McSweeney Breanna, Campbell Rachel B, Grewal Eshleen K, Campbell David J T
Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Front Clin Diabetes Healthc. 2022 Dec 22;3:1087751. doi: 10.3389/fcdhc.2022.1087751. eCollection 2022.
Persons with lived experience of homelessness face many challenges in managing diabetes, including purchasing and storing medications, procuring healthy food and accessing healthcare services. Prior studies have found that pharmacy-led interventions for diabetes improved A1C, and lowered blood pressure and cholesterol in general populations. This study evaluated how select pharmacists in Canada have tailored their practices to serve persons with lived experiences of homelessness with diabetes.
We conducted a qualitative descriptive study using open-ended interviews with inner-city pharmacists in select Canadian municipalities (Calgary, Edmonton, Vancouver, and Ottawa). We used NVivo qualitative data analysis software to facilitate thematic analysis of the data, focusing on how pharmacists contributed to diabetes care for persons with lived experience of homelessness.
These pharmacists developed diabetes programs after discovering an unmet need in the population. Pharmacists have the unique ability to see patients frequently, allowing tailored education and hands-on assistance with diabetes management. These pharmacists provided extra-ordinary care like financial and housing resources and many of them were uniquely embedded within other services for persons with lived experience of homelessness (i.e. housing and social work supports). Pharmacists reported struggling with balancing optimal medical care for individuals with the financial constraints of running a business.
Pharmacists are vital members of the diabetes care team for persons with lived experience of homelessness. Government policies should support and encourage unique models of care provided by pharmacists to improve diabetes management for this population.
有过无家可归经历的人在管理糖尿病方面面临诸多挑战，包括购买和储存药物、获取健康食品以及获得医疗保健服务。先前的研究发现，由药房主导的糖尿病干预措施可改善普通人群的糖化血红蛋白（A1C）水平，并降低血压和胆固醇。本研究评估了加拿大的部分药剂师如何调整他们的业务，以服务有过无家可归经历且患有糖尿病的人群。
我们开展了一项定性描述性研究，对加拿大部分城市（卡尔加里、埃德蒙顿、温哥华和渥太华）市中心的药剂师进行了开放式访谈。我们使用NVivo定性数据分析软件对数据进行主题分析，重点关注药剂师如何为有过无家可归经历的糖尿病患者提供糖尿病护理。
这些药剂师在发现该人群未得到满足的需求后，制定了糖尿病项目。药剂师具有独特的优势，能够频繁见到患者，从而可以针对糖尿病管理提供量身定制的教育和实际操作方面的帮助。这些药剂师提供了诸如财务和住房资源等特殊护理，而且他们中的许多人还独特地融入了为有过无家可归经历的人提供的其他服务中（如住房和社会工作支持）。药剂师们表示，在为个人提供最佳医疗护理与经营业务的财务限制之间难以平衡。
药剂师是有过无家可归经历的糖尿病患者护理团队的重要成员。政府政策应支持并鼓励药剂师提供的独特护理模式，以改善该人群的糖尿病管理。
