Community pharmacists' perspectives on shared decision-making in diabetes management.

Abstract

Shared decision-making (SDM) is an approach where patients and clinicians share evidence and patients are supported to deliberate options resulting in preference-based informed decisions. The aim of this study was to describe community pharmacists' perceptions and awareness of SDM within their provision of general diabetes management [including Ontario's MedsCheck for Diabetes (MCD) programme], and potential challenges of implementing SDM within community pharmacy. This qualitative study used semistructured interviews with a convenience sample of community pharmacists. Data were analysed using thematic analysis. We conducted 16 interviews. Six participants were male, and nine were certified diabetes educators. When providing a MCD, participants used aspects of a patient-centred approach focusing on providing education. Variation was evident in participants' description and use of SDM, as well as in their perceived level of training in SDM. Participants also highlighted challenges surrounding implementing a SDM approach in practice. Pharmacists are well positioned to apply SDM within community settings; however, implementation barriers exist. Pharmacists will require additional training as well as perceived patient and physician barriers should be addressed to encourage uptake.