This entry is part of an ongoing series where pharmacists describe inspiring patient interventions. Have a story you wish to share? Send it to vwood@ensembleiq.One of our patients had been struggling with getting her blood sugars sorted out despite some diet changes and having her insulin adjusted.Her sugar levels behaved inconsistently even though she claimed to be maintaining both parameters every day.I did a systems review and among the comorbidities were poorly managed asthma symptoms (rescue required 4 times a day or more on a regular basis) and in-home stress.We had discussed both of these, and the patient said the in-home stress would be moving out.In addition, after reviewing her inhaler use frequency and technique as well as trigger management I sent a recommendation to primary care to move her up to an ICS/LABA combination.We met today and downloaded her meter to review her blood sugar patterns through the day.What were previously low to mid teen numbers are now almost all single digit.She said the numbers came down when stress moved out, and dropped even further after about three weeks of regular asthma treatment.We know that one principle of chronic disease management is comorbidities affect each other.This example also shows that we not only helped two problems, we reduced the interventions necessary for a third, thus avoiding unnecessary therapy.Ken Burns is pharmacist at the Diabetes Care Centre at Sudbury Regional Hospital.
