Chain Drug Review, June 4, 2018

VIRTUAL ROUNDTABLE DIABETES CARE Healthy Lifestyle Choices Are Key to Keeping Diabetes in Check Furthermore for pharmacies located within grocery supermarket or club stores there are very specific opportunities for pharmacists to extend their engagement with patients and to further reinforce their counsel around lifestyle choices For example in these stores pharmacists can immediately provide patients access to a large selection of wearables produce or healthy food health and beauty sections for creams or moisturizers etc The breadth of products in these stores allows pharmacists to offer everything the patient needs to advance their health goals Tania Attanasio AmerisourceBergen In fact at AmerisourceBergen we work with our partners to help them better leverage those departments outside of the pharmacy footprint We do that by helping our partners create touchpoints that appeal to a diabetes patient and direct them to the pharmacy for greater support This can be accomplished through signage displays or language that speaks directly to that patients needs We want to ensure that those pharmacies are providing all of the connective tissue a patient needs in order to be successful Schroeder The biggest obstacle to providing care is access and 90 of Americans live within five miles of a pharmacy Combine that with the typical monthly visits to the pharmacy and interaction with pharmacy teams people with diabetes have access to great resources in a convenient setting In addition to counseling on medication regimens pharmacists can provide education on a variety of health topics including diet and lifestyle After ensuring that the patient understands their medications how to inject testing supplies pump use and supplies and other steps needed for selfcare its a natural transition to discuss holistic patient management Alongside these efforts pharmacy is well positioned to offer additional programs and services for diabetes management diet exercise goal setting and foot care for example Additionally when the pharmacist has visibility to gaps in care for each patient such as eye exam cancer screening past due provider appointment or other gaps that may exist the pharmacist can counsel towards these gaps and be the key driver in closing the gap This is not always achieved by providing the service but by working in collaboration with the payer provider and pa From 98 care during transitions medication review with a discharge and followup in the community pharmacy regular management of care regular follow ups including a dialogue on adherence minor ailments prescribing such as foot care and managing patient referrals to specialists such as an endocrinologist or an optometrist Diabetes will continue to grow By 2050 at least one in three Americans will be diagnosed with diabetes Patients with diabetes see their pharmacist seven times more often than their physician Pharmacy chains can select vendor partners that will offer high quality medicines at reasonable costs to patients and payers By choosing vendors who have vertically integrated manufacturing pharmacy chains can also maintain or improve profitability which can be invested back into systems programs or pharmacist education focused on diabetes care and diabetes prevention Communicate communicate communicate to patients payers and stakeholders A concerted effort must be made to ensure patients understand the role of pharmacists the impact they have on their health outcomes such as reducing A1c and when and how they can reach out to their pharmacist Part of the concerted effort must include other HCPs sharing the value of the pharmacist such as a physician stating If you have trouble remembering to take your medicine speak to your pharmacist Pharmacists are accessible knowledgeable and the most cost effective health care professional Just as with vaccinations pharmacists took a proactive health approach to prevent flu epidemic Pharmacists can also take a proactive role in prediabetes to prevent or slow progression of the disease state and manage adherence to therapy Even though patients may feel the pinch of prescription co pays adherence is valuable in avoiding the gauging costs they will feel from hospitalizations and additional care from uncontrolled diabetes CDR Discuss how pharmacies can help people with the disease by recommending lifestyle and diet changes perhaps pointing them to healthy food choices in the store as well as providing diabetes care products and services Attanasio As I shared pharmacists are in a unique position to help influence several aspects of a patients life and their approach to disease management even beyond medication In an effort to support patients with diabetes and other diseases we have seen some pharmacies provide nutrition counselor information cards at their counters while others have added a nutritionist to their staff Patients then have an opportunity to make an appointment with the pharmacys nutritionist bringing them back into the store for additional touchpoints while offering a valuable service that has a direct impact on their well being tient to complete the necessary steps to ensure that all suggested or required medical steps are completed Pharmacy payer and physician must form a partnership to understand and communicate where these gaps exist and identify patient specific needs If the payer provider and pharmacy pharmacist operate only in their own silo closing gaps in care wont occur and cost savings wont be achieved i e ER visits continue cost of care rises patient risk of comorbidities increase not decline and so on Kerley To properly treat diabetes management must be done from an individualized and holistic standpoint Education should not only include medication management but also a true understanding of the disease and lab values proper immunizations weight management exercise nutritional choices and proper testing Pharmacists and pharmacies are uniquely positioned to offer resources to help patients successfully achieve these lifestyle goals through services and product offerings at the pharmacy Its important for pharmacists to advocate for themselves to be seen as a vital part of the patients health care team Rajora Pharmacists are making an impact on healthy choices of patients and encouraging diet and lifestyle modifications Depending on the pharmacy chain model the education programs may vary from label reading to how to shop for healthy choices at the grocery store to rewarding health behavior via