490 Patients’ and Pharmacists’ Experiences of a Community Pharmacy-Based Diabetes Care Plan
Authors: Abdulhakeem Ikolaba F S , Schafheutle E I , Steinke D T 
Published: April 2023

Abstract

Introduction
The traditional view of healthcare professionals as the main decision-makers has changed, recognising the importance of people managing their own conditions (1). An evidence-informed Community Pharmacy-Based Diabetes Care Plan (2) provided person-centred care for adults living with type 2 diabetes in Lagos, Nigeria. Due to the Covid-19 pandemic, community pharmacists (n =20) had monthly remote consultations with patients (n =89) over six months, supporting patients in setting and reviewing their own goals.

Aim
Part of a larger evaluation, this paper aims to describe patients’ and pharmacists’ experiences, acceptability and contextual barriers and facilitators to the care plan.

Methods
An invitation for all participants to participate in study interviews during months 4-6 of the care plan was sent via the pharmacists. The researcher contacted participants that sent their consent or consent to contact form in remotely. Semi-structured telephone interviews were conducted with consent. Participants’ reasons for enrolling, participation experiences, barriers and facilitators were explored. Interviews were conducted in English, audio-recorded and transcribed verbatim. Transcripts were thematically analysed, aided by NVivo12. At study completion, all patients were provided with a post-study questionnaire (PSQ).

Results
Seventy patients completed the PSQ. Of these, 88% were satisfied with the service on a 10-point satisfaction scale (1= very dissatisfied and 10= very satisfied). All respondents stated that the care plan helped them manage their conditions better. Based on their experience with the care plan, all respondents indicated they were likely or much more likely to recommend the care plan to friends and family if they need similar care.
Interviews lasting 14-42 minutes were conducted with 10 pharmacists and 15 patients. Seven themes emerged from the data: reasons for agreeing to participate; perception of pharmacy (premises and profession); remote consultations - a new way of working; service delivery and care coordination; acceptability of the care plan; types of goals, goal attainment and patients’ satisfaction; and facilitators, barriers, and recommendations to the care plan.
The care plan was perceived as valuable, and it improved patients’ confidence regarding diabetes management. Key benefits of the care plan were patients’ empowerment, including better self-care and addition to therapeutics. Monthly online (majority) meetings between the pharmacists and patients maintained patients’ engagement with the care plan and allowed improvements in goal achievements and better follow-up across the pharmacies. The remote consultations were perceived as innovative and useful, though a few patients were seen face to face in particular circumstances. Identified barriers included time and technology. Patients were satisfied and passionate about the new service, and pharmacists were excited about the opportunities to provide person-centred care in their pharmacies.

Conclusion
This study is the first mixed-methods evaluation of a person-centred goal-setting intervention for people living with diabetes in Lagos, Nigeria. It showed that the care plan was acceptable and useful to patients and pharmacists. It supports the importance of personalised care in diabetes management. A key limitation was selection bias-only those who expressed interest were interviewed. No follow-up on non-participants was done because the research team had no access to patients’ contact details.

References
1. Coulter A, Roberts S, Dixon A. Delivering better services for people with long-term conditions. Building the house of care London: The King’;s Fund. 2013:1-28.
2. Ikolaba FSA, Steinke D, Schafheutle E. Development of a community pharmacy care programme for people with type 2 diabetes in Lagos, Nigeria, using the Medical Research Council framework. International Journal of Clinical Pharmacy. 2021:772-3.