Background: Despite general increases in statin use in the United States, statin therapy may be underutilized in diabetic patients and vulnerable populations. Objective: To determine the impact of a collaborative pharmacist initiative on statin prescribing for diabetic patients in an internal medicine residency clinic. The primary outcome was the change in prevalence of patients on statin therapy before and after intervention implementation. Secondary outcomes included recommendation acceptance rates and reported adverse effects. Methods: This was a single-center, quasi-experimental pre–post intervention study. The study site was a hospital-based primary care residency clinic serving patients regardless of financial or insurance status. Diabetic patients 40 to 75 years old who were not on a statin and had an upcoming primary care physician appointment were included. Over 3 months, a clinical pharmacist and pharmacy resident evaluated clinical appropriateness and cost of statin therapy, provided recommendations to physicians, facilitated statin prescribing, and provided patient education. Results: Of 454 patients, 343 were on statin therapy (75.6%) prior to the initiative. The mean age was 58 years, 59.7% were female, 76.4% were black, and 90% had hypertension. After implementation, 375 (82.6%) patients were on statins ( P < .0001). Recommendations were well received (90.2% accepted) and no significant adverse effects were reported. Conclusion: Pharmacist implementation of a collaborative, patient-centered initiative increased statin prescribing in diabetic patients, most of which were black and had hypertension, in an internal medicine resident clinic.
INTERNAL MEDICINE RESIDENT EDUCATION AND THE IMPACT ON CARDIAC REHABILITATION REFERRAL RATES IN AN AMBULATORY CARE SETTING: A PILOT STUDY
