Sugar Intervention

I guess it is only appropriate that American Diabetes Month comes the day after Halloween. I am literally staring at a bowl of sugar on my kitchen counter. As a mom I worry about the boys and their teeth. Constantly reminding them to brush their teeth every morning and every night to get the “sugar bugs” out of there to prevent tooth decay. Then I think about the sugar going in to their bodies and what that is doing. According to the ADA about 86 million Americans are pre diabetic and at the risk of developing Type 2 Diabetes. Ahhh!

So pharmacists I ask you how do we fit in the picture? I think we can provide a great intervention point to many of these patients. I am not always a fan of scare tactics; however, at some point you have to explain what will happen if these patients do not make a change. Wellness and preventative care are highly encouraged by many health insurance plans. It is imperative we find our place in this model. I do think we can all agree the current pay for product model is not sustainable…our “dispensing fees” have decreased. The flip side of this is a new stream of pay for service. This fall my pharmacy has seen the medication administration incentive fee adding to our bottom line. Vaccines are just one answer in preventative care in pharmacy.

Back to the topic at hand, pharmacies can now become accredited to supply Diabetic Self Management Education (DSME) to patients. The process is not even as difficult as you may think. Yes, Medicare does require paperwork. That’s how they measure outcomes…something we are not used to being held accountable for. If we can change our mindset just a little I think we could blast open a new revenue model in pharmacy. Chronic Care Management (CCM) offer the opportunity to document interventions with chronically ill patients. Why can’t we take advantage of that? In most cases these patients see us more than any other healthcare provider.

The last I leave you with in terms of pharmacist provided preventative care is an awesome article in the October 27th edition of Drug Store News. http://www.drugstorenews.com/article/study-pharmacist-intervention-improves-post-surgery-outcomes-diabetics. Please take the time to read…super short I promise :))

“After the second year, patients in the intervention were:    
• More than two times as likely to have well-controlled blood sugar the day following surgery;
• 69% less likely to have hypoglycemia (low blood sugar) in the three days following surgery;
• 33% less likely to be readmitted to the hospital in the three months after discharge; and
• 28% less likely to visit the emergency department in the three months after discharge.
Because post-surgical complications and readmissions were reduced, associated costs were also reduced. On average, in the six months following discharge, the patients in the intervention had monthly medical costs that were $284 lower than those of the patients in the control group.”

The proof is there. Another point they mentioned was the program was led by a pharmacists coordinating with the entire hospital team to develop protocols and policies. It does take a team effort. It takes the pharmacist being part of the team. So if the proof is here…we prevent extra costs…we prevent complications…we help patients!…where is the reimbursement model? Will it become proactive MTM claims with private providers or CCM codes with Medicare? Think about it guys! We must continue to evolve.
 
Bet you didn’t think that’s where the post was going. I like to keep you interested. Now I suppose I should help these children make this Halloween candy disappear. It does only come around once a year. Moderation is key! Hey, no judgment. I think patients appreciate our honesty as well. We are all human. Letting them know they have a true partner in their healthcare is extremely important.

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