School of Pharmacy, University of East Anglia, Norwich, United Kingdom.
Boots UK, Nottingham, United Kingdom.
PLoS One. 2019 Jul 18;14(7):e0219686. doi: 10.1371/journal.pone.0219686. eCollection 2019.
Diabetes 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.
Two 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.
Five 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.
This 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.
糖尿病预防计划可延缓或预防前驱糖尿病患者发生 2 型糖尿病。为了提高可及性，国家指南建议在基层医疗环境中，包括社区药房，提供糖尿病预防计划。本研究旨在探讨将英语社区药房环境作为提供糖尿病预防服务的选择。
对包括社区药剂师、全科医生和专员在内的利益相关者进行了两次焦点小组和九次半结构化访谈。主题指南使用 COM-B 理论模型构建，以引出从业者在提供或转介社区药房糖尿病预防服务方面的能力、机会和动机。数据进行了主题分析，并根据 COM-B 框架对障碍/促进因素进行了映射。
确定了五个主题：“前驱糖尿病管理及相关挑战”、“社区药房环境”、“对社区药房服务的认识”、“关系和沟通”和“提供社区药房服务”。社区药房因其可提供筛查和后续生活方式干预服务而被突出为一个可及的环境。增强社区药房团队提供干预措施的能力的关键因素包括培训和适当使用技能组合。与全科医生合作提供糖尿病预防服务被认为是提供综合初级保健服务的关键。虽然经济激励被认为是提供服务的一个激励因素，但向患者、公众和医疗保健专业人员推广服务被认为对于增强参与度至关重要。
这项研究强调了社区药房在糖尿病预防中的作用。新的服务模式应寻求将社区药房服务整合到初级保健中，以促进患者参与并与全科医生更好地沟通。
