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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)
3
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/
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
4
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
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
5
Pharmaceutical Care Practitioner
• 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
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
6
Assessment
Care Plan
Follow-up
evaluation
Pharmaceutical Care Practitioner
• 
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
7
Assessment
Care Plan
Follow-up
evaluation
ACTIVITIES
1. Meet the patient
2. Collect relevant patient information
3. Make rational drug therapy decisions
Pharmaceutical Care Practitioner
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
8
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
Pharmaceutical Care Practitioner
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
9
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
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
10
-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
communication skills
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?
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
11
7
Structured patient
communication skills
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
12
Structured patient
communication skills
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?
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
13
8
Structured patient
communication skills
Conveying Data
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
14
Structured patient
communication skills
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
15
structured patient
communication skills
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
16
Time
Management Lay Language
Empathy
Non verbal
communication
Structured patient
communication skills
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
17
Structured patient
communication skills
Testing your knowledge
Identifying Facts and Myths on Diabetes
http://my.questbase.com/take.aspx?pin=3282-9630-9513
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
18
9
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
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
19
10
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
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
20
10
Patient Self-Care
Recommendations
You are educating your patient about
Hypoglycemia
• Design your own card using the page provided from
Patients’ self-care handbook
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
21
11
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
22
Education & Management of Diabetics (DH/AY/NK, April 16, 2014)
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
Do not smoke
Exercise
Foot Care
Regular checkups doctor, dentist, eye specialist
Patient Self-Care
Recommendations
23
Education & Management of Diabetics (DH/AY/NK, April 16, 2014)
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
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
24
Education & Management of Diabetics (DH/AY/NK, April 16, 2014)
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
25

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

  • 1. 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)
  • 2. 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
  • 3. 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) 3
  • 4. 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/ Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014) 4
  • 5. 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 Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014) 5
  • 6. Pharmaceutical Care Practitioner • 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 Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014) 6 Assessment Care Plan Follow-up evaluation
  • 7. Pharmaceutical Care Practitioner • Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014) 7 Assessment Care Plan Follow-up evaluation ACTIVITIES 1. Meet the patient 2. Collect relevant patient information 3. Make rational drug therapy decisions
  • 8. Pharmaceutical Care Practitioner Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014) 8 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
  • 9. Pharmaceutical Care Practitioner Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014) 9 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
  • 10. Structured patient communication skills • Establishing Rapport • Listening • Posing questions • Providing feedback Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014) 10 -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
  • 11. Structured patient communication skills 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? Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014) 11 7
  • 13. Structured patient communication skills 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? Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014) 13 8
  • 14. Structured patient communication skills Conveying Data Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014) 14
  • 18. Structured patient communication skills Testing your knowledge Identifying Facts and Myths on Diabetes http://my.questbase.com/take.aspx?pin=3282-9630-9513 Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014) 18 9
  • 19. 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 Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014) 19 10 Patient Self-Care Recommendations
  • 20. 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 Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014) 20 10 Patient Self-Care Recommendations
  • 21. You are educating your patient about Hypoglycemia • Design your own card using the page provided from Patients’ self-care handbook Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014) 21 11 Patient Self-Care Recommendations
  • 22.  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 22 Education & Management of Diabetics (DH/AY/NK, April 16, 2014) Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
  • 23. Do not smoke Exercise Foot Care Regular checkups doctor, dentist, eye specialist Patient Self-Care Recommendations 23 Education & Management of Diabetics (DH/AY/NK, April 16, 2014) Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)
  • 24. 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 24 Education & Management of Diabetics (DH/AY/NK, April 16, 2014) Education&ManagementofDiabetics(DH/AY/NK/ZGJune6,2014)

Editor's Notes

  1. 45 years Diabetic Started metformin Grape fruit consumer Titrate the dose slowly and stop grape fruit
  2. Password : MSD