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Asghar S, Atif M, Arshad S. An exploratory study to identify the factors influencing community pharmacist retention by using COM-B model. Res Social Adm Pharm 2024; 20:786-795. [PMID: 38749895 DOI: 10.1016/j.sapharm.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 06/17/2024]
Abstract
BACKGROUND Due to multitude of gaps in Pakistan's healthcare system, community pharmacies serve as the" first port of call" for various illnesses. However, the present scarcity of pharmacists in these settings poses significant challenges to healthcare delivery in the country. This scarcity is primarily due to difficulties in retaining pharmacists for community practice. The aim of this study was to explore the factors that influence the retention of community pharmacists by using COM-B model. METHODS A qualitative methodology employing the COM-|B model was utilized to design this study. In-depth interviews were conducted with pharmacists experienced in community pharmacy practice, at time and place convenient to them. Data were transcribed, translated and analyzed by deductive thematic analysis in accordance with the constructs of COM-B model. RESULTS A diverse range of factors were identified that negatively influenced the retention of community pharmacists including working conditions and proprietor's demeanor, deficiency in training and intern experience, lack of career planning, low social acceptance, less salary and job satisfaction, less regulatory control and aptitude of renting out category. Conversely, the study also identified the factors that motivate community pharmacists to stay in their roles despite the challenges including strong educational background, abundant job opportunities, flexible schedules, direct patient engagement and positive impact on sales. CONCLUSION There was an observed discrepancy between the challenges faced by community pharmacists and the motivators that encourage them to continue their job. Due to a disparity and abundance of challenges rather than motivators, retention rates for community pharmacists are low. This imbalance shed light on areas where improvements are needed to enhance pharmacist retention. Various areas for change were highlighted including strict implementation of regulations, integration of practical experience of community pharmacy practice and internships into academic programs, career guidance, and raising patient awareness about the roles of community pharmacists.
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Affiliation(s)
- Saima Asghar
- Department of Pharmacy Practice, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan.
| | - Muhammad Atif
- Department of Pharmacy Practice, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Saria Arshad
- Department of Pharmacy Practice, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
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Desselle SP, Ung COL, Harnett JE. Could pharmacy technicians play a role in supporting the appropriate and safe use of traditional and complementary medicines? Res Social Adm Pharm 2024; 20:170-173. [PMID: 38514292 DOI: 10.1016/j.sapharm.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 02/27/2024] [Accepted: 02/27/2024] [Indexed: 03/23/2024]
Abstract
Across the world traditional and complementary medicine (T&CM) product use is prevalent with some countries reporting greater than 50% of the population using these products. T&CM products are primarily self-selected through retail outlets including pharmacies. Pharmacists across the world generally agree they should play a role in ensuring the appropriate and safe use of T&CM products but report being time and resource poor to do so. In this commentary, it is proposed that pharmacy technicians as members of the pharmacy workforce, who with adequate education, and supportive technologies could support pharmacists in providing guidance to consumers and patients about the appropriate and safe use of T&CM products. Pharmacy technicians play a crucial role in the pharmacy workforce, serving as integral members of healthcare teams fulfilling a wide array of tasks essential for the efficient functioning of pharmacies and ensuring the safe dispensation of medications. They have been described by pharmacists as the "the face of the pharmacy" in the community setting and relied on not only for mitigating and triaging problems, but also be primarily responsible for developing rapport, eliciting trust and even loyalty from pharmacy patrons. As such, there is a momentous opportunity for pharmacy technicians to play a role in providing T&CM advice and triaging the need for pharmacists' intervention where harm, or risk of is identified.
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Affiliation(s)
- Shane P Desselle
- Touro University California College of Pharmacy, Vallejo, CA, United States.
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao, China; Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, 2006, New South Wales, Australia.
| | - Joanna E Harnett
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, 2006, New South Wales, Australia.
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Chamouard V, Freyssenge J, Clairaz-Mahiou B, Ferrera Bibas F, Fraticelli L. Evaluation of an e-Learning Program for Community Pharmacists for Dispensing Emicizumab (Hemlibra) in France: Nationwide Cross-Sectional Study. JMIR Form Res 2024; 8:e54656. [PMID: 38574351 PMCID: PMC11027057 DOI: 10.2196/54656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/05/2024] [Accepted: 03/07/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Since June 2021, patients with hemophilia A with antifactor VIII inhibitors and those with severe hemophilia A without antifactor VIII inhibitors treated with Hemlibra have had to choose between a community or hospital pharmacy. The French reference center for hemophilia developed the HEMOPHAR e-learning program for community pharmacists for dispensing emicizumab. OBJECTIVE This study aims to evaluate the efficiency and safety of this new care pathway by assessing the HEMOPHAR e-learning program. METHODS The methodology is based on Kirkpatrick's model for evaluating the immediate reaction of trained community pharmacists (level 1), their level of acquired knowledge (level 2), and their professional practice after 3 months of dispensation (level 3). RESULTS The HEMOPHAR e-learning program reached a large audience, with 67% (337/502) of the eligible community pharmacists following it. The immediate reaction was overall satisfying. High rates of engagement were reported with 63.5% (214/337) to 73.3% (247/337) of completed training modules, along with high rates of success with quizzes of 61.5% (174/337) to 95.7% (244/337). We observed that 83.9% (193/230) of the community pharmacists needed less than 2 attempts to pass the quiz of the module related to professional practice, while the other quizzes required more attempts. Advice on compliance and drug interactions were most frequently provided to patients by the community pharmacists. CONCLUSIONS This study suggests ways to improve the training of community pharmacists and to optimize coordination with treatment centers. This study also reports on the feasibility of switching to a community pharmacy in a secure pharmaceutical circuit, including in the context of a rare bleeding disease. TRIAL REGISTRATION ClinicalTrials.gov NCT05449197; https://clinicaltrials.gov/study/NCT05449197. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/43091.
