2025 Southeastern Residency Conference

Title: Comparing the Impact of Pharmacist Driven Care When Patients are Enrolled in a Medical Student Telehealth Clinic 


Authors: Emily Strickland, Kate O’Connor 


Objective: To determine the impact on clinical outcomes following the addition of medical student telehealth clinic encounters to patients who are followed by the internal medicine clinical pharmacist.


Self Assessment Question: True/False: Patients enrolled in the medical student telehealth clinic had a better outcome in their diabetes management than patients who were not enrolled in the medical student telehealth clinic.
 
Background: The involvement of clinical pharmacists in patient care within primary care clinics has been shown to significantly enhance clinical outcomes. Patients receiving care from clinical pharmacists often experience improved management of their chronic conditions. Similarly, medical students have demonstrated positive contributions to patient care, particularly in the management of chronic diseases. In recent years, the Medical College of Georgia (MCG) has established a student-run telehealth clinic that offers free services to eligible patients. These encounters focus on chronic disease management, fostering a hands-on learning environment for the students. Notably, some patients enrolled in this telehealth clinic are also under the care of an internal medicine (IM) clinical pharmacist. However, there is currently limited evidence examining the effects of incorporating medical students into the care of patients already managed by a clinical pharmacist. This study aims to explore the clinical impact on patient outcomes resulting from the addition of medical students to the care teams of patients who are already being followed by an IM clinical pharmacist. By investigating this collaborative approach, we hope to identify potential benefits, enhance chronic disease management strategies, and guide the future direction of the telehealth clinic at MCG and other institutions.   


Methods: A single-center retrospective chart review was conducted at Wellstar MCG Health of patients who were 18 years or older with a diagnosis of diabetes and were followed by the IM clinical pharmacist between January 1, 2023 and December 31, 2023. This study was divided into two arms, a control arm consisting of patients who followed with the IM clinical pharmacist and the intervention arm consisting of patients who were both enrolled in the telehealth clinic and followed by the IM clinical pharmacist, and were required to have at least 1 telehealth encounter between January 1, 2023 and December 31, 2023.  Patients were excluded if they were referred to the IM clinical pharmacist after enrollment in the telehealth clinic or if their HbA1c was <7% at the time of enrollment in the telehealth clinic. The primary outcome was the percent change in HbA1c from baseline to post intervention. Secondary outcomes included percent of patients with blood pressure at goal, appropriate statin use following intervention, and documentation of annual eye exam and collection of eGFR and UACR.  Statistical analysis was performed using descriptive statistics.


Results: We identified 13 unique patients who met inclusion criteria in the intervention arm and included an identical number of patients in the control arm for comparison, which resulted in analysis of 26 patients. For the primary outcome of change in HbA1c from baseline to follow up the results were a -3.2 percent change for the control arm compared to-1.8 percent change in the intervention arm. Results of the secondary outcomes included 6 patients with blood pressure at goal in the control arm compared to 9 patients in the intervention arm, which showed improvement from baseline. In both groups, all patients were on a statin or intolerance at follow up.


Conclusion: Based on the results the incorporation of medical students to care teams of patients followed by the IM clinical pharmacist provides additional benefit for chronic disease state management. The positive findings from this study support MCG's efforts to continue providing medical students with telehealth-based learning opportunities, enhance clinic functions, and improve patient outcomes. We hope the results of this can be utilized by other intuitions to grow and establish learning opportunities for medical students and improve clinical outcomes for patients.