Outcomes of a novel pharmacy screening intervention to address the burden of type 2 diabetes and cardiovascular disease in an Arabic‐speaking country

Abstract

Aims: Aim of this study is to evaluate the capacity of a pharmacist-delivered screening model for type 2 diabetes and cardiovascular disease (CVD) in identifying and referring individuals at risk. Method: A screening programme was implemented in 12 community pharmacies in three cities in the United Arab Emirates. Trained pharmacists screened adults (≥40 years) without a previous diagnosis of diabetes or CVD. Most participants were recruited during their visits to the pharmacies; pharmacy-based advertising and social media were also used. The screening included medical history, anthropometric measurements, point-of-care glycated haemoglobin (HbA 1c ) levels, and a lipid panel.High-risk individuals (HbA 1c ≥ 5.7% [39 mmol/mol], a high diabetes risk score, or a 10-year CVD risk ≥7.5%) were given a referral letter and advised to visit their physician. Risk factors for elevated HbA 1c were identified by logistic regression. Results: Of the 568 screened participants, 332/568 (58%) were identified to be at risk: HbA 1c levels were consistent with diabetes 67/560 (12%) or prediabetes 148/560 (26%), high diabetes risk score 243/566 (43%), CVD risk score > 7.5% 79/541 (15%).Obese people were more likely to have prediabetes or diabetes OR (95% CI): 3.2 (1.3, 7.5), as were those who spent more than 11 h/day sitting: 5.7 (1.8, 17.6). Of the 332 at-risk participants, 206 (62%) responded to a telephone follow-up at six weeks; onethird had discussed screening results with their physician. Conclusions: Community pharmacists detected and referred individuals at risk for diabetes or CVD, although participant follow-up with their physician could be improved. Pharmacy screening is feasible and will potentially improve outcomes.

How is mental health care provided through community pharmacies? A quest for improvement

“… 25 However, recently, community pharmacists have expressed willingness and enthusiasm to expand their services to include screening, medication review and disease state management, and have demonstrated their ability to screen for diabetes and cardiovascular disease, as well as educate and refer at-risk individuals for further assessment. 26 , 27 …”

“…25 However, recently, community pharmacists have expressed willingness and enthusiasm to expand their services to include screening, medication review and disease state management, and have demonstrated their ability to screen for diabetes and cardiovascular disease, as well as educate and refer at-risk individuals for further assessment. 26,27 Positive attitudes towards mental disorders are essential if community pharmacists in the UAE are to successfully venture into mental health roles, since they can impact pharmacists' uptake of new roles, communication with patients, and clinical judgement, affecting their ability to provide optimal care. 28,29 A pharmacist with inadequate training in mental health, who believes that people with mental disorders are unpredictable, or who has negative attitudes about treatments or outcomes may feel unconfident or uncomfortable around these patients, thereby decreasing their engagement and adversely affecting patient outcomes.…”

People power

“…In this issue of Diabetic Medicine are several examples of creative workforce deployment. In the first, community pharmacists successfully undertook diabetes and cardiometabolic health screening, identifying people at risk of diabetes and cardiovascular disease 7 . However, only a third of those referred for onward treatment and care discussed the screening results with their physician highlighting the huge potential that exists to not only screen in pharmacies but to deliver support and education as part of a wider diabetes care and support ecology.…”