Abstract
ObjectivesDetermine the feasibility of using a diabetes risk assessment tool followed by HbA1c-measurement in a community-pharmacy setting in Norway.MethodsIn this longitudinal study two pharmacists in each of three community pharmacies were trained to perform risk assessments, HbA1c-measurements and counselling. Pharmacy customers who were > 18 years old and could understand and speak Norwegian or English were recruited in the pharmacies during a two-months-period. Information about the service was presented in local newspapers, social media, leaflets and posters at the pharmacy. Customers wishing to participate contacted the pharmacy staff. Participants completed a validated diabetes risk test and a background questionnaire including a validated instrument for self-rated health. A HbA1c measurement was performed for individuals with a moderate to high risk of developing diabetes. If HbA1c ≥ 6.5% they were recommended to visit their general practitioner for follow-up. The pharmacies performed internal and external quality control of the HbA1c instrument.ResultsOf the 211 included participants 97 (46%) were > 50 years old. HbA1c was measured for the 47 participants (22%) with high risk. Thirty-two (15%) had HbA1c values < 5.7%, twelve (5.4%) had values between 5.7%—6.4%, and three (1.4%) had an HbA1c ≥ 6.5%. Two participants with HbA1 ≥ 6.5% were diagnosed with diabetes by their general practitioner. The third was lost to follow-up. Results from internal and external quality control for HbA1c were within set limits.ConclusionThe pharmacists were able to perform the risk assessment and measurement of HbA1c, and pharmacy customers were willing to participate. The HbA1c measurements fulfilled the requirements for analytical quality. Thus, it is feasible to implement this service in community pharmacies in Norway. In a large-scale study the inclusion criteria should be increased to 45 years in accordance with the population the risk test has been validated for.
Highlights
The HbA1c measurements fulfilled the requirements for analytical quality
It is estimated that approximatly 100 000–200 000 Norwegians have undiagnosed type 2 diabetes (T2D) [1]
There is some discussion about the utility of screening for T2D [7], a systematic review concluded that this is cost-effective and could be cost-saving [8]
Summary
It is estimated that approximatly 100 000–200 000 Norwegians have undiagnosed type 2 diabetes (T2D) [1]. The disease can develop slowly and the symptoms can be diffuse, people with undiagnosed T2D have a tendency to underestimate their risk of this disease [2]. It can take 4–6 years before the disease is identified [3]. With early identification and good treatment, it is possible to prevent or to delay long-term complications [4], such as diabetic retinopathy, neuropathy and nephropathy and cardiovascular disease [5]. For early identification of people with T2D and those at risk of T2D, screening can be performed [6]. Participants reported no long-term negative psychological impact [9, 10]
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