Barriers to Community Pharmacists' Provision of Diabetes Care Services in Iowa

Abstract

Background:

Pharmacists are in a unique position to provide valuable patient care services to patients with diabetes. Even though many pharmacists have developed their diabetes care knowledge base and obtained credentials, they do not provide diabetes care on a regular basis, suggesting the existence of barriers to care other than knowledge and skills.

Objective:

To determine the barriers limiting the provision of diabetes care services in community pharmacy settings.

Methods:

Community pharmacists (N = 1,337) in Iowa were surveyed regarding (1) the types of diabetes care services provided, (2) reimbursement for services provided, (3) educational needs, (4) perceived barriers to providing diabetes services, and (5) demographics. A 46 item questionnaire was developed and mailed to participants with an addressed, stamped envelope. Nonrespondents were contacted by email or phone and asked to complete the questionnaire. Respondents' perceived barriers to diabetes care were compared based on their demographic characteristics.

Results:

Response rate to the questionnaire was 59.2%. Approximately 30% of respondents provided at least one diabetes care service. Of those respondents, 98% offered blood glucose meter training to their patients, and 64.7% offered patient education on diabetes topics. Issues pertaining to reimbursement, workload, and available time were the most limiting barriers to providing diabetes care services to their patients. Previously documented barriers such as patient attitudes, cultural/language barriers, store layout and patient privacy, and inadequate resources and start-up funds were not considered to be limiting by the respondents in this study.

Conclusions:

Provision of diabetes care services is higher than reported in earlier studies. While some barriers may no longer be as limiting as they were in the past decade, inadequate reimbursement, large workload, and lack of time continue to persist as the primary barriers cited by pharmacists who are charged with providing diabetes care.