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Affiliation(s)
- Valérie Chamouard
- Louis Pradel Hospital, Groupement Hospitalier Est, Hospices Civils de Lyon, French Reference Center of Hemophilia, Bron, France
| | - Julie Freyssenge
- University Claude Bernard Lyon 1, INSERM U1290 Research on Healthcare Performance RESHAPE, Lyon, France
| | | | | | - Laurie Fraticelli
- Laboratory P2S (Health Systemic Process), UR 4129, University Claude Bernard Lyon 1, Lyon, France
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Blakely M, Sherbeny F, Hastings T, Boyd L, Adeoye-Olatunde O. Exploratory analysis of medication adherence and social determinants of health among older adults with diabetes. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100371. [PMID: 38058361 PMCID: PMC10696385 DOI: 10.1016/j.rcsop.2023.100371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/09/2023] [Accepted: 11/11/2023] [Indexed: 12/08/2023] Open
Abstract
Background Diabetes is the fifth leading cause of death in the United States (US), affecting approximately 27%, or 15.9 million adults 65 years of age and older. Diabetes is the most expensive chronic condition in the US and accounts for the second largest avoidable healthcare cost. Adherence to long-term medication treatment plans is crucial among patients with diabetes because it decreases risk of developing comorbid conditions and improves quality of life. Greater exposure to adverse social determinants of health (SDOH) over an individual's lifespan can result in worse health outcomes. Hence, it is important to obtain a better understanding of how social determinants of health (SDOH) influence patients' behaviors and affect medication adherence among older adults with diabetes. Objectives Identify and prioritize SDOH associated with medication adherence among a nationally representative sample of older adults with diabetes. Secondary objectives were to characterize SDOH, estimate medication adherence, and explain implications for health disparity populations among older adults in the US who have been diagnosed with diabetes. Methods This study used a cross-sectional secondary data analysis to examine the National Health and Nutrition Examination Survey database, identifying associations between SDOH and medication adherence among older adults with diabetes in the US. Results A total of 1807 respondents' data were included in the analyses. Nearly three-quarters (73.9%) of patients were considered adherent to their oral diabetes medications. Multivariable analysis revealed significant differences in medication adherence based on disability status (p = 0.016), household balanced meals (p = 0.033), and interview language (p = 0.008). Conclusions Results revealed those with a disability, those who could not afford a balanced meal, and/or those who spoke English were associated with a higher likelihood of being nonadherent to their diabetes medications in comparison to individuals not in these groups. These findings can assist in developing SDOH-centered medication adherence strategies for pharmacists to implement with older patients with diabetes.
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Affiliation(s)
- M.L. Blakely
- University of Wyoming, School of Pharmacy, Department of Pharmaceutical Sciences, United States of America
| | - F. Sherbeny
- Florida A&M University, College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health. Economic, Social, and Administrative Pharmacy Division, United States of America
| | - T.J. Hastings
- University of South Carolina College of Pharmacy, Department of Clinical Pharmacy and Outcomes Sciences, United States of America
| | - L. Boyd
- Indiana University School of Medicine and Richard M. Fairbanks School of Public Health, Department of Biostatistics and Health Data Science, United States of America
| | - O.A. Adeoye-Olatunde
- Purdue University College of Pharmacy, Center for Health Equity and Innovation, Department of Pharmacy Practice, United States of America
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Haldane C, Neukom J, Lailo JM, Hero K, Vetter B. Diabetes and blood glucose monitoring knowledge and practices among pharmacy professionals in Cambodia and Viet Nam: digital survey and education. BMC MEDICAL EDUCATION 2023; 23:483. [PMID: 37386440 DOI: 10.1186/s12909-023-04449-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 06/14/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND In Southeast Asia, pharmacies are critical sources of healthcare advice for under-served communities, including those with/at risk of diabetes. AIM Explore knowledge/practices relating to diabetes and blood glucose monitoring (BGM) among pharmacy professionals in Cambodia and Viet Nam, using digital professional education to address gaps. METHODS An online survey was distributed to pharmacy professionals in Cambodia and Viet Nam registered on SwipeRx mobile application. Eligible participants dispensed medicines and/or were involved in purchasing products, and worked at retail pharmacies stocking ≥ 1 BGM product. An accredited continuing professional development module was then made available to pharmacy professionals and students on SwipeRx in both countries. After completing the 1-2 h module, users were required to correctly answer ≥ 60% (Cambodia) or ≥ 70% (Viet Nam) of knowledge assessment questions to achieve accreditation units from local partners. RESULTS Whereas 33% of survey respondents in Cambodia (N = 386) and 63% in Viet Nam (N = 375) reported performing blood glucose testing at the pharmacy, only 19% and 14% were aware that clients taking multiple daily doses of insulin should check blood glucose levels several times a day. Of 1,137 and 399 pharmacy professionals/students who completed the module and passed the assessment in Cambodia and Viet Nam, 1,124 (99%) and 376 (94%) received accreditation. Knowledge levels improved substantially in 10 of 14 learning areas in Cambodia and 6 of 10 in Viet Nam. CONCLUSIONS Digital education can strengthen pharmacy professional capacity to provide comprehensive and accurate information on diabetes management and the awareness of quality BGM products in Southeast Asia.
