2026 Southeastern Residency Conference

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Objective: To evaluate whether collaborative management with a clinical pharmacist in a family medicine setting leads to more adult patients with type 2 diabetes mellitus (T2DM) achieving hemoglobin A1c (A1C) reduction within 3–6 months compared to matched patients receiving usual care.

Background: T2DM remains a major contributor to morbidity and mortality, particularly in rural populations where access to care and provider shortages can make disease management difficult. Clinical pharmacists integrated into primary care teams may improve glycemic outcomes through medication optimization. While prior studies have demonstrated improved A1C outcomes in pharmacist-managed diabetes clinics, many evaluate outcomes over 6–12 months. Limited data exist assessing short-term (3–6 month) glycemic response under collaborative models embedded within rural family medicine practices.

Methods: This retrospective, single-system, 1:1 matched cohort study included 34 adult patients with T2DM seen at a family medicine clinic between July 31, 2024, and July 31, 2025. Seventeen patients with ≥1 documented visit and management by a clinical pharmacist were matched to 17 patients without pharmacist involvement based on provider, age (±5 years), sex, and baseline A1C category (<8%, 8–10%, >10%).
The primary outcome was any A1C reduction (yes/no) from baseline to 3–6 months. Secondary outcomes included A1C reduction ≥1% and achievement of A1C goal (<7% or individualized target) within 3–6 months.

Results: Within 3–6 months, 9 of 17 (52.9%) pharmacist-managed patients demonstrated A1C reduction compared to 5 of 17 (29.4%) patients receiving usual care. When evaluating clinically meaningful reductions (≥1%), 7 of 17 (41.2%) pharmacist-managed patients and 4 of 17 (23.5%) usual care patients met this reduction. For goal attainment, 3 pharmacist-managed patients and 6 usual care patients met A1C target, however, most were already at goal at baseline (2 and 4 patients, respectively). Among patients not at goal at baseline, new goal attainment occurred in 1 of 15 (6.7%) pharmacist-managed patients and 2 of 13 (15.4%) usual care patients.

Conclusion: Collaborative management in a rural family medicine setting was associated with a higher proportion of patients achieving short-term A1C reduction, including clinically meaningful reductions ≥1%, compared to usual care. While goal attainment rates were similar and limited by small sample size, these findings support integration of pharmacists into rural primary care teams to promote early glycemic improvement.