Current Perspectives, Practices, and Barriers Faced by Community Pharmacists Regarding Pharmaceutical Care Services for Diabetes Mellitus in the United Arab Emirates

Figures & data

Table 1 Number and Percentages of the Questions on Demographic Information (n=516)

Demographics	Groups	Frequency	Percentages
Gender	Male	192	37.2%
	Female	324	62.8%
Educational level	Bachelor’s degree	435	84.3%
	Postgraduate	81	15.7%
Pharmacy type	Independent pharmacy	269	52.1%
	Chain pharmacy	247	47.9%
Position in the pharmacy	Pharmacist in charge	362	70.2%
	Chief pharmacist	85	16.5%
	Assistant pharmacist	69	13.4%
Work experience	1–5 years	71	13.8%
	6–10 years	370	71.7%
	> 10 years	75	14.5%
Working hours/day	≤ 8 hours	160	31%
	>8 hours	356	69%
Numbers of patients served per day	5–10	308	59.7%
	11–20	94	18.2%
	> 20	114	22.1%
Trained on the DM prevention and management.	Yes	293	56.8%
	No	223	43.2%

Abbreviation: DM, Diabetes mellitus.

Table 2 Number and Percentages of the Questions on Knowledge About Pharmaceutical Care for Diabetes Mellitus (Diabetes Knowledge Test (14 Items DKT))

Knowledge Items	Incorrect Answer		Correct Answer
	F	%	F	%
1. A diabetes diet is	57	11	459	89
2. Which of these contains the most carbohydrate?	132	25.6	384	74.4
3. Which of these contains the most fat?	36	7	480	93
4. Which of these is a “free food”?	291	56.4	225	43.6
5. A1C measures a patient’s average blood glucose level over the past	65	12.6	451	87.4
6. What is the best method for testing glucose at home?	76	14.7	440	85.3
7. How does the consumption of unsweetened fruit juice affect blood glucose?	294	57	222	43
8. Which is not suitable for treating low blood glucose?	23	4.5	493	95.5
9. For a patient who has good control, how does exercise affect their blood glucose?	90	17.4	426	82.6
10. What is the most likely effect of infection on blood glucose?	388	75.2	128	24.8
11. Feet are best taken care of by	287	55.6	229	44.4
12. Consuming low-fat foods decreases the risk of	350	67.8	166	32.2
13. Numbness and tingling are symptoms of what?	66	12.8	450	87.2
14. Which of these do we not usually associate with diabetes?	50	9.7	466	90.3

Notes: Adapted from Fitzgerald JT, Funnell MM, Hess GE, et al. The reliability and validity of a brief diabetes knowledge test. Diabetes Care. 1998;21(5):706–710.⁵² The project described was supported by Grant Number P30DK020572 (MDRC) from the National Institute of Diabetes and Digestive and Kidney Diseases.

Abbreviations: F, Frequency; %, Percentages.

Table 3 Number and Percentages of the Questions on Pharmaceutical Care for Diabetes Mellitus

Practice Items	Always		Often		Sometimes		Rarely		Never
	F	%	F	%	F	%	F	%	F	%
1.Advise patients on appropriate insulin storage, handling and administration	245	47.5	180	34.9	80	15.5	5	1	6	1.2
2.Advise patients on hypoglycemia causes, symptoms, and treatment	344	66.7	119	23.1	43	8.3	10	1.9	0	0
3.Advise patients on stress, tension, and other adverse health factors	257	49.8	184	35.7	66	12.8	7	1.4	2	0.4
4.Advise patients on how over-The-counter and herbal drugs influence diabetes management	307	59.5	153	29.7	49	9.5	7	1.4	0	0
5.Educate patients on why they should continuously screen for nephropathy, neuropathy and retinopathy	439	85.1	54	10.5	19	3.7	4	0.8	0	0
6.Advise patients on techniques for foot care	32	6.2	16	3.1	92	17.8	140	27.1	236	45.7
7.Educate patients on the need to exercise regularly and control their weight and diet as part of diabetes management	42	8.1	58	11.2	108	20.9	100	19.4	208	40.3
8.Inform patients of the need to quit smoking (if appropriate)	76	14.7	26	5.0	69	13.4	146	28.3	199	38.6
9.Inform patients on when they should administer oral antidiabetic drugs and what they should do if they miss a dose	42	8.1	41	7.9	84	16.3	141	27.3	208	40.3

Abbreviations: F, Frequency; %, Percentages.

