Is Diabetes & Prediabetes Becoming Commonplace?
Managing the A1C and Outcomes in Pharmacy
More than 100 million U.S. adults are currently living with a form of diabetes or prediabetes, according to a report released in July 2017 by the Centers for Disease Control and Prevention (CDC). The report reveals that as of 2015, 30.3 million or 9.4% of the U.S. population have diabetes. Another 84.1 million have prediabetes, a condition that if not treated often leads to type 2 diabetes within five years. Unfortunately, the majority of those with prediabetes do not know they have it. Diabetes is an evolving disease and the incidence increases with age. Therefore, it may eventually touch every one of us in some way. It is a complex, chronic disease that requires a multifaceted approach of management from the healthcare ecosystem, starting with testing.
The A1C Test
The A1C Test is a critical blood test that shows the picture of a patient’s average blood glucose level over the past three months. It determines where a person is sitting on the diabetic scale. This test is used to diagnose type 2 diabetes (making up 90% of diabetes) and prediabetes. Diabetes is often present without symptoms, yet the patient may exhibit risk factors, such as high cholesterol, heart disease, obesity, or family history that warrants testing. And, with the onslaught of processed food, sedentary lifestyles, and fast-paced living, who can afford not to be tested? The A1C can be tracked over time to monitor the patient’s potential for developing diabetes. Or, if the patient has diabetes, the A1C result and tracking will determine the effectiveness of the current treatment. This testing tool is what helps healthcare providers adjust medications to reduce the risk of long-term diabetes complications. Studies have demonstrated the correlation between significant reductions in long-term complications with the lowering of the A1C level.
The Role of the Pharmacist
What is a pharmacist to do? Imagine newly diagnosed type 2 diabetes patients. They are anxious and worried about their new diagnosis. They hear their doctor and take in about every third word. All they know is that they have diabetes and fear may begin to set in. Who will see these newly diagnosed patients before they head home? Who has the greatest opportunity to educate and counsel them? Pharmacists. Pharmacists are on the front line and have a wealth of information and additional tools to help patients with diabetes.
- EDUCATING PATIENTS – Some patients may be well educated and others, however, may be new to the disease. This means starting from the beginning with helping to educate them on lifestyle modifications such diet, exercise, and weight loss.
- FOLLOW-UP EDUCATION – When those newly diagnosed patients return month after month for their prescriptions, the pharmacist has the ripe opportunity to keep the dialog going as to how they are doing with their lifestyle modifications and to see if there are any questions or concerns.
- MEDICATION COUNSELING – Whether starting a new med, changing one or on a maintenance regiment, patient counseling is necessary. Metformin, insulin, Precose, Oseni, or whatever medication is prescribed, they all come with side effects that will need reviewed.
- GLUCOSE MONITORING EQUIPMENT – Most newly diagnosed patients will be taking glucose monitoring equipment home, which is another opportunity for the pharmacist to establish rapport, making the patients feel at ease and confident that they can monitor their blood sugars. This is the time to review normal values and when to contact the doctor.
- RECOMMEND PERTINENT MATERIALS – Educational blogs, articles, websites, other reading materials, and mobile apps, all of which are known by pharmacists, can be catalogued and tracked within user defined fields and interfaces with pharmacy management software like KeyCentrix’s NewLeafRx.
- EVALUATE MEDICATIONS AND COMPLIANCE – By observing, questioning and engaging the patient, the pharmacist is clued into patient compliance and effectiveness of the medications. Preventing fluctuations between hypoglycemia and hyperglycemia, both life threatening, hinge on compliance.
- WATCH FOR ALCOHOL AND OTHER RISKS – Inquire whether the patient is using alcohol and to what frequency and amount. Some diabetes pills interact with alcohol and can lead to severe hypoglycemia or insulin shock, possibly resulting in death.
- PREPARE DIABETES CLINICAL PROTOCOLS – Pharmacists make sure pharmacy staff is educated on how to manage diabetic patients following clinical protocols and business rules defined in their pharmacy management system.
Tools of the Trade for Tracking the A1C & Outcomes
Diabetes is a disease state of specialty pharmacy. Tracking each patient’s journey through diabetes is part of the territory when it comes to KeyCentrix’s NewLeafRx pharmacy management software.
- NewLeafRx allows the pharmacist to collect and track all vital statistics from the patient — personal information, physician orders, interaction between pharmacy and prescriber and lab tests, including the A1C test results and any other tests or information that is imperative for diabetic treatment.
- NewLeafRx is unique in offering bidirectional interfaces with disease state management tools and content management platforms to facilitate pharmacies collecting and tracking outcomes.
- Once a patient is enrolled in the provided programs, clinical activities specific to their disease state and medications are created and tracked in the system.
- The user defined fields designed by the pharmacy for the pharmacy and configurable work flow offer unique solutions for tracking and managing outcomes. For example, a pharmacy could design its own diabetic disease state follow-up protocol for its patients as well as diabetic progress notes.
All of the tracking and management capabilities of NewLeafRx help to create transparency and build a common bridge for the healthcare ecosystem in treating a disease that can be outsmarted.
An app a day keeps readmission to the hospital away
In addition, there are new apps developing as alternatives for compliance and education. Like NewLeafRx, they support the pharmacist’s role. The KingFit app, for example, can help the pharmacist as educator and counselor. It is a free app for the patient, while providing continued education, it helps them stay compliant. Anything the patient needs to know about their diabetes is in the palm of their hands at any given time. Not only is it in the form of an easy app, but also it is presented in such a way that’s interesting and exciting to use. The app is still growing but ready for download. Give it a try HERE!
The Future of Diabetes in America
Where will we be in another few years? How much more will that prediabetes statistic rise? And what about cost? Diabetes is not a cheap disease. Medications, monitoring, doctor visits, potential hospitalizations, and worst of all—potential costs of soaring complications like heart disease, stroke, kidney failure, vision loss, amputations of toes, feet, or legs, just to name a few. Some sources say that by 2020 half of all Americans are destined to develop diabetes or prediabetes with a price tag of $3.35 billion by the decade’s end. Together, wherever we stand, it is time to join forces, whether pharmacist, physician, teacher, nurse, mother, friend, grocery clerk and so forth— and reach out to raise awareness and education surrounding diabetes that will ultimately shape the course of our future.
Managing diabetes means keeping up with the times and also getting out ahead of the times. KeyCentrix has one eye on the present situation and the other out in the technological future. For a demo of our NewLeafRx pharmacy management software contact us at 800-444-8486 or visit www.keycentrix.com. We look forward to meeting with you.