Clinical Pharmacology & Biopharmaceutics
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The purpose was to evaluate the clinical and pharmacoeconomic outcomes associated with improved glycemic control for
patients with type two diabetes mellitus (T2DM), whose therapy was managed in a ? day per week pharmacist-led Diabetes
Intense Medical Management (DIMM) Clinic, at the Veterans Affairs San Diego Healthcare System (VASDHS).Patients referred
the DIMM Clinic were compared to a randomly selected comparator group of patients being seen by their primary care provider.
Study subjects were greater than 18 years old, diagnosed with T2DM with HbA1c greater than or equal to 8% at initial DIMM
Clinic visit (or index visit for comparator group). Clinical outcomes evaluated were HbA1c, fasting plasma glucose, BMI, blood
pressure, and lipids. A published regression model (Gilmer et.al., 2009) was used to estimate total medical costs over a three-
year period (including inpatient and outpatient services) for two groups of patients receiving six months of care. Data used to
populate the regression model were collected via retrospective chart review. Estimated three-year total medical cost was based
on age, gender, the existence of specific co-morbidities (hypertension, hyperlipidemia and heart disease), as well as HbA1c. Cost
avoidance in each group was defined as the difference between the cost estimated using data from the initial/index visit vs. the cost
estimated using data from 6 month visit. Since HbA1c was the primary variable that could change during the six-month study
period, the cost avoidance estimates mainly reflect the change in HbA1c.Results and conclusions will be presented.
Candis Morello is founding faculty, an Associate Professor of Clinical Pharmacy, and the Associate Dean for Student Affairs at the Skaggs School of
Pharmacy and Pharmaceutical Sciences at the University of California San Diego. Following earning her Doctorate of Pharmacy from the University
of California San Francisco in 1996, she completed a Pharmacy Practice Residency with a Geriatrics Emphasis at the VA in San Diego. Dr. Morello is
a Certified Diabetes Educator and Clinical Pharmacist Specialist who directs a Diabetes Intense Medical Management Clinic at the VA in San Diego.
She is known nationally for her leadership as a diabetes clinician, educator and researcher. For 17 years Dr. Morello has authored several articles,
book chapters and abstracts and serves as a reviewer for prestigious publications.
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