Impact of a Pharmacist-led Weight Management Clinic in a Medically Underserved Population within a Federally Qualified Health Center
Rebecca Axson-Wells1, L. Tate Owens1, N. Leigh Joyner1, Carrington Huneycutt1, Joseph Magagnoli2, P. Brandon Bookstaver2, Robert Etheridge1, Reagan K. Barfield2
1Tandem Health, 2University of South Carolina College of Pharmacy
Background/Purpose: Obesity is a major public health concern associated with diabetes, cardiovascular disease, and hypertension. In South Carolina, 36% of adults are obese, with Sumter exceeding 40%. Access to weight loss medications is limited, particularly in underserved populations. Although pharmacist-led weight management programs have demonstrated improved weight loss, patient outcomes, and adherence, data on their impact within a Federally Qualified Health Center (FQHC) remain limited; therefore, this study evaluates a pharmacist-led weight management clinic in this setting.
Methodology: This was an IRB-approved, retrospective, observational cohort that included adults with a BMI ≥ 30 kg/m2 who attended ≥ 3 visits in the pharmacist-led weight management clinic. An external comparator group was matched based on obesity class, age, and sex from January 1, 2024 - March 13, 2026. Patients were excluded if they were enrolled in the diabetes self-management education clinic, had a diagnosis of diabetes, or were pregnant.
The primary outcome was the percent change in body weight. Secondary outcomes included changes in blood pressure, heart rate, waist circumference, lipid profile, HbA1c, and patient reported quality of life (QOL). Data was extracted from the electronic health record into a REDCap survey. Data was analyzed using linear mixed-effects and logistic regression models adjusting for baseline covariates.
Results: The study included thirty-six patients, with eighteen in each group. While there were mostly similar baseline characteristics (mean age 38.5 years; 83% female), there were a few notable differences. The intervention group had higher Medicaid coverage (72% vs. 22%, p = 0.013), baseline waist circumference (54.7 vs. 46.8 inches, p = 0.005), and HbA1c (5.65% vs. 5.32%, p = 0.033).
There were no significant between-group differences in changes from baseline. Weight decreased in both groups (−1.7 ± 3.5 vs. −0.2 ± 5.8 kg, p = 0.36), as did BMI (−0.6 vs. −0.1 kg/m², p = 0.45). Blood pressure declined similarly (SBP: −5.9 vs. −4.6 mmHg, p = 0.81; DBP: −4.0 vs. −5.3 mmHg, p = 0.78). Descriptive results demonstrated positive outcomes, with quality of life maintained or improved in all patients and no observed worsening over time. Patient satisfaction remained consistently high across all domains, with mean scores approaching ‘very satisfied’ and a median of 5 (IQR = 0) for all items.
Conclusion: In this small cohort, the intervention was not associated with significantly greater improvements in weight or cardiometabolic outcomes compared to usual care. However, trends favored the pharmacist-led intervention group despite a higher baseline disease burden and formulary-related treatment limitations. Patients experienced clinical and patient-centered benefits, including enhanced weight management support, medication optimization, and maintenance or improvement in quality of life. Pharmacist-led care also positively impacted the practice through high patient satisfaction, engagement, and support of comprehensive, team-based chronic disease management.
