An electronic tool to aid community pharmacists in optimizing care for persons with diabetes

Abstract

ObjectiveTo develop an electronic tool to aid community-based pharmacists in incorporating diabetes-specific clinical services into pharmacy workflow and to determine the utility of the tool. SettingThree independent community pharmacy locations. Practice descriptionRealo Discount Drugs is a group of 18 independent community pharmacies, a specialty pharmacy, and a long-term care pharmacy, all with a common owner, serving eastern North Carolina. Practice innovationAn electronic tool was developed to aid pharmacists in identifying gaps in therapy for patients with diabetes in alignment with the 2018 American Diabetes Association Standards of Medical Care in Diabetes. An RX edit (short code) alerted the pharmacist when a diabetes medication was verified. An electronic tool complemented the RX edit, through which the pharmacist would assess the patient record for the presence of an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB), aspirin, or a statin. EvaluationThe pharmacist used an electronic tool to identify gaps in therapy, to document medication therapy problems identified, to make therapeutic recommendations to the patient or provider, and to document interventions using the electronic tool. ResultsPharmacists used the tool 788 times during a 50-day period. Each completion of the tool represented 1 patient profile assessed. Pharmacists identified 99 patients (12.6%) who were not using an ACEI or ARB. Pharmacists recommended ACEI or ARB therapy for 56 patients (56.6%). Pharmacists identified 371 patients (47.1%) who were not using aspirin therapy, and recommended aspirin therapy for 198 patients (53.4%). Pharmacists identified 187 (23.7%) patients who were not given statin therapy and recommended statin therapy for 142 patients (76%). A total of 74 medication therapy problems (18.7%) were resolved. ConclusionAn electronic tool was developed and integrated into the dispensing workflow. The implementation of an electronic tool helped community-based pharmacists to identify gaps in therapy and to make recommendations in alignment with American Diabetes Association guidelines.