PharmacistCARE

Diabetes is a chronic illness that afflicts one in eight Kentucky adults. 40 percent of adult Kentuckians have pre-diabetes and are at a very high risk of developing the disease. Among the outstanding risk factors: 25.6 percent of adult Kentuckians are obese, with Kentucky ranking 5th among the states for highest prevalence of obesity; and 30.6 percent of adult Kentuckians reporting they did not participate in any physical activity in the past month.

PharmacistCARE, a UK pharmacist-administered patient care service, is working to respond to this problem by improving the health of persons with diabetes while reducing healthcare costs. Guided by Amy Nicholas and Holly Divine in the UK College of Pharmacy, this project will provide diabetes education and medication management initially to members of the UK HealthCare plan through group educational classes and individual follow-up appointments to improve glucose control, medication use, and self-care practices. The program's five-year goal is to improve control of healthcare costs by reducing the long-term consequences of diabetes, including nerve damage, kidney disease and failure, heart attacks and stroke, and eye disease and blindness. The program is designed to produce health improvements while reducing overall costs to patients and healthcare providers.

Actions and Outcomes to Date

Working with the Center for Disease Control, the UK HealthCare plan, and the UK North Fork Valley Community Health Center in Hazard, the program has produced significant achievements. These include increased numbers of individuals with diabetes working with PharmacistCARE, improvement of their glucose control, medication use, self-care practices, and patient understanding of diabetes care. Patients and providers report high satisfaction with the services. Early results and similar studies elsewhere suggest that the improved glucose control achieved by PharmacistCARE will produce reductions in health complications and, therefore, will result in long-term cost savings. The program was recognized by the American Diabetes Association in February 2007. In spring 2007 PharmacistCARE expanded beyond DiabetesCARE. The new program, CardioCARE, is working with patients with hypertension and/or hyperlipidemia. A web-based database and documentation system has been created to house the clinical and outcomes data for PharmacistCARE.

In the future, PharmacistCARE will continue to provide diabetes and cardiovascular medication therapy management services and will become an immunization provider and administer vaccines to patients as needed, particularly for influenza and pneumonia. The program will also educate pharmacists across Kentucky on how to develop and implement PharmacistCARE-like services for their local communities.