Barriers and Facilitators to Providing Diabetes Self-Management Education and Support and/or Diabetes Prevention Programs in Community Pharmacies

Abstract

Specific Aims: Identify facilitators and barriers for community pharmacists providing Diabetes Self-Management Education and Support (DSMES) and/or Diabetes Prevention Programs (DPP) services. Methods: A 68-item exploratory questionnaire was administered via Qualtrics to United States community pharmacists between February and March 2024 to collect perceived barriers and facilitators to DSMES and DPP services using a 5-point scale (strong barrier, minor barrier, indifferent, facilitator, strong facilitator). Barriers and facilitators included patient awareness, contracting with medical insurance plans, space/physical location for services, physical equipment, referral sources for patients, accreditation/recognition requirements, ability to submit medical claims, and reimbursement for services. Data were summarized using frequencies and percentages for strong/minor barriers, indifferent, and strong/minor facilitators. Results: The questionnaire was completed by 70 pharmacists, most of whom had earned a Doctor of Pharmacy degree (78%) and were currently practicing community pharmacy in Arizona (75%). Participants identified DSMES perceived barriers as insurance reimbursement processes (63.1%), staffing shortages (60.3%), and contracting with insurance (58.8%). DPP barriers include contracting with medical insurance plans (60.3%) and patient awareness/engagement (49.2%). Facilitators identified are staff expertise (DSMES=40%, DPP=42%), referral sources for patients (DSMES=38%, DPP=33%), available equipment (DSMES=28%, DPP=28%), and patient engagement (DSMES=28%, DPP=30%). Conclusions: Challenges exist in providing DSMES and DPP services, including patient engagement, insurance reimbursement and processing, and staffing shortages. Key facilitators include staff expertise, referrals, resources, and patient engagement. Support in addressing barriers is required to further improve diabetes services.