Continuous glucose monitoring shared medical appointments improve diabetes self‐efficacy and hemoglobin A1C

Pharmacist-driven continuous glucose monitoring in community and ambulatory care pharmacy practice: A scoping review

BACKGROUND

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.

OBJECTIVES

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

A Cross-Sectional Survey Study Examining the Provision of Continuous Glucose Monitoring Education in U.S. Doctor of Pharmacy Programs

Continuous glucose monitoring (CGM) is used to help patients with diabetes and their healthcare providers more effectively manage care. CGM use is expanding to all healthcare settings where pharmacists practice and new pharmacy graduates may increasingly be asked to assist patients utilizing CGM devices and assess diabetes management through the interpretation of CGM data. The purpose of this study was to describe CGM education across Doctor of Pharmacy (Pharm.D.) programs in the United States. An online survey was administered to 139 accredited Pharm.D. programs. Information was solicited about CGM education, including curricular placement, course type, hands-on experience, and credential(s) of faculty providing the education. Fifty-seven programs responded with 51 (89.5%) providing CGM education for a median of 1.0 h. Of programs providing detailed responses, content was delivered in required (60.4%) or elective (45.8%) lectures as well as experiential settings (41.7%). Education occurred most frequently in the third year (58.3%), followed by the second (43.8%) and fourth (37.5%) years. Thirty-one (66.0%) programs were taught by a faculty member with an advanced diabetes credential. The results from this study confirm that there is an ongoing need to examine optimal amount, timing, and methods for providing CGM education.