Commitment of the community pharmacy in the prevention of diabetes

Summary and introduction

Abstract

Introduction: Even though there are evidence-based diabetes prevention interventions, more than one in three Americans have prediabetes; the use of pharmacies has been explored as a way to reach and care for this population. The objective of this study was to analyze the factors that influence the adoption of type 2 diabetes prevention programs by community pharmacies.

Methods : We conducted 21 semi-structured interviews in 2018 with decision makers from 11 independent pharmacies in 6 U.S. states and the District of Columbia and 10 pharmacy chains operating in 1 state, multiple states, and nationally. We identified participants using purposive sampling. We used qualitative methods to analyze the data and conducted interviews until we reached saturation.

Results: Several themes emerged: 1) initiation of services is more likely if initial financial support is received; 2) patient demand for services, real or perceived, is paramount; 3) diabetes prevention services often integrate into existing pharmacy operations and allow maximum use of resources; 4) customer loyalty is a clearly articulated competitive advantage; and 5) engagement in diabetes prevention affirms an expanded role and value of pharmacies in serving communities.

Conclusion: Pharmacies are well placed to deliver diabetes prevention programs to communities. Although there are many opportunities for pharmacies to address diabetes prevention, more could be done to reduce barriers to their use.

introduction

Diabetes represents a burden for society and public health. More than 100 million Americans live with diabetes or prediabetes. The development of type 2 diabetes is a gradual but preventable process. In a 2019 study, nearly 1 in 5 teenagers aged 12 to 18 and 1 in 4 young adults aged 19 to 34 were living with prediabetes.[1]

For people with prediabetes, reducing body weight and exercising can prevent or delay the onset of type 2 diabetes. Studies have shown that such changes lead to a 30-60% reduction in the incidence of diabetes. diabetes;[2] these studies influenced the creation of the National Diabetes Prevention Program (DPP) of the Centers for Disease Control and Prevention (CDC). This program offers cost-effective, evidence-based interventions to prevent diabetes. The national PPD, a lifestyle change intervention, is offered by programs that meet quality standards through its recognition program (Table 1).

Several commercial and government payers provide coverage for the DPP’s national lifestyle intervention (Table 2). Expanding coverage is important to reach eligible participants and reduce financial burdens. Increasing the number of partnerships and access points is necessary to prevent diabetes. Pharmacies are well placed to support this effort. The CDC has encouraged collaboration with pharmacies and pharmacists since the publication of a guide supporting such action.[3]

Today’s transformative healthcare landscape offers an opportunity to look beyond traditional models of care to increase access, reduce costs and improve health outcomes. Despite mounting evidence of the value of pharmacists as providers of patient care,[5] legal, policy and reimbursement frameworks have not kept pace and have not sufficiently recognized pharmacists as providers.

Our study considers community pharmacies as a healthcare destination for diabetes prevention programs. Few studies have explored how pharmacies may affect diabetes prevention, and no studies have considered factors that influence pharmacy executive decision-making. The objective of our study was to identify the factors that enable or hinder the adoption by pharmacies of diabetes prevention programs.

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