Table 4 Comparison of Knowledge and Counselling Practice According to Demographics

Demographics	Knowledge scores (14 Items)				Practice Scores (9 Items)
	Mean	95% CI		P-value	Mean	95% CI		P-value
Gender
Male	9.18	8.80	9.56	0.013*	6.93	6.68	7.18	0.103
Female	10.05	9.82	10.28		7.19	7	7.37
Education level
Bachelor	9.48	9.27	9.69	0.001*	7.12	6.97	7.28	0.309
Postgraduate	11.04	10.53	11.55		6.91	6.44	7.38
Pharmacy type
Independent Pharmacy	9.56	9.29	9.83	0.095	6.69	6.48	6.91	<0.001*
Chain Pharmacy	9.907	9.59	10.22		7.52	7.33	7.72
Position in the Pharmacy
Pharmacist in charge	9.84	9.59	10.07	0.029*	7.26	7.08	7.43	0.004*
Chief pharmacist	9.82	9.36	10.29		6.74	6.37	7.11
Assistant pharmacist	9.023	8.38	9.68		6.67	6.27	7.07
Work Experiences
1–5 Years	5.93	5.67	6.19	<0.001*	5.634	5.24	6.03	<0.001*
6–10 Years	9.73	9.59	9.88		7.33	7.16	7.49
> 10 years	13.29	13.16	13.43		7.32	6.95	7.69
Numbers of patients served per day
5–10	10.11	9.88	10.34	<0.001*	8.85	8.78	8.92	<0.001*
11–20	10.06	9.63	10.50		7.49	7.38	7.60
> 20	8.41	7.91	8.92		4.57	4.36	4.78
Working hours/day
≤ 8 hours	9.49	9.12	9.87	0.131	7.29	7.09	7.47	0.001*
>8 hours	9.83	9.59	10.07		6.66	6.43	6.89
Trained on the DM prevention and management
Yes	11.38	11.22	11.54	<0.001*	7.30	7.13	7.48	0.001*
No	7.56	7.38	7.73		6.82	6.56	7.07

Notes: *P-values < 0.05 considered statistically significant, P-values obtained from independent t-test and One Way ANOVA.

Table 5 Regression Analysis for the Factors Affecting the Knowledge and Practice About DM Prevention and Management

Demographics	Good Knowledge ≥ 10				Good Practice ≥ 8
	OR	95% CI		P-value	OR	95% CI		P-value
Gender (Ref. Male)
Female	1.09	0.97	1.24	0.138	1.01	0.83	1.22	0.957
Education level (Ref. Bachelor)
Postgraduate	0.99	0.84	1.18	0.953	0.89	0.71	1.11	0.302
Pharmacy type (Ref. Independent Pharmacy)
Chain Pharmacy	1.02	0.91	1.15	0.739	1.42	1.20	1.68	<0.001*
Position in the Pharmacy (Ref. Assistant pharmacist)
Chief pharmacist	1.29	1.08	1.56	0.006*	1.56	1.18	2.06	0.002*
Pharmacist in charge	1.13	0.97	1.32	0.11	1.05	0.854	1.29	0.644
Experiences (Ref. 1–5 Years)
6–10 Years	6.92	3.43	8.86	<0.001*	1.25	0.86	1.81	0.242
> 10 years	1.99	1.67	2.36	<0.001*	1.15	0.89	1.48	0.299
Numbers of patients served daily (Ref. > 20)
5–10	1.27	1.06	1.53	0.009*	12.26	7.26	16.19	<0.001*
11–20	1.09	0.95	1.27	0.201	4.23	3.54	5.06	<0.001*
Working hours/day (Ref. >8 hours)
≤ 8 hours	1.01	0.89	1.15	0.829	1.02	0.86	1.21	0.828
Trained on the DM (Ref. No)
Yes	2.18	1.92	2.47	<0.001*	1.33	1.11	1.59	0.002*
Age	1.001	0.992	1.011	0.784	1.02	1.001	1.03	0.033*

Notes: *P-values < 0.05 considered statistically significant, Good knowledge and practice scores were generated by finding the median score.

Table 6 Number and Percentages of the Questions on Barriers for Counseling and Health Promotion Services for DM in the Pharmacy (n=516)

Obstacles and barriers	Frequency	Percentages
Lack of knowledge or clinical skills	354	68.7%
Lack of personnel or resources	168	32.53%
Lack of clinical tools	108	21%
Lack of coordination with other health care professionals	397	77%
Lack of access to additional training programs	211	41%
Lack of time	242	47%
Patients are not interested in preventive activities	150	29%

Fitzgerald JT, Funnell MM, Hess GE, et al. The reliability and validity of a brief diabetes knowledge test. Diabetes Care. 1998;21(5):706–710. doi:10.2337/diacare.21.5.706

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