The majority costs of diabetes are associated with the possible
complications of the disease including amputations, blindness,
cardiovascular conditions, stroke, and renal disease. In patients with
diabetes, cost of therapy, severity of disease, presence of co-morbid
conditions and complexity of drug regimen have all been shown to
be factors associated with medication adherence.6,7–9
Pharmacists and their role in DSM
Community pharmacies have an important role to play in DSM.10–15
In addition to dispensing prescription medications, their involvement
shows beneficial effects in patient education and disease
management.16,17 Community pharmacies are ideally placed to
contribute to DSM programmes and assist in the detection, education
and referral of individuals at risk of diabetes.18 They are widely
accessible, available, in frequent contact with the public and able to
access people who are apparently healthy. DSM in both clinics18–22
and community pharmacy settings23–27 are highly effective and a high
proportion of consumers currently support pharmacist provision of
health testing services. Such programmes may include a range of
services:
• Support of self blood glucose monitoring (SBGM)
• Monitoring and promoting patient adherence with medication
and other components of self-management
• Identifying and resolving drug-related problems
• Providing targeted education
• Monitoring blood pressure, weight and lipids
• Reminding patients of the importance of regular examinations
for the presence of diabetic complications, for example, eye and
feet examinations or drug therapy management.
• A new role of the pharmacist (educator) as tutor and facilitator
has emerged out of study circles.