Despite what those pharmacy commercials exemplifying the close patient pharmacist team tell us, most of us have limited interaction with our druggist. We drop off our prescriptions at one window and pay for them at another. If we have a question about the timing of a medication or its compatibility with alcohol, we might ask to speak to the pharmacist.
This is a shame because for people with diabetes the pharmacist can be an important member of your health care team. And pharmacists and the companies they work for are trying to change patients’ perceptions.
Traditionally, pharmacists have been concerned with the compounding and dispensing of drugs. But today’s pharmacists have a much expanded role in health care. With the explosion of drugs on the market today, they can be the physician’s right-hand man in helping you get the most out of your medications.
You can think of them as the guardians of drug safety and efficacy. They can help you understand how your medications work to treat disease or reduce symptoms, the best way to take medications, and what (if any) precautions are needed with a particular drug. They can also teach how to make taking your medications more convenient.
People with diabetes, especially if they have type 2 or if they have long-standing type 1, are usually on a variety of medications: for blood glucose, blood pressure, cholesterol control. In addition, depending on the type and severity of complications a person has, he or she may also be taking drugs to control the pain and complications of neuropathy.
Almost all of these agents have some type of side effects. And sometimes medications have side effects that can worsen glycemic control. For example, niacin is used to treat elevated triglycerides, but it can also raise glucose levels. If you go to a variety of doctors at different institutions for your medical concerns, your pharmacist may be the only person to have a complete understanding of all the medications you are on.
Most people with diabetes see their doctors three or four times a year, but questions can arise between visits. People see their pharmacist seven times more often than their primary care physician, so they can be a valuable resource to fill in the gaps.
Consider niacin—if your blood glucose control has been good for a long time but has recently deteriorated, your pharmacist could identify it as a possible culprit.
One of the reasons people don’t take their medications as prescribed is the number of times a day they have to take them. A pharmacist can look over your medications and make recommendations to your physician about extended release forms of a drug or a different brand that can be taken at a more convenient time.
And insurance companies know that when people take their medication as prescribed they suffer fewer complications and it costs less to insure them, so they, too, see the pharmacist as an important link in helping patients adhere to their prescriptions.
Studies have demonstrated that when pharmacists work with other health care providers patients have better outcomes. The National Standards for Diabetes Self-Management Education have recognized that pharmacists are a key part of the multidisciplinary team, helping develop education materials and providing education or other aspects of self-management training for patients with diabetes.
“A growing number of pharmacists are becoming CDEs,” Alissa Segal, Pharm.D, R.Ph. CDE., the on-site pharmacist for Joslin. “Many patients do not have access to diabetes educators—the pharmacist is an accessible health provider who can render the patient additional value due to their knowledge of medication, their ability to educate patients’ about their medications and their ability to advise medication adjustments.”
So the next time you are in the pharmacy to pick up your meds, stop by the consultation area and start a conversation with your pharmacist—you will be surprised what you can learn.