I had the opportunity to chat with Samina yesterday at #ENDO2013 at the poster session. She was presenting an RCT designed to address health disparities in diabetes care through a community-based intervention comparing health promoter + clinical pharmacist vs health promoter alone in a cross-over design of a year each per intervention. Such intervention is expected to address barriers to compliance with medication and lifestyle modification. The health promoter and/or clinical pharmacist will visit the patients at home or meet up with them in the community and do phone call visits as well.
What an interesting idea! It caught my eye since the abstract said that traditional models focus on physician visits to improve adherence. As a clinician, I do admit that getting a patient to comply with both lifestyle and modification can be challenging! And it would be nice if the advice I give in the short time I have in a patient encounter can be reinforced by either a health promoter or a clinical pharmacist.
Such health disparities are happening as well in my own country, the Philippines, were health care is mostly out-of-pocket. I did ask Samina why they chose pharmacists instead of nurses and she replied that pharmacists are able to recommend dose adjustments of medications and address any possible adverse effects from medication use. I told her that back home (as far as I know) we have more nurses than pharmacists and that perhaps if I were to adopt a similar strategy, the team will probably be composed of a nurse and a barangay (community) health worker.
Nice to meet you Samina!