How to help your diabetic patients manage their diagnosis
A certified diabetes education program can help patients and your business
- More than 1 million patients are newly diagnosed with diabetes annually, and more than 12% of American adults have diabetes.1
- Pharmacies with certified diabetes education programs can bill Medicare for eligible patients.
- Personalize each patient encounter based on where a patient is in their disease.
In 2014, more than 1.4 million American adults ages 18–79 were newly diagnosed with diabetes.2
When these newly diagnosed patients come into your pharmacy to fill their prescriptions, they can be overwhelmed and their heads can be spinning from their doctors’ instructions, says Wendy Mobley-Bukstein, a pharmacist, certified diabetes educator and assistant professor of pharmacy practice at Drake University.
Whether customers are newly diagnosed or further along in dealing with diabetes, a pharmacy can play an important role in helping patients manage the disease and make lifestyle changes. Having a certified diabetes education program can allow a pharmacy to bill Medicare if they’re contracted with insurance plans for diabetes self-management education (DSME). Medicare covers 10 hours of DSME at diagnosis and 2 hours annually after that.
Your pharmacy can also partner with others to provide the educational information and training that patients need, such as a registered dietician and a trainer at the local gym.
Normal, heathy adults can retain only about 15 to 20 minutes of information, Mobley-Bukstein notes. “Our brain gets overloaded.” So it’s important to provide information over time, in manageable segments, based on where patients are with their disease.
“We want to be sure we’re giving individualized care to each patient,” says Mobley-Bukstein. Instead of just inundating patients with information, have a dialog with them to learn about their concerns. Guide the conversation, but allow them to set their own goals.
The best times to help diabetic patients
The American Diabetes Association (ADA) notes four critical times for working with patients:
- When newly diagnosed
- When there are complicating factors
- During transitions in care, such as when they are returning home from a hospitalization
Develop a process in your pharmacy to identify those diabetic patients who may benefit from DSME, whether they are longtime customers who may be newly diagnosed or new customers transferring prescriptions from another pharmacy.
Here are examples of the personalized care a certified diabetes educator can provide at different points:
- Pre-diabetes. A patient with a prescription for a glucose meter and test strips may not yet have diabetes, but this is an opportunity to talk with them about the importance of monitoring correctly and making lifestyle changes. With patients whose glucose levels are more elevated, you first want to focus on changes and mention smoking cessation.
- Starting metformin. “When someone goes on metformin, you need to target nutrition,” Mobley-Bukstein says, because of the gastrointestinal side effects. “If the person does not decrease the amount of carbs they are eating, they will get diarrhea, abdominal cramping and gas,” she says. “It’s important that you talk to the patient about making dietary changes when they start metformin.”
Patients also need to understand the importance of monitoring blood sugar every day, not just once or twice a week.
- Dual therapy. A patient who has a prescription for metformin and insulin needs to understand how those medications work together. They also need to understand how to recognize and deal with low blood sugar. For example, often they will drink an 8-ounce glass of orange juice, which will cause blood sugar to spike and crash. Instead, they need to drink half as much orange juice and eat some protein and complex carbohydrates, such as fruit or a thin layer of peanut butter, on five or six saltine crackers.
All along the way diabetes educators need to assess where patients are in their understanding and ability to make lifestyle changes, including the support network they have around them. Help set short- and long-term goals, and at your next meeting ask about the results. “It’s very important to have easy wins up front,” she says, to encourage patients to make more progress.
The Foundations of Care from the ADA also recommends ensuring that patients with diabetes have recommended immunizations for flu, pneumonia and hepatitis B, another service your pharmacy may be able to provide.3
Identifying patients with pre-diabetes and diabetes and educating them can be incorporated into your pharmacy workflow, particularly if you have a medication synchronization program that allows you to schedule time with them at pickup.
“Managing the Newly Diagnosed Diabetes Patient,” a webinar with Wendy Mobley-Bukstein, is one of dozens of courses available through Health Mart University℠.
She recommends these sites for patient education materials: