SUN-846 - Bridging the Gap: Integrating Pharmacists to Enhance Patient Care in Endocrinology in A Rural Clinic Setting

Abstract:

Background:
Integration of clinical pharmacists into specialty care settings has been shown to improve outcomes in chronic disease management through medication optimization and comprehensive patient care.

Objective:
To evaluate the clinical and operational impact of integrating a pharmacist into a rural endocrinology clinic, with a focus on glycemic control, hospital readmissions, and access to care.

Methods:
This retrospective quality improvement study evaluated patients managed between April 16, 2024, and July 31, 2025. Pharmacists co-managed patients with uncontrolled diabetes, defined for this study as an A1c >8% or requiring intensified therapy, in collaboration with endocrinology providers.

Results:
Among 185 patients co-managed by a clinical pharmacist, 167 (90%) had follow-up A1c values. Of those, 152 patients (91%) demonstrated a sustained A1c improvement. The average starting A1c for the pharmacist-managed group was 9.35%, which improved to 7.39% by the end of the study period. Patients who had a follow-up A1c saw an average A1c reduction of 2.06%. By the end of the study, 92% of patients achieved an A1c ≤ 9%, and 75% met the ≤ 8% A1c goal. The 30-day hospital readmission rate was 3.2%. Average daily patient volume increased from 3.3 to 9.5 patients per day.
In a comparison group receiving usual care without pharmacist co-management, 41% of patients experienced A1c improvement, with a mean A1c reduction of 0.05% from a baseline A1c of 8.33%. The 30-day readmission rate in the comparison group was 16.5%

Conclusion:
Pharmacist integration in an endocrinology clinic led to significant improvements in glycemic control, patient access, clinic efficiency, and a reduction in hospital readmissions. Given our success in a rural setting, we believe this model could work well in similar clinics facing provider shortages to provide a multidisciplinary approach to patient care.

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