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Affiliation(s)
| | | | | | - Kol Hero
- Department of Preventive Medicine, Ministry of Health, Phnom Penh, Cambodia
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Al Assaf S, Kleiner D, Zelkó R, Hankó B. Type 2 Diabetes Patients' Views of Local Pharmacists and Fulfilment with Pharmaceutical Diabetes Care in Syria's Latakia Governorate: An Online Survey Research. Healthcare (Basel) 2023; 11:1720. [PMID: 37372838 DOI: 10.3390/healthcare11121720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/09/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
Assessing the attitudes of diabetic patients towards community-pharmacy services and determining the demand for new services could help monitor and evaluate the therapeutic response. This study aimed to evaluate type 2 diabetes patients' satisfaction regarding pharmacy care in community pharmacies and shed a light on the reasons for diabetic patients' non-adherence to treatments. An online survey was conducted on a random sample of patients (n = 196) at the national Diabetes Centre in Latakia, Syria, from April to November 2022. The questionnaire consisted of four primary parts: (1) demographic characteristics of responders, (2) patients' therapeutic behaviors, (3) diabetes knowledge, and (4) the general level of satisfaction with pharmacy diabetes services. The data were analyzed using descriptive analysis. Around 89% of respondents were satisfied with the information provided by community pharmacists. The patients' non-adherence showed a maximum as a function of the number of concomitantly taken medicines, which indicated that in most serious cases patients' adherence was increasing. Overall, most patients were delighted with community pharmacists' expertise and pharmacy services. This positive image allows pharmacists to expand their duties as healthcare providers in diabetes care, and increase the patient therapeutic adherence by performing a reconciliation of the patient's medicines, which involves reviewing all patients' drugs and identifying realistic solutions to their adherence issues.
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Affiliation(s)
- Sarah Al Assaf
- University Pharmacy Department of Pharmacy Administration, Semmelweis University, 1092 Budapest, Hungary
| | - Dénes Kleiner
- University Pharmacy Department of Pharmacy Administration, Semmelweis University, 1092 Budapest, Hungary
| | - Romána Zelkó
- University Pharmacy Department of Pharmacy Administration, Semmelweis University, 1092 Budapest, Hungary
| | - Balázs Hankó
- University Pharmacy Department of Pharmacy Administration, Semmelweis University, 1092 Budapest, Hungary
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Cahyaningsih I, Lambert M, Ochi T, Li F, Li X, Denig P, Taxis K. Community pharmacist-led interventions for patients with type 2 diabetes in low-income and middle-income countries: A scoping review. Res Social Adm Pharm 2023:S1551-7411(23)00238-3. [PMID: 37270326 DOI: 10.1016/j.sapharm.2023.04.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 04/13/2023] [Accepted: 04/24/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Studies assessing community pharmacist-led interventions conducted in high-income countries indicate that community pharmacists are successful in taking opportunities to support diabetes management. It is not yet clear as to what extent this is also true for low-income and middle-income countries. OBJECTIVES To provide an overview of the types of interventions performed by community pharmacists and available evidence about their effects on patients with type 2 diabetes mellitus in low-income and middle-income countries. METHODS PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for (non) randomized controlled, before-and-after, and interrupted time series design studies. There was no restriction on publication language. Interventions to be included had to be delivered by community pharmacists in a primary care or community setting. Study quality was assessed using the National Institute of Health tools, with results analyzed qualitatively, and the review itself was conducted in accordance with guidelines for scoping reviews. RESULTS Twenty-eight studies were included, representing 4,434 patients (mean age from 47.4 to 59.5 years, 55.4% female) from community pharmacies (16 studies), primary care centers (8 studies) or community setting (4 studies). Four studies were single-component and the remaining represented multi-component interventions. Face-to-face counseling of patients was the most common intervention, often combined with the provision of printed materials, remote consultations, or conducting medication reviews. Generally, studies showed improved outcomes in the intervention group, including clinical, patient-reported and medication safety outcomes. In most studies, at least one domain was judged to be of poor quality, with heterogeneity among studies. CONCLUSIONS Community pharmacist-led interventions on type 2 diabetes mellitus patients showed various positive effects but the quality of the evidence was poor. Face-to-face counseling of varying intensity, often combined with other strategies and representing a multi-component intervention, was the most common type. Although these findings support the expansion of the community pharmacist's role in diabetes care in low-income and middle-income countries, better quality studies are needed to evaluate the impact of specific interventions.
