Optimizing Collaborative Care of Patients with Chronic Kidney Disease Associated with Type 2 Diabetes: An Example Practice Model at a Health Care Practice in Kentucky, United States.

Suboptimal multidisciplinary team collaboration is a barrier to effective health care provision for patients with chronic kidney disease (CKD) associated with type 2 diabetes mellitus (T2DM). We describe an example practice model of a clinical practice called Baptist Health Deaconess, based in Madisonville, Kentucky, USA, where a small multidisciplinary team consisting of an endocrinologist, nurse practitioner, and pharmacist (authors of this article) work collaboratively in an ambulatory care setting to provide health care to the patients they serve. Many of the patients who receive care at Baptist Health Deaconess are on a low income, have poor health literacy, and do not have a primary care physician. The presence of a pharmacist in the team allows for insurance/access investigations to assess drug choice and affordability; such aspects can be performed quickly with a pharmacist in the office. Plain Language Summary: Health care professionals (HCPs) supporting people living with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) may work at one or more health care settings such as a health care practice, a hospital, a pharmacy, or they might support people in their own homes. When HCPs do not work well together this negatively affects the quality of care that people visiting them receive. This paper gives the point of view of three HCPs (a nurse practitioner, a pharmacist, and a diabetes specialist [an endocrinologist]) who work at a health care practice called Baptist Health Deaconess situated in Kentucky, USA. The three HCPs describe how many of the people who visit them at their practice do not have much money, they do not really understand what their conditions are about or how they can be best treated, and they do not have a primary care physician. The HCP team believe that having a pharmacist on their team (which is not common throughout the USA) means that they work better together because it saves money, people with T2DM and CKD visiting get the best treatment recommendations for them, and this is all done quicker compared to having no pharmacist on the team. [ABSTRACT FROM AUTHOR]