Bridging the Gap: Reducing Health Disparities in Diabetes Care through a Community Health Promoter/Pharmacist Team

Bridging the Gap: Reducing Health Disparities in Diabetes Care through a Community Health Promoter/Pharmacist Team

Background: Diabetes disproportionately affects African Americans and Latinos in both disease burden and rates of diabetic complications. Multiple factors contribute to these health disparities, such as limited resources, low literacy, and language barriers, which can make treatment for diabetes more difficult. Traditional models of care focus on physician visits and medication adherence to improve diabetes outcomes. However, without focused interventions that help address other barriers embedded in the context of patients’ lives, health disparities in diabetes have persisted.

Hypothesis: We propose that community-based health promoters, as part of a team based approach with a clinical pharmacist, may help reduce diabetes disparities by addressing lifestyle and medication adherence barriers.

Methods: We are performing a randomized, controlled trial to evaluate the cost and effectiveness of providing a health promoter/pharmacist team targeting African Americans and Latinos with uncontrolled diabetes (A1c ≥8). Three hundred patients who receive their primary care at University of Illinois Medical Center are being recruited and randomized to either: (1) a clinical pharmacist or (2) a clinical pharmacist + health promoter. After one year, a cross-over design will allow patients in group 1 to have the addition of a health promoter, while patients from group 2 will have health promoters phased out. This design allows for evaluation of both the impact of health promoters and the maintenance of their impact on diabetes behaviors, A1C, blood pressure, and lipids.

Conclusion: A novel pharmacist/health promoter team-based intervention that targets African Americans and Latinos may help improve glucose control by improving medication adherence.