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Diabetes and cardiovascular disease risk screening model in community pharmacies in a developing primary healthcare system: a feasibility study
  1. Hamzah Tareq Alzubaidi1,
  2. Subhash Chandir2,
  3. Sanah Hasan3,
  4. Kevin McNamara4,5,
  5. Rachele Cox2,
  6. Ines Krass6
  1. 1 Pharmacy Practice & Pharmacotherapy, University of Sharjah, College of Pharmacy, Sharjah, United Arab Emirates
  2. 2 Center for Global Health Delivery–Dubai, Harvard Medical School, Dubai, United Arab Emirates
  3. 3 Ajman University of Science and Technology College of Pharmacy and Health Science, Ajman, United Arab Emirates
  4. 4 Deakin Rural Health, School of Medicine, Deakin University, Geelong, Victoria, Australia
  5. 5 Institute for Healthcare Transformation, Deakin University, Geelong, Victoria, Australia
  6. 6 Faculty of Pharmacy, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr Hamzah Tareq Alzubaidi; halzubaidi{at}sharjah.ac.ae

Abstract

Objectives This study aimed to develop an evidence-based community pharmacist-delivered screening model for diabetes and cardiovascular disease (CVD), and assess its feasibility to identify and refer patients with elevated risk.

Design A feasibility study.

Setting A purposive sample of 12 community pharmacies in three cities in the United Arab Emirates (UAE).

Participants Adults 40 years of age and above who have not been previously diagnosed with either diabetes or CVD.

Intervention Pharmacist screening of adults visiting pharmacies involved history, demographics, anthropometric measurements, blood pressure and point-of-care testing including glycated haemoglobin (HbA1c) levels and lipid panel. Participants with a 10-year CVD risk ≥7.5%, HbA1c level ≥5.7% or American Diabetes Association (ADA) risk score ≥5 points were advised to visit their physician.

Primary and secondary outcome measures The primary outcomes were (1) development of UAE pharmacist-delivered screening model, (2) the proportion of screened participants identified as having high CVD risk (atherosclerotic CVD 10-year risk defined as ≥7.5%) and (3) the proportion of participants identified as having elevated blood glucose (high HbA1c level ≥5.7% (38.8 mmol/mol)) or high self-reported diabetes risk (ADA risk score ≥5 points). Secondary outcome is participants’ satisfaction with the screening.

Results The first UAE pharmacist-delivered screening model was developed and implemented. A total of 115 participants were screened, and 92.3% of the entire screening process was completed during a single visit to pharmacy. The mean duration of the complete screening process was 27 min. At-risk individuals (57.4%) were referred to their physicians for further testing, while 94.5% of participants were at least satisfied with their screening experience.

Conclusions The community pharmacist-delivered screening of diabetes and CVD risk is feasible in the UAE. The model offers a platform to increase screening capacity within primary care and provides an opportunity for early detection and treatment. However, pathways for the integration of the pharmacist-delivered screening service with physicians in primary care are yet to be explored.

  • diabetes
  • cardiovascular diseases
  • screening
  • pharmacy
  • point-of-care testing
  • primary health care

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors HTA designed the study, supervised data collection process, assisted with data analysis, wrote, reviewed and edited the entire manuscript. SC and RC analysed data, reviewed and edited manuscript. SH wrote parts of manuscript. KM and IK assisted with designing of the study, reviewed the methods and data analysis contributed to the discussion, and reviewed all drafts.

  • Funding This research was supported by two research grants: (1) the research cooperative grant from Center for Global Health Delivery-Dubai, Harvard Medical School, Harvard University (agreement No. 027562-746845-0302), (2) operational grant from the University of Sharjah.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Ethics approval This study was approved by the Research Ethics Committee of the University of Sharjah, the Ministry of Health and Prevention in the United Arab Emirates, and deemed Exempt by the Harvard T.H. Chan School of Public Health Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.

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