How clinical pharmacists can improve outpatient diabetes care

Abstract

team members and unified messaging to patients are sometimes challenging in team care environments, recent advances in the use of electronic health records (EHRs) and other communications technology have improved key aspects of patient-centered care coordination across a range of care providers [4,5]. In addition to increased involvement by other diabetes care providers, pharmacists have been playing an increasingly prominent role in outpatient diabetes care. The value of pharmacist care has been widely recognized [6], and pharmacist-provided medication therapy management (MTM) services have been successful in reducing direct medical costs, improving clinical outcomes, achieving quality measures and resolving medication-related problems in a variety of chronic disease states, including diabetes and hypertension, and among medically complex patients [7]. It is important to note that nearly all patients with diabetes are on multiple medications [8], and most see a pharmacist multiple times each year to obtain their medications and supplies. Therefore, pharmacists have a natural opportunity to add substantial value to the care of large numbers Uncontrolled diabetes creates major cost and care burdens on the healthcare system. Management of diabetes is time and resource intensive, medically complex and requires patient engagement to be fully effective [1]. Despite improvement in the last decade, outpatient diabetes care is far from optimal [2]. Especially in the context of an escalating number of Americans with diabetes, the current influx of newly insured patients into the primary care system, and increasing scarcity of primary care providers, it is important to consider new strategies to provide high-quality care to the more than 25 million Americans with diabetes mellitus [3]. The value of team-based, well-coordinated care and unified messaging to patients has long been recognized as a cornerstone of chronic disease management [4], and diabetes educators, nutritionists, diabetes nurse clinicians and other care providers have joined with primary care providers, diabetologists, endocrinologists and others to provide team-based diabetes care. Each team member brings an important skill set and perspective that may be helpful to patients with diabetes. While clear communication among