life-years (QALYs) over 10 years. RESULTS: Base case ICER results indicated that from the clinic perspective, the DIMM clinic costs $21 per additional percentage point of A1c improvement and $115-$164 per additional patient at target A1c goal level compared with the PCP group. From the health system perspective, medical cost avoidance due to improved A1c was $8,793 per DIMM patient versus $3,506 per PCP patient (P = 0.009), resulting in an ROI of $9.01 per dollar spent. From the payer perspective, DIMM patients had estimated lower total medical costs, a greater number of QALYs gained, and appreciable risk reductions for diabetes-related complications over 2-, 5- and 10-year time frames, indicating that the DIMM clinic was dominant. Sensitivity analyses indicated results were robust, and overall conclusions did not change appreciably when key parameters (including DIMM clinic effectiveness and cost) were varied within plausible ranges. CONCLUSIONS: The DIMM clinic endocrinologist-pharmacist collaborative practice model, in which the pharmacist spent more time providing personalized care, improved glycemic control at a minimal cost per additional A1c benefit gained and produced greater cost avoidance, appreciable ROI, reduction in long-term complication risk, and lower cost for a greater gain in QALYs. Overall, the DIMM clinic represents an advanced pharmacy practice model with proven clinical and economic benefits from multiple perspectives for patients with T2DM and high medication and comorbidity complexity. DISCLOSURES: No outside funding supported this study. The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Preliminary versions of the study data were presented in abstract form at the American Pharmacists Association Annual Meeting & Exposition; March 27, 2015; San Diego, California, and the Academy of Managed Care Pharmacy Annual Meeting; April 21, 2016; San Francisco, California. Study concept and design were contributed by Hirsch, Bounthavong, and Edelman, along with Morello and Morreale. Arjmand, Ourth, Ha, Cadiz, and Zimmerman collected the data. Data interpretation was performed by Ha, Morreale, and Morello, along with Cadiz, Ourth, and Hirsch. The manuscript was written primarily by Hirsch and Zimmerman, along with Arjamand, Ourth, and Morello, and was revised by Hirsch and Cadiz, along with Bounthavong, Ha, Morreale, and Morello.</div></div><div class="c-scholworks__media"><ul class="c-medialist"></ul></div></div><div class="c-scholworks__ancillary"><a class="c-scholworks__thumbnail" href="/uc/item/42z7k5tp"><img src="/cms-assets/0034395284626d5ba15c87bd66c5857afff79442f3c203797ffee1dedb90fe18" alt="Cover page: Estimated Cost-Effectiveness, Cost Benefit, and Risk Reduction Associated with an Endocrinologist-Pharmacist Diabetes Intense Medical Management Tune-Up Clinic."/></a></div></section><nav class="c-pagination"><ul><li><a href="" aria-label="you are on result set 1" class="c-pagination__item--current">1</a></li><li><a href="" aria-label="go to result set 2" class="c-pagination__item">2</a></li></ul></nav></section></main></form></div><div><div class="c-toplink"><a href="javascript:window.scrollTo(0, 0)">Top</a></div><footer class="c-footer"><nav class="c-footer__nav"><ul><li><a href="/">Home</a></li><li><a href="/aboutEschol">About eScholarship</a></li><li><a href="/campuses">Campus Sites</a></li><li><a href="/ucoapolicies">UC Open Access Policy</a></li><li><a href="/publishing">eScholarship Publishing</a></li><li><a href="https://www.cdlib.org/about/accessibility.html">Accessibility</a></li><li><a href="/privacypolicy">Privacy Statement</a></li><li><a href="/policies">Site Policies</a></li><li><a href="/terms">Terms of Use</a></li><li><a href="/login"><strong>Admin Login</strong></a></li><li><a href="https://help.escholarship.org"><strong>Help</strong></a></li></ul></nav><div class="c-footer__logo"><a href="/"><img class="c-lazyimage" data-src="/images/logo_footer-eschol.svg" alt="eScholarship, University of California"/></a></div><div class="c-footer__copyright">Powered by the<br/><a href="http://www.cdlib.org">California Digital Library</a><br/>Copyright © 2017<br/>The Regents of the University of California</div></footer></div></div></div></div> <script src="/js/vendors~app-bundle-7424603c338d723fd773.js"></script> <script src="/js/app-bundle-63f992b6abba5f8338a3.js"></script> </body> </html>