Pharmacist-managed diabetes education service.

A pharmacist-managed education service for diabetes patients is described. Clinical pharmacists in three ambulatory-care centers provide diabetes-patient education based on guidelines developed and approved by the pharmacy, therapeutics, and standing orders committee. Patients are referred by their primary health-care provider; they receive individualized information concerning the pathophysiology and therapy of diabetes mellitus and instruction in self-care methods. A questionnaire completed by the patient before the initial visit aids the pharmacist in assessing the patient's educational needs, developing an individualized teaching program, and establishing long- and short-range treatment goals. The pharmacist spends one hour with the patient for the initial visit and 15 minutes for subsequent visits; patient charges are $15 for the initial visit and $7.50 for further teaching sessions. Records maintained by the pharmacist enable primary-care providers to follow the patient's progress and anticipate problems. Patients return for periodic assessment of their progress. Patient teaching by pharmacists has been provided and reimbursed in this ambulatory-care setting for 10 years. The pharmacist-educators' responsibilities include assessment, planning, instruction, and follow-up.