According to the CDC, approximately 30.3 million people in the United States have diabetes.1 Pharmacies that offer ongoing diabetes care and counseling do more than deliver a valuable service; providing such services makes sound business sense.
“Patients need help navigating their care and managing the disease,” said Dorinda Martin, PharmD, RPh, FACA, FASAP. “Diabetic patients fill more prescriptions and visit the pharmacy more often than most of our other patients. The more services and products we offer, the more patients we will see. It's the ‘build it and they will come’ story. Offering individualized patient care and not just prescriptions increases patient trust, dedication and loyalty.”
One common way pharmacists help patients with diabetes is by showing them how to properly use prescribed devices. Although basic instruction in the self-monitoring of blood glucose levels is the set-up and demonstration of the device, pharmacists can use the opportunity to present information on glycemic goals. What should glucose levels be during fasting, before meals, after meals, and bedtime? What are the signs/symptoms/treatment of high and low glucose values and how often should I test?
Answering the simplest questions can be a game changer. “Interestingly, ‘How often should I test my blood glucose?’ is repeatedly asked—patients often state they have never been told how often or when to check glucose levels so this is an excellent opportunity for pharmacists,” said Jennifer Smith, PharmD, BCACP, BCADM, CDE.
“My one question I always ask takes 2 seconds. ‘Where do you inject your insulin?’ You would be amazed at the responses received (ie calf, breast, back, forearm). This becomes the easiest diabetes education moment that will profoundly impact absorption that takes less than 10 seconds to complete. Even the busiest pharmacist can spare 10 seconds.”
Monitoring medication use and adherence may be a more time-consuming task, but it’s something pharmacists are uniquely positioned to do. Pharmacists can recognize when medications are not optimized, if another medication is recommended for comorbid diseases, but not prescribed, and note any adverse or intolerable effects.
Ideally, counseling on the importance of medication adherence, plus the risks of the newly-diagnosed disease, should begin when a patient first shows up at the pharmacy with a new prescription for diabetes.
“If they don't have time at that moment of POS, then promise to call them the next day and outline what services the pharmacy offers, such as 1-on-1 diabetic counseling,” Martin said. “Create a summary and a template sheet for each pharmacist to create a plan for each of these patients, then place in ticker to ensure a follow-up call to monitor the patient every few months. This follow-up could include taking their weight and blood pressure as well as A1c and checking on their immunization records.”
Whether diabetes care and counseling happens in an independent pharmacy or at a nationwide pharmacy chain, systems that monitor patient adherence are an essential tool. At Walgreens pharmacies, pharmacists use a program with predictive analytics to identify patients most likely to become nonadherent to their maintenance medications, including those with diabetes, then provide personalized recommendations.
“By providing patient specific solutions to help them effectively manage their chronic condition, lifestyle modifications and medication regimen, diabetes patients can be empowered to meet their health goals,” said Alexandra Broadus, PharmD, director, Patient Outcomes Performance for Walgreens.
Prominently displaying diabetes products and services in the pharmacy is a good way to let customers know what you offer, but pharmacists can also help spread the word in the community “Outside of our stores, it’s important that pharmacists are participating in local community events and organizations to raise awareness of the care and services they can provide,” said Broadus. “Our pharmacists participate in community outreach programs. As part of these, we offer presentations on diabetes care and solutions.”
1. New CDC report: More than 100 million Americans have diabetes or prediabetes [news release]. CDC’s website. https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html.