How Pharmacists Can Participate
The Action Guide for Pharmacists is designed to help pharmacists and members of the pharmacy workforce reach people at high risk of developing type 2 diabetes who could benefit from the National Diabetes Prevention Program (National DPP) lifestyle change program and prevent new cases of type 2 diabetes among patients at high risk by taking steps to help expand the reach of the National DPP.
About This Guide
Who Should Use This Guide?
This guide is designed to help pharmacists and members of the pharmacy workforce—including pharmacy technicians, residents, and students—reach people at high risk of developing type 2 diabetes who could benefit from the National Diabetes Prevention Program (National DPP) lifestyle change program (LCP). You will learn how the National DPP, which is led by the Centers for Disease Control and Prevention (CDC), can be applied in the pharmacy setting to maximize the unique skills and abilities of the pharmacy workforce.
How Should This Guide Be Used?
The purpose of this guide is to help pharmacists prevent new cases of type 2 diabetes among patients at high risk by helping to expand the reach of the National DPP. It does not provide a comprehensive overview of the program, but this information is available on CDC’s National DPP website. Instead, this guide outlines ways that pharmacies can:
- Raise awareness of prediabetes and the National DPP among their patients at risk.
- Screen and test for prediabetes and refer or enroll people with prediabetes in a National DPP LCP delivered by an organization recognized by CDC.
- Deliver the National DPP LCP.
This guide also provides tips, case studies of pharmacies involved in the National DPP, and links to additional resources. Key terms and phrases related to the program are highlighted in bold text in the text throughout and defined in the glossary.
Acknowledgments This guide was developed by the Centers for Disease Control and Prevention’s (CDC) Division of Diabetes Translation in collaboration with pharmacists and pharmacy partners across the nation. Contributors to the development and review of this guide include the American Association of Colleges of Pharmacy, American Pharmacists Association, American Society of Health-System Pharmacists, National Alliance of State Pharmacy Associations, National Association of Chain Drug Stores – Foundation, National Community Pharmacists Association, Virginia Commonwealth University School of Pharmacy, and Community Pharmacy Enhanced Services Network.
CDC-Recognized Organization: An organization that offers the National Diabetes Prevention Program (National DPP) lifestyle change program (LCP) and has received pending, preliminary, temporary preliminary, or full recognition from CDC’s Diabetes Prevention Recognition Program (DPRP).
Centers for Medicare & Medicaid Services (CMS): The federal agency that runs the Medicare program and works with states to administer the Medicaid program.
Diabetes Prevention Program (DPP): The original research study led by the National Institutes of Health, which showed that making modest behavior changes helped participants with prediabetes lose 5% to 7% of their body weight and reduce their risk of developing type 2 diabetes by 58% (71% for people over 60).
Diabetes Prevention Recognition Program (DPRP): The quality assurance arm of the National DPP charged with evaluating organizations’ performance in effectively delivering the National DPP LCP with quality and fidelity to the original science. Organizations can earn CDC recognition by following a CDC -approved curriculum and achieving outcomes proven to prevent type 2 diabetes in participants at high risk.
DPRP Recognition Statuses:
- Pending Recognition: The CDC recognition status granted to all applicant organizations once an initial application is approved.
- Preliminary Recognition: An intermediate level of CDC recognition (allows organizations to become MDPP suppliers and to begin billing Medicare). Organizations achieve preliminary recognition when they meet the following criteria:
- The requirements for pending recognition
and - DPRP Standards Requirement 5.
- The requirements for pending recognition
- Temporary Preliminary Recognition: If an organization has preliminary or full recognition for one delivery mode and subsequently applies to deliver the National DPP LCP through an additional delivery mode, the DPRP will convey temporary preliminary recognition to the new delivery mode. This is a special designation that will only last until the organization has its first evaluation for the new delivery mode.
- Full Recognition: The highest level of CDC recognition where all DPRP requirements are met (allows organizations to become MDPP suppliers and to begin billing Medicare). Organizations achieve full recognition when they meet the following criteria:
- The requirements for pending recognition
and - The requirements for preliminary recognition
and - DPRP Standards Requirements 6 (at least one condition is met) and 7.
- The requirements for pending recognition
DPRP Standards: National quality assurance standards that describe the requirements that program delivery organizations must meet to achieve CDC recognition. See the CDC Diabetes Prevention and Recognition Program Standards and Operating Procedures [ PDF – 2 MB] online.
Lifestyle Coach: A person responsible for implementing the yearlong CDC-approved curriculum and providing support and guidance to participants in the National DPP LCP.
Medicare Diabetes Prevention Program (MDPP): MDPP services became available on April 1, 2018. About 26 million US adults 65 or older have diabetes and could directly benefit. For more information, visit the MDPP website.
Motivational Interviewing: A counseling technique that supports patients in working through their beliefs until they actively seek change and become engaged in making behavior change.
National Diabetes Prevention Program (National DPP): A partnership of public and private organizations working to build a nationwide delivery system for a lifestyle change program proven to prevent or delay onset of type 2 diabetes in adults at high risk.
National DPP Customer Service Center (CSC): A website where organizations can access training materials, toolkits, and videos; ask questions; and receive technical assistance related to all aspects of the National DPP. For more information, visit the National DPP CSC.
National DPP Lifestyle Change Program: The translated adaption of the DPP lifestyle intervention, which:
- Is a yearlong, structured program offered in person, online, through distance learning, or through any combination of these delivery modes, as defined in the DPRP Standards. It consists of:
- An initial 6-month phase offering at least 16 sessions over 16 to 26 weeks and
- A second 6-month phase offering at least 1 session a month (at least 6 sessions).
- Is facilitated by a trained Lifestyle Coach.
- Uses a CDC-approved curriculum.
- Includes regular opportunities for direct interaction between the Lifestyle Coach and participants.
- Focuses on behavior medication, stress management, and social support.
Prediabetes: A health condition marked by blood glucose levels that are higher than normal but not high enough to be diagnosed as type 2 diabetes. Prediabetes can lead to heart disease and stroke and increases a person’s risk of developing type 2 diabetes. Prediabetes is defined by one of the following measures: HbA1C of 5.7% to 6.4%, fasting plasma glucose of 100 to 125 mg/dL, or plasma glucose of 140 to 199 mg/dL measured 2 hours after a 75 gm glucose load.
Prediabetes Risk Test: A prediabetes screening test that can be administered online at www.cdc.gov/prediabetes/risktest/index.html or in person using a paper [PDF – 263 KB] test.
Type 2 Diabetes: A condition characterized by high blood glucose levels caused by either a lack of insulin or the body’s inability to use insulin efficiently. Type 2 diabetes develops most often in middle-aged and older adults but can develop in children, teens, and young adults.