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                     Pharmaceutical Care for Patients with Diabetes


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Pharmaceutical Care for Patients with Diabetesis an innovative and intensive certificate program that focuses on the pharmacist's role in the area of diabetes management. The program, which emphasizes a health care team approach, seeks to foster the implementation of pharmaceutical care interventions that will promote disease self-management. Pharmaceutical Care for Patients with Diabetes is conducted in three parts:

  • Self-study activity
  • Online learning reinforcement activities and case studies
  • Live interactive training seminar

The goals of the certificate training program are to:

  • Provide comprehensive instruction in the pathophysiology of diabetes and the acute and long-term complications of the disease
  • Teach current approaches to the medical management of diabetic patients, with special emphasis on nutrition and pharmacologic therapies
  • Help pharmacists understand their important role as drug therapy experts on the diabetes health care team
  • Provide pharmacists with information about becoming a Certified Diabetes Educator, and about other diabetes management-related credentialing opportunities
  • Introduce pharmacists to their broader responsibilities as a diabetes educator, with special emphasis on communication skills and the psychosocial aspects of diabetes

 

Self-Study Module Descriptions and Learning Objectives

The self-study learning activity is meant to ensure that all participants have a solid understanding of the role of pharmacists as core members of the diabetes care team. The three learning modules present in-depth information on the disease state, management and monitoring strategies, and educational strategies and psychosocial issues. As pharmacists work through the self-study activity, they will learn more about the important role of pharmacists in empowering patients to make the best use of their medications to achieve the desired therapeutic outcomes.


Module 1. Diabetes: The Disease State and Its Complications

After completing this module, pharmacists will be able to:

  • Describe the team approach to diabetes education and define the pharmacist’s role on that team
  • Define the term “diabetes educator†and list the requirements for certification(s)
  • Define diabetes mellitus and describe key features of its two major clinical subclasses
  • Discuss the growing prevalence of diabetes
  • Describe the role of glucose in the body and state its optimal blood concentration
  • Explain the normal process of glucose metabolism when glucose levels are low (fasting state) and when glucose levels are high (fed state)
  • Describe the defects in carbohydrate metabolism that occur in type 1 diabetes and type 2 diabetes and explain how they are related to the etiology of each type
  • Compare and contrast the etiology and common symptoms of type 1 diabetes and type 2 diabetes
  • Define pre-diabetes and discuss interventions that have been shown to delay or prevent the development of type 2 diabetes
  • Discuss insulin resistance syndrome and name five metabolic abnormalities associated with it
  • Describe the various tests that are used to diagnose and monitor diabetes
  • Discuss hypoglycemia and hyperglycemia as acute complications of diabetes and describe methods of treating both conditions
  • List and describe the mechanisms thought to be responsible for the vascular damage that leads to many of the long-term complications of diabetes
  • Compare and contrast microvascular and macrovascular complications of diabetes
  • Describe the pathogenesis of the following long-term complications of diabetes: neuropathy, retinopathy, and nephropathy
  • Discuss the results of the Diabetes Control and Complications Trial, the United Kingdom Prospective Diabetes Study, and other pertinent trials and explain how these studies have influenced approaches to the treatment of diabetes
  • Explain the concept of patient self-management in diabetes.


Module 2. Diabetes: Management and Monitoring Strategies

After completing this module, pharmacists will be able to:

  • List the basic objectives in the treatment of diabetes mellitus
  • Explain the roles of nutrition, exercise, education, drugs, self-monitoring of blood glucose (the five NEEDS), assessment, and follow-up that constitute a comprehensive management strategy for diabetes
  • List specific goals of nutrition therapy for diabetes and describe different strategies for achieving these goals in type 1 and type 2 diabetes
  • Discuss the relative contributions of proteins, fats, carbohydrates, and various micronutrients to healthy eating plans for patients with diabetes
  • Describe various meal planning techniques used by patients with diabetes
  • Discuss fuel metabolism and glucose regulation during exercise
  • Compare and contrast important exercise-related considerations for patients with type 1 and type 2 diabetes
  • Describe the exogenous insulin preparations currently available and discuss important considerations regarding the mixing and storage of insulins and the choice of injection site
  • Compare and contrast standard and intensive insulin therapy regimens in terms of treatment objectives, number and timing of injections, and dosage adjustment
  • List the oral antidiabetic agents currently used in the treatment of type 2 diabetes and identify types of patients who may benefit most from each agent
  • Discuss the rationale for and composition of combination drug therapy for type 2 diabetes
  • Discuss the treatment of coexisting lipid disorders or hypertension in patients with diabetes
  • Describe treatment options for complications of diabetes, including neuropathic pain, orthostatic hypotension, gastroparesis, enteropathy, genitourinary neuropathy, nephropathy, retinopathy, and macrovascular complications
  • Explain the importance of self-monitoring of blood glucose in a diabetes treatment regimen and describe methods of performing such monitoring
  • Discuss special precautions that patients with diabetes must take in the areas of general skin care, foot care, dental care, and eye care


