Above: Barrera, McLemore and Nair at the Diabetes Expo in San Antonio, Texas.
Unexpected celebrityOne Saturday morning in August, a line formed to meet three women at a San Antonio mall.
To an outsider, it may have looked like they were local celebrities, or at the very least giving away tickets to a Spurs game. But the reason for their popularity was something quite different: They were offering pharmacist expertise and advice at a community diabetes expo.
Mini Nair, Cynthia Barrera and Victoria McLemore are all Walgreens pharmacists in areas around San Antonio, a city known for the Alamo, amazing Tex-Mex food, a strong military presence … and a notably high prevalence of diabetes. As community pharmacists, they’re used to seeing many patients with disease; it’s not unusual for McLemore to go an entire day seeing only patients with diabetes, or for Nair to help a patient figure out how to work his blood glucose monitor. In the rural border town where Barrera’s Walgreens is located, a lack of access to health care and high rates of poverty mean fielding frequent phone calls from patients needing her to decipher their glucose readings.
Despite this, all three were a little shocked at the clamoring crowd wanting their attention and advice, demonstrating the dire need for education and awareness. “People were coming up to me with prescriptions that had been sitting in their wallet for months, if not longer,” says Barrera. “Until they talked to me and I addressed their fears, they’d had no intention of filling it.”
Standing nearby, Aimee Lusson, Health Care Supervisor for the San Antonio, Texas, area, watched proudly as the three pharmacists answered questions about nutrition and affording medications, as well as basic health care inquiries about flu shots and travel vaccines.
“These pharmacists came in on a Saturday, on their own time,” Lusson says of the expo, a community event co-sponsored by local health provider WellMed and UnitedHealthcare. “I think by the end of the event, all three had lost their voices, but they didn’t care. They just wanted to do more for the communities they serve.”
Filling the voidWhen Lusson first took on her role, she immediately saw a tremendous need for diabetes care in the area. High rates of poverty, lack of access to primary care and poor nutrition had created a perfect storm for the disease, for which pharmacists were often the only port.
She witnessed countless examples that drilled home the need for this local, accessible care – for example, the patient with diabetes who drank copious amounts of soda and couldn’t understand why his A1C was skyrocketing. Or patients taking less of their medicines than directed, trying to “stretch” prescriptions out when they couldn’t afford them. In these real-life cases, simple conversations – explaining the need for proper dosage, calling doctors to try to find lower-cost medications, showing how soda adds significant sugar to a patient’s diet – was all it took to set patients on a healthier track.
Inspired by these stories, Lusson saw more opportunity for local Walgreens pharmacists to step up.
“Our pharmacists can be that face in the community people can go to – in some cases, 24 hours a day – to help navigate things like nutrition, problems affording medicines or transportation barriers,” she says. “Whether it’s an urban desert or an economically struggling rural area with limited access to care, I feel passionate that pharmacists can fill the void.”
Accessible knowledgeIn the famous words of the late Stan Lee, with great power comes great responsibility. In the case of these pharmacists, with great accessibility comes great responsibility.
Lusson felt that pharmacists in her region would benefit from additional training, because diabetes care is constantly evolving. So in 2018, Nair, McLemore and Barrera, along with other pharmacists in high-prevalence areas took part in a special American Pharmacist Association diabetes certification course.
“In the community where I work, almost every patient I see has diabetes, so it’s important for me to be up on all the latest knowledge,” says McLemore. “I have patients who come in complaining of excessive sweating, increased urination, but they don’t realize these could be warning signs. As their neighborhood pharmacist, that’s an opportunity for me to urge them to see a physician.”
Nair believes pharmacists are an essential link between patients, doctors and insurance companies.
“If there are clinical issues, insurance issues, we are an accessible resource that can connect with a patient’s doctor and insurance without even requiring an appointment,” she says. “We can even help with something as simple as learning to use the equipment to check glucose – patients aren’t always comfortable doing it on their own. Being a walk-in health professional who has developed a relationship with them as they come in regularly to shop our store … it can be powerful.”
A satisfying SaturdayIn the days following the expo, McLemore had new patients coming into her store, saying they’d “seen her at the mall” and asking to continue their conversations. Nair recalled the handful of people she’d educated about the various services and vaccinations available at their local Walgreens. And Barerra, back at work on the Mexican border, hoped she had spread awareness of a disease that had affected so many she knew personally and professionally. (She had done so at a mall right down the street from where she’d gone to high school, no less.)
All three found the experience so impactful, they’re hoping to do another similar event later this fall.
“It’s important to look at ways pharmacists use their knowledge to truly impact health, especially in low-income areas,” Lusson notes. “The information, education and assistance these three pharmacists were able to provide the community … I truly believe it can lead to better outcomes. When people talk about our legacy of trust at Walgreens, it’s because of pharmacists like these.”