JUNE 2020 - We’ve long been hearing about community pharmacists’ lack of time and adequate reimbursement as barriers to doing medication follow-ups. But now a recently published Canadian study exploring why community pharmacists aren’t doing more diabetes follow-ups is providing proof to the anecdotes.
Supported by the Canadian Foundation for Pharmacy’s Innovation Fund, the study validates what pharmacists have been saying all along: the lack of reimbursement and professional recognition, as well as a lack of support in the workplace, are preventing pharmacists from doing more diabetes medication follow-ups.
“The good news is that pharmacists want to do this and believe it is part of their role,” says lead researcher and pharmacist Lori MacCallum. "It’s not that pharmacists need another CE course on diabetes follow-ups, but what we need is to look at strategies for the work environment that makes it easier for them to do these follow-ups.”
Study investigator Lori MacCallum
In surveying 346 pharmacists for the study, MacCallum says one research revelation was that pharmacists feel patients and physicians aren't clear on the pharmacist’s role in diabetes follow-ups. "Knowing this we can tailor the interventions we develop, making sure patients and physicians know what pharmacists can offer and why they should be doing follow-ups."
The study also revealed that those doing diabetes follow-ups currently have to overcome significant obstacles with little incentive, such as working through lunch or staying after work to finish the required documentation. "What I found interesting is that they said they want more reimbursement for services as they hope managers will see the benefit from a revenue standpoint and improve the work environment," says MacCallum. "It's not just that they want more money, it's that they want the model to change too."
Once the researchers identified the barriers, they worked with five Ontario community pharmacies to initiate various quality improvement methods to implement into real-world practice. Taking what they learned from these pharmacies, MacCallum and her team are developing a web page to launch on the Diabetes Pharmacists Network by the end of this summer, with videos from the participating pharmacists describing what strategies worked in improving diabetes follow-up rates. (Pharmacists and pharmacy students can sign up to become a member for free, and others can subscribe to the newsletter to get notified when this initiative goes live.)
MacCallum says having the study published in an international journal and now sharing the results with pharmacy stakeholders across the country is a critical next step. "There are things pharmacists can do now using quality improvement methods, but there are big, system-level issues in the profession that need to be addressed," she says. "These study results show us where to focus our energies going forward."