loyalty rewards Building easy to use work flow friendly MTM technology systems which enable a customized approach to care such as document lifestyle interventions adherence to lifestyle and diet and medication and developing a report card from regular follow ups with the pharmacist could be beneficial in keeping patients motivated while supporting the pharmacist in customized care so that the right message is being delivered to the right patient at the right time Zabeli As is common knowledge in the industry people with diabetes often have comorbidities and utilize pharmacy services more than most Offering a wide variety of products that a person with diabetes uses is the first step in helping Related to that is ensuring that the product selection includes some of the newest products and especially those that are technological advancements Pharmacists and pharmacy techs can help by pointing these out Konz Many resources are available for pharmacies to provide support materials to patients educating them on diabetes and healthy lifestyles The American Association of Diabetes Educators website provides meal planning tools and shopping lists on diabetes org suggesting supportive magazines blogs and podcasts with great resources and education such as Diabetes Forecast Cardinal Health provides supplier resources and monthly education through our Diabetes Specialized Care Center to support the educational journey Lifestyle changes can be overwhelming Taking one step in the right direction each week can make a big impact Brennan Healthy lifestyle choices are key to keeping diabetes in check A healthy diet full of plant based foods lean animal proteins and foods low in saturated fat can help keep weight off and diabetes under control In addition regular light to moderate exercise for at least 30 minutes per day can help control blood glucose maintain a healthy weight and support appropriate blood pressure and cholesterol levels Because these types of modifications can be challenging CVS pharmacists are able to help by providing personalized support as well as helping direct patients to information and products which can aid in lifestyle management In addition our more than 1100 MinuteClinic locations provide important health screenings and monitoring that help keep track of key risk measures for chronic disease such as diabetes Nurse practitioners and physician assistants at MinuteClinic also help patients manage their diabetes and keep blood sugar in check in between doctors visits and over time Schlanger Awareness and education efforts across all stakeholders in diabetes care starting with the physician continuing through to the pharmacist and pharmacy staff and even the retail pharmacy itself is key Delivering education at every potential touchpoint from the physicians office to the pharmacy shelf to the pharmacy counter helps drive the patient to make better more informed choices with respect to their diabetes care Creating a Diabetes Destination within the store that incorporates educational components from the physician from the manufacturers into the pharmacy with the pharmacy staff and possibly to the retail shelf as well keeping the messaging consistent and concise Trividia Healths Meet Lance education program provides patients physicians and pharmacies educational materials that are easy to read and simple to understand and it uses the education provided to help patients navigate the products that are available at the retail shelf to help them live a healthy lifestyle with diabetes Tying these elements together from physician to pharmacy helps deliver a consistent educational message especially for the newly diagnosed CDR Discuss digital advances that can help patients track their progress in managing diabetes and how pharmacies can foster greater use of them Kerley There are endless possibilities on how and what digital devices can do in diabetes management For example a person with diabetes may use a monitor or smartphone application for blood glucose blood pressure weight medication adherence and meal tracking To make utilization of these products more appealing many apps now offer gamification The ability for patients to have easy access to monitor their disease in an engaging way helps improve the patient experience and ideally improve outcomes Pharmacists are key in ensuring their patients are aware of the different advances that are available Pharmacists are also qualified to help patients select products specific to their needs and understand the components of utilization Rajora Successfully managing diabetes over time requires the ability to capture consolidate and report a broad range of data sets Examples include blood glucose levels at different times of day number of carbs consumed at specific meal times exercise levels and frequency units of insulin and other biologics injected or infused Managing this broad set of data daily can easily overwhelm people living with this chronic lifestyle condition Caregivers have historically relied on patients accurate self reporting of their data to assess responsiveness to therapies and make adjustments in doses or changes in therapies accordingly Recent advances in smart technologies and phone apps have greatly advanced the capture of the breadth of data that has historically been questionable due to the nature of self reporting The challenge for all stakeholders today is the reporting of this information in a secured open environment format versus proprietary closed formats The proprietary Brahim Zabeli Smart Meter closed formats require stakeholders to manage numerous data sources which is unrealistic By providing consolidated and synthesized data in a secured open format its envisioned patient specific dashboards can be developed so that trusted stakeholders like pharmacists can simply and easily engage patients in meaningful data centric conversations Pharmacists can reinforce behaviors or through exception reporting intervene and advocate on patients behalf with other stakeholders caring for patients such as doctors and nurses Having access to accurate real time data will allow pharmacists to practice at the top end of their licenses and improve the quality of care while driving customer loyalty Numerous companies are all rushing to be first to market in providing this integrated data solution to life First to succeed will enhance how health care enabled through IT can have a direct impact on patients lives Brennan CVS Health has a number To 103 100 Chain Drug Review June 4 2018