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Diabetes and cardiovascular disease risk screening model in community pharmacies in a developing primary healthcare system: a feasibility study.


ABSTRACT: OBJECTIVES:This study aimed to develop an evidence-based community pharmacist-delivered screening model for diabetes and cardiovascular disease (CVD), and assess its feasibility to identify and refer patients with elevated risk. DESIGN:A feasibility study. SETTING:A purposive sample of 12 community pharmacies in three cities in the United Arab Emirates (UAE). PARTICIPANTS:Adults 40 years of age and above who have not been previously diagnosed with either diabetes or CVD. INTERVENTION:Pharmacist screening of adults visiting pharmacies involved history, demographics, anthropometric measurements, blood pressure and point-of-care testing including glycated haemoglobin (HbA1c) levels and lipid panel. Participants with a 10-year CVD risk ?7.5%, HbA1c level ?5.7%?or American Diabetes Association (ADA) risk score ?5 points were advised to visit their physician. PRIMARY AND SECONDARY OUTCOME MEASURES:The primary outcomes were (1) development of UAE pharmacist-delivered screening model, (2) the proportion of screened participants identified as having high CVD risk (atherosclerotic CVD 10-year risk defined as ?7.5%) and (3) the proportion of participants identified as having elevated blood glucose (high HbA1c level ?5.7% (38.8 mmol/mol)) or high self-reported diabetes risk (ADA risk score ?5 points). Secondary outcome is participants' satisfaction with the screening. RESULTS:The first UAE pharmacist-delivered screening model was developed and implemented. A total of 115 participants were screened, and 92.3% of the entire screening process was completed during a single visit to pharmacy. The mean duration of the complete screening process was 27?min. At-risk individuals (57.4%) were referred to their physicians for further testing, while 94.5% of participants were at least satisfied with their screening experience. CONCLUSIONS:The community pharmacist-delivered screening of diabetes and CVD risk is feasible in the UAE. The model offers a platform to increase screening capacity within primary care and provides an opportunity for early detection and treatment. However, pathways for the integration of the pharmacist-delivered screening service with physicians in primary care are yet to be explored.

SUBMITTER: Alzubaidi HT 

PROVIDER: S-EPMC6858145 | BioStudies | 2019-01-01

REPOSITORIES: biostudies

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