Following on from our overview of the health condition that accounts for £10 billion of the NHS budget, today we look at how community pharmacists play a vital role in medicating diabetes.
Before we get on to the details of medication, it’s worth considering what wider options are possible. Graham Philips, the superintendent pharmacist for the Hertfordshire-based Manor Pharmacy Group (see our day in the life feature), which has done extensive work on Type 2 diabetes, says: “We should be talking about what causes Type 2 diabetes and what the preventative actions are, and only then should be talking about the medicines. We should be starting with how we can avoid people developing Type 2, and how we can help people with Type 2 to live healthier lives.”
However, in many cases people will need medication to help them manage their diabetes – something that only works if people actually take it. A study from 2002 showed of 4,000 patients prescribed metformin, just 65 per cent were taking the medication as prescribed one year later. For patients prescribed more than one drug (metformin and Sulphonylurea) that fell to 44 per cent.
Philips says: “Someone could start taking medication but find it has side effects; so he stops taking the medication but he keeps taking the prescription to keep the doctor happy.
“Hypertension is a good example as it doesn’t generally cause any symptoms, whereas the drugs often cause side effects. So people stop taking the anti-hypertensive they’ve been prescribed as they may actually feel don’t feel better, even though they stop illness. That’s the story of long-term conditions.”
Community pharmacists are well placed to have a conversation here. Do people who are prescribed medication understand what it does and why it is so important? Are there side effects? If so, are there alternatives?
That is an ongoing conversation, but Diabetes UK recommends that formal medicine reviews happen for people with diabetes at least annually – and as diabetes often comes with co-morbidities that require their own medication that may conflict, it’s an essential step.
And thinking broadly about medication and its effects are vital here. Erectile dysfunction is a good example: it can be common for men with diabetes, and a pharmacist might be the first health professional who deals with their concerns.
Community pharmacists could also proactively provide checks to assess people’s risk of developing Type 2 diabetes. They can also use the New Medicine Service as a tool to help people who are prescribed new medications to really understand how they work and how they can be used.
Join us tomorrow to discover the resources available to diabetic patients and how you can start the conversation with them.