Research
Impact of wellness coaching and monitoring services provided in a community pharmacy

https://doi.org/10.1331/JAPhA.2013.11227Get rights and content

Abstract

Objective

To assess the clinical and patient-centered outcomes of health coaching provided in the workplace by community pharmacists.

Design

Prospective interventional cohort study.

Setting

11 independent community pharmacy chain locations in northwest and central Missouri, from January 2010 to January 2011.

Participants

81 benefit-eligible patients and 23 community pharmacy coaches employed by the self-insured pharmacy chain.

Intervention

Patients were stratified into monitoring groups according to baseline screening values for cholesterol, blood pressure, fasting blood glucose (FBG), body mass index (BMI), and waist circumference. Patients selected their pharmacist coach. Follow-up appointments occurred monthly to quarterly. Appointments consisted of education, goal setting, and monitoring through evaluation of treatment goals and physical assessment.

Main outcome measures

Change from baseline in mean total cholesterol, serum triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, systolic blood pressure (SBP), diastolic blood pressure (DBP), FBG, weight, BMI, waist circumference, health-related quality of life (HRQoL), and patient satisfaction.

Results

Patients' total cholesterol, LDL cholesterol, HDL cholesterol, DBP, and FBG were reduced significantly. Mean changes in triglycerides, SBP, weight, BMI, and waist circumference were not statistically significant. The 36-Item Short-Form Health Survey version 2.0 showed improvements in both the Physical and Mental Component Summaries but did not reach statistical significance. More than 90% of patients were satisfied with the service and the care they received.

Conclusion

Wellness coaching by a pharmacist provided in a community pharmacy can result in significant improvements in cardiovascular risk factors, with a trend toward improved HRQoL. In addition, patients were satisfied with the wellness program from the start of the project.

Section snippets

Objectives

The purpose of this study was to assess the clinical and patient-centered outcomes of health coaching provided in the workplace by community pharmacists. The study is ongoing, with this article addressing the short-term outcomes from the first 12 months of the intervention. Specifically, the objectives were to (1) evaluate patients' clinical improvements in cholesterol, hypertension, diabetes, and weight management after pharmacist coaching in an EWP and (2) determine whether improvements in

Methods

The EWP was developed at a self-insured, independent, small chain pharmacy in rural northwest and central Missouri and was provided at its 11 locations. Pharmacy employees and dependents who were 18 years or older, nonpregnant, and using the company's health insurance were invited to participate. Employees who were not insured with the company's health insurance benefit could enroll in the EWP but were excluded from the study. Employees began enrollment in January 2010. Patients who completed

Results

Of the 169 employees and dependents eligible for the program, 90 enrolled. Of those, 81 patients (90%) completed the entire study. The remaining nine patients (10%) withdrew from the program secondary to changes in employment (five patients), insurance status (two), or conflicts in scheduling (two). At study enrollment, patients were stratified into the healthy (n = 6), cholesterol (n = 67), hypertension (n = 50), diabetes (n = 23), and weight (n = 51) monitoring groups. Overall, the majority

Discussion

This study demonstrates that a community pharmacy–based employee wellness coaching and monitoring program improved cholesterol levels, DBP, and FBG in a patient population through interventions consisting of lifestyle changes. Pharmacists' education and training, motivation to expand their patient care focus, approachability, and accessibility to patients and physicians makes them prime candidates for coaching and disease monitoring programs. Point-of-care testing provides easy access to

Limitations

The major limitations of this study were small sample size and lack of randomized controlled design. Our sample size was limited by the number of employees working for the company, but we further limited this to include only those who had the company insurance plan. This may have created a selection bias by focusing the population to include only full-time employees. Further, this patient population was primarily female and highly educated, which may decrease the generalizability of our study.

Conclusion

An EWP was implemented in a community pharmacy as a demonstration project using pharmacist coaches to improve the health of the company's employees and, in turn, collect data to market this service to external employer groups. Significant improvements were seen in cardiovascular risk factors with a trend toward improved HRQoL. In addition, patients were satisfied with the wellness program from the start of the project.

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Disclosure: The authors declare no conflicts of interest or financial interests in any product or service mentioned in this article, including grants, employment, gifts, stock holdings, or honoraria.

Acknowledgments: To Rafia S. Rasu, PhD, and Bithia Fikru for statistical guidance and analysis and to Hubert Ekpoh for data collection.

Previous presentations: American Pharmacists Association Annual Meeting & Exposition, March 25–28, 2011, Seattle, WA, and University of Missouri–Kansas City Health Sciences Research Summit, April 20, 2011.

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