Development and application of a toolkit for community pharmacist-led review of patients with diabetes

Abstract

Introduction: Accessibility of community pharmacists puts them in a strategic position to support and empower patients in managing and reducing risks associated with diabetes mellitus. Objectives: To develop and validate a toolkit for community pharmacist-led review of patients with diabetes, apply the toolkit, and evaluate pharmacist interventions. Methods: A toolkit for community pharmacists to use to review patients with diabetes was developed and validated. Sixty patients registered with a community pharmacy taking at least one antidiabetic medication were invited to participate in the study. At baseline (t0), the toolkit was used to compile chronic and non-prescription medications before the first session (t1) with the patient. During t1, the toolkit was used to assess diabetes knowledge, drug therapy, medication adherence, diabetic complications, lifestyle, laboratory investigations, and monitoring. Education and drug-related needs that were identified were documented. An intervention was pro-posed for each identified need, and patient follow-up was conducted after 1 month(t2) to assess if the needs were met. Results: From the 60 patients invited to the study, 55 patients completed the study. Needs were identified in 50 patients. Education-related needs were identified in50 patients and drug-related needs in 18 patients. Education needs were related to medication use, storage, and therapy adherence (n = 28), lifestyle modifications(n = 26), and self-monitoring (n = 23). Drug-related needs involved inappropriate drug selection (n = 10), dose selection (n = 9), and medicine handling by the patient(n = 6). Referral to a general practitioner was required for nine patients. At t2, 65% of the identified needs were addressed. The implementation rate was highest with respect to appropriateness in dose selection (89%), followed by patient medication handling (83%).Conclusion: This research has led to a practical toolkit to be used by community pharmacists for a structured review of patients with diabetes within a collaborative practice approach. The toolkit targets the identification of patient needs. A limitation of the study was patient self-reporting.