Project IMPACT: Diabetes
Centro De Salud Familiar La Fe, Inc.
Centro de Salud Familiar La Fe, Inc. (La Fe) is a not-for-profit 501(c)3 community-based organization that has over a 40-year history of advocacy and service delivery to disadvantaged and underserved communities of El Paso, Texas. As a federally qualified community health center, La Fe takes a holistic approach when caring for their patients’ health and well-being, striving to improve the overall quality of life of the people they serve. In addition to health care services, La Fe provides the community with a charter school and a cultural and technology center with classes such as cooking, music, and computer literacy.
In the video to the right, community members discuss the type of care patients received during Project IMPACT: Diabetes and the role pharmacists played in improving people's health.
La Fe was committed to maintaining a holistic approach while implementing Project IMPACT: Diabetes. They organized an integrated care team who would provide a comprehensive diabetes program to their patients. The departments involved in the Project IMPACT: Diabetes program at La Fe included pharmacy, medical, dental, social services, health education, laboratory, and the cultural center. Using a collaborative team approach, the team was able to customize the care provided to meet the needs of each individual patient to ensure each patient would receive all the services they could benefit from that were offered at La Fe.
La Fe also partners with the University of Texas at El Paso/University of Texas at Austin Cooperative Pharmacy Program. This partnership facilitates the development and expansion of clinical pharmacy services at La Fe while teaching pharmacy students and residents about the value of collaborative care.
Albert Lucero, Jeri Sias & Jennifer Castrellon
La Fe provides care to a primarily underinsured Spanish-speaking population near the US-Mexico border. Patients often experience limited levels of literacy and may face barriers that create issues with access to care or adherence to medications and diabetes recommendations. Some patients may not seek health care until they feel sick, and as such are often diagnosed with diabetes after the disease has progressed to such a state that it causes complications. However, there are many patients who maintain healthy lifestyles and participate actively to improve their health through education, appointments, and adherence to medication.
Pharmacists’ Role on the Collaborative Care Team
Pharmacists play an important role on the collaborative diabetes care team at La Fe. Patients who would benefit from individual diabetes management are referred to the pharmacist by physicians and other providers at the clinic. During appointments, pharmacists use their medication expertise to review medication therapy and diabetes standards of care (e.g., foot exams, immunizations) with each patient. As part of the healthcare team, pharmacists tailor education to each patient’s needs and assess potential barriers that may limit the patient’s adherence to medication or treatment recommendations. Based on the pharmacist’s interactions with the patient, appropriate referrals/recommendations may be made to specialty services (e.g., social work, health education, dental, optometry). Pharmacists work together with the health education team to provide group classes covering topics such as exercise, healthy nutrition, stress management, depression, medication management, glucometer training, and self-management. The pharmacist also attends the grocery store tours at local markets where the patient purchases food for a family of four with a budget of only $5.00. This holistic, collaborative approach to diabetes care has been well received by the patients and shown significant improvements in key clinical outcomes.
Relevant Statistics – Community Level
According to the Texas Diabetes Prevention and Control Program1:
- It is estimated that 9.7% of adults 18 years and older in Texas have been diagnosed with diabetes
- Nearly 1.8 million adults in Texas have been diagnosed with diabetes
- In Texas, diabetes disproportionately affects black adults, people over the age of 65, and those who have a high school degree or less as their highest level of education
- Source: Texas Diabetes Prevention and Control Program. Diabetes Status in Texas, 2012. Available at: http://www.dshs.state.tx.us/diabetes/tdcdata.shtm. Accessed June 17, 2013.
- 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.
- 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.