Trying to reverse type 2 diabetes but don’t know how? Zara Syed, Lead Pharmacist, Spirit Health Group, explains how specialist pharmacy support can help make it happen – all you need to do is send your prescription to the right place.
This year, around 200,000 people in the UK – roughly one every three minutes – will be diagnosed with Type 2 diabetes (T2D). For many, it will be a daunting prospect; the condition can lead to long-term complications such as sight loss, amputation or kidney failure, as well as increasing the risk of heart attack or stroke. However, while the potential implications of diabetes are well documented, the disease is commonly misunderstood. A high percentage of people think that T2D is untreatable and irreversible. Thankfully they’re mistaken. Managed properly, with the right combination of medicine and lifestyle change, the impact of living with the condition can significantly reduce. Better still, in some cases, T2D can be overturned.
Reversing it, of course, isn’t easy; it takes determination and a willingness to reshape old habits. It can also require specialist support from a healthcare professional – but with GP services struggling to cope with demand, accessing that support can be difficult. Yet it’s not impossible. Expertise that can dramatically improve patients’ management of diabetes is now readily accessible from a surprisingly familiar source: pharmacy. You just need to choose the right one.
As the NHS adapts to meet 21st century needs, a new route is emerging that gives T2D patients anywhere in the UK access to the specialist support they need to overturn the disease. Specialist, ‘distance-selling’ pharmacies are, in addition to dispensing prescribed medicines, becoming increasingly effective in providing additional services to help patients control their diabetes. Their emergence is a welcome boost for anyone looking to reverse the disease. It’s a remarkable proposition: in addition to looking to GPs for support in managing their diabetes, patients’ ability to overturn the condition be hugely supported by the pharmacy they choose to dispense their prescription.
The diabetes ‘epidemic’
The challenge of facing up to a diabetes diagnosis is common all over the country. Recent figures show that around 3.8 million people in the UK are diagnosed with diabetes – and 90% of them have Type 2. What’s more, it’s estimated that a further million are currently living with T2D but are undiagnosed and unaware. By the end of the decade, as many as 5.5 million people could have the disease. Unfortunately, misconceptions, misinformation and poor awareness of T2D mean that many people fail to spot the signs in order to prevent it, or don’t know how to make the lifestyle adjustments that can help them manage it more effectively.
Alongside medicine, controlling T2D – and, where possible, reversing it – generally comes down to diet, activity and routine. However, human nature means that even when we know the behaviours we need to change, sustaining those changes over the long-term can be difficult. As such, the NHS has put tools in place to help patients address the challenges. NICE recommends that T2D patients are offered structured diabetes education, with GPs encouraged to refer patients to programmes within 9 months of diagnosis. However, uptake is often poor, with the average recorded adoption for type 2 programmes just 7.1% in 2017[i]. Since these programmes are often carried out at GP surgeries during the working week, attending them can intrude on day-to-day life, with patients forced to take annual leave or reschedule everyday commitments. Similarly, programmes operate within fixed schedules that require attendees to cram information into a limited timeframe and then continue learning (alone) in their own time. Unfortunately, in the Internet age, the information found online can’t always be trusted meaning patients sometimes pick up bad advice.
The underwhelming impact of structured diabetes education suggests the need for more flexible ways of delivering reliable information to patients at times that suit their individual needs. Alongside it, patients need professional support to answer their real-world questions and help keep them on the right road when their progress threatens to go off track. The theory sounds great, but how do you deliver it? Step forward the ‘specialist’ distance-selling pharmacy.
Keeping a healthy distance
First the back-story. Although it’s often overlooked, UK consumers have complete freedom to choose where they get their prescriptions dispensed. GPs are not allowed to ‘direct’ us to any particular pharmacy and we’re not restricted by geographical boundaries – we can send our prescriptions to any licensed pharmacy anywhere in the UK. Yet we rarely take advantage of the opportunity – often choosing the dispensary at our practice or the nearest high street pharmacy. However, whilst convenient, these may not always be the best options. Alternatives exist that provide value for patients far beyond medicine. ‘Distance-selling’ pharmacy is one such option.
Distance-selling pharmacies are registered pharmacies that, as the name suggests, provide pharmacy services ‘at a distance’, including via the internet. Unlike traditional bricks and mortar pharmacies, distance-selling providers are forbidden from face-to-face engagement with patients and must service every part of the UK rather than a defined locality. Once a patient has registered, prescriptions can be collected by pharmacy staff or received in the post or electronically from a patient’s GP. Crucially, distance-selling pharmacies are able to offer ‘enhanced’ services to patients that can be harder for busy high street pharmacies or dispensing practices to provide.
For example, unlike high street pharmacies, which by their nature have to be generalists, distance-selling pharmacies have the ability to specialise in services and medicines to support specific conditions. In fact, the specialist model is well-suited to diabetes, providing a gateway for patients to access personalised support, advice and education for the duration of their treatment. The best are run by pharmacists that specialise in diabetes, allowing them to provide expert one-to-one telephone or digital support for patients. This attribute distinguishes distance-selling providers from ‘faceless and voiceless’ online pharmacy. In addition, some distance operators provide innovative – and properly supported – ‘On Demand’ models of diabetes education that are accessible anytime, and anywhere.
Specialist pharmacy, provided at distance, offers advantages that are rarely available via traditional routes of NHS care. Patients are able to build trusted relationships with expert healthcare professionals that are simply not possible within busy healthcare services or on the hectic shop floor of retail pharmacy. Although community pharmacists are highly accessible, private dialogue with them in crowded public environments is often impossible. Distance-selling pharmacy, on the other hand, provides a safe, convenient and confidential environment, giving patients the time and space to have what can often be quite personal conversations with experts, without feeling rushed or exposed. What’s more, because these services are run by specialists, patients have the reassurance of knowing that the information they’re being given is reliable, accurate and, crucially, helpful.
Fundamentally, specialist distance-selling pharmacies give patients easy access to trusted information, support and expertise that’s rarely available anywhere else in the NHS. Their services can play a huge role in helping T2D patients manage – and indeed reverse – their condition. However, provision of these services, whilst open to anyone diagnosed with T2D, is intrinsically linked to the prescription. Patients can only benefit from the specialist services on offer if their prescription is dispensed by the same provider.
The message for T2D patients is therefore simple: it’s more than possible to reverse your condition. But doing so could ultimately depend on the pharmacy you choose to dispense your prescription. Ironically, in the final reckoning, it’s the distance that could bring you closer to your goal.
[i] The Healthcare Quality Improvement Partnership (HQIP). National Diabetes Audit, 2016-17 report 1: care processes and treatment targets England and Wales. 2018. https://www.hqip.org.uk/wp-content/uploads/2018/03/National-Diabetes-Audit-2016-17-Report-1-Care-Processes-and-Treatment-T….pdf (accessed 17 September 2019)
This article was written by Medilink EM Member The Spirit Health Group. For more information on Medilink EM Membership, click here