Abstract
BackgroundDiabetes prevention programmes delay or prevent the onset of type 2 diabetes in people with pre-diabetes. To increase accessibility, national guidelines recommend delivering diabetes prevention programmes in primary care settings, including community pharmacy. This study aimed to explore the English community pharmacy setting as an option for delivering diabetes prevention services.MethodsTwo focus groups and nine semi-structured interviews were conducted with stakeholders including, community pharmacists, general practitioners and commissioners. The topic guide was framed using the COM-B theoretical model for behaviour change to elicit practitioners’ capability, opportunity and motivation to engage with providing or referring to community pharmacy diabetes prevention services. Data were analysed thematically, and barriers/facilitators mapped to the COM-B framework.ResultsFive themes were identified: ‘Pre-diabetes management and associated challenges’, ‘The community pharmacy setting’, ‘Awareness of community pharmacy services’, ‘Relationships and communication’ and ‘Delivery of community pharmacy services’. Community pharmacy was highlighted as an accessible setting for delivering screening and follow-on lifestyle interventions. Key factors for enhancing the capability of community pharmacy teams to deliver the interventions included training and appropriate use of skill mix. Delivering diabetes prevention services in collaboration with general practices was identified as key to the provision of integrated primary care services. Whilst financial incentives were identified as a motivating factor for delivery, service promotion to patients, public and healthcare professionals was perceived as crucial for enhancing engagement.ConclusionsThis research highlights a role for community pharmacy in diabetes prevention. New service models should seek to integrate community pharmacy services in primary care to facilitate patient engagement and better communication with general practices.
Highlights
In England, approximately five million people have pre-diabetes [1]
This study aimed to explore the English community pharmacy setting as an option for delivering diabetes prevention services
This research highlights a role for community pharmacy in diabetes prevention
Summary
In England, approximately five million people have pre-diabetes [1]. It is estimated that 5–10% of people with pre-diabetes develop type 2 diabetes every year, this may vary with population characteristics and pre-diabetes definitions [2, 3]. Evidence indicate that early identification of individuals with pre-diabetes and subsequent implementation of behaviour change related to diet and physical activity can significantly reduce progression to type 2 diabetes [4]. Systematic review evidence suggests that the impact of diabetes prevention programmes (DPPs) could be undermined by poor engagement amongst people with pre-diabetes [5]. A National Health Service DPP (NHS DPP) in England, which aims to identify people with pre-diabetes and refer them onto a behavioural change group-based intervention, was implemented in 2016 [6]. National guidelines recommend delivering diabetes prevention programmes in primary care settings, including community pharmacy. This study aimed to explore the English community pharmacy setting as an option for delivering diabetes prevention services
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