DECEMBER 2016
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CDPHP Partner, Kyla Newland, PharmD
Consultant to the community-based Diabetes Empowerment Education Program (DEEP), Kyla Newland, PharmD
Pharmacists are an Integral Part of the Diabetes Health Care Team
Nearly 30 million Americans have diabetes, and almost 18 million of them
manage their disease through insulin use, oral medication, or both.[1]
Consequently, most pharmacists work with diabetes patients every day. These
frequent interactions show that community pharmacists are uniquely positioned
to help people with diabetes manage the disease.[2] Although a pharmacy
may be a challenging place for patient education, there are other ways pharmacists
can help.
There’s a clear need to educate patients about
ways to better manage diabetes in Alaska, where nearly 8% of the population has
been diagnosed with the disease.[3] A variety of community-based,
peer-led, and professional diabetes self-management programs are offered across
the state to reduce illness and death related to diabetes, reduce health care costs,
and empower people to understand and manage their disease. These programs
include the Diabetes Self-Management Program (DSMP), National Diabetes
Prevention Program (NDPP), and Diabetes Empowerment Education Program (DEEP).
Taught in a group format, these programs are available at little or no cost to people
with diabetes, those with prediabetes or at high risk for diabetes, their
family members, and caregivers. Classes are led by health educators, health
care providers, lifestyle coaches, or trained community members.
Even with these efforts, more help is needed to teach people how to
prevent or manage their diabetes. Expanding the role of pharmacists in diabetes
education is a new and innovative way of helping reduce the impact of diabetes.
Despite their frequent interaction with people who have diabetes, few Alaska
pharmacists are involved with these diabetes self-management programs. More
pharmacists help with the Medicare Diabetes Self-Management Training (DSMT)
benefit because they can receive direct reimbursement through the Centers for
Medicare and Medicaid Services.[4] Medicare DSMT is part of the
Standards of Diabetes Care for people with diabetes and is performed in
programs recognized or accredited by the American Diabetes Association or the
American Association of Diabetes Educators. However, access to Medicare DSMT
may be a challenge for some people who face potential barriers that include a
referral required from a physician or qualified non-physician practitioner and a
copay.[4] Even so, pharmacist involvement in Medicare DSMT benefits
patients, and increased pharmacist participation in other diabetes
self-management programs would likely result in additional support for diabetes
patients and help many patients who aren’t reached through Medicare DSMT.
As a consultant to the community-based Diabetes Empowerment Education Program
(DEEP), Kyla Newland is one of a few Alaska pharmacists involved in a program
that isn’t Medicare DSMT. A pharmacist at Fred Meyer and a member of the
quality improvement staff at Mountain-Pacific Quality Health, Newland says her
work with DEEP is meant to “create that link to the formal medical community.”
Each DEEP series consists of six classes, and Newland helps with lessons that
focus on diabetes self-monitoring, understanding medications, and talking to
medical providers and pharmacists. She discusses many aspects of diabetes —
such as parts of the body affected, the disease process, complications, and
medications — but there’s an equal focus on empowering participants. DEEP is
built on the premise that people’s ability to understand health information and
then make health care decisions is essential to improving the lives and health
outcomes of people with diabetes. During DEEP classes, participants role-play
and identify questions they might ask a pharmacist. Newland hopes that
participants leave the program knowing that pharmacists and health care
providers are approachable, and they have gained confidence in their ability to
talk with them.
Newland has been through two diabetes certification programs, including
the Pharmacist and Patient-Centered Diabetes Care Certificate Training Program
developed by the American Pharmacists Association and the University of
Southern Indiana’s Diabetes Management Certificate Program. She provides diabetes
education through her work at Fred Meyer, but her role at Mountain-Pacific gives
her the opportunity to work with DEEP. She acknowledges that involvement with these
programs is contingent on employer support and may not be possible for all
pharmacists. Newland also recognizes reimbursement is complicated and doesn’t
necessarily incentivize providing diabetes education. However, she said she is
hopeful that pharmacists will soon be able to bill for providing health
education services. New federal legislation to add pharmacists to the list of
recognized providers is currently being considered, and if adopted, would be a
step toward removing the barriers many pharmacists face in providing patient
education.
Newland considers her work as a
DEEP consultant rewarding. She’s seen many participants have “aha moments”
about what they can ask their pharmacist and likes the idea of redefining the
patient-pharmacist relationship. Newland sees great value in increasing the
presence of pharmacists in diabetes self-management programs and believes that
pharmacists “are in a great position to help with community-based diabetes programs, because they really know the patients."
References:
-
National Diabetes Statistics Report, 2014.
Centers for Disease Control and Prevention website. 2014 Report Estimates of Diabetes and its Burden in the United States. Accessed February 22, 2016.
- Dhippayom T, Krass I. Supporting self-management
of type 2 diabetes: Is there a role for
the community pharmacist? Patient Preference and Adherence. 2015; 9:1085-92. doi: 10.2147/PPA.S88071
-
Health Indicator Report of Diabetes Prevalence.
Alaska Department of Health and Social Services, AK-IBIS website.
Published February 3, 2016. Accessed February 22, 2016.
- Fleck S. EDC DSME vs. Medicare DSMT Benefit.
Published February 2015. Everyone with Diabetes Counts, Quality Improvement
Organizations, Centers for Medicare and Medicaid Services website. EDC DSME vs. Medicare DSMT Benefit.
Published February 1, 2015. Accessed February 25, 2016.
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