J Am Pharm Assoc (2003). 2023 Nov-Dec;63(6):1660-1668.e2. doi: 10.1016/j.japh.2023.07.010. Epub 2023 Aug 2.
Continuous glucose monitoring (CGM) devices improve clinical outcomes and facilitate achieving patient-specific goals. However, opportunities and barriers to implementation of pharmacist-driven CGM services are not well-described.
This scoping review was conducted to identify opportunities and barriers to implementing pharmacist-driven CGM services in the community and ambulatory care setting. Clinical outcomes resulting from pharmacist-driven CGM were also explored.
A health librarian searched Ovid MEDLINE, Cochrane CENTRAL, Embase, Web of Science, Scopus, International Pharmaceutical Abstracts using keywords and subject headings from inception through December 2, 2022 to identify studies describing pharmacist or pharmacy-based CGM programs. No publication type, date limits, language restrictions, or other filters were applied. The database search was supplemented by a search of Google Scholar and a citation search of preselected gold standard articles.
The scoping review initially identified 942 citations of which 249 passed abstract screening and 11 were included in the review. Among studies, the most common design was retrospective, populations varied, control groups were not consistently used, follow-up was primarily short, and sample sizes were small. One study evaluated pharmacist-driven CGM in a community pharmacy setting. Ten studies took place in the ambulatory care setting. Barriers to initiating pharmacist-driven CGM as a clinical service include educational, logistical, workflow, and financial incentive. Beneficial outcomes from pharmacist-driven CGM include improved quality of life, increased empowerment, and improved glycemic control.
There is lack of strong evidence to support pharmacist-driven CGM in the community pharmacy setting. However, small studies suggest pharmacist-driven CGM is feasible and beneficial in the ambulatory care setting. Further exploration of how educational, logistical, workflow, and financial barriers can be overcome is warranted, given potential for improved clinical outcomes.
连续血糖监测（CGM）设备可改善临床结果，并有助于实现患者特定的目标。然而，药剂师主导的 CGM 服务实施的机会和障碍尚未得到充分描述。
本范围界定综述旨在确定在社区和门诊环境中实施药剂师主导的 CGM 服务的机会和障碍。还探讨了由药剂师主导的 CGM 带来的临床结果。
健康图书馆员使用从开始到 2022 年 12 月 2 日的关键词和主题词在 Ovid MEDLINE、Cochrane CENTRAL、Embase、Web of Science、Scopus 和国际药学文摘中进行了搜索，以确定描述药剂师或基于药房的 CGM 计划的研究。未应用任何出版物类型、日期限制、语言限制或其他筛选器。数据库搜索还补充了 Google Scholar 的搜索和预选黄金标准文章的引文搜索。
范围界定综述最初确定了 942 条引文，其中 249 条通过了摘要筛选，11 条被纳入综述。在研究中，最常见的设计是回顾性的，人群各不相同，对照组并未始终使用，随访主要是短期的，样本量较小。一项研究评估了社区药房环境中的药剂师主导的 CGM。十项研究发生在门诊环境中。启动药剂师主导的 CGM 作为临床服务的障碍包括教育、后勤、工作流程和财务激励。药剂师主导的 CGM 的有益结果包括提高生活质量、增强自主权和改善血糖控制。
没有强有力的证据支持社区药房环境中的药剂师主导的 CGM。然而，小型研究表明，在门诊环境中，药剂师主导的 CGM 是可行且有益的。鉴于改善临床结果的潜力，进一步探索如何克服教育、后勤、工作流程和财务障碍是有必要的。
