Pharmacy practice in the diabetes care team - a quality and economic approach for the Caribbean

ABSTRACT

As the number of people with diabetes increases, the disease with it's complications takes an ever-increasing toll on health care budgets. It is projected to become one of the world's main disablers and killers by 2025. In the Caribbean the rates of diabetes are also projected to continue to climb rapidly. Immediate action is needed to prevent the rise of new diabetics and instill cost-effective interventions in patients with established diabetes. A multidisciplinary team approach is recommended in the provision of diabetes care. The benefits of this approach to diabetes management are well established globally. A "pharmacist-managed" diabetic clinic operating in collaboration with health care team has extended quality and cost-effective services to diabetic population. In the Caribbean, the multidisciplinary team needs an improved collaborative approach within which the vital role of pharmacy practitioner can be defined. The objective of this study is to recommend evidence-based approaches that Caribbean pharmacists as members of diabetes multidisciplinary team, can adopt in order to develop pharmacist-managed diabetes practice. A literature search was conducted from 1995 to present. Of the 49 studies identified only 14 met the inclusion criteria. There were no published studies on diabetes disease management by pharmacists in the Caribbean. The selected studies were reviewed to determine the primary care functions that Caribbean pharmacists should opt to introduce in a pharmacist managed diabetes practice and thereby assist with quality of care and cost effectiveness. Studies from several countries have confirmed the improved quality of health care and positive impact on costs that pharmacists' involvement had on the management of diabetic patients. A Caribbean pharmacist-managed diabetic practice can result in a meaningful and sustained impact on the diabetes epidemic and its escalating cost to regional health systems.