Supporting self-management of type 2 diabetes: is there a role for the community pharmacist?

Figures & data

Table 1 Details of focus group participants

Focus group	Respondent number	Sex	Age (years)	Length of time since diagnosis (years)	Level of adherence (MMAS score)	Experience of receiving extended services*
1	1	Female	56	5	Low (5.75)	Y
	2	Male	54	13	High (8)	N
	3	Female	64	13	Medium (6)	Y
	4	Male	60	1	Low (4.75)	N
	5	Female	61	20	Low (5.75)	N
	6	Female	56	15	Low (3.75)	Y
2	7	Female	66	20	Low (3.5)	Y
	8	Male	72	17	Medium (6)	Y
	9	Male	74	23	Medium (6.75)	N
	10	Male	69	25	Medium (7)	Y
	11	Male	76	8	Medium (6.75)	N
	12	Male	68	15	Medium (6.75)	Y
3	13	Male	78	15	Low (3.75)	N
	14	Female	76	9	Medium (7)	Y
	15	Male	65	20	Low (5.75)	Y
	16	Male	71	3	High (8)	Y
	17	Male	81	4	High (8)	Y
	18	Male	68	15	Medium (7)	Y
4	19	Male	68	12	High (8)	Y
	20	Female	68	13	Low (5.75)	Y
	21	Female	65	12	Medium (7)	Y
	22	Male	69	1	Low (3.75)	Y
	23	Male	70	18	High (8)	N
	24	Male	69	1	Medium (6)	N
	25	Female	66	8	High (8)	Y
	26	Male	66	2	Medium (7)	Y
5	27	Female	62	2	Medium (6)	N
	28	Male	49	16	Medium (7)	Y
	29	Female	70	30	Low (5)	Y
	30	Male	71	5	Medium (6)	Y
	31	Male	72	1	Medium (7)	Y
	32	Female	52	5	Medium (6)	Y

Notes: MMAS classified level of adherence into low (score <6), medium (score 6 to <8), and high (score =8) adherence.

* Experiences of receiving any of the following extended services: written medicines information, dose administration aid, blood glucose-monitoring advice, printouts of blood glucose meter results, Diabetes Meds Check, and home medicines review.

Abbreviation: MMAS, Morisky Medication Adherence Scale; Y, yes; N, no.

Table 2 Themes and key quotes associated with patients’ preferences for a support model for T2D to be delivered in Australian community pharmacies

Themes	Key quotes
The potential to deliver self-management services
Support
Friendliness of pharmacists	“I find pharmacy pretty good. They will certainly ask you if you’ve taken them before, offer some information”. [R20]
	“I went in he would ask how was it going? How was I feeling? Did I need any information? He is very kind and generous like that”. [R32]
Convenience of pharmacies	“If I have to have Insulin, I think it would not be a bad thing if I go to the pharmacy and get the top up advice or help which is much more accessible”. [R1]
	“I seem to be able to have more time and information from a pharmacist than often I can get with a doctor. I mean call into a pharmacist on a Saturday afternoon if you’ve got an enquiry, you can’t go the GP because they’re not working, and often they won’t assist over the phone anyway, so yes, it’s a good point of information and support”. [R32]
Obstacles
Lack of a private area	“If you’re talking to somebody about your diabetes, there’s another lady there talking about being pregnant, and they say, ‘You’re pregnant are you?’… all that sort of stuff”. [R12]
	“I think that’s the problem with going to your average chemist – you’ve got a counter and no private areas at all, if you need it, not that anything about it is really private”. [R23]
Time constraints in a busy pharmacy	“If I want to know something I’ll ask them, but they’re all so busy too”. [R21]
	“The pharmacies are all very busy I wonder whether they have staff for this purpose. (supporting peoples adherence to medication)”. [R31]
A perceived low level of interest in offering diabetes services by pharmacists	“My pharmacist was whinging to me the other day because we were saying that somebody is trying to oblige pharmacists to become diabetes helpers and she just found the way it was being structured it was not in her interest – it was a whole lot more trouble for no benefit”. [R13]
	“‘Why do not you do the diabetes thing?’ and they said, ‘Well a) we do not want to because it is all too much trouble, but b) there’s somebody else close by who is therefore we do not want to do that’, so I actually changed pharmacists”. [R14]
Reservations about the pharmacists’ skill and knowledge in diabetes management	“I think any new service like that somehow the public, the client has to have the feeling you can trust their knowledge. How do I know when I walk in, you know? So is there accreditation for some pharmacists who can assist so that you know”. [R1]
	“I do not think a chemist would be nearly as qualified to tell me what to do as my GP is”. [R15]
The suggested role of pharmacist
Target specific groups of patients in need of additional support	“This sort of service (monitoring service) would be of great value especially on the newly diagnosed”. [R2]
	“It could be for some people, yes. I’m not saying for me because I manage my own regimen quite easily, but for some people I still think it could be almost a necessity”. [R17]
Administrative role (eg, reminder service or arranging for the supply of diabetes medication)	“Well I think there is a role. I think it could be improved. For instance if they had my profile in some sort of filing system and they communicated with me electronically, send me an email when things are due, or how are you going, or how’s your diet, these medicines go best with this food”. [R10]
	“The chemist will fulfill more than one prescription at a time if you’re going on holidays or you need it”. [R23]

Abbreviations: T2D, type 2 diabetes; GP, general practitioner; R, respondent number.