How to Promote Medication Management for People With Diabetes
5 Actions for Health Care Teams
We all have a role to play to help people with diabetes live their best life!
Pharmacists do more than just fill prescriptions. They help patients get the most benefit from their medicines by working directly with primary care providers to identify, prevent, and resolve medication-related problems. This partnership is called collaborative drug therapy management (CDTM).
Pharmacists also play a key role in administering recommended vaccines for people with diabetes, including those that protect against influenza, pneumococcal disease, and hepatitis B. In addition, they can advise patients about diabetes self-management, help them take their medicines as prescribed, and provide information about lower-cost options for medicines and medical supplies.
- Make sure your patients know that:
- Pharmacists don’t just fill prescriptions. They can provide tools to help patients track their medicines. They can also provide resources to help patients get the medicines and medical supplies they need safely and affordably.
- As part of CDTM, pharmacists can work with health care providers to adjust medicines to improve dosing and add or remove drugs that may or may not be effective.
- Pharmacists can play a key role in referring patients to DSMES services.
- Share information from CDC’s Take Charge of Your Diabetes: Your Medicines fact sheet.
Take These 5 Actions to Help Your Patients
People with diabetes can be at high risk for drug-related problems because they often have multiple medical conditions, take multiple medicines, receive medicines from different sources, and see a range of health care providers.
For example, patients may inadvertently take the wrong dose at the wrong time, which can cause serious illness, long-term disability, or even death. When patients don’t take their medicines as prescribed—or when their medicines are no longer meeting their needs—they may struggle to meet their health goals.
In the United States:
- Studies have shown that 20% to 30% of medication prescriptions are never filled and about 50% of medicines for chronic diseases are not taken as prescribed (at the correct time or dose or in relation to eating).1
- Only about 50% of people with diabetes reach their blood glucose goals as measured by a hemoglobin A1C test. 2
- Among people with diabetes and other chronic conditions, only 51% of those with high blood pressure and only 56% of those with high cholesterol meet their target goals.2 Only 18% reached all three recommended ABC goals (A1C, blood pressure, and cholesterol).2
- Inappropriate drug choice
- Inappropriate dosage
- Adverse drug reactions
- Drug interactions
CDTM is associated with improved glycemic control in people with diabetes.3 Pharmacists can help lead CDTM by:
- Conducting comprehensive reviews of medicines and medical records.
- Educating patients to improve the safety and appropriate use of medicines.
- Assessing patients’ responses to therapy to ensure timely interventions, communication back to primary care and other providers, and coordination and continuity of care.
- Helping patients choose an appropriate blood glucose meter and training them how to use it.
- Asking patients about their use of nonprescription medicines; vitamin, herbal, or nutritional supplements; and topical or skin care products. They can also encourage patients to keep a list of everything they are currently taking or using.
- Making sure patients understand the information shared by asking them to repeat back what they heard.
- Did you bring a list of all your medicines and their exact doses, including over-the-counter medicines, vitamins, and herbal supplements?
- Do you know why you take each medicine?
- Do you know how your medicines affect your diabetes?
- Do you update and review your list of medicines with your pharmacist when there is a change?
- Have you reported any side effects from your medicines to your pharmacist?
- Do you let your pharmacist know if you have a problem with missing doses of your medicines?
You can offer to connect your patients with a pharmacist or ask them if they want more information about recommended medication management approaches for people with diabetes. You can take this action depending on how your patients answer your questions or any other concerns they share during their visit.
4. Remind your patients to keep their blood glucose, blood pressure, and blood lipids within normal levels for optimum hearing health.
Use the following discussion points to help you talk with your patients about their self-care habits and their feelings about managing diabetes:
- Promote the ABCs of diabetes (A1C, blood pressure, cholesterol, and smoking cessation) and a healthy lifestyle.
- Ensure that patients have access to health coaches, patient navigators, and community health workers when possible.
- Ask your patients what other health exams they are getting, including regular ear health checkups.
- Assess symptoms that might require referral to a specialist.
- Follow up with your patients to track how well they are managing their diabetes and connecting with their health care team.
- Assess socioeconomic factors that can affect health, such as food insecurity, housing insecurity or homelessness, financial barriers, and lack of social support. Use this information when you make treatment decisions.
- Refer patients to local community resources when available.
DSMES services help people live well with diabetes. Whether a person has just been diagnosed with diabetes or has had it for years, DSMES services will make it possible for them to:
- Work with a diabetes care and education specialist to set and track goals.
- Practice how to fit diabetes self-care behaviors, like healthy eating and problem-solving, into all parts of their life.
- Learn how to use knowledge, skills, and tools to build confidence and emotional strength to manage diabetes.
- Find ways to get support (in person or online) from family, friends, their community, and their health care team.
Learn more about DSMES and encourage your patients to find a DSMES programexternal icon that is recognized by the American Diabetes Association or accredited by the Association of Diabetes Care & Education Specialists.
- Viswanathan M, Golin CE, Jones CD, et al. Interventions to improve adherence to self-administered medications for chronic diseases in the United States: a systematic review. Ann Intern Med. 2012;157(11):785–795. doi:10.7326/0003-4819-157-11-201212040-00538
- Stark Casagrande S, Fradkin JE, Saydah SH, Rust KF, Cowie CC. The prevalence of meeting A1C, blood pressure, and LDL goals among people with diabetes, 1988–2010. Diabetes Care. 2013;36(8):2271–2279. doi:10.2337/dc12-2258
- McAdam-Marx C, Dahal A, Jennings B, Singhal M, Gunning K. The effect of a diabetes collaborative care management program on clinical and economic outcomes in patients with type 2 diabetes. J Manag Care Spec Pharm. 2015;21(6):452–468. doi:10.18553/jmcp.2015.21.6.452