Pharmacotherapy

  • This topic has 55 replies, 45 voices, and was last updated 2 weeks, 6 days ago by Shireen Ateereh.
Viewing 55 reply threads
  • Author
    Posts
    • #29443
      Faucy B
      Keymaster

      The Essentials Clinical Resource Tool (Annual)

      What barriers do you face in individualizing antihyperglycemic agents? Please share any strategies that have worked for you.

    • #31190
      Annabelle Bittle
      Participant

      The Essentials Clinical Resource Tool (Annual)

      Barriers I have encountered with patients are motivation & cost of the medications

    • #31197
      Linda Dube
      Participant

      Diabetes Education

      barriers are pt motivation and insurance coverage

    • #31198
      Linda Dube
      Participant

      Diabetes Education

      1

    • #31205
      Shauna Prouten
      Participant

      Diabetes Education

      Usually the biggest barriers are medical complexity /frailty and cost of treatment

    • #31223
      Veronica Tooley
      Participant

      Diabetes Education

      cost of medication and lack of coverage in many drug plans and patient motivation to sustain change long term

    • #31224
      Veronica Tooley
      Participant

      Diabetes Education

      above

    • #31231
      Shereen Elsayad
      Participant

      Diabetes Education

      cost, coverage and clinician reluctancy to change when A1C is at target

    • #31237
      Brittany Parmentier
      Participant

      Diabetes Education

      Cost and coverage

    • #31239
      Kyla Aben
      Participant

      Diabetes Education

      Some barriers are client hesitancy due to insufficient client knowledge and (expressed) lack of previous client involvement/engagement or client centered care with health care providers. My strategies to over come this is to work on building a therapeutic relationship that is client centered. I support building confidence and empowerment in clients management of their diabetes care. I explore their experiences and offer support and information to be able to make informed decisions with regards to their care.

    • #31243
      Linda Kelland
      Participant

      Diabetes Education

      Most common barriers encountered relating to individualizing antihyperglycemic agents are costs of the medications for the patients and fear of needles when GLP1 agonists or insulins are recommended.
      Demonstrating the ease with which these medications are delivered with demo devices helps patients accept them and feel confident using the devices.

    • #31253
      Linda Mireku
      Participant

      Diabetes Education

      Income of clients impacts the diet modifications that work well with antihyperglycemic agents. Non adherent of diet modification poses a big challenge to individualizing glycemic agents. It took a long time for a client whose main staple was ramen, to incorporate dry legumes and other cheaper options of foods with low glycemic index ratio in her diet . She could not afford healthier food options like vegetables most of the times and legumes were foreign to her.

    • #31294
      Marlena Morrison
      Participant

      Diabetes Education

      The main barriers I have faced in my practice for individualizing antihyperglycemic agents include drug coverage/cost, increased frailty, and complex comorbidities ie liver cirrhosis, ESRD, and cogntive impairment. In Ontario, where I am located, for those who do have private coverage or coverage under the Ontario Drug Benefit, I find the biggest barrier to individualizing antihyperglycemic agents is recultance to add an additional medication (ie polypharmacy) and concerns regarding potential associated side effects with some antihyperglycemic agents. I find exploring these concerns and using reflective listening to be a good approach, as well as providing the necessary education an individual needs to make an informed decision without casting judgement.

    • #31315
      Laurie Cornelis
      Participant

      The Essentials CDE Exam Prep Package

      Cost is a barrier to optimal care

    • #31316
      Laurie Cornelis
      Participant

      The Essentials CDE Exam Prep Package

      Cost is a barrier to care

    • #31329
      Ana Neves
      Participant

      Diabetes Education

      I always find if cost is a barrier to any type of treatment, then there will always be difficulty in maintaining client engagement. Diet and exercise is cumbersome to many yet the effective lifestyle changes could ultimately bring down the cost of the pharmacotherapy.

    • #31341
      Alexandra Glover
      Participant

      Diabetes Education

      Barriers I have encountered for patents are cost of medications, compliance, and diet/exercise concerns.

