Computerized Monitoring Protocols as a Pharmaceutical Care Practice Enhancement: A Conceptual Illustration Using Diabetes Mellitus

Abstract

Spanish

French

OBJECTIVE:

To illustrate how a computer system used in an ambulatory care pharmacy setting might enhance care of patients with diabetes by prospectively monitoring and prompting them to seek routine medical care.

DATA SOURCES:

A MEDLINE search to identify existing works on informatics was conducted. An epidemiology and general medical literature review of diabetes mellitus was also performed via MEDLINE. Additionally, known textbooks on the disease were consulted.

CONCLUSIONS:

Programming a computer system to prompt pharmacists to remind their patients of necessary medical interventions could save medical resources by warning chronically ill patients not to ignore routine medical care. Also, this would allow the pharmacist to prospectively monitor patient outcomes. By knowing when medical interventions are due and obtaining feedback from patients on the results of the medical contact, pharmacists increase their knowledge about patient outcomes and the rationale behind changes in pharmacotherapy. It is expected that such a system would prevent the inconspicuous development of chronic complications.

Get full access to this article

View all access options for this article.

References

Dasta

Greer

Speedie

. Computers in healthcare: Overview and bibliography. Ann Pharmacother 1992; 26:109–17.

Woodruff

Hunt

. Involvement in medical informatics may enable pharmacists to expand their consultation potential and improve the quality of healthcare. Ann Pharmacother 1992; 26:100–4.

Foy

Eastman

Nealon

Bowen

Pengelly

Drass

. Automated therapeutic drug monitoring in an ambulatory care endocrine clinic. Ann Pharmacother 1992; 26:675–8.

Omnibus Budget Reconciliation Act Pub. L. No. 101-508., 4000-801, 104 Stat. 1388, 30-218 (1990).

Master drug data base (brochure). Indianapolis: Medi-Span. Brochure number JG2.5M0892.

Diabetes 1991 vital statistics. Alexandria, VA:American Diabetes Association, 1991:1–59.

Direct and indirect costs of diabetes in the United States in 1987. Alexandria, VA: American Diabetes Association, 1988:1–20.

Foster

. Diabetes mellitus. In: Harrison's principles of internal medicine. 12th ed. New York: McGraw-Hill, 1991:1739–79.

Siperstein

. Diabetic microangiopathy, genetics, environment, and treatment. Am J Med 1988; 85 (5A):119–30.

10.

Verrillo

de Teresa

Martino

Verrillo

di Chiara

. Long-term correction of hyperglycemia and progression of retinopathy in insulin dependent diabetes. A five year randomized prospective study. Diabetes Res 1988; 8:71–6.

11.

Klein

Moss

Davis

DeMets

. Glycosylated hemoglobin predicts the incidence and progression of diabetic retinopathy. JAMA 1988; 260:2864–71.

12.

Alvarsson

Grill

. Effect of long term glycemic control on the onset of retinopathy in IDDM subjects. A longitudinal and retrospective study. Diabetes Res 1989; 10:75–80.

13.

Krolewski

Barzilay

Warram

Martin

Pfeifer

Rand

. Risk of early-onset proliferative retinopathy in IDDM is closely related to cardiovascular autonomic neuropathy. Diabetes 1992; 41:430–7.

14.

Position statement of the American Diabetes Association. Standards of medical care for patients with diabetes mellitus. Diabetes Care 1992; 15:10–3.

15.

Position statement of the American Diabetes Association. Urine glucose and ketone determinations. Diabetes Care 1992; 15:38.