A study that paired pharmacist expertise with community health centers that serve low-income patients found diabetes management improved dramatically.
As part of the national three-year, 18-center study, a faculty member from the University of Utah College of Pharmacy worked with health care professionals and patients who have diabetes at the Community Health Centers of Utah Salt Lake clinic.
Laura Shane-McWhorter, professor (clinical) of pharmacy at the U., worked one-on-one with patients who had diabetes to review their medications, tests and other aspects of controlling the disease, which affects 18 million Americans a year at an estimated cost of $132 billion.
One way to measure how well diabetes is controlled is a test called Hemoglobin A1C, a weighted blood glucose test that shows the average blood sugar level for a three-month period. For the study patients with whom Shane-McWhorter worked, the test dropped from an average of 9.4 to 8 percent. Experts say that for every 1 percent the A1C drops, complications from diabetes are reduced twofold.
The American Diabetes Association sets a target goal of Hemoglobin A1C at less than 7 percent.
Those in the study group also saw significant declines in total cholesterol, LDL and triglyceride levels, according to the study.
Shane-McWhorter and Gary M. Oderda, a professor of pharmacotherapy, recently wrote about the Utah portion of the study in the journal "Pharmacotherapy."
The study evolved when the federal government noted that pharmacists were one discipline not generally involved with the federally supported Community Health Centers, which serve millions of low-income and uninsured Americans. The U.S. Health Resources and Services Administration came up with grants to study the impact of the pairing in the context of diabetes.
Shane-McWhorter had the right skills for the job in Utah, she said, because she speaks Spanish, teaches pharmacy and is also a certified diabetes educator. As part of the project, she also involved the pharmacy students in provider and patient education, she said.
They started tracking data on patients with diabetes and for each patient have one to three years' information. Because the center serves a very mobile population, she said she "kept track of them anyway, even if they didn't come in. I did a chart review every three months" on what needed to be done with each.
In the meantime, she started tracking not only data the grant called for, but more. It wanted to know demographics, patient height and weight, whether they spoke English, whether they were insured, the A1C scores, blood pressure and LDL cholesterol levels. To that, she added all other lipids, whether patients were getting eye exams (diabetes can result in significant eye complications), immunizations, flu shots, exercise, diabetes education and what medications they were taking.
Federal funding for the project ended last summer, though she and her students have tried to keep the work going because of its impact. The Diabetes Prevention and Control Program has picked up some of the cost, but the future of the effort is uncertain.
Shane-McWhorter said there's been another significant benefit as well, this time to the students involved. They have learned about a population that is very medically underserved and now know there are things they can do to make a difference, she said.
E-mail: lois@desnews.com