The Importance of Diabetes Credentials for Pharmacists

Diabetes has the dubious distinction of being the 7th leading cause of death and the leading cause of kidney failure, non-traumatic lower-limb amputations, and blindness in the United States.

Diabetes prevalence is expected to more than triple in incidence from 1 in 10 Americans today to 1 in 3 Americans by 2050. The shortage of qualified practitioners exacerbates this burgeoning epidemic.

The American Association of Diabetes Educators recommends that all diabetes educators secure formal credentials, such as Certified Diabetes Educator (CDE) or Board Certified-Advanced Diabetes Management (BC-ADM). Some jurisdictions, such as Indiana, license diabetes educators separately.

Here's an incentive for this credentialing: the Affordable Care Act provides reimbursements for diabetes self-management education and support programs for pharmacists who have recognized credentials.

An article published ahead-of-print in the Journal of the American Pharmacists Association indicated that half of community pharmacists believe advanced diabetes credentialing is important, but less than 1% of pharmacists currently possess these credentials.

The researchers conducted a telephone survey of 1024 community pharmacists in Indiana from November 2014 to March 2015, and 907 (88.5%) agreed to participate. The researchers asked about demographics, current credentials, common diabetes-related counseling topics, and perceptions of advanced diabetes credentials.

Only 1 in 6 respondents were aware of their state’s diabetes educator license, and 1 in 4 expressed an interest in pursuing the license. Fewer than 4% of respondents had a concrete plan to pursue an advanced credential related to diabetes.

Most pharmacists with lapsed diabetes education credentials and 10% of non-credentialed pharmacists believed having CDE or BC-ADM credentials conferred no individual benefit.

Participants identified several barriers to credentialing, including study time (70.3%), expense (13.3%), lack of knowledge about the process (10.7%), access to patient care opportunities (5.2%), their employers’ lack of willingness or encouragement (3.8%), and a low perceived value for the license (2.6%). On a positive note, they identified benefits as desire to improve patient care (52.5%), interpersonal respect (3.1%), self-satisfaction (2.7%), financial bonus (0.4%), and career benefit (0.1%).

The researchers compared Indiana's state licensing with Kentucky's, where most licensed diabetes educators are pharmacists. The impetus was that across the nation, only 6% of CDE holders are pharmacists. They found that Kentucky doesn’t require an exam and has much lower fees and practice hour requirements than Indiana.

Indiana respondents reported reimbursement structure, work flow, and employer support would need to change before their mindset would shift. The researchers are planning a nationwide survey to expound on this study.