Managing Diabetes in the Community - Considerations in older people

Older people with diabetes often have co-morbidties and functional impairments that impact on how they use medicines. Even when every effort has been made to follow the best available evidence, medicines ‘prescribed’ doesn’t always mean medicines ‘taken’ in community settings. Decisions about medicines are often made without patient involvement or a good understanding of their reality of taking medicines. Yet ultimately, it is the patient, not the prescriber, who is the final arbiter of whether the drug is taken or not.

Also poor communication between prescribers themselves, and the many ‘others’ involved with the patient’s medicines, can lead to adverse drug events and poor outcomes.

So actualising medicines optimisation in this patient group requires

- An individualised approach to drug therapy that considers multi-morbidities, functional status, presence of frailty, polypharmacy burden, psychosocial needs and the patient’s goals and preferences

- A lead clinician within the integrated team to co-ordinate all aspects of medicines related care

This session demonstrates how pharmacists can utilise patient centred medication reviews and consultations as a strategy to optimise medicines use for patients living in community settings. It identifies and tackles underlying, often unresolved issues associated with poor therapeutic management of blood glucose, blood pressure and long-term diabetic complications.