goods Most independent pharmacies provide durable medical equipment, such as diabetes testing supplies, therapeutic shoes for diabetics, prosthetics, orthotics and other supplies to meet essential health needs. Compounding Compounding pharmacists provide customized medications ordered by prescribers, sometimes when all other options will not work. Compounded medications are prepared by pharmacists for individual patients, often with special needs, and/or as a result of relationships with medical specialists, such as Dermatologists, Oncologists, Pediatricians, and Veterinarians who are unable to take medication in its originally manufactured form. Diabetes training Independent pharmacists provide diabetes care and management to help patients achieve therapeutic and lifestyle goals. Pharmacists screen patients at high risk for diabetes, assess patient health status, educate patients to care for themselves, monitor outcomes, and when appropriate, refer patients to other health care professionals. Some independent pharmacists provide patients with diabetes self-management education/training (DSME/T) that teaches patients to adhere to the standards of care including, but not limited to, healthy diet, physical exercise, medication, self-monitoring, healthy coping and behavior change, and reducing risks (i.e. diabetic foot care). Medication therapy management Medication therapy management (MTM) programs are designed to optimize the benefits of prescribed drugs, improve medication use, reduce the risk of adverse drug events and drug interactions, and increase patient adherence to prescribed regimens. Immunizations Pharmacists are approved to administer vaccinations in all 50 states. In 2009, pharmacists throughout the nation administered hundreds of thousands of doses of H1N1 influenza vaccine and demonstrated the critical role pharmacists play in public health and the value they deliver to their patients. Independent pharmacies may also offer routine and travel vaccines, including vaccines for pneumococcal, meningococcal, Hepatitis B, human papillomavirus (HPV), herpes zoster (shingles), typhoid, and yellow fever. Medicare plan comparisons Many pharmacies offer Medicare plan comparisons. Pharmacists help patients/enrollees navigate their options, but must beware of steering. Many pharmacies use plan comparison software available to consumers through the Medicare website. Smoking cessation Independent pharmacies provide tobacco cessation counseling including recommendations for over-the-counter nicotine replacement products, advice, and continuous counseling. Asthma management Independent pharmacists assist patients to manage and maintain asthma control. Asthma management services include education on the types and purposes of asthma medications; demonstrating the correct techniques on using their oral medications, inhaled medications, and peak flow meters; reinforcing and clarifying instructions as outlined in their asthma management plan provided by their physician; and addressing patient concerns. In addition, pharmacists can refer patients who