How to Promote Medication Management for People With Diabetes

We all have a role to play to help people with diabetes live their best life!

Pharmacists do more than just fill prescriptions. They help patients get the most benefit from their medicines by working directly with primary care providers to identify, prevent, and resolve medication-related problems. This partnership is called collaborative drug therapy management (CDTM).

Pharmacists also play a key role in administering recommended vaccines for people with diabetes, including those that protect against influenza, pneumococcal disease, and hepatitis B. In addition, they can advise patients about diabetes self-management, help them take their medicines as prescribed, and provide information about lower-cost options for medicines and medical supplies.

Take These 5 Actions to Help Your Patients

1. Know the risks of problems with medication management for people with diabetes.

People with diabetes can be at high risk for drug-related problems because they often have multiple medical conditions, take multiple medicines, receive medicines from different sources, and see a range of health care providers.

For example, patients may inadvertently take the wrong dose at the wrong time, which can cause serious illness, long-term disability, or even death. When patients don’t take their medicines as prescribed—or when their medicines are no longer meeting their needs—they may struggle to meet their health goals.

In the United States:

• Studies have shown that 20% to 30% of medication prescriptions are never filled and about 50% of medicines for chronic diseases are not taken as prescribed (at the correct time or dose or in relation to eating).¹
• Only about 50% of people with diabetes reach their blood glucose goals as measured by a hemoglobin A1C test. ²
• Among people with diabetes and other chronic conditions, only 51% of those with high blood pressure and only 56% of those with high cholesterol meet their target goals.² Only 18% reached all three recommended ABC goals (A1C, blood pressure, and cholesterol).²

2. Understand the importance of coordinated care and how CDTM can improve diabetes outcomes.

CDTM is associated with improved glycemic control in people with diabetes.³ Pharmacists can help lead CDTM by:

• Conducting comprehensive reviews of medicines and medical records.
• Educating patients to improve the safety and appropriate use of medicines.
• Assessing patients’ responses to therapy to ensure timely interventions, communication back to primary care and other providers, and coordination and continuity of care.
• Helping patients choose an appropriate blood glucose meter and training them how to use it.
• Asking patients about their use of nonprescription medicines; vitamin, herbal, or nutritional supplements; and topical or skin care products. They can also encourage patients to keep a list of everything they are currently taking or using.
• Making sure patients understand the information shared by asking them to repeat back what they heard.

3. Ask your patients questions about their medicines at each health care visit.

For example:

• Did you bring a list of all your medicines and their exact doses, including over-the-counter medicines, vitamins, and herbal supplements?
• Do you know why you take each medicine?
• Do you know how your medicines affect your diabetes?
• Do you update and review your list of medicines with your pharmacist when there is a change?
• Have you reported any side effects from your medicines to your pharmacist?
• Do you let your pharmacist know if you have a problem with missing doses of your medicines?

You can offer to connect your patients with a pharmacist or ask them if they want more information about recommended medication management approaches for people with diabetes. You can take this action depending on how your patients answer your questions or any other concerns they share during their visit.

4. Remind your patients to keep their blood glucose, blood pressure, and blood lipids within normal levels for optimum hearing health.

Use the following discussion points to help you talk with your patients about their self-care habits and their feelings about managing diabetes:

• Promote the ABCs of diabetes (A1C, blood pressure, cholesterol, and smoking cessation) and a healthy lifestyle.
• Ensure that patients have access to health coaches, patient navigators, and community health workers when possible.
• Ask your patients what other health exams they are getting, including regular ear health checkups.
• Assess symptoms that might require referral to a specialist.
• Follow up with your patients to track how well they are managing their diabetes and connecting with their health care team.
• Assess socioeconomic factors that can affect health, such as food insecurity, housing insecurity or homelessness, financial barriers, and lack of social support. Use this information when you make treatment decisions.
• Refer patients to local community resources when available.

5. Refer your patients to diabetes self-management education and support (DSMES) services.

DSMES services help people live well with diabetes. Whether a person has just been diagnosed with diabetes or has had it for years, DSMES services will make it possible for them to:

• Work with a diabetes care and education specialist to set and track goals.
• Practice how to fit diabetes self-care behaviors, like healthy eating and problem-solving, into all parts of their life.
• Learn how to use knowledge, skills, and tools to build confidence and emotional strength to manage diabetes.
• Find ways to get support (in person or online) from family, friends, their community, and their health care team.

Learn more about DSMES and encourage your patients to find a DSMES programexternal icon that is recognized by the American Diabetes Association or accredited by the Association of Diabetes Care & Education Specialists.