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Associate Professor of Medicine, Institute for Health Research and Policy, University of Illinois at Chicago
Research Assistant, Institute for Health Research and Policy, University of Illinois at Chicago
Research Assistant, Institute for Health Research and Policy, University of Illinois at Chicago
Clinical Assistant Professor/Clinical Pharmacist, Department of Pharmacy Practice, Ambulatory Care Pharmacy Services, College of Pharmacy, University of Illinois at Chicago
Clinical Assistant Professor/Clinical Pharmacist, Department of Pharmacy Practice, Ambulatory Care Pharmacy Services, College of Pharmacy, University of Illinois at Chicago
Clinical Assistant Professor/Clinical Pharmacist, Department of Pharmacy Practice, Ambulatory Care Pharmacy Services, College of Pharmacy, University of Illinois at Chicago
Professor of Community Health Sciences, Institute for Health Research and Policy, University of Illinois at Chicago
Assistant Professor of Medicine, Institute for Health Research and Policy, University of Illinois at Chicago
Reprints: Dr. Gerber, Institute for Health Research and Policy (M/C 275), University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608, fax 312/413-8950, bgerber{at}uic.edu
BACKGROUND: There is a need to improve blood glucose levels of underserved Latino patients with uncontrolled diabetes.
OBJECTIVE: To determine the feasibility of a pharmacist and health promoter team designed to address the barriers to medication adherence and adjustment and improve self-care among Latinos with type 2 diabetes.
METHODS: Clinical staff at the University of Illinois at Chicago
Medical Center referred Latino patients with uncontrolled diabetes (hemoglobin
A1c [A1C] 
8.0%) to the study. A research assistant
assessed patients on diabetes and medical history, medication list, medication
adherence and related habits, health literacy, diabetes knowledge and
numeracy, beliefs in benefits of diabetes therapy, depression, social support,
and access to care. A bilingual, bicultural health promoter reviewed these
assessments and worked with patients through home and clinic visits and
telephone calls. The health promoter communicated with a pharmacist to receive
assistance in medication management (reconciliation and adjustment).
Participants received case management for 6 months.
RESULTS: Nine patients were successfully recruited. The mean age was 58 years and mean duration of diabetes was 21 years. Successful collaboration between pharmacists and the health promoter required frequent communication and intense effort to address complex patient barriers. Health promoter contact time, in person, per participant ranged from 0 minutes to 640 minutes, and telephone call time ranged from 27 minutes to 111 minutes during the study period. Eight participants had medication adjustments during the study period, with a maximum of 7 adjustments per participant. Mean hemoglobin A1C declined from an average of 9.6% to 9.0%. Two patients are presented as case studies to describe how the pharmacist-health promoter team functioned. Information was obtained from health promoter records, survey results, and chart reviews.
CONCLUSIONS: The pharmacist and health promoter team management of uncontrolled diabetes among Latinos appears to be a feasible approach to improving medication management.
Key Words: community health aides, diabetes mellitus, type 2, Hispanic Americans, medication adherence, pharmacists
Published Online, December 22, 2009. www.theannals.com, DOI 10.1345/aph.1M389
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