Patient education, lifestyle modification, and medication therapy management (MTM) with a diabetes focus in an underserved population within a primary care setting

Purpose: Many chronic conditions can be improved with lifestyle modification and appropriate medication therapy; however, especially in underserved populations, patients lack the education necessary to make healthier choices. An Ambulatory Care pharmacist sought to establish a clinical service that would benefit an underserved community and provide a unique pharmacy student opportunity.

Methods: The development of a referral based education and MTM clinic has been designed to tackle specific obstacles identified in the primary care setting, including patient’s perceptions, physician’s lack of time available to provide comprehensive education, and limited affordable resources for patients to acquire disease, medication, and lifestyle specific education. This poster describes an interdisciplinary practice model including a primary care physician, nursing staff, schedulers, pharmacy students, and a clinical pharmacy faculty member. Patients are offered a one hour initial visit with patient history taking, vital sign and laboratory value assessment, education, and MTM services provided by an ambulatory care pharmacist and pharmacy students. Follow-up monitoring and return visits were recommended according to individual patient needs.

Results: Chronic disease state education and MTM Clinic was established July 2011. Referrals from the primary care physician have been able to receive one hour of education regarding pathophysiology of chronic disease(s), appropriate medication use, rationale for specific medication use, individualized nutritional counseling, and self-monitoring reinforcement. Over 300 patients have been seen for initial visits and many have returned for follow-up visits within the last year. Interdisciplinary team and patients are pleased with the success of the program and the trends seen with patient health improvement.

Conclusion: Data collection is underway for evaluation of clinical pharmacist interventions in improving patient health and altering patient perceptions.