Improving the Health of Patients with Diabetes Using Pharmacist Prescriber/Provider Extenders

This program is funded in part by sanofi-aventis U.S.

Program Quick Facts
Name: Improving the Health of Patients with Diabetes Using Pharmacist Prescriber/Provider Extenders

Program Design: Two part program

Primary Objective: To assess the feasibility of a program utilizing pharmacists as prescriber/provider extenders for the care of patients with Type 2 diabetes

Number: 100-140 plans/payers, 100 prescribers/providers, 100-200 patients

Diabetes Q & A with Bruce Schrader, Pharm D & Scott Charland, Pharm D, FCCP

What is a Pharmacist Prescriber/Provider Extender program?
Pharmacist prescriber/provider extender programs utilize allied health care professionals such as a Pharmacist, Nurse or Physician’s Assistant to assist in initiating and/or adjusting medications in conjunction with, and under the authorization of the prescriber/provider. The ultimate goal of the program is to improve patient care.

Please provide a brief description of your program and how it may improve the health of diabetes patients using pharmacist prescriber/provider extenders.
The management of diabetes becomes much more complex with the presence of multiple associated co-morbidities and polypharmacy needs often require initiation and/or intensification of therapy with insulin. Pharmacists are well positioned as prescriber/provider extenders since they have access to detailed clinical data, are already a part of the patient’s care team, and possess the necessary knowledge and skills.

The program contains two parts:

(1) Survey plans/payers and prescribers/ providers for interest in a pharmacist prescriber/provider extender program based upon a prescription for diabetes basal insulin management. We explore needs and barriers associated with the implementation of the program; and (2) Diabetes Therapeutic Resource Center® (TRC) interventions and feasibility of a pharmacist prescriber/provider extender program. During the Diabetes TRC interventions, we evaluate: (a) prescriber/provider non-adherence reports associated with diabetes medications and typical pharmacist-patient interactions within the Diabetes TRC; (b) modified prescriber/provider non-adherence reports with specific patient-pharmacist interventions; and (c) feasibility of implementing a pharmacist prescriber/provider extender program managing basal insulin therapy based on a prescription from a referring prescriber/provider.

When did the program start?
The program began in May 2011.

Please provide a brief description of the role that the Diabetes TRC will play in this program.
In this feasibility evaluation program we are using Diabetes TRC pharmacists who have extensive training in diabetes. In addition to counseling patients on adherence to medications, they are adjusting doses of basal insulin based upon an insulin prescription. The pharmacist reviews blood glucose readings and starts or intensifies insulin therapy following the prescription, and communicates regularly with both patient and prescriber.