Clinical pharmacists in diabetes management: What do minority patients with uncontrolled diabetes have to say?

Abstract

Objective: Clinical pharmacist support for patients with type 2 diabetes mellitus (T2DM) can optimize patient outcomes and medication adherence. However, there is limited understanding of what pharmacist roles patients perceive as most helpful in T2DM management interventions. This study describes experiences of minority patients with uncontrolled T2DM in terms of perceived pharmacist helpfulness and specific roles found to be most helpful within diabetes management. Design: A secondary analysis of a 2-year randomized, crossover trial was conducted. Setting and participants: This study included 244 African American and Hispanic adults with uncontrolled T2DM who received clinical pharmacist support within a team-based model. Outcome measures: The patients completed a mixed-methods survey regarding their experience with the intervention that included a general helpfulness rating on a 10-point unipolar Likert scale and described the support qualitatively, including their perception of the pharmacist roles. Thematic analysis guided coding of the responses. Results: One hundred forty-seven (60%) patients completed the survey and had at least 1 encounter with a clinical pharmacist. Of these, 108 (74%) were African American, 39 (27%) were Hispanic, and 101 (69%) were women. The median rating of clinical pharmacist helpfulness was 10 (very helpful). Only 10 (7%) participants rated pharmacist helpfulness as 1 (not at all helpful). "Medication education and management" was the most frequently perceived supportive role of the clinical pharmacists, followed by "nonemedication-related patient education," "social support," and "care coordination." Miscommunication related to scheduling was the most common reason cited for not meeting with the clinical pharmacist. Conclusion: This sample of minority patients with uncontrolled T2DM recognized many roles outlined within the American Pharmacists Association Medication Therapy Management framework. Patient experiences with clinical pharmacist T2DM support are crucial for developing effective programs, maximizing patient engagement, satisfying patient needs, and ensuring that a program's intended purpose aligns with the patient perspective.

A qualitative study of barriers to care‐seeking for diabetic foot ulceration across multiple levels of the healthcare system

“…Since most persons with diabetes see their pharmacist more frequently than any other member of their health care team, developing collaborations between pharmacies, providers, or healthcare system in which pharmacists take on the role of providing medical equipment such as wound care supplies or diabetic shoes, may be an effective approach. Pharmacist supported diabetes care has been shown to be well received by minority patients and to result in improved diabetes outcomes [ 30 , 31 ].…”

The Effect of a Pharmacist-Intervention Program on Clinical Outcomes in Diabetes Mellitus Patients

“…9 Clinical pharmacists who have completed a residency programme have received more specialised training in patient care and are typically assigned to work with a team of medical professionals in a clinic environment. 10,11 As healthcare moves from fee-forservice models to value-based care, which is delivered with the quadruple goals of increasing population health, reducing the cost of care, enhancing the patient experience, and improving provider satisfaction, there are unique opportunities for pharmacists. There are numerous manifestations of pharmacistmanaged diabetes treatment 12. The current study thus evaluates the effect of pharmacist interventions in diabetes management.…”