Community Pharmacies Make Big Impact on Prediabetes

Community pharmacists and pharmacy technicians who are part of the National Diabetes Program have been able to help people with prediabetes improve their health through weight loss, nutrition counseling, and other actions.

More than 45 pharmacies have been participating in the CDC-recognized National Diabetes Program (DPP), with assistance from the National Community Pharmacists Association (NCPA).

The first 10 participating pharmacies have had notable results, helping people with diabetes or prediabetes lose an average of 7% of their initial body weight, or 16 pounds, on average, said Carlie Traylor, PharmD, director of Strategic Initiatives and Student Affairs at NCPA.

Mathes Pharmacy in New Albany, Indiana—which has specialized in helping those with diabetes as a designated Diabetes Education Program for more than 10 years—expanded its services in 2020 to include the DPP.

“The central focus of the CDC's DPP is weight loss and increasing physical activity, as those are the biggest modifiable risk factors for diabetes,” Madeline Moses, PharmD, Director of Clinical Services and Alternative Revenue at Mathes Pharmacy, told Drug Topics®.

A diabetes educator meets weekly with people with prediabetes to discuss nutrition, stress management, exercise, sleep hygiene, support systems, and other factors that contribute to the disease.

The weekly check-ins are beneficial, allowing participants to regroup more often, helping them stay on track, Moses said. “Offering make-up sessions and alternate delivery methods has helped—especially given the pandemic,” she added.

To keep participants interested in the year-long program, the pharmacy offers contests, prizes, and other rewards as participants progress.

In Mathes’ first DPP group, all participants lost weight, and no one was diagnosed with diabetes while in the program. Nine out of 17 participants who finished the program met their weight loss goal of at least 5%, 1 one participant lost 18% of their original weight.

“The feedback I got from the first class was that they felt like this program was sustainable, something they could stick to for life,” Moses said. “Unlike other programs, they enjoyed that they had freedom of food choices, didn't feel deprived, and were able to make changes slowly over time to help ensure the changes were going to stick.”

Participants also enjoyed the group atmosphere, as the program runs more like a support group than a class, Moses added.

Surgoinsville Pharmacy, Surgoinsville, TN, realized similar results with participants’ weight loss: 2 participants lowered their HbA1c levels under prediabetic range, said Amber Suthers, CPhT, MSAH, clinical services manager at the pharmacy.

The pharmacy also created a community walking group, and all 15 participants “walked away with the knowledge to take charge of their health,” Suthers noted.

Especially helpful was showing patients how to shop at the grocery store during a store tour, she said. And group communication was also key. “We usually have a group text with everyone which gives accountability and encouragement,” Suthers said.

Although it was challenging to navigate venue spaces and keep up attendance during COVID-19 surges, “we adapted by having the classes in smaller groups throughout the week and moving to the local fire department for a bigger space,” Suthers said.

These programs may be effective, but reimbursement for programs like this is a challenge, Moses and Suthers agree.

“Unfortunately, we are not receiving reimbursement for this service unless we charge the patient out of pocket. For the most part, the insurance companies will only pay for diabetes self-management education,” Suthers said. Commercial insurance plans do not have a clear pathway for billing for these services and education on how to bill would be helpful, Suthers added. “A process for obtaining grant funding through block grants would also be a great resource,” she said.

Most programs only offer a 1-time cash prize for the class, Moses noted. If more payers recognized the benefit of this program, and made it easier for programs to be reimbursed, the positive impact on patient lives would be astronomical,” she said.