Implementation of pharmacist-run diabetes education in internal medicine resident clinics

Objectives: In 2010, according to the Center for Disease Control and Prevention (CDC), 8.3% of the United States population has been diagnosed with diabetes mellitus (DM).  It is estimated that 11.7% of Alabamians have DM.  It is well documented that lowering hemoglobin A1C by 1% reduces the incidence of microvascular complications by 40%.  It is known that diabetes education is a powerful tool to provide patients with knowledge and self-management skills.  However, estimates show that only 55.7% of DM patients in the United States have received diabetes self-management education (DSME).  At an internal medicine resident clinic in Birmingham, Alabama, a formal means for diabetes education managed by pharmacists and pharmacy students was established in May 2010.  The goal is to provide DSME to patients in the clinic where they receive medical care.  Many of these patients would otherwise go without education due to challenges following up and inability to pay.  

Methods: This is a retrospective chart review where two pharmacy students and a faculty advisor analyzed the number of patients who received DSME and its impact on A1C trends and diabetes control.  All patients that received DSME between May 2010 and November 2011 were evaluated and analyzed using descriptive statistics.  In addition, we plan to evaluate the education topics covered in DSME in comparison to the National Standards for DSME and assess the diabetes related medication use by each patient. This study has been approved by the Institutional Review Board.  Based on lessons learned, revisions to the program will be described.

Results: Forty-seven patients received DSME, and twenty-five patients had adequate data to assess A1C trends. Twenty-four of twenty-five patients experienced an average A1C drop of 1.2% after DSME. 

Conclusion: Working with other healthcare providers, pharmacists and student pharmacists play a vital role in providing this beneficial service to patients.