Future of Treating Diabetes


Troy Trygstad, PharmD, MBA, PhD; Dhiren Patel, PharmD; Tripp Logan, PharmD; and Javier Morales, MD, FACP, FACE, summarize the discussion on diabetes and cardiovascular disease with hopes for the future for these patients including incentivizing patient self-management and motivation, affordability of medications, and interoperability of electronic medical records.

Troy Trygstad, PharmD, MBA, PhD: Dhiren, you’ve got a new resident. He or she completes in June. They’re released into the wild in July. How do they need to change their practice, or change their mindset, or set out to practice in a contemporary way? What are the most important elements today, in 2018?

Dhiren Patel, PharmD:I would say we’re in a very metric-driven world. Numbers matter. The numbers matter, but put the patient in front of that. So, treat the patient.

Troy Trygstad, PharmD, MBA, PhD: You’re never going to hit your numbers unless you realize that it really is about relationships. You can focus, like a laser, on those numbers. But, in the absence of establishing those relationships, you’re never going to see those numbers change.

Dhiren Patel, PharmD:You’re going to find out so much just from listening to the patient. With some of our patients, before you go in with your recommendation on what you’re going to go up on or go down on, they’ve been living with this disease for so long that they’ve seen you do the same pattern. They already have a good idea of what you’re going to do. Sometimes, I kick it to them. “What do you think?” I get them engaged. They feel like they have some ownership and control in what they’re doing. But, I’d say to treat the patient first, and treat them in a holistic manner. Then, the numbers will fall into place.

Troy Trygstad, PharmD, MBA, PhD: If you could wave a magic wand, and you could either have a study done, a new therapy, a new way of interacting with patients, a new way of doing health information technology, or a new way of funding health care, but you only have 1 wand, with respect to diabetes and cardiovascular disease states, what would you wish for?

Tripp Logan, PharmD:My magic wand would be to see patient ownership from birth to death. If I’m going to invest in something, if it’s a long-term investment, I’m investing differently than I am if I’m investing for a 12-month turnaround. I think if we look at health as a journey, and not in a 12-month span, I think that’s where my magical wand would go.

Troy Trygstad, PharmD, MBA, PhD: So, incentivizing self-management and motivation. Magic wand?

Javier Morales, MD, FACP, FACE:It would be to make the elephant in the room disappear. I’d like to see affordability. These agents are very effective, but they are costly. So, in the perfect world, if these medications were more affordable, then it would probably enable greater utilization.

Troy Trygstad, PharmD, MBA, PhD: So, access to new therapies. Dhiren?

Dhiren Patel, PharmD:I would say interoperability of the EMRs.

Troy Trygstad, PharmD, MBA, PhD: Now, time out. You’re at the VA.

Dhiren Patel, PharmD:This is for everyone. We hear about these buzz words every day—big data, machine learning, and AI. This information has been there. It’s been there for years. We are capable of bringing it together and doing something meaningful with it. I think that’s going to be the case, or it’s going to have to be the case if we want to do that. You could take these lessons from other business lines, where they’ve done it and they’ve done it successfully. I don’t understand why we can’t do that in health care.

Troy Trygstad, PharmD, MBA, PhD: Well, that’s a great closing thought. This has been a great discussion. We’ve certainly covered a lot. Before we end this discussion, I’d like to open up the floor to ask each of you to provide some final thoughts on what we’ve just discussed. If you’re talking to the audience, in 15 or less words, how do you want to summarize what you want to accomplish over the next 10 years of your career, with diabetes and cardiovascular disease?

Tripp Logan, PharmD:For me, Troy, it is engaging patients more by asking them how we’re going to make them better. Instead of dictating to, we should open the door a little bit more to bring a patient in to that conversation and make them be the hub. I don’t always feel like that’s the case.

Troy Trygstad, PharmD, MBA, PhD: Sounds good. Javier?

Javier Morales, MD, FACP, FACE:Greater risk reduction, and more effective tools that are available in the marketplace, that are affordable and accessible.

Troy Trygstad, PharmD, MBA, PhD: Twenty-five words or less?

Dhiren Patel, PharmD:Listen to patients, give patients options, and they’ll do what’s right.

Troy Trygstad, PharmD, MBA, PhD: Excellent. Well, thank you for your contributions to the discussion panel. And, on behalf of our panel, we thank you for joining us. We hope you found this Peer Exchange®discussion to be useful and informative. We’ll see you next time.

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