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Affiliation(s)
- Indriastuti Cahyaningsih
- Department of PharmacoTherapy, -Epidemiology, and -Economics, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands; Department of Pharmacist Profession Education, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Brawijaya, Geblagan, Tamantirto, Bantul, Daerah Istimewa Yogyakarta, 55183, Indonesia.
| | - Maarten Lambert
- Department of PharmacoTherapy, -Epidemiology, and -Economics, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands
| | - Taichi Ochi
- Department of PharmacoTherapy, -Epidemiology, and -Economics, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands
| | - Fang Li
- Department of PharmacoTherapy, -Epidemiology, and -Economics, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands
| | - Xinyu Li
- Department of PharmacoTherapy, -Epidemiology, and -Economics, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands
| | - Petra Denig
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
| | - Katja Taxis
- Department of PharmacoTherapy, -Epidemiology, and -Economics, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands
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Woodhams L, Chalmers L, Hillis GS, Sim TF. Developing community pharmacists' role in the management of type 2 diabetes and related microvascular complications: a nationwide survey in Australia. PeerJ 2023; 11:e14849. [PMID: 36811008 PMCID: PMC9939021 DOI: 10.7717/peerj.14849] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/12/2023] [Indexed: 02/18/2023] Open
Abstract
Background Community pharmacists have regular interactions with people living with type 2 diabetes to supply medications, and have a potential role in supporting other primary care professionals in the screening, management, monitoring and facilitation of timely referral of microvascular complications. This study aimed to investigate the contemporary and future roles of community pharmacists in diabetes-related microvascular complication management. Methods This study involved an online Australian nation-wide survey of pharmacists administered via Qualtrics® and distributed through social media platforms, state and national pharmacy organisations, and via major banner groups. Descriptive analyses were undertaken using SPSS. Results Among 77 valid responses, 72% of pharmacists already provided blood pressure and blood glucose monitoring services for the management of type 2 diabetes. Only 14% reported providing specific microvascular complication services. Over 80% identified a need for a comprehensive microvascular complication monitoring and referral service, and agreed it is feasible and within the scope of practice of a pharmacist. Almost all respondents agreed that they would implement and provide a monitoring and referral service if provided with appropriate training and resources. Potential barriers to service implementation were competing demands and lack of remuneration and awareness among consumers and health professionals. Conclusions Type 2 diabetes services in Australian community pharmacies do not currently focus on microvascular complication management. There appears to be strong support for implementing a novel screening, monitoring and referral service via community pharmacy to facilitate timely access to care. Successful implementation would require additional pharmacist training, and identification of efficient pathways for service integration and remuneration.
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Affiliation(s)
- Louise Woodhams
- Curtin Medical School, Curtin University, Perth, Western Australia, Australia
| | - Leanne Chalmers
- Curtin Medical School, Curtin University, Perth, Western Australia, Australia
| | - Graham S. Hillis
- Medical School, The University of Western Australia, Perth, Western Australia, Australia,Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Tin Fei Sim
- Curtin Medical School, Curtin University, Perth, Western Australia, Australia
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Hamurtekin E, Bosnak AS, Azarbad A, Moghaddamshahabi R, Hamurtekin Y, Naser RB. Knowledge, attitude, and practices regarding proton pump inhibitors among community pharmacists and pharmacy students. Niger J Clin Pract 2023; 26:201-210. [PMID: 36876609 DOI: 10.4103/njcp.njcp_430_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
Background There are concerns about inappropriate use and insufficient knowledge of proton pump inhibitors (PPIs) use among medical staff. Aims This study was designed to examine pharmacy students' and community pharmacists' knowledge, attitude, and practices toward PPIs and their relationship with specific sociodemographic characteristics. Subjects and Methods This descriptive study was conducted on the pharmacy students (first and last year) at Eastern Mediterranean University and community pharmacists in North Cyprus Data were collected by a validated questionnaire, which assessed knowledge, attitude, and practices regarding PPI use. Students were included without sampling in a volunteer-based manner. Registered community pharmacists were selected randomly. Results First-year pharmacy students (n = 77) showed significantly lower knowledge levels than last-year students (12.00 vs. 13.65; P < 0.001); however, there was no significant difference between last-year students (n = 111) and community pharmacists (n = 59). First-year pharmacy students were significantly less aware of PPIs' "dosage and administration" than the other two groups. Last-year students and community pharmacists exhibited significantly higher attitude scores regarding PPI use (24.7 and 24.6 vs. 22.7; P < 0.001). Omeprazole was found to be the most preferred PPI among the three studied populations. Community pharmacists used PPIs mainly to treat acid reflux. Gender, nationality, and pharmacy education program type did not influence pharmacy students' knowledge, attitude, or practices. Conclusions There was not a significant difference regarding knowledge and attitude between the last-year pharmacy students and community pharmacists. The practices of community pharmacists were significantly different from the pharmacy students. It was concluded that certain essential topics regarding PPI use should be emphasized in pharmacy education and during pharmacy practice. Further, it is essentially important for community pharmacists to continue their education through training programs after graduation to enhance their knowledge of PPI use.
