In a special session on September 16, Mrs Gillian Hawksworth (a member of the Royal Pharmaceutical Society's Council and chairman of the Diabetes Task Force) launched the Society's new guidelines for community pharmacists on the care of patients with diabetes
The Royal Pharmaceutical Society's new "Guidelines for community pharmacists on the care of patients with diabetes" were launched at the Conference on September 16, after a special session on diabetes care.
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Gillian Hawksworth: advice into practice |
She explained that the guidelines consisted of an introduction to diabetes care and how to become more involved in it. This was accompanied by practice advice - which had been classified as either "essential" or "desirable" - covering the pharmacist's role in the primary prevention of diabetes, in the detection of undiagnosed diabetes and in the prevention of complications. Referral criteria and information about quality assurance were also included.
The guidelines contained information on specific diabetes articles, journals and textbooks, as well as details of courses on diabetes that were available to pharmacists and services available from the British Diabetic Association.
There was also a comprehensive appendix covering recent UK projects in diabetes care that had involved pharmacists, a critical review evaluating the pharmaceutical care of hospital inpatients with diabetes, a suggested list of professional contacts to be made, and examples of a diabetes care leaflet, a patient questionnaire and a diabetes audit.
Mrs Hawksworth hoped, given the Society's strategic objective of enabling pharmacists to make the greatest possible contribution to health care, that the guidelines would result in benefits to people with diabetes and to their carers. "I hope they will be useful in order to translate practice advice into actual practice," she said.
n Copies of the guidelines are available from the Society's practice division (fax 020 7582 3401, e-mail ACanning@rpsgb.org.uk).
Every new patient, every addition of a medicine, every alteration of a dose and every patient with a problem provided an opportunity for pharmacists to interact with their diabetic patients, Mrs Irene Gummerson (a member of the Diabetes Task Force) told the Conference.
Pharmacists who were interested in diabetes could make changes in their practice which would help extend their role in diabetes care, she said. They could display posters listing the symptoms of diabetes. They could develop a hand-out to invite questions on aspects of diabetes care; indeed, there was an example in the newly launched guidelines.
Pharmacists could stock leaflets specific to diabetes - on diet, medication, physical activity, alcohol and foot care. Mrs Gummerson kept hers in her dispensary and used them as a discussion tool. Such leaflets were available at a charge from the BDA, she said.
Now that her patients knew that she had a role and interest in diabetes care, she did not need to approach them; they came to her. They knew that she was knowledgable, could help, and would refer appropriately, if necessary.
Mrs Gummerson felt there was a need for a forum where pharmacists interested in diabetes could exchange information and ideas.
Earlier in the session, new developments in diabetes care were outlined by Mr Simon O'Neill (head of diabetes care services) and Ms Bridget Turner (health care delivery officer) of the British Diabetic Association.
Mr O'Neill said that proposals had been put forward for a revised diabetic diagnostic criterion. The fasting plasma glucose level would be reduced from 7.8 to 7.0mmol/L. This, it was hoped, would help to pick up people with symptoms of diabetes who were currently overlooked.
There was also work going on to standardise HbA1c determination. HbA1c (glycosylated haemoglobin) was a measure of long-term diabetic control, but it could not be compared between clinics. Standardisation would facilitate research comparisons, would enable easier outcomes of care, and would ease the transfer of patients between clinics. It was possible that this could impact on pharmacists, said Mr O'Neill, as there were trials going on of HbA1c testing in pharmacies.
There were new medicines appearing, including inhaled insulins, insulins for buccal absorption, and insulin pumps. Pumps were small and accurate, and insulin could be administered at a variable rate. In the UK, not many people were currently using pumps, although 55 per cent of diabetic patients in the United States used them.
Mr O'Neill told pharmacists that new monitoring methods were being developed, including non-invasive methods (especially for children, who hated to prick their fingers) and continual methods (for example, a monitoring implant).
Ms Turner told the audience about the national service framework for diabetes, which was due to be ready by spring, 2001. It was important because it put diabetes on the national agenda.
It would be set out as a package which pulled together all strands of work in diabetes nationally, including work on research and development, clinical decision making, and information technology.
The NSF would ensure national standards and models of best practice, said Ms Turner. Indeed, it would set out explicit standards of care to be delivered and would ensure that all interested agencies were involved.
It was important that pharmacists were involved, she said, because they came into contact with the most people.
Correction
We mistakenly referrred to the chairman as Mrs, instead of Dr, Gillian Hawskworth.