CDC: Partnerships With Pharmacists Expand Diabetes Prevention Efforts

July 1, 2020

The CDC has identified the pharmacy sector as a key partner in offering its lifestyle change-based program for patients with high risk for type 2 diabetes.

The CDC partnered with pharmacy stakeholders to develop resources and promotional materials tailored to the needs and values of pharmacists to expand the National Diabetes Prevention Program (National DPP) in pharmacies across the country.

First implemented in 2010, the National DPP is a public-private partnership that aims to become a nationwide delivery system for an evidence-based lifestyle change program for adults with an increased risk for developing type 2 diabetes. The program uses a curriculum taught by trained lifestyle coaches, delivered in person or virtually. 

Pharmacies and pharmacists are key partners in the program, since they are uniquely positioned to care for underserved populations who are also at increased risk for prediabetes, and developing type 2 diabetes, according to the CDC. One in 3 adults in the United States has prediabetes, which leads not only to type 2 diabetes, but also heart disease and stroke.

Related: ADA 2020: Pharmacists Can Improve Diabetes Outcomes in Rural Settings

Ninety-two percent of individuals living in the United States reside within 1.6 miles of a pharmacy, and patients often visit their pharmacist more often than their primary care physician. Convenience on the basis of proximity and extended hours allow patients increased access to care, particularly for those who otherwise would have limited access.

CDC data has reported that that the National DPP can promote a 58% decreased risk for type 2 diabetes, and a 71% lowered risk for individuals 60 years or older. Another benefit of the program is its accessibility, as it is offered in settings such as hospitals and clinics, community organizations, and worksites.

The CDC identified 7 pharmacies that had already been offering the lifestyle change program and worked with the locations to evaluate the pharmacy workforce, including pharmacists, technicians, residents, community health workers, and students, in their ability to maintain and expand National DPP initiatives. The data was used to develop a pharmacy-specific resource that enables pharmacists to implement and sustain the lifestyle change program.

Data found that 5 of the 7 served rural populations; 4 focused on patients who have low incomes or who are medically underserved.

Additionally, 5 were independent pharmacies, whereas 1 was a school of pharmacy and the other was a retail chain grocery pharmacy.

The CDC analysis reported the following trends:

  • Pharmacists are increasingly working as providers, expanding their portfolio of patient care services.
  • More independent pharmacies than other pharmacy types exist in areas with a high prevalence of diabetes, although their limited resource capacity makes scalability a challenge.
  • National pharmacy associations are strong advocates for enabling pharmacists to offer more services and can influence pharmacist decision making.

Phase 2 of the study included testing a guide for pharmacists to help them get involved in the DPP. Results were based on establishing 3 tiers of pharmacy involvement:

  • Tier 1: Promote awareness of prediabetes and the National DPP. This is a simple, low-cost step to get involved with type 2 diabetes prevention efforts. The guide outlines existing promotional materials and campaigns that pharmacies can use to raise awareness of prediabetes and the National DPP.
  • Tier 2: Screen, test, and refer. By using a CDC-approved risk assessment or blood glucose test, pharmacies can help determine whether patients are at high risk of developing type 2 diabetes or currently have prediabetes. Pharmacy staff can then refer patients to the CDC-recognized lifestyle change program.
  • Tier 3: Offer the lifestyle change program. The guide describes how pharmacies can become CDC-recognized providers of the National DPP lifestyle change program.

CDC’s engagement with several diverse pharmacies revealed limitations on the basis of state-to-state scope of practice and unique barriers that limited engagement in type 2 diabetes prevention programs; however, authors stressed the success of the study in demonstrating the ways that public health and pharmacy sector partnerships are able to expand type 2 diabetes prevention.

“Pharmacists are accessible, credible, and dedicated health professionals who can play a key role in preventing type 2 diabetes and other chronic diseases while addressing health inequities in their communities,” the authors wrote.

Reference:

  1. Ross LW, Bana F, Blacher RJ, et al. Continuous Stakeholder Engagement: Expanding the Role of Pharmacists in Prevention of Type 2 Diabetes Through the National Diabetes Prevention Program. Prev Chronic Dis 2020; 17:190374. doi: http://dx.doi.org/10.5888/pcd17.190374.