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Affiliation(s)
- E Hamurtekin
- Department of Pharmacology, Faculty of Pharmacy, Eastern Mediterranean University, Famagusta, North Cyprus, Mersin 10, Turkey
| | - A S Bosnak
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cyprus International University, Nicosia, North Cyprus, Mersin 10, Turkey
| | - A Azarbad
- Department of Pharmacology, Faculty of Pharmacy, Eastern Mediterranean University, Famagusta, North Cyprus, Mersin 10, Turkey
| | - R Moghaddamshahabi
- Department of Pharmacology, Faculty of Pharmacy, Eastern Mediterranean University, Famagusta, North Cyprus, Mersin 10, Turkey
| | - Y Hamurtekin
- Department of Pharmacology, Faculty of Pharmacy, Eastern Mediterranean University, Famagusta, North Cyprus, Mersin 10, Turkey
| | - R B Naser
- Department of Pharmacology, Faculty of Pharmacy, Eastern Mediterranean University, Famagusta, North Cyprus, Mersin 10, Turkey
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Isenor JE, Cossette B, Murphy AL, Breton M, Mathews M, Moritz LR, Buote R, McCarthy L, Woodill L, Morrison B, Guénette L, Marshall EG. Community pharmacists' expanding roles in supporting patients before and during COVID-19: An exploratory qualitative study. Int J Clin Pharm 2023; 45:64-78. [PMID: 36289174 PMCID: PMC9607833 DOI: 10.1007/s11096-022-01430-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/10/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Timely access and attachment to a primary healthcare provider is associated with better population health outcomes. In Canada, community pharmacists are highly accessible and patients struggling to access a family physician or nurse practitioner (i.e., "unattached") may seek care from a community pharmacist. Community pharmacists took on additional roles during the COVID-19 pandemic; however, little is known about how community pharmacists managed the needs of attached and unattached patients before and during the COVID-19 pandemic. AIM To describe Nova Scotian community pharmacists' roles in caring for unattached patients before and during the COVID-19 pandemic and identifying barriers and facilitators to optimizing patient access. METHOD Semi-structured interviews with community pharmacists (n = 11) across the province of Nova Scotia (Canada) were conducted. RESULTS Five key themes were noted: (1) rising pressure on pharmacists to meet unique health needs of attached and unattached patients; (2) what pharmacists have to offer (e.g., accessibility, trustworthiness); (3) positioning pharmacists in the system (e.g., how pharmacists can address gaps in primary healthcare); (4) pharmacist wellbeing; and, (5) recommendations for practice post-pandemic (e.g., maintain some policy changes made during the COVID-19 pandemic). CONCLUSION Before and during the pandemic, community pharmacists played a significant and increasing role providing care to patients, especially unattached patients. With growing numbers of unattached patients, it is vital that community pharmacists are supported to provide services to care for the health needs of patients.
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Affiliation(s)
- Jennifer E. Isenor
- grid.55602.340000 0004 1936 8200College of Pharmacy and Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Benoit Cossette
- grid.86715.3d0000 0000 9064 6198Department of Community Health Sciences, Université de Sherbrooke, Longueuil, Canada
| | - Andrea L. Murphy
- grid.55602.340000 0004 1936 8200College of Pharmacy and Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Mylaine Breton
- grid.86715.3d0000 0000 9064 6198Department of Community Health Sciences, Université de Sherbrooke, Longueuil, Canada
| | - Maria Mathews
- grid.39381.300000 0004 1936 8884Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Lauren R. Moritz
- grid.55602.340000 0004 1936 8200Primary Care Research Unit, Department of Family Medicine, Dalhousie University, Halifax, Canada
| | - Richard Buote
- grid.55602.340000 0004 1936 8200Primary Care Research Unit, Department of Family Medicine, Dalhousie University, Halifax, Canada
| | - Lisa McCarthy
- grid.417293.a0000 0004 0459 7334Institute for Better Health, Trillium Health Partners, Mississauga, ON Canada ,grid.17063.330000 0001 2157 2938Leslie Dan Faculty of Pharmacy and Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Lisa Woodill
- Pharmacy Association of Nova Scotia, Dartmouth, NS Canada
| | - Bobbi Morrison
- grid.264060.60000 0004 1936 7363St. Francis Xavier University, Antigonish, NS Canada
| | - Line Guénette
- grid.23856.3a0000 0004 1936 8390Faculty of Pharmacy and CHU de Québec Research Centre, Université Laval, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390Faculty of Pharmacy, Université Laval, Québec, QC Canada
| | - Emily Gard Marshall
- Primary Care Research Unit, Department of Family Medicine, Dalhousie University, Halifax, Canada.
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Axon DR, Alamer A, Almatruk Z, Fazel MT. Assessing student pharmacists' confidence and knowledge of basic diabetes self-management skills. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:982-989. [PMID: 36055707 DOI: 10.1016/j.cptl.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 06/02/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The significance of diabetes self-management and recent advances in diabetes medications call for healthcare professionals' preparedness in educating patients. This study assessed correlations between student pharmacists' confidence and knowledge of diabetes self-management skills. METHODS An online questionnaire was administered to third-year student pharmacists at one United States college of pharmacy. Students indicated their level of agreement (strongly disagree, disagree, agree, strongly agree) with nine confidence items and identified the correct multiple-choice response for nine knowledge items. Correlations between confidence and knowledge scores were assessed using simple linear regression, logistic regression, and Spearman rank (Rho) test. RESULTS Forty-five students completed the questionnaire. The majority agreed/strongly agreed that they were confident in their knowledge for eight of the nine confidence items. The majority correctly answered six of the nine knowledge items. No associations were identified between confidence and knowledge scores in the linear regression (beta scaled = 0.25) or Spearman's correlation test (r = 0.294). In the logistic regression model, confidence and knowledge scores were associated positively for three domains: glucose meter use (odds ratio [OR] = 4.88), glucagon-like peptide-1 receptor agonist use (OR = 4.23) and hyperglycemia treatment (OR = 3.33); confidence and knowledge scores were associated negatively with one domain: insulin syringe administration (OR = 0.41). CONCLUSIONS This study found no overall association between confidence and knowledge scores in third-year student pharmacists' basic diabetes self-management skills, although there were significant associations with four specific domains. Student pharmacists may require additional training to improve their diabetes self-management skills.
