The Role of Pharmacists in Diabetes Care
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How often do you see your pharmacist?
Is it to only get your prescriptions? Did you know your pharmacist can do more than just dispense medications? If so, you’re not alone and professionals are hoping to change the perception of pharmacists in diabetes care. At the American Diabetes Association’s 81st Scientific Sessions, Staci-Marie Norman, PharmD, CDCES provided insight into how essential the role pharmacists are in diabetes care and education.
Why Pharmacists are Vital for People with Diabetes
There are 84,000 pharmacies in the United States and in 2019, it was reported there were 311,000 pharmacists available, a number that’s increased from 224,000 in 2001. But that’s not the primary reason why they’re important for people with diabetes—they’re essential to one’s healthcare team because a patient sees a pharmacist seven times for every one physician appointment.
According to Norman, most people think of pharmacists as the person in the white coat behind the counter, but actually, about half of them work in government via Indian Health Services, Armed Services, Federally Qualified Health Centers (FQHCs) and the VA. Most pharmacists work under a collaborative agreement with physicians, allowing them to do more than just fulfill medication orders. They can:
- Manage patients’ medications, including starting medications
- Initiate and adjust insulin regimens
- Initiate pump therapy
Norman also pointed out there are pharmacists who are also certified diabetes care and education specialists (CDCES) and provide diabetes education, especially in community pharmacies. However, they aren’t considered to be healthcare professionals under Center for Medicare and Medicaid Services (CMS) guidelines.
Pharmacists Help Save Money and Improve Diabetes Outcomes
Still, pharmacists can have a significant positive impact on people with diabetes. Norman mentioned a systematic review of how pharmacists improve health outcomes and save patients money on health-related expenses. In that review, she noted a study conducted by Kaiser Permanente that included 6,000 patients who were assigned to one of three different models:
- Model One = “Typical” pharmacist interaction – pharmacist provides information if asked.
- Model Two = Pharmacist initiates counseling with medication dosage changes or introduction to new medications.
- Model Three = Provides full medical history review, assesses the frequency of medication usage and medication education.
In the second and third models, medical costs improved by nearly 10 percent and 22 percent, respectively.
Other notable figures from the review included:
- Significant A1C reductions from 1.7 to 3.4 percent
- Cost savings ranging from $61,500 to $244,500
- Patients who benefitted from a physician and pharmacist collaboration compared to just seeing a physician saw greater decreases in their A1C and blood pressure.
While many are familiar with the pharmacists from large chains like CVS and Walgreens, community and independent pharmacies can play a major role in improving the lives of people with diabetes, too. Norman cited the Asheville Project in North Carolina, where pharmacists developed patient services through community services to improve health outcomes for people with chronic illnesses. Results from this program showed:
- Improved A1C levels
- Lower total healthcare costs
- Fewer sick days
- Increased satisfaction with pharmacists
The American Pharmacist Association wanted to model the Asheville Project in other areas such as Charleston, Pittsburgh, Colorado Springs, Honolulu, Los Angeles, Tampa Bay, Milwaukee, Northwest Georgia and Chicago. This model, called the Diabetes Ten City Challenge, surveyed 573 patients who:
- Improved their A1Cs
- Increased flu vaccinations
- Maintained visits for eye exams and foot exams
- Saw a decrease in health care costs (an average of $1079 per year)
At the end of her presentation, Norman emphasized that pharmacists need to continue to be part of the diabetes healthcare team, perhaps, in an expanded role than people are used to.
For more coverage of the American Diabetes Association’s 81st Scientific sessions, CLICK HERE.