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Role of pharmacist in managing diabetes

Rekha Gupta
Tuesday, November 15, 2016, 08:00 Hrs  [IST]

Diabetes is a chronic disease in India and across the globe. Nearly 51 million people are suffering from this life style turned deadly disease. The tide is still rising. Diabetes will kill nearly one million people in India this year according to reports.

The situation is turning bad to worse. Immediate action has to be taken, andthis life style turned disease can be prevented, treated and complications of diabetes can prevent from happening or arising.

The effective delivery of healthcare requires a partnership between people and their healthcare providers. As vital members of any healthcare team, pharmacistscan have a significant impact on diabetes care and education. In certain circumstances, pharmacists may be in a position to identify people with diabetes, offer advice on their condition, and encourage them to seek appropriate medical care.

Importantly, pharmacists see people with diabetes on average up to eight times more often than other healthcare providers and have an important role in the provision of diabetes supplies. This requires pharmacists to offer guidance in the effective use of these products. In recent years, the role of pharmacists in diabetes care has expanded in countries throughout the world.

Pharmacists are in a unique position to provide the services necessary to optimize treatment, facilitate education, and improve outcomes.

The medications given to a patients contain many drugs with lots of advices which makes compliance difficult. Whatever is the potency of a medicine, it cannot act unless the patient takes it. Treatment may be complex, meddling and inconvenient. Many patients are prescribed very complicated regime of diet, exercise, and medication including several medicine a day. Such complexity of treatment and factors like age, duration of diseases, depression, disabilities, psychosocial issues and life style changes directly or indirectly influences diseases self-management. Compliance to treatment is very important in lowering blood sugar levels.

Pharmacist can contribute and play major role in the appraisal of patients understanding of the illness and drug regime convey the benefits of the treatment, assess the patient’s readiness to the care plan, and discuss any barriers to the treatment if any the patients may have. Understanding of medication is very important for the good outcome of the disease in this case lowering the blood sugar and preventing all kind of complications related to diabetes. Very little data is available regarding medicine compliance of the patient in developing country like India.

In the last three decades role of pharmacist has changed dramatically. Presently, the pharmacists are becoming more patient oriented than product oriented. The image of pharmacistis still a person who stands behind the counter and dispenses the medicine written by the doctor but in reality the pharmacist is the most knowledgeable as regard to the medicines. He can avoid the medicine errors which are very common in day to day practise. He can guide the patient regarding drug–drug and food–drug interaction   Patient counselling by pharmacist deals with providing information to the patients regarding the disease, medications and lifestyle modifications. It has been shown to improve their blood sugar levels and HbA1c.

Patient counselling is an important for SMBG (self-monitoring of blood glucose). Pharmacist can provide medication related information orally or in written form to the patients or the care giver, direction of use, advice on side effects, precautions, and storage, diet and life style modifications. Patient counselling is interactive and involves a one-to–one interaction between a pharmacist and a patient and/or caregiver.

The pharmacist, although not the healthcare professional to diagnose diabetes, is important in helping the patient maintain control of their disease. The pharmacist can monitor the patient's blood glucose levels and keep a track of it. During their contact, the patients can ask the pharmacist any questions they did not ask the physicians and can get further information regarding diabetes. The pharmacist can also counsel the patients regarding insulin administration regularly so that the onset of complications can be postponed by having tight glycaemic control. Another important role of pharmacist is always being available to answer the questions of the patients. Overall, it is the pharmacist's role to help a diabetic patient in the best possible way to cope with their disease. In country like ours where there are very few certified diabetes educators, a pharmacist can play an important role in educating the patient regarding all aspects of the disease (diabetes).

Hypoglycemia is a large concern for both patients with diabetes and their clinicians. Pharmacists are able to identify the potential risks for hypoglycaemia and encourage patients to discuss their experiences with hypoglycaemia.. In addition, pharmacists should review potential treatment options of hypoglycaemia such as the use of glucose tablets. Pharmacists can also educate and review proper techniques for the self-monitoring of blood glucose that may also reduce the occurrence of hypoglycemia.

Pharmacistscan help the patient to overcome the barrier to start insulin by talking to them and showing them the right technique to use the insulin injection. They can tell the benefits of starting insulin in their medication regime. Patients have more frequent or easy access to pharmacistsin community, clinic, and hospital settings.

Pharmacists can play an important role in chronic diseases, including T2DM.
As the prevalence of T2DM increases and more novel treatment options become available, pharmacists will be relied on more to provide T2DM education and management programmes.

Pharmacistsare in an excellent position to work closely with patients to address medication and self-management issues that greatly impact T2DM care.

Pharmacists need to be familiar with the diabetes counselling and the different treatment guidelines for managing T2DM so they can effectively work with providers and patients to improve glucose control and prevent complications associated with the T2DM epidemic.

Being a pharmacist has always helped me counsel my patients more effectively. As my knowledge regarding drugs, their mechanism of action, side effects and interactions has helped the patients to use their medication regime more effectively and to full potency.

In my opinion a short course for diabetes management should be included in the course of pharmacy education so that they are well versed and help the patients with diabetes. This is a good way to stop diabetes.

(Author is dietician and nutritionist)


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