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Affiliation(s)
- David R Axon
- University of Arizona College of Pharmacy, 1295 N. Martin Ave., PO Box 210202, Tucson, AZ 85721, United States.
| | - Ahmad Alamer
- University of Arizona College of Pharmacy, 1295 N. Martin Ave., PO Box 210202, Tucson, AZ 85721, United States; Prince Sattam bin Abdulaziz University College of Pharmacy, Al-Kharj, Riyadh, Post Box 173, 11942, Saudi Arabia.
| | - Ziyad Almatruk
- University of Arizona College of Pharmacy, 1295 N. Martin Ave., PO Box 210202, Tucson, AZ 85721, United States; King Abdelaziz University College of Pharmacy, Jeddah, Makkah 22252, Saudi Arabia.
| | - Maryam T Fazel
- University of Arizona College of Pharmacy, 1295 N. Martin Ave., PO Box 210202, Tucson, AZ 85721, United States.
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Coutureau C, Slimano F, Mongaret C, Kanagaratnam L. Impact of Pharmacists-Led Interventions in Primary Care for Adults with Type 2 Diabetes on HbA1c Levels: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063156. [PMID: 35328842 PMCID: PMC8949021 DOI: 10.3390/ijerph19063156] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/02/2022] [Accepted: 03/05/2022] [Indexed: 02/01/2023]
Abstract
Type 2 diabetes mellitus (T2D) is responsible for an important premature mortality. Pharmacists involved in community-based pharmaceutical care services could help patients with diabetes through education and management as they participate in their regular and long-term care. This meta-analysis aimed to evaluate the association between interventions led by pharmacists in the primary care setting and mean change in HbA1c levels. Randomized controlled trials and quasi-experimental studies with a control group were included. Standardized mean differences (SMD) and their 95% confidence intervals (95% CI) were calculated to compare the mean change in HbA1c values between baseline and end of the intervention in each group. Subgroup analyses were performed to explore heterogeneity. Twelve articles were included. The results showed that pharmacist’s interventions significantly reduced HbA1c compared to usual care with an overall SMD of −0.67 (95% CI = [−0.87; −0.48], p < 0.0001). Even if no significant difference between subgroups were found, the reduction of HbA1c seemed more important when baseline HbA1c was ≥8.5%, the intervention occurred monthly, in a primary care center and in countries with a lower human development index. Our results suggest that pharmacists-led interventions in the primary care setting can improve glycemic control for adults with T2D.
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Affiliation(s)
- Claire Coutureau
- Department of Research and Public Health, Reims University Hospital, 51092 Reims, France;
- UR 3797 Vieillissement, Fragilité (VieFra), Faculty of Medicine, University of Reims Champagne-Ardenne, 51092 Reims, France
- Correspondence: ; Tel.: +33-3-26-78-45-21
| | - Florian Slimano
- Department of Pharmacy, Reims University Hospital, 51092 Reims, France; (F.S.); (C.M.)
| | - Céline Mongaret
- Department of Pharmacy, Reims University Hospital, 51092 Reims, France; (F.S.); (C.M.)
| | - Lukshe Kanagaratnam
- Department of Research and Public Health, Reims University Hospital, 51092 Reims, France;
- UR 3797 Vieillissement, Fragilité (VieFra), Faculty of Medicine, University of Reims Champagne-Ardenne, 51092 Reims, France
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Alnais MA, Altebainawi AF. Implementation of the first
Pharmacist‐Led
Diabetes Clinic at Ministry of Health Hospitals, Saudi Arabia. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2022. [DOI: 10.1002/jac5.1602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Meshal Abdullah Alnais
- Pharmaceutical Care Services, King Salman Specialist Hospital, Hail Health Cluster Hail Saudi Arabia
| | - Ali Faris Altebainawi
- Pharmaceutical Care Services, King Salman Specialist Hospital, Hail Health Cluster, Ministry of Health Hail Saudi Arabia
- Medication Safety Research Chair, King Saud University Riyadh Saudi Arabia
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14
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Kassem AB, Ghoneim AI, Nounou MI, El‐Bassiouny NA. Community pharmacists' needs, education, and readiness in facing COVID-19: Actions & recommendations in Egypt. Int J Clin Pract 2021; 75:e14762. [PMID: 34472166 PMCID: PMC8646646 DOI: 10.1111/ijcp.14762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 08/08/2021] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) outbreak is considered one of the most important public health crises all over the world and in Egypt. Community pharmacists represent the third largest health care professional group after physicians and nurses. Community pharmacists are expected to be fully prepared at the frontline of defending their community needs by limiting the spread of COVID-19 via different pharmaceutical care services. AIM This study aimed to evaluate the sources of knowledge and readiness of community pharmacists in facing COVID-19 early outbreak in Egypt. METHODS A descriptive cross-sectional study was performed via a self-administered online google form questionnaire during the early period from 14 April to 3 June 2020. The questionnaire focused on; evaluating education level, sources of information, and readiness of Egyptian community pharmacists in the COVID-19 pandemic crisis. RESULTS A total of 318 community pharmacists from Egypt participated in this questionnaire. About half of the surveyed pharmacists reported that they were frequently consulted and that their patients were seeking consultation regarding COVID-19 management more than 10 times per day. More than half of the pharmacists reported using social media as a source of information and knew the right social distancing recommendations. Regarding protective measures, only a quarter of pharmacists disclosed the availability of personal protective equipment (PPE). Nevertheless, the majority of pharmacists significantly reported some initial lack of support either inform of recommendations or PPE supply. CONCLUSION The study revealed the dependence of community pharmacists on social media as the main source of information and the lack of early awareness of evidence-based practice resources. Community pharmacists were in need of more initial support to achieve better satisfaction, patient counselling and infection control. Corrective measures were promptly undertaken to support and satisfy the Egyptian community pharmacists' initial awareness and readiness facing COVID-19.
