According to the CDC’s 2017 National Diabetes Statistics Report, 30.3 million individuals in the U.S. have diabetes, and 7.2 million people living with the disease are undiagnosed. This showcases the need for diabetes management programs and continuous patient education and monitoring.
According to a study published in Diabetes Spectrum, pharmacist-led interventions in a rural primary care clinic were associated with the majority of patients experiencing an A1C reduction of at least 1%, which has the potential to reduce the risk of complications and decrease diabetes associated costs. Pharmacists’ have a unique skillset as drug experts and play an integral role as part of the healthcare team—not only improving patient outcomes, but also expanding business opportunities.
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Pharmacists can play an integral role in establishing diabetes management services in the community and health system settings. According to a study published in American Health & Drug Benefits, 96% of the providers approved of the collaborative practice agreement for pharmacist-led diabetes services.
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Additionally, pharmacists’ satisfaction with the new protocol was high. The majority (89%) of patients were referred by providers who received a personalized provider report card, which identified patients who met the criteria (A1C > 9%) for pharmacist referral under the protocol. Pharmacists can use these personalized provider report cards to establish a relationship with physicians and expand diabetes management services. This may lead to expanded patient care opportunities and enhanced communication with prescribers.
The CMS offers reimbursement for Medicare beneficiaries for diabetes self-management training (DSMT), provided that individuals have been recently diagnosed with diabetes or are at risk for complications. Pharmacies first need accreditation to provide DSMT. The National Community Pharmacists Association (NCPA) has teamed up with the American Association of Diabetes Educators to provide an educational program known as “Diabetes Accreditation Standards-Practical Applications” (DASPA), which provides the necessary requirements for accreditation to be recognized as a certified program provider. Approved program instructors may include pharmacists, registered nurses, and registered dietitians, which demonstrates the importance of interprofessional patient care programs. The DSMT programs should include education on self-monitoring blood glucose (SMBG), diet and exercise counseling, an insulin treatment plan, and motivation to use skills for diabetes self-management.
Bhavana Mutha, RPh, BCMAS, a clinical consultant in Woodstock, GA, with over 14 years of practice experience in different retail centers says “personal support and guided education to manage and control different aspects of diabetes can lead to a very balanced approach in disease management.” Mutha also says she believes in the importance of keeping up with the profession and expanding her horizons, so she is pursuing additional training and certification for diabetes.
Pharmacists are being recognized by Medicare Part B for their role in managing patients with diabetes, even in perhaps unconventional ways. Part B covers furnishing and fitting of custom-molded shoes and inserts, and pharmacists are recognized as other qualified individuals besides podiatrists that are able to provide those options for patients. However, individual states may require additional requirements for pharmacists to prescribe therapeutic shoes, so they should double check with their state laws.
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