Managing Diabetic Patients with Hypertension Comorbidity by Retail Pharmacists Using a Digital Solution in China

Objective: To identify the effects of implementing a digital approach at pharmacies to manage the healthcare outcomes of comorbidities of diabetes and hypertension. Methods: A digital solution that includes a set of blood glucose (BG) and blood pressure (BP) tele-monitors, an App, and a cloud engine with decision support algorithms was implemented in 941 drug stores in 91 cities in China. During Jun 8th 2015 to Dec 26th 2017, a total of 3,468 patients of both uncontrolled BG and BP were recruited to receive the monthly in-store healthcare services of: 1) BG and BP testing with the results synchronized to the cloud, 2) App-assisted lifestyle modification for meal planning, coaching and exercise, and 3) App-guided medication consultation. Results: The study population had an average age of 65.3 ± 10.1, BMI of 24.6 ± 3.3, and male of 47.2%. Their fasting blood glucose (FBG) and random blood glucose (RBG) were reduced by 0.8 mM (baseline: 9.1 ± 2.2 mM, last time: 8.3 ± 2.3 mM, P<0.001) and 3.1 mM (baseline: 14.4 ± 3.2 mM, last time: 11.3 ± 4.0 mM, P<0.001), respectively. Systolic and diastolic BPs were reduced by 9.1 mm Hg (baseline: 154.3 ± 14.7 mm Hg, last time: 145.2 ± 18.7 mm Hg, P< 0.001) and 4.4 mm Hg (baseline: 86.5 ± 11.1 mm Hg, last time: 82.1 ± 11.8 mm Hg, P<0.001), respectively. The proportion of controlled diabetic and hypertensive patients was 30.0% (n=1,040, P<0.001) and 36.1% (n=1,251, P<0.001) by the time of this analysis. Patients were satisfied with the intervention due to the convenient access to the digital database and the services available. The health outcomes were not associated with geographic differences or economic status of the site. Conclusion: Mobilizing community pharmacists with new digital technologies presents an effective approach to provide patient-centered care for diabetic patients with comorbidities such as hypertension. Disclosure W. Wang: None. Y. Li: None. Z. Wang: None. D. Li: None. H. Zhang: None. K. Liu: None. J. Cao: None.