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Affiliation(s)
- Amira B. Kassem
- Department of Clinical Pharmacy and Pharmacy PracticeFaculty of PharmacyDamanhour UniversityDamanhourEgypt
| | - Asser I. Ghoneim
- Department of PharmacologyFaculty of PharmacyDamanhour UniversityDamanhourEgypt
| | - Mohamed I. Nounou
- Department of Pharmaceutical SciencesSchool of PharmacyUniversity of Saint Joseph (USJ)HartfordCTUSA
| | - Noha A. El‐Bassiouny
- Department of Clinical Pharmacy and Pharmacy PracticeFaculty of PharmacyDamanhour UniversityDamanhourEgypt
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Establishment of a Framework to Support Multi-Faceted Initiatives for Pharmacy-Practice Transformation: Lessons Learned. PHARMACY 2021; 9:pharmacy9030153. [PMID: 34564560 PMCID: PMC8482234 DOI: 10.3390/pharmacy9030153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 11/16/2022] Open
Abstract
We describe the first two years of a multifaceted, five-year program to support sustainable pharmacist-provided health services in Alaska. In 2018, the Alaska Pharmacists Association funded the Sustainable Education and Training Model under Pharmacist as Providers (SETMuPP) to train and support pharmacists to navigate the insurance medical billing process for nondispensing healthcare services. The SETMuPP employed a three-pillar implementation approach: (1) training and practice support infrastructure, (2) PharmD curriculum augmentation, and (3) advocacy and legislative support. The first two years have demonstrated the effectiveness of triad partnerships between professional associations, state policy makers, and academic centers to catalyze meaningful practice transformation.
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Sami SA, Marma KKS, Chakraborty A, Singha T, Rakib A, Uddin MG, Hossain MK, Uddin SMN. A comprehensive review on global contributions and recognition of pharmacy professionals amidst COVID-19 pandemic: moving from present to future. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2021; 7:119. [PMID: 34150911 PMCID: PMC8195448 DOI: 10.1186/s43094-021-00273-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 05/31/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND COVID-19, a respiratory tract infection caused by SARS-CoV-2, is a burning question worldwide as it gives rise to a pandemic situation. No specific medications are still recommended for COVID-19; however, healthcare support is crucial for ameliorating the disease condition. Pharmacists are the frontline fighters who are responsible for providing healthcare support to the COVID-19 infected patients around the world. This review endeavored to briefly rationalize the contributions of several pharmacy professionals in diverse fields along with their collaborative efforts and dedication regarding their limitations during the COVID-19 situation and view the prospects of pharmaceutical care services in the post-pandemic period. MAIN BODY OF THE ABSTRACT Online databases were utilized to search for scholarly articles and organizational websites, to sum up the information about the contemporary and expanded role of pharmacists. Key articles were retrieved from Google Scholar, PubMed, and Science Direct databases using terms: "COVID-19," "novel coronavirus," "community," "industrial," "hospital," "clinical," "recognition," "obstacles," "collaboration," "SARS-CoV-2," "healthcare," and "outbreak" in combination with "pharmacist." The articles were included from the inception of the pandemic to January 25, 2021. The current review found pharmacist's global contributions and involvements with other professionals to provide healthcare services amidst COVID-19. This included testing of suspects, providing medical information, psycho-social support, debunking myths, mitigating drug shortage events, telemedicine, e-prescription, infection control, and controlling the drug supply chain. In many countries, pharmacists' activities were much appreciated but in some countries, they were not properly acknowledged for their contributions amidst COVID-19 outbreak. They played additional roles such as participating in the antimicrobial stewardship team, improving value-added services, conducting clinical data analysis to suppress the outspread of the SARS-CoV-2. SHORT CONCLUSION During the COVID-19 pandemic while the whole world is fighting against an invisible virus, the pharmacists are the earnest hero to serve their responsibilities along with additional activities. They need to be prepared and collaborate with other healthcare professionals further to meet the challenges of post-pandemic circumstances.