    • #31346
      Bukola Lumor
      Participant

      Diabetes Education

      cost ,coverage,adverse reactions are barriers

    • #31352
      Jamie Schmidtke
      Participant

      Diabetes Education

      Cost without adequate coverage, is a large barrier for treatment along with motivation towards self-care. Some barriers in seniors care, can be related to the decisions made by legal representatives towards treatment options. Whether this is related to misinformation, costs of treatments, or values/beliefs, the patient-care direction is influenced with each.

    • #31371
      Janet Wilpstra
      Participant

      Diabetes Education

      Pill burden is a big barrier for my clients as well as compliance in taking medications.
      When we begin discussing the need for an add on OHA there is often hesitancy to “take one more pill”.
      I try to offer combination options as often as possible to ease that burden as well as giving once daily options.
      Regarding compliance, I educate regarding the purpose of each of the medications so that there is an understanding of their action profile in the body and why the medication has been prescribed.

    • #31378
      Kathryn Bourque
      Participant

      Diabetes Education

      Compliance and understanding. Health literacy is an issue for many. It is necessary to use plain language and sometimes even pictures to show how and where in the body the medication is working.

    • #31382
      Ana Neves
      Participant

      Diabetes Education

      cost of treatment, accessibility and support

    • #31401
      Idia Umolu
      Participant

      The Essentials Clinical Resource Tool (Annual)

      The major barrier for most of my clients is cost. Many of them don’t have drug coverage.

    • #31402
      Muhammad Nasir Rafique
      Participant

      Diabetes Education

      Cost and patient’s motivation

    • #31417
      Hilda Mariano
      Participant

      Diabetes Education

      In the areas that I cover, access to prescribers is a huge issue. Many clients find it difficult to attend appointments with their prescriber/ Family doctor due to issues like transportation, staff turnover and racism.

    • #31419
      Julie Douville
      Participant

      Diabetes Education

      What works nicely is offering different options with their pros and cons, including insulin. Chosen option is tried and changed if needed. The decision is theirs.

    • #31421
      Roshni John
      Participant

      Diabetes Education

      Cost and lack of adherence to recommended dietary changes

    • #31439
      Su Gupta
      Participant

      Diabetes Education

      I echo all of the concerns voiced above and by far it seems that a lack of motivation, the inability to maintain the healthy eating behavior long term is a challenge. This applies to self management of most chronic conditions. As an RD CDE and health coach, I try to use more action based strategies, involve pt. more in their own decisions, empower them with easy to sue tools and encourage routine follow ups with their diabetes care team. People tend to slack off on their follow ups once the A1c is on target.

    • #31453
      faiza hemraj
      Participant

      Diabetes Education

      yes

    • #31454
      Bailey McNutt
      Participant

      The Essentials Clinical Resource Tool (Annual)

      Cost is a big issue but even when medications are covered or cost is not an issue, a lot of patients do not want to start a new medication or are only willing to start if it is place of something else.

    • #31461
      Dhiraj Verma
      Participant

      Diabetes Education

      cost is the most common barrier

    • #31466
      Michael Amatto
      Participant

      Diabetes Education

      cost/coverage issues

    • #31520
      Maike Lorenzen
      Participant

      Diabetes Education

      Costs to patients without extended healthcare plan or coverage by the government determine most of my treatment choices.

    • #31522
      Ravneet Dhillon
      Participant

      Diabetes Education

      Cost and Coverage are big barriers for most patients. This dictates treatment choices. Maintaining healthy eating choices is anouther big one.

    • #31526
      Andreane Barette
      Participant

      Diabetes Education

      Cost and coverage issues

    • #31529
      Natalie Green
      Participant

      Diabetes Education

      There are many barriers to compliance with medication. Some of which include lack of understanding and motivation, lack of funds to purchase medication, not believing that they have diabetes and concerns about medication side efects.

    • #31530
      Natalie Green
      Participant

      Diabetes Education

      Medication side effects, lack of knowledge and understanding, cost

    • #31817
      Andrea Portelance
      Participant

      Diabetes Education

      Motivation (wrap in medication compliance) probably continues to be the biggest barriers. With an ongoing aging population and increasing diagnosis for co-morbidities, motivational interviewing skills become so important to be able to evaluate where a patient is in their understanding and compliance to any changes in their regular routine (Lifestyle/nutrition/activity/financial, etc).

