A consensus model for delivery of structured pharmaceutical care for the patient with type 2 diabetes mellitus by Scottish community pharmacists

摘要

Objective To generate a model of pharmaceutical care for the patient with type 2 diabetes mellitus in primary care, from a consensus determined among community pharmacists in Scotland. Setting Community pharmacists within Scotland already involved in providing structured pharmaceutical care. Method The Delphi questionnaire was based on a validated multidisciplinary model of care for the patient with type 2 diabetes mellitus in primary care comprising 47 items under five themes: assessment, treatment plan, treatment administration, patient monitoring, confirmation/review. Seventy participants already participating in a pharmaceutical care model schemes initiative to encourage pharmaceutical care from community pharmacies and with an interest in diabetes mellitus were sent an initial questionnaire. Thirty-seven participants agreed to enter two further rounds; response rates were 22/37 (59%) and 18/22 (82%). Final round cut-off defining consensus was 80% scoring 6-7 from a seven-point Likert scale. Key findings A model emerged from the achieved consensus. There was an early consensus achieved on the core functions that participants were already delivering to the patient with diabetes mellitus. These are functions that have been highlighted and delivered in previous studies within this disease state: receiving and sharing patient information, individualising treatment, identifying unsatisfactory treatment and monitoring and prescribing analgesia. Conclusions For service development and linked continued professional development a well-defined service model for delivering pharmaceutical care to patients is required. This study proposes such a model based on consensus among a self-selected group of community pharmacists leading diabetes pharmacy practice in Scotland.