Feasibility and outcomes of a collaborative pharmacy and general practice service for people with type 2 diabetes...

New approaches are needed to respond to increasing numbers of patients with type 2 diabetes and high HbA1c (glycated haemoglobin). This pilot supported additional care from five primary care nurses and community pharmacists for people with type 2 diabetes with high HbA1c.

To describe uptake, outcomes and experiences of a collaborative pharmacy and general practice diabetes programme.

Quantitative data from patients enrolled before 31 August 2022 included change in HbA1c and medication, and pharmacist activity. Interviews with seven patients, five pharmacists and four practice nurses were analysed thematically.

The evaluation included 26 people with an average baseline HbA1c of 97.6 mmol/mol (range 69-136 mmol/mol), of whom 84.6% were Māori or Pacific peoples. HbA1c reduced by an average 25.2 mmol/mol; 20.7 mmol/mol for Māori and Pacific peoples. HbA1c reduced by ≥5 mmol/mol in 84.6% of service users, and 81.8% of Māori and Pacific peoples. HbA1c reductions were sustained an average 7.5 months after programme completion. Pharmacists tailored their actions to the individual. The programme was highly acceptable to patients, pharmacists and nurses, with generally good communication and trust between them. Understanding about diabetes and medication, and medication adherence improved. New, effective medicines and insulin were often introduced. Some participants described increased blood glucose testing and lifestyle changes. Diabetes distress and denial, goal setting, client understanding of HbA1c and dropouts need further attention. COVID-19, staffing changes and staff shortages impacted enrolments. Pharmacist mentoring may help enrolments.

A collaborative pharmacy-general practice model has potential to improve HbA1c in patients with type 2 diabetes through relatively simple interventions.