A Diabetes Pharmaceutical Care Clinic in an Underserved Community

Background

Xavier University of Louisiana is an historically Black University (HBCU) located in New Orleans. Xavier's reputation for graduating students in the scientific disciplines is well known. It is the leading producer of African American students graduating in the fields of biology and the life sciences and number one in placing African Americans in medical schools. Additionally, as one of five HBCUs with a pharmacy school, Xavier has been a leader in producing African American pharmacists. Xavier's College of Pharmacy is dedicated to developing pharmacists who are experienced and competent in delivering pharmaceutical care, especially to those individuals in the community served by Xavier University. Its vision is to prepare pharmacy practitioners who demonstrate leadership and dedication to the medically underserved populations in our society, while striving to eliminate health care disparities. As a result, the College has developed partnerships with several ambulatory care clinics in medically underserved neighborhoods. These clinics serve as sites for clinical service and experiential education, and represent excellent resources for development of ongoing projects in disease state management, health outcomes and disparities research, and prevention research. One such clinic was the Diabetes Pharmaceutical Care Clinic (DPCC). The objectives of this report are to provide a description of the DPCC; to discuss the ongoing DPCC activities involving faculty and students prior to Hurricane Katrina in August 2005; and to discuss the impact of the abrupt discontinuation of its operation.

Overview

In 2002, Xavier University of Louisiana established the Minority Health and Health Disparities Research and Education Program (MHDREP), funded by research endowment grants from the National Center on Minority Health and Health Disparities of the National Institutes of Health, in order to contribute to the national goal of eliminating health disparities. An important goal of the MHDREP, now renamed the Center for Minority Health and Health Disparities Research and Education (CMHDRE), is to develop and test the effectiveness of models of diabetes management characterized by pharmacist-directed diabetes patient education in medically underserved communities. Pursuant to this goal, Xavier University of Louisiana's College of Pharmacy (XULACOP) established the Diabetes Pharmaceutical Care Clinic (DPCC), which was also partially supported through Xavier's Center of Excellence grant funded by the Health Resources and Services Administration of the United States Department of Health and Human Resources, in October 2003. The purpose of the DPCC was to provide a site for clinical education of Doctor of Pharmacy students, to engage community residents more actively in diabetes management, to increase the level of self-monitoring of blood glucose by patients, and ultimately to lead to better glucose control and decreased diabetes complications. This model of practice would later be expanded, based on outcomes, to include management of other chronic diseases that contribute to the problem of health disparities, including asthma and hypertension.

Description of a University-Based Diabetes Pharmaceutical Care Clinic

The College of Pharmacy acquired space through a partnership with the City of New Orleans in a city-operated clinic known as the Mandeville-Detiege Health Center, which was located in the Gert Town (GT) community less than half a mile away from Xavier's campus. Established as a residential neighborhood in the late nineteenth century, GT has historically been a predominately African American community and the home to many musicians, the hard working poor, and some small industries. In those early years, GT was recognized as a viable neighborhood in New Orleans, but more recently has seen a drastic decline in population. Xavier University has taken an active role in the community advocacy group called the Gert Town Revitalization Initiative. This group strives to improve the future outlook of the neighborhood through various channels including health care, education, housing, safety, and economics. Pre-Katrina, the GT community had a population of approximately 4,748 people, nearly 95% of whom were African American. It was estimated that earners in 40% of the households in this community brought home an annual salary of less than $10,000.¹

With the availability of office and clinic space and funding support, the XULACOP prepared and...