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Project IMPACT: Diabetes
West Virginia Health Right
West Virginia Health Right
West Virginia Health Right (WVHR) is a free clinic with a 90% volunteer medical staff. Underserved patients in West Virginia have access to free medications, educational classes, and one-on-one consultations with the pharmacist through services provided by WVHR.
WVHR partnered with volunteer pharmacists, physicians, and other health care providers to provide patient care through Project IMPACT: Diabetes. The health center offers comprehensive primary and specialty care and is the largest free clinic in the state - seeing 20,000+ uninsured and under-insured patients each year. WVHR operates with a 90% volunteer medical staff averaging 450 volunteers. The health center is predicated on four assumptions: each person is unique and worthy of respect; basic health care is a fundamental right of all people; patients are responsible for participating in their care; and society is responsible to care for the weak and vulnerable.
Patricia White, MS and Keith Settle
West Virginia has the highest incidence of diabetes in the nation. Some of the patients seen through Project IMPACT: Diabetes have limited access to medical care. Many do not have transportation and travel infrequently to population centers for groceries, supplies, and medical care. Patients are often considered working poor, with jobs at fast food restaurants, department stores, or as waitresses. These jobs may offer health insurance, but the high cost makes this benefit unaffordable. When faced with the choice of purchasing food or medication, food is the logical choice. Poor eating habits are also passed down from generation to generation, demonstrating the importance of educating family and friends to assist their loved ones in achieving improvement in diabetes care.
Pharmacists’ Role on the Collaborative Care Team
Pharmacists meet with each patient one-on-one to review medication histories and determine the optimal route to achieving the patient’s health related goals. The pharmacist also assesses the patient’s knowledge and understanding of his/her disease. Through the Patient Self-Management Credential, the health care team realized that many patients knew little about their diabetes. Therefore, a beginner’s diabetes class was created to fill this gap. The pharmacist also meets the patient and begins personalized education on diabetes. While the steps in achieving the patient’s health related goals are determined, the reasoning behind each step is explained to the patient. Experience at this site showed that when people are explained ‘why’ something should be done, compliance increases. This additional step led to higher medication adherence. The patients’ physical and emotional wellbeing were improved, and they became more active and social. Feelings of isolation dissipated as patients realized they were not alone in their struggle. Some patients even took the information they had learned and paid it forward, sharing it with their friends and family. The pharmacists’ involvement in Project IMPACT: Diabetes was a new service for WVHR and resulted in improved care for patients with diabetes.
Relevant Statistics – Community Level
According to the West Virginia Diabetes Prevention and Control Program1:
- 229,000 (11.7%) of West Virginia adults were diagnosed with diabetes as of 2010
- 32.8/100,000 West Virginians die from diabetes as of 2009
- West Virginia Diabetes Prevention and Control Program. Health Statistics Center: West Virginia Department of Health and Human Resources. Available at: http://www.wvdiabetes.org/Portals/12/Health_Eq_Stat_Brief.pdf. Accessed July 19, 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.