The Centers for Disease Control (CDC) reports more than 38 million Americans – roughly 10% of the population – have diabetes, with most, 90% to 95% diagnosed with type 2 diabetes (T2D). So when new guidance is issued with regard to diabetes prevention and treatment, health professionals, including pharmacists, take note.
Such was the case in August, when a panel of international experts, writing in the open source BMJ Diabetes Journal, recommended the use of sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists “in all or almost all adults with type 2 diabetes at higher risk of cardiovascular and kidney complications, and in the majority of adults at moderate risk of complications.” For patients at lower risk, the panel advised against routine use of these drugs. Instead, treatment plans should be personalized to address each patient’s unique situation.
The panel’s recommendations are noteworthy, explains Pharmacy Times, because they come at time when “the central goal of diabetes management has shifted from controlling blood glucose to preventing cardiovascular and kidney complications.” This change in approach is driven by the fact that T2D affects nearly 500 million people across the globe, and is the ninth leading cause of death, “connected to multiorgan health issues,” the article notes.
Previous research has demonstrated the effectiveness of SGLT-2 inhibitors and GLP-1s such as finerenone and tirzepatide in achieving protective benefits for the heart and kidney, as well as weight loss. The current guidelines make note of this prior research, and offer six recommendations for use of these medications in T2D patients with cardiovascular and kidney complications. Those recommendations include:
However, the panel notes that when choosing between GLP-1 receptor agonists and tirzepatide, “clinicians should weigh the higher certainty of cardiovascular and kidney benefits (offered by GLP-receptor agonists) against larger weight loss benefits (offered by tirzepatide) based on a patient’s risk profile as well as their values and preferences.”
The panel’s recommendations should be of particular note to pharmacists, who have an important role in helping patients manage their diabetes. While pharmacists have always been responsible for dispensing required medications, a recent analysis in the peer-reviewed journal Diabetes, Metabolic Syndrome and Obesity described the many ways in which their role has evolved. “The pharmacist’s role has changed significantly over the last fifty years. Transitioning from strictly dispensing to providing clinical services that include patient education, direct patient care responsibilities, and chronic disease management through team-based care.” This transition has occurred as healthcare overall has shifted to value-based care, which prioritize the quality of care given to a patient, rather than the volume of medications or services provided.
The pharmacist’s role is so essential to diabetes management, that the American Diabetes Association considers pharmacists essential diabetes care team members. Technology is another important member of the team. Pharmacists rely on their technology management systems, including PrimeRx, to automate and manage critical pharmacy workflows and facilitate important patient services.
Specific to diabetes management, PrimeRx stands apart from other pharmacy management systems, with capabilities that include:
Patient Records Management
PrimeRx allows pharmacists to create and maintain comprehensive patient health records. For diabetes patients, the system maintains a history of each patient’s prescription medications, along with information about any supplements or OTC medications the patient may take. Pharmacists can capture information about a patient’s medical history including diagnosed conditions, lifestyle behaviors, family situation, living situation, and any other information that would add to an understanding of a patient’s profile.
Additional records-related features include:
Medication Synchronization. Patient records can be quickly adjusted so that all refills are set for the same day. Allowing patients to obtain all medications during a single trip to the pharmacy – making the process as easy as possible -- has proven to be an effective tool in improving medication adherence.
Medication Therapy Management
Medication therapy management (MTM) is defined as “a range of services provided to individual patients to optimize therapeutic outcomes (help patients get the most benefit from their medications) and detect and prevent costly medication problems.”
The National Community Pharmacists Association’s 2024 NCPA Digest found that 81% of independent pharmacies offer medication therapy management (MTM) services. PrimeRx offers comprehensive MTM functionality that includes:
eCare Plans
eCare plans provide a standardized format for documenting the medications and services offered to patients. In addition, eCare plans allow community pharmacists to join with other healthcare providers and payers to collaborate and exchange patient information. Through eCare plans, pharmacists engage with members of a diabetes patient’s healthcare team to ensure consistency of care and to identify any changes needed in medication protocols. In addition, pharmacists have a way to demonstrate the many clinical services offered to patients, which may improve the likelihood of reimbursement.
PrimeRx was among the earliest supporters of the eCare plan concept, and among the first approved technology providers. Pharmacists can quickly create eCare plans within PrimeRx with required functionality that includes:
Medication Procurement
Pharmacists can rely on another PrimeRx solution, PrimeRx MARKET, to ensure steady supplies of prescription medications and diabetes-related supplies at the best possible prices.
Patient Communication
Good communication is essential to the success of a diabetes management program. Pharmacy staff must have options for checking in with patients, and for patients to contact the pharmacy with questions or concerns.
PrimeRx offers extensive communication capabilities through the myPrimeRx.com solution. With myPrimeRx.com, patients are kept informed with real-time SMS delivery updates, notifications about scheduled refills, and personalized reminders including dosage requirements. The system also enables two-way communication, which allows pharmacists and patients to interact about medications and other aspects of a patient’s diabetes management plan.
Two-way communication also facilitates compliance with auto-refill requirements and helps pharmacies promote medication adherence initiatives.
Patient Education
PrimeRx helps patients learn about their prescribed medications through access to the VucaHealth library of educational materials. When patients receive their medications from the pharmacy, each will have a QR code printed on the label. Patients can quickly scan the QR code to access materials including fact sheets, medication guides, and videos that provide detailed, but easy-to-understand, information about each medication.
The latest recommendations regarding the use of SGLT-2 and GLP-1 medications continue the good work to find ways to prevent, and manage, diabetes. Pharmacists, as essential members of diabetes care teams, will ensure patients have access to these and other medications, while offering extensive counseling and educational services. And PrimeRx will also have a role to play, making it easier for pharmacists to help patients manage this very serious condition, and facilitate good patient outcomes.
