Hypoglycemia: A closer look at a community pharmacist's impact in optimizing diabetes care.

ABSTRACT

BACKGROUND: Hypoglycemia is a complication of diabetes and can have considerable clinical impact on mortality, morbidity, and quality of life. Certain patient populations with diabetes are at an increased risk of experiencing hypoglycemia, posing as a safety concern and may have possible negative affect(s) on diabetes if not appropriately managed. With community pharmacies often being an accessible means of health care, there is potential for widespread diabetes education in this setting. OBJECTIVES: Assess impact of pharmacist-initiated education on proper recognition/management of hypoglycemia in patients with type 1 and 2 diabetes. Secondary objectives aim to optimize diabetes care (1) assessment of patient need for a glucagon kit prescription, (2) evaluation of adherence to highly recommended vaccinations for individuals with diabetes and acceptance of pharmacist vaccination recommendations, and (3) assessment of patient satisfaction with the study intervention. SETTING AND PRACTICE DESCRIPTION A community pharmacy in the Suffolk County of Massachusetts serving middle- to lower-class and medically underserved patients. Most of the population includes an elderly, Hispanic, and Asian demographic. EVALUATION Outcomes evaluated through change in hypoglycemia questionnaire scores from preintervention to postintervention, the percentage of patients who received a prescription for glucagon kit post pharmacist intervention, the percentage of patients that received a vaccination because of pharmacist intervention, and Likert scale-based survey for the assessment of patient satisfaction. RESULTS: Participant knowledge of hypoglycemia awareness/treatment improved significantly post pharmacist intervention (P < 0.001). Average gain in questionnaire scores from pre-edcation to posteducation was 6.4 points (maximum score = 9, P < 0.001). Glucagon prescriptions were facilitated/dispensed for 28.5% of eligible participants. Fifty-eight vaccinations were recommended, and 25.8% were administered. Patients' overall satisfaction score averaged 4.7 out of a maximum of 5 (higher scores more favorable). CONCLUSION: An educational service in a community pharmacy setting can provide effective education to recognize signs, symptoms, and proper treatment of hypoglycemia in patients on diabetes therapy that carries a high risk.