Shoppers Drug Mart pharmacists provide diabetes education and life management counselling, seven days a week, in locations close to home and work. Pictured: Akeel Jaffer
When a customer visited a Shoppers Drug Mart in Toronto in June to pick up his diabetes medication, the pharmacist did something that would have been done in the past only in a doctor's office: she administered a sophisticated blood test called an A1C test.
"This particular customer thought he had been taking good care of himself, eating right and exercising, but we found his A1C a bit high," recalls the pharmacist, Lisa Ferrara. "So I referred him to a dietitian, and I also sent a fax to his doctor regarding the A1C test and recommending the addition of a medicine to help protect his kidneys."
The customer got the test as part of a new management program offered jointly by Great-West Life and Shoppers Drug Mart. Beginning in March, approximately 70,000 of the insurer's eligible group plan members received a letter from Great-West Life notifying them of the voluntary program, which directs members and eligible family members who are living with diabetes to a local Shoppers Drug Mart. There they have access to A1C testing and monitoring, medication therapy recommendations and lifestyle management counselling with certified diabetes educators or pharmacists trained in diabetes management.
"Through this program, we offer free consultations to Great-West Life group plan members who take any kind of prescription related to diabetes," says Ms. Ferrara, one of 450 Shoppers Drug Mart pharmacists who are certified diabetes educators. "At the pharmacy level, when members pick up their prescription at Shoppers Drug Mart, we can engage in a dialogue with them."
Blood glucose tests, which individuals with diabetes do several times daily, reveal blood sugar levels only at the time of testing. By comparison, an A1C test shows a person's average blood sugar level for the past two to three months. The test determines what percentage of the oxygen-carrying red blood cells, called hemoglobin, are coated with sugar.
Shoppers Drug Mart pharmacists provide diabetes education and life management counselling, seven days a week, in locations close to home and work. Pictured above: Akeel Jaffer. SUPPLIED
"Once glucose sticks to the red blood cell, it remains stuck there until the end of the cell's life cycle, which generally lasts 120 days," explains Ms. Ferrara. "When your blood sugar level is high, more glucose will be stuck to the red blood cells."
The test, which uses a blood sample, takes only about five minutes to administer and does not require fasting or any kind of preparation. It can be repeated every three months and is free for eligible Great-West Life group plan members or their eligible family members.
A high A1C test reading points to poor blood glucose (sugar) control, which increases the risk of complications such as nerve, kidney or eye disease, Ms. Ferrara says, noting that people with well-managed diabetes should get an A1C result of seven per cent or lower. Anything above than may mean the person needs to take action to bring his or her diabetes under better control.
Keeping your A1C at or below 7.0 can reduce your chances of serious events such as heart attack and stroke by 50 per cent, as outlined in the Canadian Diabetes Association's 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada.
"It's empowering to patients to know their A1C number. "Studies have shown that keeping your A1C under seven per cent decreases your risk for complications. A one per cent decrease in A1C can decrease your risk of these complications by 40 per cent – that is huge." Lisa Ferrara is a Pharmacist at Shoppers Drug Mart
Ms. Ferrara says that it's empowering to patients to know their A1C number. "Studies have shown that keeping your A1C under seven per cent decreases your risk for complications," she explains. "A one per cent decrease in A1C can decrease your risk of these complications by 40 per cent – that is huge."
Canadians diagnosed with diabetes usually have their A1C levels tested periodically by their doctors. The Canadian Diabetes Association has also approved the A1C test as a tool for monitoring diabetes.
The Shoppers Drug Mart agreement with Great-West Life gives plan members the convenience of getting their average blood glucose (sugar) level measured at the Shoppers Drug Mart closest to their work or home. Because the stores are open seven days a week and have extended business hours – some operate around the clock – Great-West Life plan members with access to the diabetes program can have the test done at a time that works best for them, says Ms. Ferrara.
An appointment is needed to get the A1C test performed by a Shoppers Drug Mart pharmacist. Once members have registered for the program through the innovative Shoppers Drug Mart scheduler (Shoppersbooknow.ca), they can find locations that offer the A1C test and book their appointment online. They also have the option of contacting a dedicated pharmacy team member at a call centre to schedule the appointment.
Ms. Ferrara has seen first-hand the benefits of the Shoppers Drug Mart A1C testing program. The customer she tested in June returned in September for another test, and the result was below seven per cent.
"His doctor had taken my recommendation and put him on kidney medication, and the dietitian we referred him to helped him improve his diet," says Ms. Ferrara. "The customer was extremely thrilled, and he thanked me."