In practice
The following scenarios focus on decision making, communication and taking a patient-centred approach. Review each one and come up with a suitable response to manage the situation. You may wish to practise these responses with another member of your pharmacy team.
Amy has recently been diagnosed with type 2 diabetes. She has been carrying a prescription for metformin around for several days because she’s reluctant to start taking it. She has finally come to you to get a bit more information.
How would you explain the condition and this initial treatment?
Rahul is 41 and was diagnosed with impaired fasting glucose about four years ago. He has been told that he has type 2 diabetes and that he needs to attend a structured education programme. He is annoyed because he doesn’t understand why he has to attend the course and he’s struggling to get time off work to go.
How can you help Rahul to see the value in attending the course and address his concerns?
George was diagnosed with type 2 diabetes several years ago and then with peripheral neuropathy a year later. He also has hypertension, which has been well controlled to date. George is concerned that the blood pressure medicine may cause “problems downstairs” and he’s anxious not to let his new girlfriend down.
How would you help George to understand that stopping the medicine is likely to accelerate the underlying cause much more rapidly?
Marie has recently started taking sitagliptin in addition to her existing prescription for metformin. A friend told her that this meant she needed to start self-testing her blood glucose, but the doctor didn’t mention this to Marie. She is keen to self-test if that will reduce her risk of complications.
What would you say to Marie to ensure that she can manage her condition with confidence and to reassure her that the treatment is in line with current evidence?