The University of Connecticut/Hartford Hospital MAP has demonstrated not only positive clinical outcomes but positive economic outcomes as well. Recently, a cost-benefit analysis by Gillespie and colleagues⁷ found that, over a 2-year period, this MAP yielded a positive net-benefit to the hospital of $76,008, demonstrating that such a program can be a financially worthwhile investment for an institution.

It should be noted that the before-and-after study design used in this evaluation could introduce biases and confounders that could reduce the evaluation's internal validity. For example, factors outside of the MAP, such as additional emphasis on diet and exercise or patient medication adherence, may have aided patients in attaining improved glycemic control. Concerns such as these can be addressed adequately only through the utilization of prospective, randomized, controlled study design. Previous investigators,¹¹ however, have expressed ethical concerns with conducting a randomized, controlled evaluation of such a program. Consequently, such a study may not come to fruition. Due to the current absence of such studies evaluating the clinical outcomes of a MAP, our evaluation represents one of the best assessments available at this time.

CONCLUSIONS

Dr Patel is a pharmacoeconomics and outcomes research fellow at the School of Pharmacy, University of Connecticut, Storrs, Conn, and Hartford Hospital, Hartford, Conn. Dr Kuti is an assistant professor of pharmacy practice at the School of Pharmacy, University of Connecticut, Storrs, Conn. Dr Dale and Dr Shah are cardiovascular outcomes fellows at the School of Pharmacy, University of Connecticut, Storrs, Conn, and Hartford Hospital, Hartford, Conn. Dr White is an associate professor of pharmacy practice at the School of Pharmacy, University of Connecticut, Storrs, Conn, and director of the Cardiovascular Pharmacology Service at Hartford Hospital, Hartford, Conn. Dr Coleman is an assistant professor of pharmacy practice at the School of Pharmacy, University of Connecticut, Storrs, Conn, and director of the Pharmacoeconomics and Outcomes Studies Group at Hartford Hospital, Hartford, Conn. He may be reached at ccolema@harthosp.org.

Disclosure Information: The authors report no financial disclosures as related to products discussed in this article.

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