2026 Eastern States Conference

Title: Evaluating pharmacist impact on clinical outcomes in chronic care management  
Author: Justin Chan, PharmD; Kimberly Dowdell, MD, FACP; Morgan Lockhart, PharmD, BCACP 
Learning Objective: At the conclusion of my presentation, the participant will be able to describe how the involvement of a pharmacist in chronic care management can influence diabetes-related clinical and financial outcomes.  
Self-Assessment Question: Pharmacist and nurse involvement in the chronic care management (CCM) program increase revenue compared to those not enrolled in the CCM program. (True/False)
Background: No studies have directly compared clinical outcomes among patients seen by nurse care coordinators, patients seen by nurse care coordinators and pharmacists, and those not enrolled in chronic care management (CCM). 
Methods: This is a single-center, retrospective, cohort study. Patients included were adults 65 years and older, enrolled in Medicare, with a diagnosis of type 2 diabetes mellitus who received care at the University Physicians of Charlottesville from January 1, 2024- June 30, 2025. Patients had at least two recorded hemoglobin A1c values (baseline and follow-up) and followed for a minimum of 6 months. Primary endpoint is the proportion of patients achieving a target A1c goal of <8% among those managed by a pharmacist and nurse care coordinators, compared with patients managed by nurse care coordinators alone, and those not enrolled in the CCM program. Secondary endpoints include meeting individualized A1c goals, mean A1c change, completion of eye exams, foot exams, urine albumin-to-creatinine ratio screening (UACR), ratio of reimbursed to billed revenue, and mean net revenue generated per month. Fisher’s exact test, Kruskal-Wallis tests, and descriptive statistics were used where appropriate. 
Results: There were 24 patients in the non-CCM group, 5 patients in the nurse-care coordinators group, and 4 patients seen by nurse-care coordinators and a pharmacist. A1c <8% was achieved in 75% (3/4) of patients in the nurses and pharmacist group compared to 42% (10/24) and 40% (2/5) in the non-CCM group and nurses' only group respectively; target A1c was achieved in 50% (2/4) vs 25% (6/24) and 20% (1/5), respectively. Patients in the pharmacist and nurses’ group had the greatest mean A1c reduction (2.15%) and the highest rates of annual diabetic preventable screenings completed except for UACR. Mean net revenue generated was $155.48 per month in patients seen by nurses only compared to $191.48 per month in those seen by nurses and a pharmacist.  
Conclusion: These results suggest pharmacist involvement may improve clinical outcomes and increase revenue. Lack of statistical significance from the results is likely due to small sample size and limited power. Larger prospective studies are needed to confirm these findings. Future studies should assess patients transitioning from pharmacist to nurse-only care and could include additional endpoints such as BMI changes and statin use.