By Annette M. Boyle

Janet Dailey (l) and Katherine Werner (r) discuss the Diabetes Certificate Course at the Federal Pharmacist Forum in Washington this fall. Photo courtesy of Ralph H. Johnson VAMC

MYRTLE BEACH, SC—A free online certificate course on diabetes made available at the VA and DoD earlier this year already has had more than 550 enrollments and awarded 15 certificates.

As of November, at the Federal Pharmacist Forum, the program was made available for pharmacists and other healthcare professionals in the broader federal system.

“We recognized that offering accreditation in-house in conjunction with specific education and information on how to manage patients with diabetes was a win-win situation for everyone,” said program co-developer Katherine Werner, PharmD, of the Ralph H. Johnson VAMC in Myrtle Beach, SC. “The field does not need to pay out of pocket for accreditation costs, and the course expands their knowledge in diabetes management and applies the information into clinical practice to patients with a condition that is widely seen.”

A 2014 Needs Assessment survey conducted by the VHA Pharmacy Benefits Management (PBM) Education Advisory Committee identified diabetes as the No. 1 topic on which pharmacy staff desired additional education and training. More than 11,000 VA pharmacy employees were surveyed, and 2,377 responded.

The online format circumvents problems in continuing education commonly cited by survey respondents, including being too busy to undertake training at work (66%), lack of VA travel funds (32%), limited off-duty personal time to participate (29%), lack of VA tuition funds (28%) and lack of organizational support or approval (27%). 

Pharmacy staff use the Moodle platform to take the self-paced certificate program, which offers 31.5 hours of free continuing education credit through the Accreditation Council for Pharmacy Education for those who register in the VA’s Talent Management System (TMS) and choose the credit option. Anyone with a .mil or .gov email address can access the Moodle platform.

Pharmacists, pharmacy technicians, students and residents and other healthcare providers who complete all 13 modules and pass the associated quizzes with a score above 80% will receive a certificate.

Werner and co-developer Janet Dailey, PharmD, VHA Pharmacy Benefits Management Services, estimate that the free program could save pharmacy staff from $700 to more than $1,000, based on the cost of similar programs offered elsewhere. For instance, a comparable program offered by the University of Florida costs $795 for five modules and 27 hours of continuing education credit, and the American Association of Diabetes Educators’ CORE Concepts online course runs $386-$586 with another $249 for the textbook for 21 hours of credit.

The diabetes program modules cover metabolic syndrome and pre-diabetes, standards of care in diabetes management, medical nutrition therapy, VA-DoD guidelines for diabetes care, management of hyperglycemia and diabetes complications as well as use of insulin and care in the elderly and special populations. Other modules discuss the national standards on diabetes self-management education, the pharmacist’s role in managing diabetes, clinic management and diabetes case studies.

Werner and Daily note that the program could be used for residency training programs, annual competency testing, expansion of the scope of practice, mentoring or as a resource for pharmacists studying for certification or recertification. It also could be a helpful resource for all health disciplines.

Managing Diabetes

The course will help pharmacists and pharmacy staff better respond to patients who have diabetes and increase the VA’s capacity to appropriately manage a growing number of diabetic veterans. “As more clinical pharmacy specialists are trained as pharmacist-providers, more veterans with uncomplicated diabetes access care in a timely fashion. This will alleviate some of the workload of specialists so they can focus on managing patients with severe complications and result in more patients with better-controlled diabetes,” Werner told U.S. Medicine.

Pharmacists have given the program good reviews so far. “Post-course survey data indicate that participants have been able to apply the knowledge and skills learned from the course to improve job performance,” Dailey said. Participants said the program has helped them improve clinic management, provide better dietary recommendations, answer provider questions and increase screening of patients with metabolic syndrome for early diabetes.

The program is designed to provide better care for patients, as well. “The benefits of developing an in-house program and offering standardized information to the entire field is a no-brainer,” Werner said. “Improved management and safety outcomes while minimizing complications for all patients throughout the entire system is our expectation.”

Previous studies have demonstrated that patients receive improved diabetes care under pharmacist-provider management when compared to usual care, Dailey noted. “Managing diabetes utilizes agents that are known to be high-risk medications, so any education and training that changes practice to minimize potential safety concerns and improve outcomes is worthwhile,” she said.

The three groups involved in the program’s development—the VA’s PBM Educational Advisory Committee, the Employee Education Service and the PBM Clinical Pharmacy Informatics Program Office—hope to roll out the Diabetes Certificate course to other federal agencies. 

“We have already established working relationships with the Public Health Service on other educational initiatives and we look forward to collaborating more with other federal partners. The educational platform is accessible outside the VA firewall, so the field and any federal employee can participate, even from the comfort of their home,” Werner told U.S. Medicine.