Marilyn Bulloch, PharmD, BCPS, FCCM
Marilyn Novell Bulloch, PharmD BCPS, is an Associate Clinical Professor of Pharmacy Practice at the Auburn University School of Pharmacy and an Adjunct Associate Professor at the University of Alabama-Birmingham School of Medicine and the University of Alabama College of Community Health Sciences . She completed a post-graduate pharmacy practice residency at the University of Alabama-Birmingham Hospital and a post-graduate specialty residency in critical care pharmacy at Charleston Area Medical Center in Charleston, West Virginia. Dr. Bulloch also completed a Faculty Scholars Program in geriatrics through the University of Alabama-Birmingham Geriatric Education Center in 2011. She serves on multiple committees and in leadership positions for many local, state, and national pharmacy and interdisciplinary medical organizations.
November is diabetes awareness month, and it is the perfect time to review the key role that pharmacists play in helping patients manage this chronic condition.
Diabetes has widespread effects, especially in the United States, with 11.3% of those 20 and older having type 2 diabetes mellitus (DM). And this percentage is growing. For every 4 people who have type 2 DM, about 1 is undiagnosed. Some of the factors that put a person at risk for diabetes include a family history of the disease, obesity, physical inactivity, high blood pressure, and high cholesterol. Pharmacists are in a prime position to identify these and other risk factors in patients. However, not all patients have textbook presentations. The disease can sometimes go undetected and without symptoms until it reaches an emergency state. This is particularly true in patients who do not receive routine medical care or have an established relationship with a primary-care physician. Routine and simple tests such as blood glucose testing conducted at health fairs and wellness clinics at pharmacies across the country are an example of how a simple test conducted in the pharmacy or by the pharmacy team may provide an efficient method for identifying a patient with a potential diagnosis and help direct them to appropriate medical attention.
Because pharmacists are the most accessible health care providers, they are key players in the betterment of patients’ health, not just in terms of screening but in the lifelong management of the disease. For those who are diagnosed, pharmacists are able to provide counseling about monitoring glucose levels and how to manage out-of-range levels, including developing an action plan for what to do if sugar levels go too low. Pharmacist can help patients select the most appropriate hypoglycemic management strategy on an individual basis. Pharmacists can counsel on an appropriate diet and exercise routine to compliment medication management in treating diabetes. This can be especially useful in underserved areas where access to nutritionists or dieticians may be unavailable. The number of treatment options for diabetes has increased substantially over the past few years, and pharmacists are best positioned to help patients understand the fundamentals and intricacies regarding the medication as well as helping them understand which medications may be best suited for them. Pharmacists can also help guide patients through the management of adverse effects, knowing when and how to treat these so that therapy can be continued and when it might be better to switch to an alternative treatment regimen. For patients requiring insulin, the pharmacist can help instruct the patient on how to administer the medication, as well as answer common questions and concerns.
With prompt diagnosis, proper lifestyle changes, and appropriate pharmacotherapy, patients can minimize and/or delay the complications that uncontrolled diabetes can cause. Integrating simple ways to ensure that pharmacists follow up with diabetic patients, not just when new medications are prescribed but at each and every refill, can help improve the health and quality of life for these patients and make every month, not just November, one where they are aware of, understand, and are invested in the best possible management of the disease.
This article was co-written by Lauren Speakman, PharmD candidate at the Harrison School of Pharmacy at Auburn (Alabama) University.
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