Innovative practices: Three pharmacists' stories

Approximately 90% of patients with diabetes do not control their condition well enough to avoid related health risks, according to both the American College of Endocrinology and the American Association of Clinical Endocrinologists.

As pharmacists, this means many of our customers and patients still desperately need our help. Providing patients with counseling and monitoring can help prevent poor outcomes. Many R.Ph.s are already working with these patients to some degree, but here are the stories of three pharmacists whose unique practices focus primarily on diabetes.

"We provide culturally appropriate diabetes education classes in Los Angeles and Washington, D.C., and have contracts with a community health plan and independent physician associations," she explained.

All broadcasts are viewed by patients in their private physician's office or healthcare institution and are archived and available 24 hours a day, seven days a week. Coleman also offers free diabetes information targeting the African-American, Latino, and other minority populations on her company's Web site http://www.blackandbrownsugar.com/ and has recently coauthored "Healing Our Village: A Self-Care Guide to Diabetes Control."

"So far, I've taken 24 students to camp with me, and my colleague Allyson Gaylor, Pharm.D., another faculty member at TTUHSC, has taken 12 students," explained Condren.

In 1997, the hospital had acquired a few physician practices in surrounding counties and Perdue put forth the notion of having a clinical pharmacist working collaboratively with other practitioners to monitor patients with diabetes and other chronic illnesses. Initially, two positions were approved.

"We just extrapolated from a tertiary care model to a small family practice setting," Perdue said. "We see patients one-on-one, interview them, and consolidate data concerning their blood sugars and lipids." Perdue and his colleagues also perform a limited physical exam, getting patients' weight and blood pressure, and addressing any concerns the patient may have. His group also draws blood for any necessary labs and adjusts medications as needed.

Currently, Perdue follows about 40 diabetes patients in two practices. The primary goals of his program are to minimize the risk for heart disease and stroke by aggressively treating modifiable risk factors such as hypertension, lipids, and cigarette smoking. He also hopes to delay or minimize the microvascular complications by optimizing blood sugar control through diet, exercise, and pharmacotherapy.