Beruflich Dokumente
Kultur Dokumente
Magaly Rodriguez de Bittner, Pharm.D., BCPS, CDE Associate Professor University of Maryland School of Pharmacy and Program Coordinator, Giant Pharmacy Diabetes Care Outpatient Education Program
Objectives
1. Provide an overview of the need for pharmacist involvement in diabetes management and education. 2. Describe the Diabetes Care Program at Giant Pharmacy 3. Describe the challenges facing pharmacies and pharmacists in diabetes management and education 4. Describe the role of the pharmacist in DSME programs
Background
Incidence of Diabetes is increasing at an alarming rate- Epidemic Proportions
18 million Americans 6-8 million have diabetes but have not been diagnosed
Complications of Diabetes Treatment Complexity Diabetes education is instrumental in reducing complications and decreasing overall health care costs Prevention
Background
Pharmacists are knowledgeable about the treatment and management of many chronic illnesses Pharmacists are accessible Pharmacist managed diabetes programs have increased dramatically over the last five years Payment for these services have been a challenge
Pharmacists Role
Diabetes Care
Variety of settings Variety of roles Direct providers of care Members of the Interdisciplinary Team Providers of education (400 CDE RPh/12, 390 CDEs) Providers of Pharmaceutical care Providers of Products Consultants
Background
Joint venture between the University of Maryland School of Pharmacy and Giant Pharmacy Offers the convenience of the community pharmacy and the expertise of an academic center
Setting
Giant Food Inc. Food-drug chain store 137 pharmacies in 4 states and D.C. Employs ~600 pharmacists Strong interest in health and wellness- Healthy Ideas Program Excellent reputation and client base
Educational Sessions
Overview of Diabetes Monitoring Complications Medications Foot, Skin, and Dental Care Coping with Diabetes Nutrition and Exercise Conclusion/ Wrap-up
Program Evaluation
Throughout, 3, and 6 months after completion of program
Outcomes
Improvement in Clinical Markers
Blood glucose, HbA1c, BP, weight, etc.
Improvement in patients quality of life Improvement in patients knowledge of the disease Patients satisfaction with the services Decrease in overall health care cost, hospitalizations, ER visits and complications of diabetes
Challenges
Breaking new grounds Slow Process Recognition Process Reimbursement Pharmacist Training Marketing Medicare Provider Number
Patient Testimonials
Giants Diabetes Program
Where have you been? I have been to group programs before that were covered by my insurance and they just went too fast and didnt give me a chance to ask questions. Having my prescription filled at this Giant was the best thing I could have done. No one has ever taken the time to explain my condition to me and I have had diabetes for 11 years.
In the Future...
Expansion of the Diabetes Care Program to other sites Giant employees program Secure Reimbursement from Insurance Companies Medicare Billing Expanding to other diseases like Asthma, Cholesterol, Weight Management and Osteoporosis
Medicare
Balanced Budget Act of 1997 Expanded coverage (effective 7/1/98) Outpatient diabetes self-management training by certified providers Blood glucose monitors, test strips, and other monitoring supplies Interim program rules published 2/99 Final program rules 12/29/00 Effective date February 27, 2001
Medicare
Eligibility (Conditions of Coverage) Physicians (practitioners) order Comprehensive educational plan
Content, number, frequency, and duration Individual training permitted under special
circumstances
Conclusions
Community-based pharmaceutical care is feasible even in large volume chains Pharmacists have a significant role in diabetes care