The community pharmacy setting for diabetes prevention: Views and perceptions of stakeholders

Abstract

Background Diabetes prevention programmes delay or prevent the onset of type 2 diabetes in people with pre-diabetes. To increase accessibility, national guidelines recommend delivering diabetes prevention programmes in primary care settings, including community pharmacy. This study aimed to explore the English community pharmacy setting as an option for delivering diabetes prevention services. Methods Two focus groups and nine semi-structured interviews were conducted with stakeholders including, community pharmacists, general practitioners and commissioners. The topic guide was framed using the COM-B theoretical model for behaviour change to elicit practitioners’ capability, opportunity and motivation to engage with providing or referring to community pharmacy diabetes prevention services. Data were analysed thematically, and barriers/facilitators mapped to the COM-B framework. Results Five themes were identified: ‘Pre-diabetes management and associated challenges’, ‘The community pharmacy setting’, ‘Awareness of community pharmacy services’, ‘Relationships and communication’ and ‘Delivery of community pharmacy services’. Community pharmacy was highlighted as an accessible setting for delivering screening and follow-on lifestyle interventions. Key factors for enhancing the capability of community pharmacy teams to deliver the interventions included training and appropriate use of skill mix. Delivering diabetes prevention services in collaboration with general practices was identified as key to the provision of integrated primary care services. Whilst financial incentives were identified as a motivating factor for delivery, service promotion to patients, public and healthcare professionals was perceived as crucial for enhancing engagement. Conclusions This research highlights a role for community pharmacy in diabetes prevention. New service models should seek to integrate community pharmacy services in primary care to facilitate patient engagement and better communication with general practices.

Implementation of a Real-Time Medication Intake Monitoring Technology Intervention in Community Pharmacy Settings: A Mixed-Method Pilot Study

“…Additionally, pharmacists expressed that there should be reasonable remuneration for the additional time and resources needed to monitor the real-time adherence and follow up with the patients and physicians. Several studies have identified lack of financial remuneration or poor remuneration as a barrier for pharmacists potentially offering clinical services in healthcare systems [55][56][57]. Canada has a universal healthcare funding model [58].…”

Facilitators and Barriers to Uptake of Community-Based Diabetes Prevention Program Among Multi-Ethnic Asian Patients With Prediabetes

“…Our findings underline the importance of recognizing modifiable physical and social opportunities leading eligible individuals to opt-out of the program. Similar to prior literature (30,33), the most commonly cited factors for nonparticipation were physical location and scheduling of the program. In countries such as the US and UK, many DPPs are outsourced, which allows for flexibility in program delivery (e.g.…”

“…It is therefore important to adopt an approach designed to address key issues related to capabilities, such as improving communication skills of program staff who recruit participants and more attention to how messages about the program and diabetes prevention are conveyed. Literature suggests that diagnosis of prediabetes can be a 'teachable moment' (18,(27)(28)(29)(30) and presents an opportune time to introduce preventive interventions to patients. The attitude of and messages conveyed by healthcare professionals were also found to affect an individual's views of the gravity of the condition and hence his/her commitment to making changes (18,31,32).…”

The community pharmacy setting for diabetes prevention: A mixed methods study in people with ‘pre-diabetes’

“…. This future work will also include components identified in a parallel study which explored the study objectives in healthcare professionals and commissioners 67 .…”