Public Health Practice Stories from the Field Diabetes is a manageable Pharmacists Help Improve Health of Yakama Indians Living with Diabetes disease, and with proper medication and monitoring, patients can avoid expensive, painful, and fatal complications.
American Indian and Alaska Native (AI/AN) teens and preteens have the highest rate of newly diagnosed diabetes among youth of all races and are more likely to have complications or die from the disease.
1 AI/AN adults are 2.3 times as likely as non-Hispanic whites to develop diabetes.
2 The type 2 diabetes rate among adults on the Yakama Nation Reservation in Washington is double that of the rest of the state (14.8% versus 7.7%)
.3, 4 Since 2004, the Indian Health Service (IHS) Special Diabetes Program for Indians has continuously funded 32 Healthy Heart demonstration projects to reduce cardiovascular disease risk in patients with diabetes.
The Yakama Indian Health Service used its funding to create the Yakama Healthy Heart Program (YHHP), the only demonstration project to rely on clinical pharmacists. In YHHP, patients are scheduled for pharmacist appointments coinciding with medication refill due dates.
The program has established collaborative practice agreements with medical providers for pharmacists to
• Prescribe and adjust medication for treatment of diabetes, hypertension, and hyperlipidemia
• Order and interpret laboratory results
• Perform brief physicals and foot exams
• Give immunizations
• Educate patients about cardiovascular disease risks
• Refer patients to specialists