Module 3. Diabetes: Educational Strategies and Psychosocial Issues

After completing this module, pharmacists will be able to:

  • Explain the components of and rationale for a multidisciplinary team for diabetes education
  • Describe two different educational approaches for teaching adults with diabetes
  • Discuss the elements of the teaching process as described by the National Standards for Diabetes Self-Management Education
  • Identify and describe teaching methods used in diabetes education
  • Explain the impact that psychosocial issues have on diabetes self-care practices
  • Discuss methods for assessing psychosocial issues related to diabetes and self-care
  • Define the empowerment approach for facilitating behavior change
  • Identify steps involved in facilitating patient empowerment
  • Describe the demographics of patients affected by diabetes
  • Explain the impact of culture and health beliefs on diabetes self-care practices
  • Develop a plan for implementing diabetes care into clinical practice
  • Recall the requirements for gaining recognition from the American Diabetes Association for diabetes education programs
  • Discuss measures regarding privacy and security of patients’ protected health information that are required under the Health Insurance Portability and Accountability Act of 1996.


Pre-Seminar Exercises

After reviewing each self-study module within the certificate training program, participants will be prompted to complete that module’s learning reinforcement activities consisting of a Key Concepts Review and Case Study. These activities are intended to build upon and apply the knowledge learned in the self-study modules. They will also give participants an opportunity to identify questions and specific areas of difficulty to address during the live seminar. This activity is integral to a comprehensive learning experience and is useful for identifying personal areas for additional practice and improvement. Participants should be prepared to use the information learning within the self-study during the interactive portions of the live seminar.


Live Seminar Description and Learning Objectives

The live seminar portion of the certificate training program is an active learning seminar focusing on pharmacy practice implementation; it is based upon the experience of practitioners involved in the development and delivery of services for patients with diabetes. Participants will practice conducting a patient self-management assessment, design and implement a sample medication plan, as well as conduct a diabetic foot exam on another participant, and administer an injection and blood glucose monitoring on yourself.

After attending the live seminar, participants will be able to:

  • Discuss medications used to treat diabetes
  • Conduct a patient self-management assessment
  • Describe the elements of a diabetes self-management education program
  • Design and implement a diabetes medication plan
  • Provide diabetes self-care instruction, including use of devices, products, and equipment


Post-Seminar Final Exam

Following completion of the live seminar, participants will have two weeks to complete the open book final exam. The final exam will be conducted similarly to the self-study final exam. Log-in information and password will be provided at the seminar.  Successful completion is defined as a score of 70 percent or greater.

ACPE_logoThe American Pharmacists Association and the American Society of Consultant Pharmacists are accredited by the Accreditation Council for Pharmacy Education as providers of continuing pharmacy education.

The self-study learning portion of Pharmaceutical Care for Patients With Diabetes is approved for 18 hours (1.8 CEU) of continuing pharmacy education credit (UAN 202-999-08-097-H01-P). The seminar is approved for 6 hours (0.6 CEU) of continuing pharmacy education credit (UAN 202-999-09-229-L01-P).

Initial Release Date: April 1, 2009; Expiration Date April 1, 2012.


Completion Information:  A Certificate of Achievement is awarded to participants who successfully complete all activity requirements which include the self-study and learning reinforcement exercises, the self-study final exam, the live training seminar and the live seminar final exam.  Successful completion is defined as a score of 70 percent or greater on the self study and seminar final exams.

For more information on the program curriculum or agenda, contact the Certificate Training Department by e-mailing ctp@aphanet.org or calling 202-429-7512.

Pharmaceutical Care for Patients With Diabetes was developed by the American Pharmacists Association and the American Association of Diabetes Educators and is supported by an independent educational grant by Merck and Co., Inc.