Implementation of a Diabetes Self-Management Education (DSME) Program as part of Discharge Counseling at a County Hospital.

The CDC reports 30.3 million people in the United States have diabetes. Adults with diabetes that received Diabetes Self Management Education (DSME) have been shown to have improved outcomes and reduced healthcare expenditures. Those that did not receive DSME are four times more likely to develop complications. The 2016 American Diabetes Association (ADA) Standards of Care in Diabetes recommends that every person receive DSME at diagnosis and as needed thereafter, such as during hospital discharge.

Diabetes education is most commonly provided by a Certified Diabetes Educator (CDE), most of whom are nurses or dietitians but about 8% of CDEs are pharmacists. At Zuckerberg San Francisco General Hospital and Trauma Center, there has not been a certified diabetes nurse educator (RN CDE) for the past 4 years. Pharmacists have the clinical training and counseling skills to be effective diabetes educators whether or not they are CDEs. Since August 2017, a pharmacist CDE along with the clinical pharmacy staff have been providing diabetes education along with discharge medication counseling to patients with diabetes prior to hospital discharge.

Currently, national rates of newly diagnosed patients that report receiving DSME in their first year ranges from 4-7%. The Center for Disease Control (CDC) reports that 57.4% of people with diabetes report ever attending a DSME class and that 59.8% report ever attending a DSME class within California. At ZSFG, the pharmacist CDE and clinical pharmacy staff provide DSME to patients with newly diagnosed diabetes, diabetic ketoacidosis and diabetic exacerbations. From May 2017 to September 2018 quarterly DSME rates increased from 0.6% in quarter 2 of 2017 to 97.8% in quarter 3 of 2018. Thus, showing that pharmacists can be a valuable resource to improve inpatient diabetes education rates in an institutional setting.


L.I. Mulala: None.

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