Clinical Pharmacy Forum
Monday, November 13, 2023
01:00 PM–02:30 PM
Abstract
Service or Program:
HEED the GAP is a pharmacist led Emergency Department initiative at UI Health. It identifies and provides glucagon to patients at risk of hypoglycemia, especially those with Diabetes Mellitus (DM) on hypoglycemic medications. This initiative is an adaptation of UI Health’s Naloxone access program. In this initiative, an ED pharmacist identifies at-risk patients via ED tracking board. They approach eligible patients, provide information on usage and effectiveness of glucagon, demonstrate administration of the intranasal (IN) or intramuscular (IM) formulation and offer glucagon bedside
Justification/Documentation:
In 2018, there were 242,000 ED visits and 60,000 hospital admissions for hypoglycemia in DM patients. Glucagon is a life-saving, self-administered medication that is highly effective in treating severe hypoglycemic event. However, glucagon uptake has been low in patients living with DM, due to previous formulation issues. A nationwide study demonstrated decreased glucagon fill rates among adult DM patients between 2011 and 2021. UI Health ED pilot data demonstrated that only 3% of adult patients with hypoglycemia between 2016 and 2018 were prescribed glucagon. The glucagon access program initiative at UI Health was designed to improve access to glucagon and reduce hospital admissions in the DM population.
Adaptability:
There are several considerations for adapting this labor intensive, grant funded initiative to other EDs. Leveraging the Electronic Medical Record to automate identification of at-risk patients can help integrate the initiative into ED workflow seamlessly. Identification of resources to offset medication costs can ensure sustainability of the initiative.
Significance:
DM is the second most frequent chronic disease among ED patients and EDs serve as safety nets for vulnerable populations with poor access to care. Glucagon access programs in EDs can reduce ED and hospital utilization in populations at risk of hypoglycemic events.
Presenting Author
Renee Petzel Gimbar PharmD, FAACTUniversity of Illinois at Chicago College of Pharmacy
Authors
Janet Lin MD, MPH, MBA
UIC
Anjana Maheswaran MPH
UIC
Cammeo Mauntel-Medici MPH
UIC
Yuval Eisenberg MD
UIC