Education and Management of Diabetics: A patient outcome/education driven session

Education & Management of Diabetics
A patient outcome/education-driven
session
Ahmed F. El-Yazbi
BPSc, PhD, BCPS,
RP (ACP)
Dalia A. Hamdy
BPSc, MSc, PhD,
RP (ACP), MRSC
Nahla H. Kandil
BPSc, MSc, BCPS
Zeyad A. ELgamal
BPSc, PharmD,
BCPS, CDE,
RP (ACP)

Establishing a foundation for
Diabetic patient education:
Effective approaches for
communication of health
information
Dalia A. Hamdy
BPSc, MSc, PhD, RP (ACP), MRSC
Assistant professor, Faculty of Pharmacy
Alexandria University, Alexandria, Egypt
dr.daliahamdy@gmail.com

Outline
• Identifying the role of Pharmaceutical Care Practitioner
• Implementation of structured patient communication
skills
• Employing counselling skills to educate the diabetic
patient
• Practicing data collection from reputable Information
Resources/databases
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
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References
Hopkins M., Silver R. Patient Self-Care. 2nd Edition. Canadian
Pharmacists Association; 2010. Chapters 2, 27 & 28
Cipolle RJ, Strand LM, Morley PC . Pharmaceutical Care
Practice: The Clinician’s guide. 2nd Edition. The McGraw-Hill
Companies, Inc.; 2004. Chapter 1
2013 Canadian Diabetes Association Guidelines.
http://guidelines.diabetes.ca/
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Pharmaceutical Care Practitioner
• Pharmaceutical Care:
• Is a relatively new patient care practice
• A patient centered practice in which the
practitioner assumes responsibility for a patient’s
drug-related needs and is held accountable for his
commitment
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• Pharmaceutical Care Practitioner:
Job is to assure that
a. Appropriate use of patient’s drug therapy
for each medical condition
b. Drug therapy used is effective and safe
c. The patient is able and willing to take the
medication intended
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Assessment
Care Plan
Follow-up
evaluation

•
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Assessment
Care Plan
Follow-up
evaluation
ACTIVITIES
1. Meet the patient
2. Collect relevant patient information
3. Make rational drug therapy decisions

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Assessment
Care Plan
Follow-up
evaluation
ACTIVITIES
1. Establish goals of therapy
(endpoints and timeframe)
2. Select appropriate interventions
-consider therapeutic alternatives
-patient specific pharmacotherapy
-non drug interventions
-Educate patients
3. Schedule a follow-up evaluation

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Assessment
Care Plan
Follow-up
evaluation
ACTIVITIES
1.Compare lab data or clinical evidence to
Establish goals of therapy to evaluate
effectiveness
2. Evaluate safety (determine any side effects)
3. Document any change in the clinical status or
pharacotherapy
4. Assess patient for any new drug therapy
5. Schedule the next follow up

Structured patient
communication skills
• Establishing Rapport
• Listening
• Posing questions
• Providing feedback
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-History taking
-Probing for further details regarding the
problem
-Checking information and using resources
-Providing a recommendation, instructions, or
information to the patient
- Final Recap
-Introduction

Structured patient
Data Collection
A lady in the aisles is looking for an antidiarrheal and an
antispasmodic and she is seeking your help?
1. Collect the data from this patient using the rubrics given
2. What do you think is the reason behind such symptoms?
3. Do you have any other comments?
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7

Structured patient
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Structured patient
Looking up information using resources
1. Can Januvia be administered to pregnant ladies?
2. Do we need dose modification for patients with CrCl < 30
mL/min?
3. I am allergic to eggs . Would Januvia be safe?
4. I am on digoxin, is it OK to take januvia with my therapy?
5. I heard about the Januvia and incretin based therapy and I
would like to prescribe it to a 14 years old boy. Is it safe?
6. Do I need to change the dose of my oral contraceptive upon
taking Januvia?
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Structured patient
Conveying Data
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Structured patient
15

structured patient
16
Time
Management Lay Language
Empathy
Non verbal
communication

Structured patient
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Structured patient
Testing your knowledge
Identifying Facts and Myths on Diabetes
http://my.questbase.com/take.aspx?pin=3282-9630-9513
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You are educating your patient about foot care
• Inspect
Check your feet every day. Look for scratches, cracks between
the toes, blisters, corns and other sores. Watch for swelling and
changes in the temperature of or color of your feet.
• Bathe
Wash your feet daily with warm water
Dry your feet well specially between toes
• Moisturize
Top and bottom not between toes
Do not use talc powder between toes
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Patient Self-Care
Recommendations

You are educating your patient about foot care
• Trim
Cut your tow nails straight across
Do not cut calluses or corns
• Shoes and Socks
Always wear shoes and breathable socks and with good fit
Check your shoes for sharp objects before putting them on
• Keep Feet warm
Wear socks to bed and Do not use heating pads or hot water bottles
• Circulation
Avoid pressure on foot, smoking and alcohol
Do not cross legs when sitting
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Patient Self-Care
Recommendations

You are educating your patient about
Hypoglycemia
• Design your own card using the page provided from
Patients’ self-care handbook
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Patient Self-Care
Recommendations

 Wear diabetic identification at all times
Achieve healthy lifestyle
BGL at target level
Blood pressure and Cholesterol levels at target
levels
Patient Self-Care
Recommendations
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Education & Management of Diabetics (DH/AY/NK, April 16, 2014)

Do not smoke
Exercise
Foot Care
Regular checkups doctor, dentist, eye specialist
Patient Self-Care
Recommendations
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Vaccination (Influenza every winter and
pneumonia once)
Attend diabetes education sessions
Framework, Tools and Resources
http://guidelines.diabetes.ca/SelfManagementE
ducation/SMETools
Patient Self-Care
Recommendations
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