    • #31822
      Joanne Tremblett
      Participant

      Diabetes Education

      Cost and coverage

    • #31865
      Mary Guetg
      Participant

      Diabetes Education

      Low health literacy, transportation to appointments, lack of resources to start healthy interventions.
      Strategies that are working: allowing for longer appointments, incentivized walking program, offering ongoing support with Ozempic injections, rtCGM systems.

    • #31891
      Andrea Portelance
      Participant

      Diabetes Education

      Polypharmacy, Cost and motivation tend to be the most impacting medication adherence.

    • #31893
      Kim Scriven
      Participant

      Diabetes Education

      Cost, coverage and prescriber comfort prescribing.

    • #32192
      Saravanan Bheeman
      Participant

      Diabetes Education

      cost, adherence to medications, insurance coverage, inertia from physician’s side are some of the barriers.

    • #32232
      Puneet Kalkat
      Participant

      Diabetes Education

      mostly cost

    • #32281
      Stella
      Participant

      The Essentials Clinical Resource Tool (Annual)

      Cost/coverage issues

      most people do not have physicians to prescribe the medications needed.

    • #32287
      Barbara Hall
      Participant

      Diabetes Education

      As others have stated, cost of medications is a large barrier to changes/ additions to AHA therapy.

    • #32295
      Jasmin Gregory
      Participant

      Diabetes Education

      Agreed, the cost of medication is unfortunate for those who do not qualify for government or other funding

    • #32312
      Barbara Hall
      Participant

      Diabetes Education

      A more recent complication that has been occurring is the transfer of what is covered… Namely biosynthetic insulin has been the only insulin covered by many insurance plans now (as well as the Ontario drug benefit). I have had a lot of push back from clients, so much so that they are choosing to pay out of pocket to continue to use their current insulins. I feel as though insurance and government plans should be considering “grandfathering” in the current insulin being used by individuals. It seems like a lot of undue stress and potential issues.

    • #32324
      Abderrahmane Boumediene Derkaoui
      Participant

      Diabetes Education

      Motivation and cost are the most important barriers

    • #32325
      Abderrahmane Boumediene Derkaoui
      Participant

      Diabetes Education

      he emergence of new weight loss drugs has sparked considerable interest in the field of diabetes management, particularly in relation to diabetes remission. These innovative medications exhibit significant potential not only in aiding individuals in achieving sustainable weight loss but also in contributing to the remission of diabetes. The correlation between excess weight and the development of diabetes is well-established, and these novel drugs, with their targeted mechanisms of action, offer a promising avenue for addressing both issues simultaneously. As research progresses, there is growing optimism that these drugs may play a pivotal role in not only mitigating the symptoms of diabetes but potentially inducing remission in certain cases. The integration of these weight loss drugs into comprehensive diabetes care plans holds the promise of providing more effective and holistic treatment options for individuals struggling with both conditions, offering a new frontier in the pursuit of improved health outcomes.

    • #32332
      Manju Patil
      Participant

      Diabetes Education

      Cost is definitely in low income group or having no drug coverage. But some time physician / pharmacy also has no time to explain option for them.

    • #32333
      Manju Patil
      Participant

      Diabetes Education

      For me health education is important because different cultures have different beliefs asking open ended questions and making general about their diet helps along with medication therapy, importance of daily movement with reward helps for my clients.

    • #32334
      Manju Patil
      Participant

      Diabetes Education

      antihyperglycemic drugs based on ALC target in place and pt goal , understanding of following drug therapy with other factors

    • #32337
      Idia Umolu
      Participant

      The Essentials Clinical Resource Tool (Annual)

      Barriers faced by some clients is the affordability of medications. Some are forced to decide between buying medication or food or paying rent.

    • #32412
      Angela Walker-Sterling
      Participant

      Diabetes Education

      Ditto for cost.

    • #32424
      Shireen Ateereh
      Participant

      Diabetes Education

      Coverage eligibility for senior plans

Viewing 55 reply threads
  • You must be logged in to reply to this topic.
Scroll to Top

The
Essentials

Welcome,

Programs

Diabetes Canada

The Essentials