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Affiliation(s)
- Saad Ahmed Sami
- Department of Pharmacy, University of Chittagong, Chittagong, 4331 Bangladesh
| | - Kay Kay Shain Marma
- Department of Pharmacy, University of Chittagong, Chittagong, 4331 Bangladesh
| | - Agnila Chakraborty
- Department of Pharmacy, University of Chittagong, Chittagong, 4331 Bangladesh
| | - Tandra Singha
- Department of Pharmacy, University of Chittagong, Chittagong, 4331 Bangladesh
| | - Ahmed Rakib
- Department of Pharmacy, University of Chittagong, Chittagong, 4331 Bangladesh
| | - Md. Giash Uddin
- Department of Pharmacy, University of Chittagong, Chittagong, 4331 Bangladesh
| | | | - S. M. Naim Uddin
- Department of Pharmacy, University of Chittagong, Chittagong, 4331 Bangladesh
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Mallhi TH, Liaqat A, Abid A, Khan YH, Alotaibi NH, Alzarea AI, Tanveer N, Khan TM. Multilevel Engagements of Pharmacists During the COVID-19 Pandemic: The Way Forward. Front Public Health 2020; 8:561924. [PMID: 33364224 PMCID: PMC7753011 DOI: 10.3389/fpubh.2020.561924] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/12/2020] [Indexed: 01/01/2023] Open
Abstract
Severe acute respiratory syndrome caused by the novel coronavirus (SARS-CoV-2) was first reported in China in December 2019 which was later declared to be a public health emergency of international concern by the World Health Organization (WHO). This virus proved to be very contagious resulting in life-threatening respiratory intricacies posing overall public health and governance challenges. Amid the coronavirus pandemic and the unprecedented increase in healthcare demands, only inventive and adaptive practice among healthcare professionals is the need of the hour. Pharmacy services are an important mainstay in the public health and have considerable potential to combat the coronavirus disease 2019 (COVID-19) pandemic. Pharmacists working in several localities and health facilities are linked to patients either directly or indirectly. They can act swiftly in public health response such as drafting professional service guidance to pharmacists working in various healthcare facilities, ensuring effective medicine supply system, monitoring and resolving drug shortage issues, establishing and promoting remote pharmacy services, counseling the public on infection prevention basics, educating about proper use of personal protective equipment, discouraging self-medication, participating in clinical trials, small-scale manufacturing of sanitizers and disinfectants, busting the prevailing myths, and conducting drug evaluation and active surveillance. These interventions will help ease unprecedented burden on healthcare facilities during the ongoing pandemic and eventually will add value to patients and the healthcare system. The current manuscript accentuates the potential roles and activities that pharmacists can initiate in various healthcare facilities to help in relieving pressure on the overwhelmed healthcare system. The information and suggestions offered in this review could help in the restructuring of existing pharmacy services by governments, public health bodies, and policy makers in response to the COVID-19 pandemic. Moreover, this manuscript will underscore any unrealized potential among pharmacists working in various sectors including community, hospital, industry, and drug regulatory authorities.
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Affiliation(s)
- Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
| | - Aroosa Liaqat
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Arooj Abid
- Primary and Secondary Healthcare Department, Tehsil Headquarter Hospital, Rawalpindi, Pakistan
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
| | - Nasser Hadal Alotaibi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
| | | | - Nida Tanveer
- Tehsil Headquarter Hospital, Jaranwala, Faisalabad, Pakistan
| | - Tahir Mehmood Khan
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
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Compared benefits of educational programs dedicated to diabetic patients with or without community pharmacist involvement. Prim Health Care Res Dev 2020; 21:e49. [PMID: 33155539 PMCID: PMC7681120 DOI: 10.1017/s1463423620000390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractBackground:International guidelines on diabetes control strongly encourage the setting-up of therapeutic educational programs (TEP). However, more than half of the patients fail to control their diabetes a few months post-TEP because of a lack of regular follow-up by medical professionals. The DIAB-CH is a TEP associated with the follow-up of diabetic patients by the community pharmacist.Aim:To compare the glycated hemoglobin (HbA1c) and body mass index (BMI) in diabetic patients of Control (neither TEP-H nor community pharmacist intervention), TEP-H (TEP in hospital only) and DIAB-CH (TEP-H plus community pharmacist follow-up) groups.Methods:A comparative cohort study design was applied. Patients included in the TEP-H from July 2017 to December 2017 were enrolled in the DIAB-CH group. The TEP-H session was conducted by a multidisciplinary team composed of two diabetologists, two dieticians and seven nurses. The HbA1c level and the BMI (when over 30 kg/m2at M0) of patients in Control (n= 20), TEP-H (n= 20) and DIAB-CH (n= 20) groups were collected at M0, M0 + 6 and M0 + 12 months. First, HbA1c and BMI were compared between M0, M6 and M12 in the three groups with the Friedman test, followed by the Benjamini-Hochberg post-test. Secondly, the HbA1c and BMI of the three groups were compared at M0, M6 and M12 using the Kruskal-Wallis test.Findings:While no difference in HbA1c was measured between M0, M6 and M12 in the Control group, Hb1Ac was significantly reduced in both TEP-H and DIAB-CH groups between M0 and M6 (P= 0.0072 andP= 0.0034, respectively), and between M0 and M12 only in the DIAB-CH group (P= 0.0027). In addition, a significant decrease in the difference between the measured HbA1c and the target assigned by diabetologists was observed between M0 and M6 in both TEP-H and DIAB-CH groups (P= 0.0072 andP= 0.0044, respectively) but only for the patients of the DIAB-CH group between M0 and M12 (P= 0.0044). No significant difference (P> 0.05) in BMI between the groups was observed.Conclusion:The long-lasting benefit on glycemic control of multidisciplinary group sessions associated with community pharmacist-led educational interventions on self-care for diabetic patients was demonstrated in the present study. There is thus evidence pointing to the effectiveness of a community/hospital care collaboration of professionals on diabetes control in primary care.
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