Assessing Adherence to XXXX Initiation Recommendations at a Suburban Family Medicine Clinic.

@entity1 @entity2690 @entity6
UNASSIGNED: The American @entity6 Association recommends @entity2690 initiation when A1c >= 10%. The aim of this study was to determine adherence to @entity2690 initiation in @entity1 with an A1c >= 10% at an outpatient family medicine clinic. The secondary objectives were to determine whether initiation of @entity2690 within 3 weeks of an A1c >= 10% increased the rate or decreased the time to achieve an A1c <7% and to determine whether pharmacist involvement increased the rate of reaching an A1c <7%. This institutional review board-approved, retrospective, observational, cohort study identified 120 @entity1 with @entity6 and an A1c >= 10% in 2014. @entity1 already receiving @entity2690 or those without a follow-up A1c were excluded. Study outcomes included proportion of @entity1 receiving @entity2690 therapy within 3 weeks of A1c >/=10%, rate of meeting A1c <7%, time to reach A1c <7%, and proportion of @entity1 meeting with a pharmacist. Fifty-five @entity1 with a mean age of 55 years, a mean duration of @entity6 of 6.4 years, and a mean baseline A1c of 11.7% met the inclusion criteria. Most @entity1 were receiving no therapy (29%), monotherapy (27%), or dual therapy (29%) at baseline. @entity2690 was initiated in 5 @entity1 (9.1%, P < 0.05) within 3 weeks of the qualifying A1c. Another 5 @entity1 (P < 0.05) received @entity2690 at some point during the study. An A1c <7% was achieved in 35.6% of @entity1 not receiving @entity2690 , 20% of @entity1 receiving early @entity2690 , and no @entity1 who received @entity2690 after 3 weeks. The mean time to A1c <7% was 6 months for @entity1 not on @entity2690 and 3 months for those receiving early @entity2690 . Thirty-three percent of @entity1 who met with a pharmacist reached an A1c <7% compared with 30% of @entity1 who did not. Adherence to @entity2690 initiation guidelines and rate of achieving A1c <7% in @entity1 with A1c >= 10% is low. Increasing pharmacy involvement may increase the rate of reaching goal A1c.
