Program Overview

Community pharmacists from Grundy, Oakwood, and the surrounding rural area of Virginia have teamed up with local health clinics and a mobile health unit to bring diabetes care to rural, underinsured people in the Appalachian Region of southwestern Virginia. Through the Project IMPACT: Diabetes grant and clinical faculty subsidy by the Appalachian College of Pharmacy and partners, the services are provided at no cost to patients.

Appalachian College of Pharmacy (ACP) offers the only three-year doctor of pharmacy program in the commonwealth of Virginia, and is committed to serving the needs of rural and underserved communities in Appalachia and throughout the world. A majority of ACP graduates practice pharmacy in the Appalachian Region, positively impacting health care in an underserved population. The mission of ACP is to cultivate a learning community committed to education, community outreach, and the professional development of pharmacists.

For Project IMPACT: Diabetes, ACP has established seven interprofessional sites at which its 126 patients can meet with a pharmacist to receive focused education about diabetes, medications, and self-management strategies.

Program Partners

ACP partnerships for Project IMPACT: Diabetes include Buchanan Health Diabetes Center, Johnston Memorial Hospital Diabetes Care Center, Health Wagon, Southwest Virginia Community Health Services, and Antioch Church.

Community Champion: 

Elshamly Abdelfattah, PharmD

Patient Profile

Participating patients are rural Appalachian-area residents with uncontrolled diabetes.  Patients were eligible to participate if his or her A1C was greater than 9%.  In general, the population consists of people with low educational and socioeconomic statuses. Additionally, the rural geography adversely affects patients’ ability to make and keep appointments, as does lack of access to transportation, high poverty rates, and other socioeconomic issues. Partnering with the Health Wagon helps to reach some of the less accessible individuals in need of care.

Pharmacists’ Role on the Collaborative Care Team

Community pharmacists act to enroll patients in the program. Pharmacists first meet with patients at a clinic near their homes in order to conduct an initial diabetes assessment. They administer a knowledge assessment to determine what they already understand about their diabetes and identify gaps for educational focus. Visits are scheduled with patients on an every-other-month basis. Pharmacists educate patients on the American Association of Diabetes Educators 7 behavioral goals to manage their diabetes. Vital signs are recorded and necessary lab tests ordered as part of every visit. Visits usually last between 15 and 30 minutes. Patients are contacted by phone and in person at churches, clinics, and pharmacies to maintain active engagement with patients in the program. Pharmacists collaborate and communicate with other members of the healthcare teams providing care to patients.

Relevant Statistics – Community Level

According to the Virginia Department of Health²:

• In 2010, Virginia ranked as having the 25^th highest age-adjusted prevalence of diabetes among adults in the U.S. (estimated at 8.3%)¹
• Prevalence by income ranges from 6.0% of those who make $50,000 or more per year to 18.4% of those who make less than $15,000
• In Buchanan County, where the pharmacy school is located, 12.3% of patients have diabetes and the median household income for 2007-2011 was $30,606 

Learn more about Appalachian College of Pharmacy Clinic from its profile in Pharmacy Today.

View a video to learn more about this community and its patients before Project IMPACT: Diabetes.

References

1. Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report. Increasing prevalence of diagnosed diabetes - Unites States and Puerto Rico, 1995-2010. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6145a4.htm. Accessed July 2, 2013.
2. Virginia Department of Health. Diabetes in Virginia. Available at: http://www.vdh.virginia.gov/ofhs/prevention/diabetes/documents/2012/pdf/Diabetes%20Burden%20Report1.pdf. Accessed on July 3, 2013.
3. U.S. Census Bureau. (2011, January 12). State & county Quickfacts: Allegany County, N.Y., Available from http://quickfacts.census.gov. Accessed on July 3, 2013.
4. Centers for Disease Control and Prevention. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011.
5. American Diabetes Association. Fast Facts Data and Statistics About Diabetes. Available at: http://professional.diabetes.org/admin/UserFiles/0%20-%20Sean/FastFacts%20March%202013.pdf. Accessed June 12, 2013.

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