This is a framework for community pharmacists to start a diabetes education program

1. Role of Community
Pharmacists in
Diabetes
Management
Anas Bahnassi PhD CDM CDE

2. • A pharmacist is one of few medical professionals in the
world to whom a patient or anyone else can go for a
consultation or advice without an appointment.
• They are knowledgeable about a myriad of aspects
concerning patients and their medication.
• It is thus of the utmost importance to take these skills
into consideration when it comes to diabetic
education.
• Pharmacists have long-term relationships with most of
their chronic patients, which sets a good foundation for
mutual trust and respect and better patient
compliance.
11/15/2013
2
The role of community pharmacist in diabetes management
Strengths of community pharmacist

3. Provider of
healthcare
education
Provider of
pharmaceutical care
Formulator,
distributor,
and
compounder
11/15/2013
Provider of
costeffective
therapy
Provider of
essential
care
services
Advisor on
the safe and
rational use
of meds
3
The role of community pharmacist in diabetes management
Pharmacy is a dynamic, information
driven, patient-orientated profession

4. The role of community pharmacist in diabetes management
•
•
•
Wild S et al. Diabetes Care 2004;27:1047–53.
Diabetes and disease state
management
An escalating epidemic with predictions of
worldwide prevalence exceeding three million by
2030.
Strict control of type 2 diabetes can delay the
onset of the complications of this disease is costeffective, and brings about improvements in
overall quality of life.
Disease state management (DSM)
approaches focus on intensive
management of type 2 diabetes
involving regular monitoring, followup, and continuity
of care.
11/15/2013
4

5. The role of community pharmacist in diabetes management
Pharmacist’s role in diabetes DSM
Pharmacists are ideally placed to contribute to DSM
programs and assist in the detection, education and
referral of individuals at risk of diabetes.
•
•
•
•
•
•
•
Support of self blood glucose monitoring (SBGM)
Monitor & promote patient adherence
Identify and resolving drug-related problems
Provide targeted education
Monitor blood pressure, weight
and lipids
Remind patients of the
importance of regular exams
A disease management educator
and tutor
11/15/2013
5

6. A small group of people interested in the same subject
invite lecturers, and had discussions.
The aim is to gain knowledge that does not only include facts
but change ones existence.
Knowledge should be sought by group members in texts as
well as from their own experiences.
The long-term goal of an SC for diabetes should be to develop
a diabetes education program to teach glucose control and
help participants cope with their diabetes.
The pharmacy is a good setting since it is a widely distributed
service.
11/15/2013
6
Clifford RM et al.Int J Pharm Pract 2002;10:85–9.
The role of community pharmacist in diabetes management
Study circles

7. Pharmacists should be trained
to promote learning and be
able to handle conflict that
might arise out of group
discussions. For some it can
be hard in the beginning to
abstain from lecturing and let
the group do the work and it
is therefore imperative that
some knowledge of group
dynamics is present.
11/15/2013
7
The role of community pharmacist in diabetes management
Pharmacist as a SC facilitator

8. The role of community pharmacist in diabetes management
Effective disease state management
The key to effective diabetes management is
the adoption of a systematic approach of:
• Collecting
• Interpreting, and
• Acting on blood glucose data.
11/15/2013
Berringer R. et al. J Am Pharm Assoc 1999;39:791–7.
8

9. The role of community pharmacist in diabetes management
Collection
Glucose profiling has consistently been
associated with improved glycemic control,
whether evaluated as part of an intensive
insulin management strategy or as a component
of management of patients not treated with
insulin.
Intensive insulin therapy guided by SMBG
performed at least four times per day was
associated with a > 2.0% reduction in
HbA1c.
Similar findings were observed in patients
with type-2 diabetes
11/15/2013
9

10. • Handwritten logbooks can be incomplete, inaccurate, and
illegible faulty analyses of BG trends
• The use of data-management software may help both
patients and health care professionals manage these profiles
and achieve glycaemic control.
• A free online software provides text and graphic
presentations of downloaded data.
This may:
11/15/2013
• help in the management of patients’ diabetes
• increase their knowledge of diabetes
• increase SMBG frequency
• improve overall glycaemic control
• increase patients’ satisfaction with their care
• be cost effective
http://software.ascencia.com
10
The role of community pharmacist in diabetes management
Interpretation

11. The role of community pharmacist in diabetes management
Action
• Base on systematic approach of pre- and postmeal targets
• Management plan can be reassessed depending on changing
glucose readings
• Recognizing patterns and implement changes is critical.
• Systematic use of glucose profiles improves glycaemic control
• SMBG data be accurately
obtained and reviewed.
• Patient education may facilitate
adherence to appropriate
treatment regimens and
improveoutcomes.
11/15/2013
11

12. The role of community pharmacist in diabetes management
Ideal diabetes care program
• Based on national standards for
diabetes self-management
education programs-Life with
Diabetes
• Pharmaceutical care + Education +
Nutrition
• Multidisciplinary program/
Dietitian
• Advisory Board that oversees the
Program
11/15/2013
12

13. 







Overview of Diabetes
Monitoring
Complications
Medications
Foot, Skin, and Dental Care
Coping with Diabetes
Nutrition and Exercise
Conclusion/ Wrap-up
The role of community pharmacist in diabetes management
Ideal educational sessions ideas

14. The role of community pharmacist in diabetes management
Session outcomes
Improvement in Clinical Markers
• Blood glucose, HbA1c, BP, weight, etc.
Improvement in patient’s quality of life
Improvement in patient’s knowledge of the
disease
Patient’s satisfaction with the services
Decrease in overall health care cost,
hospitalizations, ER visits and complications
of diabetes
11/15/2013
Krass I. et al. Diabet Med 2007;24:677–83.
14

15. The role of community pharmacist in diabetes management
Challenges
• Breaking new grounds
• Slow Process
–
–
–
–
11/15/2013
Recognition Process
Reimbursement
Pharmacist Training
Marketing
Krass I. et al. Diabet Med 2007;24:677–83.
15

16. • Pharmacists could, in fact, play a more active role
in quality diabetes care.
• Systematically educated pharmacists could
perform group education for diabetes patients,
thus easing the burden on the primary health
care centers and giving participants the time they
need.
• Mutual respect between medical professionals
and the pharmacist for each other’s competence
could lead to a well functioning system for all
parties involved.
11/15/2013
16
The role of community pharmacist in diabetes management
Sum-up

17. The role of community pharmacist in diabetes management
The Community Pharmacist’s Role in Diabetes Management
CE program for pharmacists
Anas Bahnassi PhD CDM CDE
abahnassi@gmail.com
http://www.twitter.com/abpharm
http://www.facebook.com/pharmaprof
http://www.linkedin.com/in/abahnassi
11/15/2013
17