Impact of a Collaborative Ambulatory Diabetes Outreach Pathway Using Clinical Pharmacists and Registered Nurse Certified Diabetes Care and Education Specialists
by Amy M. Wolff, PharmD, Calloway S. Van Epern, PharmD, BCACP, Amanda E. Mauerman, PharmD, BCACP, Sarah K. Lopina, PharmD, BCACP, Kathryn L. Henry, PharmD, BCACP, Mindy M. Deura, RN, CDCES, Jill P. O’Lena, RN, CDCES, Ryan D. Conrardy, MS
Abstract
Background:
Clinical pharmacists and Registered Nurse Certified Diabetes Care and Education Specialists (RN CDCES) at Froedtert & the Medical College of Wisconsin provide type 2 diabetes management services within primary care clinics via the Ambulatory Diabetes Outreach Program (ADOP). In 2023, ADOP launched a pilot, known as the Collaborative ADOP pathway (CAP), to enhance collaboration between pharmacists and RN CDCES. This pilot allowed clinical pharmacists to transition patient care to an RN CDCES in select scenarios. CAP aimed to reduce pharmacist time spent on tasks that are manageable by an RN CDCES. This study was designed to determine the potential efficiency gains with CAP, while ensuring optimal patient outcomes.
Methods:
A retrospective chart review was conducted to compare pre-specified outcomes between patients in ADOP versus CAP. The primary outcome was the difference in the median number of 30-minute pharmacist-led appointments per patient between ADOP and CAP. Secondary objectives were designed to further evaluate efficacy, quality, safety, and efficiency.
Results:
Pharmacists saved an average of four appointment slots per patient managed via CAP, compared with ADOP, a difference that was statistically significant (six vs. two slots in ADOP and CAP, respectively; p<0.001). Efficacy and safety outcomes were similar between the two groups.
Conclusion:
Patients enrolled in CAP had safety and efficacy outcomes similar to those in ADOP, and implementation of CAP significantly reduced the time primary care clinical pharmacists spent, allowing them to focus on the management of other complex patients.
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2026 March/April Table of Contents
Abstract
Background:
Clinical pharmacists and Registered Nurse Certified Diabetes Care and Education Specialists (RN CDCES) at Froedtert & the Medical College of Wisconsin provide type 2 diabetes management services within primary care clinics via the Ambulatory Diabetes Outreach Program (ADOP). In 2023, ADOP launched a pilot, known as the Collaborative ADOP pathway (CAP), to enhance collaboration between pharmacists and RN CDCES. This pilot allowed clinical pharmacists to transition patient care to an RN CDCES in select scenarios. CAP aimed to reduce pharmacist time spent on tasks that are manageable by an RN CDCES. This study was designed to determine the potential efficiency gains with CAP, while ensuring optimal patient outcomes.
Methods:
A retrospective chart review was conducted to compare pre-specified outcomes between patients in ADOP versus CAP. The primary outcome was the difference in the median number of 30-minute pharmacist-led appointments per patient between ADOP and CAP. Secondary objectives were designed to further evaluate efficacy, quality, safety, and efficiency.
Results:
Pharmacists saved an average of four appointment slots per patient managed via CAP, compared with ADOP, a difference that was statistically significant (six vs. two slots in ADOP and CAP, respectively; p<0.001). Efficacy and safety outcomes were similar between the two groups.
Conclusion:
Patients enrolled in CAP had safety and efficacy outcomes similar to those in ADOP, and implementation of CAP significantly reduced the time primary care clinical pharmacists spent, allowing them to focus on the management of other complex patients.
Download PDF
2026 March/April Table of Contents