Two pharmacists from the University of Georgia College of Pharmacy, this week published a study in U.S. Pharmacist looking at the prevalence of celiac disease and encouraging pharmacists to become proactive about helping their celiac patients.
The article was by far one of the most interesting I've read in the past few years because it gave an easy to understand overview of the disease and galvanized pharmacists to do more than just fill prescriptions. Although the article acknowledged that many pharmacists remain unsure about how to support patients with celiac disease since there is no pharmaceutical treatment, the authors suggest that pharmacists become proactive about treatment by encouraging patients with celiac disease to:
- Consult a licensed dietitian to properly learn how to manage a gluten-free diet including how to read food labels and maintain a well balanced diet.
- Encourage female patients consume at least 1,500 mg of elemental calcium to prevent bone loss.
- Remind patients of the importance of vaccinations, especially the pneumococcal and influenza vaccines.
Additionally, the authors recommend that pharmacists become keenly aware of which medications, vitamins and mineral supplements contain gluten as an inactive ingredient. Although the active ingredients of medications are required to be listed on the package inserts, there are few, if any, guidelines about inactive ingredients, especially related to starch.
The ingredients in question for a patient with celiac disease include any mention of gums and starches. Vegetable gums commonly contain gluten, however if corn starch is used, it can be assumed that it is gluten-free. Pregelatinized starch and sodium starch glycolate are derived from either corn, wheat, potatoes or rice, so they may or may not contain gluten. In the absence of proper labeling, the only way to definitively determine if a medicine is safe for a patient with celiac disease is to speak directly to the manufacturer.
Additionally, it is incredibly important to note that generic medications require the same attention as brand name drugs. Just because a brand name medication is considered gluten-free, does not mean the generic is as well.
The authors make a great case for pharmacists playing an active role in celiac disease management and improving the lives of patients. Check out the full article on Medscape.