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AMBULATORY CARE

Diabetes Mellitus Non-Glucose Monitoring: Point-of-Care Testing

Assistant Professor, Department of Pharmacy, Clinical and Administrative Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK

Mark L Britton, PharmD CDE

Associate Dean for Academic Affairs, Associate Professor, Department of Pharmacy, Clinical and Administrative Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center

Reprints: Becky L Armor PharmD CDE, College of Pharmacy, University of Oklahoma Health Sciences Center, 1110 N. Stonewall, Oklahoma City, OK 73117-1223, fax 405/271-3830, becky-armor{at}ouhsc.edu

OBJECTIVE: To review and evaluate reimbursable point-of-care testing devices yielding immediate results, other than glucometers, that are available to evaluate and monitor diabetes and its complications and to describe how pharmacists may use these devices.

DATA SOURCES: A MEDLINE search (1966–March 2003) was performed using the following search terms: point-of-care systems, clinical diabetes monitoring, decision support systems, glycosylated hemoglobin, and microalbumin. Pertinent company and product Web sites and customer service departments were accessed for information about point-of-care devices and supplies.

STUDY SELECTION AND DATA EXTRACTION: All descriptive, evaluative, and comparative articles and product information were reviewed, and relevant information was included.

DATA SYNTHESIS: Diabetes mellitus is a complex, chronic metabolic disease that is a challenging management problem and requires routine monitoring for disease control and screening for complications. Point-of-care tests are available to monitor hemoglobin A_1c, glucose, fructosamine, ketones, lipid profiles, urinary microalbumin concentrations, and alanine aminotransferase concentrations. Many of these tests are Clinical Laboratory Improvement Amendments (CLIA)–waived and, therefore, practical for pharmacists to use in a variety of settings. Tests for measuring sensation are also discussed. Pharmacists should consider each of these tests in the establishment of a comprehensive diabetes care service.

CONCLUSIONS: The availability of many new point-of-care testing methods creates new opportunities for pharmacists to monitor drug therapy and screen for complications in patients with diabetes. Reimbursement is possible since many of these tests are CLIA-waived.

Key Words: diabetes, pharmacy practice, point-of-care tests

Published Online, April 30, 2004. www.theannals.com, DOI 10.1345/aph.1D247

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