Devon LPC Diabetes Support Service: Supporting patients to achieve the best outcomes from their medicines Mark Stone , Pharmacist & Project Lead Devon LPC Michael Wilson, Sanofi Diabetes Mathew Robinson, Pharmacist Boots The Chemist
WHO 2003 - “that increasing the effectiveness of adherence interventions may have far greater impact on health of the population than any other improvement in specific medical treatments” ADHERENCE TO LONG-TERM THERAPIES
Diabetes Therapy - Challenges Cost of diabetes medicines: £764.1 million 12-13 (49% increase since 05-06) Wasted diabetes medicines: £30.5 million (thrown away) Missed Positive Outcomes From Diabetes Medicines: 53% of patients have good adherence to diabetes medicines Over £100 million per yr (800,000 individuals with type 2 diabetes) A US Study showed missed outcomes from non-adherence to diabetes medicines at $24.4bn (0.9% of total health spend) MS Institute for Healthcare Informatics. June 2013 Avoidable Costs in U.S. Healthcare
Diabetes Therapy - Challenges Development of life-expectancy tables for people with type 2 diabetes Jose Leal, European Heart Journal (2009)
Why Can Pharmacists Help? Community Pharmacy • Accessibility o 99% people can access in 20 minutes car, 96% can walk o No appointment o Long opening hours o High footfall (of both well and ill). 3.5x more visits than GP practice (1.8 million per day) • Pharmacist o Knowledgeable (4 year MPharm degree) o Recognised as the experts in medicines o Are one of the most trusted professionals
The Project Journey Stakeholder diabetes event hosted by Rt Hon Adrian Sanders MP, Torbay (Friday 3rd December 2010) Working group: Graham Cooper (Diabetes UK), Michael Wilson (Sanofi Diabetes),Fawz Farhan (MediaPharm), Mark Stone Devon LPC. Reference group: Diabetes UK, Torbay CCG (Diabetes C2C), Patrick English (Diabetologist), Torbay Diabetes Nurse Practitioner, Devon LPC Pharmacists, PSNC, NPA . Devon LPC – Pharmacist Diabetes Medicines Support Service Aim: To improve a patient’s self management of their condition and to increase adherence to the diabetes medicine regimes Service: Two consultations, identify adherence issues, enhance patients knowledge and management of their condition, understanding of medicines, influence beliefs of benefits and overcome medicine issues.
The Evaluation Results Service Activity • Twelve pharmacies,186 consultations,109 patients • Medicines adherence; good 57.8%, medium 21.1%, poor 21.1% • 18.3% experienced hypoglycaemia in past 2 months • Pharmacists provided up to 3 recommendations to 96.3% patients • On follow up 88.5% adhering to all/some pharmacist recommendations Service Outcomes ( From independent researcher interview) • “I appreciated receiving the service from the pharmacist” o Strongly agree/agree = 100% “ The service motivated me to stay in control of my diabetes” • o Strongly agree/agree = 82% Neutral 18% • “I am more compliant with my medications since participating in the service” o Strongly agree/agree = 76% Neutral = 17% Disagree = 6%
The Next Steps Project Learning • Industry, health professionals (multi-disciplinary), patients can co-design effective programmes to address self management and adherence issues. Patient Awareness • Raise awareness among diabetes patients’ of support pharmacists can provide. Diabetes UK to help communicate? Commissioners Awareness • Raise awareness of the waste and lost positive outcomes of adherence and poor self management, and methods to tackle Build the evidence base • Larger study, refine service.
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