Dedicated to cardiometabolic care: A conversation with Christie Schumacher, PharmD
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During the early days of the COVID-19 pandemic when most people were hunkering down at home, Christie Schumacher, PharmD, BCPS, BCACP, BCCP, BC-ADM, CDCES, FCCP, kept going to her clinic in-person.
Many diabetes clinics shifted to telehealth during the COVID-19 lockdowns, but Schumacher, a clinical pharmacist at Advocate Medical Group Southeast Center in Chicago, kept seeing patients in-person because many of them did not have the capability to conduct telehealth visits.
“I went in every day during COVID,” Schumacher told Healio. “My colleagues around the country were discussing the conversion to telehealth and innovative strategies and I had to drive to clinic every day to see patients in-person to try to help them manage their diabetes. We had a large amount of COVID cases [in Chicago] in the area surrounding our clinic, and I was still going down there, seeing patients face-to-face, just making sure they had all the resources they needed to better manage their diabetes. We also had issues with medication access from pharmacies being looted, so I had to work with local pharmacists to to help get our patients their medications.”
Schumacher’s dedication during the pandemic is one of many reasons she is being honored by the Association of Diabetes Care & Education Specialists. Schumacher, who is also a professor of pharmacy practice and director of the PGY2 Ambulatory Care Pharmacy Residency Program at Midwestern University College of Pharmacy, Downers Grove Campus in Illinois, is the recipient of the 2024 Diabetes Care and Education Specialist of the Year award.
Schumacher spoke with Healio about why she decided to become a certified diabetes care and education specialist (CDCES), what mentor was most influential in her career and what she enjoys most about being a part of ADCES.
Healio: When did you decide you wanted to take up a career in health care and specifically pharmacy?
Schumacher: My mom was a pharmacist and worked at CVS for years before she recently retired. I worked as her technician while completing my undergraduate degree and she just loved her job. When I was younger, I always remembered my mom having a positive outlook on everything and enjoyed going to work every day.
I also enjoyed chemistry classes growing up, so I majored in biochemistry at the University of Michigan and was able to take pharmacy school classes, such as medicinal chemistry as electives for my undergraduate biochemistry degree. I enjoyed chemistry and learning how everything works in the body which further solidified my career choice as a pharmacist.
Healio: When did you decide to get your certification as a diabetes care and education specialist?
Schumacher: I started my career as a cardiology pharmacist. I received diabetes training during my residency and completed a heart failure traineeship when I was a resident. I came out of residency with an opportunity to start services as a heart failure pharmacist through a pilot patient-centered medical home program at Advocate Medical Group, which was co-funded with Midwestern University College of Pharmacy, Downers Grove Campus. When I was managing people with heart failure, I would get them on the correct medications. At the time. it was just an [angiotensin-converting enzyme] or [angiotensin receptor blocker] inhibitor, a beta blocker or spironolactone to reduce morbidity and mortality in heart failure; however, some of the patients would have HbA1cs of 15%, 16%. It didn't actually matter how well I managed their heart failure, if their diabetes was not well managed, it made everything a lot more difficult. What I found when I started working in cardiology was that diabetes was having a massive impact on our cardiology patients. We didn't have an endocrinologist in our clinic, so there wasn't anyone that was available all the time to help better manage diabetes. I started asking our internal medicine physicians if I could help with diabetes management as well as cardiology. After a while, our patients’ outcomes for diabetes started to improve and the providers asked if I could start managing diabetes in addition to heart failure. This was the point in my career where I decided to start attending diabetes conferences to learn more and sat for the for the CDCES and BC-ADM exams.
Healio: Did you have a mentor who helped you, especially early in your career?
Schumacher: I was lucky I had a mentor, Mary Ann Kliethermes, PharmD. She was my mentor at Midwestern, and she had experience starting services. I started in 2009, and there wasn’t a lot of pharmacists managing people with heart failure and diabetes in physician offices 2009. I needed guidance in terms of developing protocols, building a workflow and creating something sustainable, because there’s a million different things you can do. She was really helpful with building relationships, developing resources, navigating the role, especially being co-funded with a university, helping with expansion and growth, and basically everything needed in clinical service development.
Healio: Is there an achievement in your career that you are most proud of and why?
Schumacher: My biggest achievement is the growth of our practice site. When I started, it was just myself and a nurse practitioner doing heart failure management. Now we have three pharmacists doing comprehensive chronic disease state management. I feel like we’ve grown pharmacy services since I’ve started in 2009. Our patients are a lot healthier because we have shifted to a comprehensive chronic disease management focus, which focuses on managing all the co-conditions including, diabetes, heart failure, chronic kidney disease, etc. When I first started, we had a lot of really sick patients. Our team has evolved, and we’ve definitely grown and focus more on chronic disease management. You can see it in the health of our patients, a lot less people go to the hospital than when I first started.
Healio: What do you like most about the Association of Diabetes Care & Education Specialists? What drives you to be involved with the organization?
Schumacher: I like it because it’s interdisciplinary. I like hearing what other professions are doing, it’s just a different perspective. In pharmacy, we’re very data focused and obviously medication focused. I enjoy ADCES because you get a more robust picture of what’s going on in diabetes management. I enjoy going to some of the different sessions and learning what others are doing and their clinical practice sites. I also enjoy the online resources the organization provides, such as Danatech. Recently, I’ve been more involved as a speaker just because of my cardiometabolic background.
Healio: What’s up next for you? Is there any project or research that you’re currently working on?
Schumacher: Our clinic is pretty well expanded. There’s three pharmacists and six physicians, so we’re in a good place. Recently, I’ve been trying to wrap up a couple of research projects. I was looking at SGLT2 inhibitors and acute kidney injury, and whether or not the use of [angiotensin-converting enzyme] inhibitors, [angiotensin receptor blocker] inhibitors, or a diuretic around the same time might precipitate acute kidney injury. What we’re learning is that SGLT2 inhibitors have a low risk of acute kidney injury in our population in general. Then, I’m doing another study about hyperkalemia and SGLT2 inhibitors. Recently I have been conducting research on SGLT2 inhibitors. We have a large database of people within Advocate Health that are on SGLT2 inhibitors that we can pull from.
I do want to look at more continuous glucose monitoring data. I’m always amazed about how we’re still fighting for CGM coverage and why it is sometimes only cover for those on insulin. I feel like everyone could benefit from a CGM and it should be offered like a glucometer. They have been game changing at our practice site. I want to try to get more into the real-world CGM data with our population.
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