Pharmacist/Physician Collaboration in Diabetes

Jasmine D. Gonzalvo, PharmD; Serge Jabbour, MD; and Dhiren Patel, PharmD, share their perspectives on the importance of physicians and pharmacists working together to improve outcomes for patients with type 2 diabetes mellitus.

Jasmine D. Gonzalvo: Collaboration and care for diabetes is incredibly important. Collaboration between physicians, primary care providers, nurse practitioners, dieticians, pharmacists, diabetes educators—collaboration among all of us—is critical to support people with diabetes because they have so much to learn, retain, and apply throughout the course of their disease. So, collaboration and care are critically important for the success of a patient with diabetes.

Serge Jabbour, MD: When we manage patients who have type 2 diabetes, it’s very important to work as a team. The team is the endocrinologist or any provider, the diabetes educator, and the pharmacist. I believe pharmacists are extremely important because they are the ones who would provide all the medications to our patients. There are even pharmacists who may do diabetes teaching, train patients on how to use insulin, notify us, and so on. So, I think it’s very important for them to understand all the products we have on the market and how to train patients the right way.

Dhiren Patel, PharmD: Regarding the ways that a pharmacist could optimize care for a patient with diabetes, there are a variety of different ways. The first one, I would say, comes to care coordination and transitions of care. Those points are really important because in a patient with diabetes, there’s a lot that’s going on. You have a lot of specialists who are managing that patient, such that you end up being that hub where you’re getting prescriptions from all the different providers. You have a good idea of if the patient is taking their medications, if they’re not taking their medications, when they stopped therapy, if they were supposed to stop therapy, when a new medication got started, or if they were supposed to continue it.

And so, I think if they can serve as that person who can close some of those gaps, or at least care coordinate and make those outbound calls saying, “Mrs. Smith was started on this medication, and it wasn’t clear to her if she’s going to be stopping drug X or drug Y. What was your intention here?” Simple things like that can prevent low blood sugar down the line or a drug-drug interaction down the line. That’s just one aspect. But beyond that, medication therapy management, immunizations, and all these other factors are very important in the care of a patient with diabetes.

Jasmine D. Gonzalvo: Working with other clinicians to optimize care for people with diabetes really takes the whole team, within the primary care clinic especially. A primary care physician, nurses, diabetes educators, and pharmacists are all part of an integral group to take care of the person with diabetes. For me, the primary care physicians or physician assistants, nurse practitioners, actually refer their patients to me so that I can do cardiovascular risk reduction, including for type 2 diabetes. So, I do a lot of medication management, laboratory monitoring, and physical assessment relative to diabetes for those referrals from the primary care physician.