2021 Outcomes Grant Final Reports

FREESTYLE LIBRE PRO USE FOR IMPROVED CONTROL OF BLOOD SUGARS IN PATIENTS WITH DIABETES

Author: Wendy Mobley-Bukstein, PharmD, BCACP, CHWC, CDCES, FAPhA, Drake University College of Pharmacy & Health Sciences

Amount: $6,149

Summary: Individuals (n=5) were identified in the clinic by the diabetes care and education specialist or a medical provider as having unmanaged diabetes. The person received informed consent regarding the study. If they agreed, a professional Freestyle Libre CGM device was applied, and the person wore it for 14 days. At the end of the 14 days, the person returned to the clinic for removal of the device and interpretation of the data collected from the device. Therapy changes were made to the person’s diabetes treatment plan. The person adhered to the new plan for 4 weeks and then returned to the clinic to wear a second CGM for 14 days. Data from this CGM wear was recorded.

The average glucose was decreased by approximately 20mg/dL. The glucose variability was decreased by more than 8% and the average GMI was decreased by 1%. Looking at the time-in-range data, recall that the changes in these numbers are occurring over a 6-week time period. In most clinical practices, an A1C would be drawn every 12 weeks. These averages are heavily skewed by individual patients who had very high glucose at the beginning of the study period, and although improvement in the blood glucose ranges occurred, they remained above the target range. The more impressive improvement was the average low or very low was decreased by 2.7%. This is an area of importance because this decrease in hypoglycemia and severe hypoglycemia has a cost savings of an emergency department visit, hospitalization or death attributed to it. Lastly, you can see that the high touch follow-up that was being performed has been beneficial to these patients, resulting in more interactions and subsequently more frequent adjustments of their insulin dosages.

CGM Data Points First Wear (n=5) Second Wear (n=4)* Average Glucose 222.6 mg/dL 200 mg/dL Glucose Variability (%) 43.8% 35.8% Glucose Management Index 9.05% 8.1%

Time-In-Range (TIR) 36.8% High/Very High Range 59% Low/Very Low Range 4.2% Number of patient interactions 28

Number of drug therapy interventions 27 39.75%

58.75%

1.5%

56

56

*One patient is scheduled to return for second wear in the two weeks.

PATIENT PREFERENCES AND WILLINGNESS-TO-PAY FOR MEDICARE PART D CONSULTATIONS OFFERED IN A COMMUNITY PHARMACY SETTING

Author: Logan Thomas Murry, PharmD, The University of Iowa

Amount: $10,000

Summary: The objectives of this study were to 1) identify patient preferences for Medicare Part D consultation service offerings from the perspective of service-naive and service-experienced patients, and (2) quantify patient stated preferences for service attributes using partworth utilities and willingness-to-pay.

The study used a mixed methods design with qualitative interviews of Iowa CPESN patients and a national quantitative discrete choice experiment. Patients at 5 Iowa CPESN community pharmacies were interviewed about their experiences selecting a Medicare Part D plan. Perspectives were collected from 17 patients who both had and had not used a Medicare Part D consultation service offered by a community pharmacy in the past. After 17 interviews had been completed, qualitative analysis identified themes within the SERVQUAL framework domains of: Technical Quality, Interpersonal Quality, Environmental Quality, and Administrative Quality. Thematic analysis identified five attributes important to Medicare Part D service quality from Iowa CPESN patients: Service Length, Information Provided, Service Location, Service Provider, and Price.

The DCE showed that when considering Medicare Part D consultation services, patients associated the highest value with shorter services (15 minutes), a discussion of Medicare Part D plans and a follow-up phone call, offered in person at the pharmacy, and provided by a pharmacist they knew. While patients had the highest preference for a service offered free of charge, a charge of $25 USD was still associated with positive utility. Community pharmacies currently offering or interested in offering Medicare Part D consultation services may benefit from considering patient preferences for service offerings and the monetary value of these services.

VAXITAXI.COM PROVIDER PILOT

Author: Casey Villhauer, PharmD, Vaxi Taxi

Amount: $15,000

Summary: The goals of the Vaxi Taxi Provider Pilot were restructured from the original presentation to better align with the Board’s recommendations in anticipation of delivering COVID-19 vaccines to those Iowa communities of greatest need. Revised project goals include: Develop key roles with the intent of expanding Vaxi Taxi services beyond the primary service locations; Streamline training and credentialing of Vaxi Taxi pharmacists with an in-house program to minimize onboarding and “Vaxi Taxi certification” costs; Experience and document the challenges of serving individuals living in areas with high Social Vulnerability Index scores vs. suburban neighborhoods. The key role was identified as the Director of Pharmacy, fulfilling responsibilities related to Pharmacy Partner Relations (Community Pharmacies), Immunizer Relations, and Patient Relations. In expanding services, Vaxi Taxi established a Pharmacy Partner program, created a dedicated team consisting of a clinical coordinator, eight immunizers and an administrative assistant, and streamlined with Pharmacy Partner onboarding process. In addition, Vaxi Taxi streamlined its training and credentialing for pharmacists, utilizing state funding to cover these costs. The final goal, experiencing and documenting challenges serving patients in high vulnerability areas, was not achieved due to insufficient data.

NEW FUNDING OPPORTUNITY

The IPA Foundation is looking to support the next generation of innovative pharmacy ideas through the Outcomes Innovative Pharmacy Grant Program. New this year, there are TWO funding pathways available for Iowa pharmacists!

OUTCOMES GRANT Original Track

• Funding up to $10,000 per project • Iowa PGY1/PGY2 residents eligible to apply • Up to five residents funded per year • Funding up to $2,000 for residents • Application Deadline: September 1

OUTCOMES GRANT Entrepreneur Track

• Funding up to $50,000 • Must submit letter of interest to IPA • Must complete 10/20/30 pitch deck (10 slides, 20 minutes, 30-point font) • Application Deadline: Rolling

Applicants must be a current Iowa licensed pharmacist and active member of the Iowa Pharmacy Association. To be considered for the original Outcomes Grant, complete the online application by September 1, 2022. Individuals interested in learning more about the Entrepreneur Track may submit a letter of interest to ipa@iarx.org.

The IPA Foundation Outcomes Innovative Pharmacy Endowment was established by the original investors of Outcomes Incorporated to support innovative pharmacy initiatives in the state of Iowa. The Outcomes Innovative Pharmacy Grant Program provides financial support for research, education and promotion of innovative pharmacy practice initiatives in the state of Iowa.