Title:Evaluation of a Pharmacy-Managed Weight Loss Program in the VA Healthcare System One Year Post-Implementation Authors: Melissa Contreras PharmD; Tanvi Patil,MPH, PharmD, BCPS, DPLA; Brandi Sugonis, PharmD, BCACP; John Minchak, BS, PharmD, MBA, BCPS, BCGP; Alamdeep Kaur, PharmD, BCPS; Jena Willis, PharmD, Kayla Williams
Presentation Objective: At the conclusion of my presentation, the participant will be able to evaluate the effectiveness of a pharmacy-managed weight loss program within the VA Healthcare System one year after its implementation. Self-Assessment Question: True or false: There is greater follow-up in patients managed by a CPP compared to a non-CPP.
Background: Obesity is a chronic disease associated with significant morbidity, mortality, and healthcare costs, yet it remains undertreated despite the availability of effective pharmacologic therapies. Weight loss medications have demonstrated meaningful reductions in body weight, along with improvements in cardiovascular outcomes however, clinical inertia has limited their use. Contributing factors include limited provider time and lack of healthcare resources. Clinical Pharmacy Practitioners (CPPs) can fill this gap by supporting medication optimization, education, and monitoring to improve weight management care. This study aims to evaluate the impact of pharmacist managed weight loss program (PMWP) at a single center rural VA healthcare system one year post implementation.
Methods: This single-center quality improvement study evaluated a PMWP implemented in collaboration with VA MOVE! program dietician (weight management program for veterans). Weight loss medications were managed by either a CPP or other providers. Patients with less than 6 months of follow-up after medication initiation, therapy discontinuation, or those transferred to another facility within a 6-month period were excluded. The primary outcome was to compare the proportion of patients achieving ≥5% weight loss within 6 months in the CPP versus non-CPP groups. Secondary outcomes included the proportion of patients achieving ≥5% weight loss by the end of the study and the mean difference in the average weight loss % achieved between the two groups at 6 months and end of study period. Patients who were followed for >6 months an additional weight was recorded at last follow-up to calculate weight loss at the end of the study period. The primary outcome was evaluated using chi-square test or Fisher’s exact. Continuous variables were compared using Student t-test or Mann-Whitney U test. Results The preliminary analysis of our study is included currently as the data collection is still in progress. A total of 161 patients were reviewed. After applying exclusion criteria, where non-completion of at least 6 months of weight loss medication therapy was the most common reason for exclusion, the study had a sample of 54 patients to be included. The study included 47 patients in CPP group and 7 patients in non-CPP managed group. The mean age was 58.1 years, height was 69.9-inches, and weight was 324.5 lbs. Majority of patients were non-Hispanic, white male with type 2 diabetes. The most common comorbidities included type 2 diabetes, hypertension, hyperlipidemia, and obstructive sleep apnea. The most prescribed weight loss medication was tirzepatide followed by semaglutide. At 6 months proportion of patients who achieved at least 5% of weight loss in CPP vs. non-CPP group were 25 (71.43%) vs. 3 (42.86%) with p-value 0.197 while at the end of the study period the proportion of patients were CPP 27 (81.82%) vs. non-CPP 3 (42.86%) and p-value of 0.052 respectively. At the end of 6 months and end of study period mean weight loss in CPP vs. non-CPP group was 31.86 vs. 13.19 lbs. P-value of 0.03 and 35.69 vs. 13.71 lbs. with p-value of 0.03 respectively. The mean percent weight loss achieved in CPP vs. non-CPP group was 9.74% vs. 3.8% at 6 months and 11.54% vs.4.32% at the end of study period. Conclusion Overall, our study shows at the preliminary analyses that patients enrolled in the CPP group had higher proportion of patients achieving at least 5% of weight loss and the mean weight loss achieved was significantly higher in the CPP group as compared to the non-CPP group.
