Outcomes of a novel pharmacy screening intervention to address the burden of type 2 diabetes and cardiovascular disease in an Arabic-speaking country.

Abstract

Aim of this study is to evaluate the capacity of a pharmacist-delivered screening model for type 2 diabetes and cardiovascular disease (CVD) in identifying and referring individuals at risk. A screening programme was implemented in 12 community pharmacies in three cities in the United Arab Emirates. Trained pharmacists screened adults (≥40years) without a previous diagnosis of diabetes or CVD. Most participants were recruited during their visits to the pharmacies; pharmacy-based advertising and social media were also used. The screening included medical history, anthropometric measurements, point-of-care glycated haemoglobin (HbA1c ) levels, and a lipid panel. High-risk individuals (HbA1c ≥5.7% [39mmol/mol], a high diabetes risk score, or a 10-year CVD risk ≥7.5%) were given a referral letter and advised to visit their physician. Risk factors for elevated HbA1c were identified by logistic regression. Of the 568 screened participants, 332/568 (58%) were identified to be at risk: HbA1c levels were consistent with diabetes 67/560 (12%) or prediabetes 148/560 (26%), high diabetes risk score 243/566 (43%), CVD risk score>7.5% 79/541 (15%). Obese people were more likely to have prediabetes or diabetes OR (95% CI): 3.2 (1.3, 7.5), as were those who spent more than 11h/day sitting: 5.7 (1.8, 17.6). Of the 332 at-risk participants, 206 (62%) responded to a telephone follow-up at six weeks; one-third had discussed screening results with their physician. Community pharmacists detected and referred individuals at risk for diabetes or CVD, although participant follow-up with their physician could be improved. Pharmacy screening is feasible and will potentially improve outcomes.