• Toni Fera, Benjamin M Bluml, and William M Ellis.
• American Pharmacists Association Foundation, Washington, DC, USA. tfera@mirixa.com
• J Am Pharm Assoc (2003). 2009 May 1; 49 (3): 383-91.

ObjectiveTo assess the economic and clinical outcomes for the Diabetes Ten City Challenge (DTCC), a multisite community pharmacy health management program for patients with diabetes.DesignQuasiexperimental observational analysis, pre-post comparison.SettingEmployers at 10 distinct geographic sites contracting with pharmacy providers in the community setting.Participants573 patients with diabetes who had baseline and year 1 medical and pharmacy claims and two or more documented visits with pharmacists.InterventionsCommunity-based pharmacists provided patient self-management care services via scheduled consultations within a collaborative care management model.Main Outcome MeasuresChanges in health care costs for employers and beneficiaries and key clinical measures.ResultsAverage total health care costs per patient per year were reduced by $1,079 (7.2%) compared with projected costs. Statistically significant improvements were observed for key clinical measures, including a mean glycosylated hemoglobin decrease from 7.5% to 7.1% (P = 0.002), a mean low-density lipoprotein cholesterol decrease from 98 to 94 mg/dL (P < 0.001), and a mean systolic blood pressure decrease from 133 to 130 mm Hg (P < 0.001) over a mean of 14.8 months of participation in the program. Between the initial visit and the end of the evaluation period, influenza vaccination rate increased from 32% to 65%, eye examination rate increased from 57% to 81%, and foot examination rate increased from 34% to 74%.ConclusionDTCC successfully implemented an employer-funded, collaborative health management program using community-based pharmacist coaching, evidenced-based diabetes care guidelines, and self-management strategies. Positive clinical and economic outcomes were identified for 573 patients who participated in the program for at least 1 year, compared with baseline data.

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