Southwest Michigan Behavioral Health sponsored this study, which was funded by Genoa, a QoL Healthcare Company. SWMBH is a client of Care Management Technologies and permitted the use of its data for this analysis. Wright and Clayton are employed by Care Management Technologies, which was contracted by Genoa to conduct this analysis. Gorman owns Franklin Behavioral Health Consultants and reports consulting fees from Care Management Technologies; Gorman also reports stock ownership in various pharmaceutical companies. Odorzynski and Peterson are employed by Genoa. Study concept and design were contributed by Clayton, Odorzynski, Peterson, and Gorman, with assistance from Wright. Wright took the lead in data collection, with assistance from Clayton and Odorzynski, and data interpretation was performed by Wright and Gorman, with assistance from Odorzynski, Clayton, and Peterson. The manuscript was written by Gorman, Wright, and Odorzynski, assisted by Clayton and Peterson, and revised by Clayton, Gorman, Odorzynski, and Peterson.
Considering their high level of contact with patients, pharmacists are in the best position to provide valuable patient-centered care services to patients with diabetes. Many pharmacists have completed diabetes care certificate programs and/or obtained credentialing through a variety of mechanisms (ie, Certified Diabetes Educator, Board Certified in Advanced Diabetes Management, Certified Diabetes Manager [CDM]). 1 A study conducted in 2003 surveyed CDM pharmacists to determine their disease state management activities. 2 The majority (67%) of the 279 respondents practiced in community pharmacy settings. Sixty-four percent of the respondents cited disease state management with diabetes care (59%) as the most frequently provided service. Although encouraging, 34% of the respondents reported that they spent less than 10% of their time providing direct patient care. 2 In a survey of community pharmacists, nearly all (94%) of the 93 respondents indicated that they performed basic medication counseling services more than 50% of the time. 3 In comparison, 26% of pharmacists provided intermediate care (ie, hypoglycemia information, blood glucose meter use, foot care, administration of insulin, dietary/nutrition and exercise information, when to contact healthcare provider) and 27% provided advanced diabetes patient care (ie, defining target glucose ranges, stressing of importance of yearly eye exams as well as regular lab testing, information regarding the occurrence of illness/severe stress) more than 50% of the time. Likewise, Plake et al. 4 found that 68% of pharmacists (n = 62) who completed a diabetes certificate program for community pharmacists in the Midwest provided diabetes care. The range of care varied widely, with 66% providing blood glucose monitor training, 34% assisting with goal setting, and 9% completing foot checks. All services were part of the certificate program, suggesting that barriers may be preventing the provision of advanced diabetes care.A number of researchers have studied barriers that exist in the delivery of pharmaceutical care in community practice, 5-11 as well as community and migrant health centers 12 and smoking cessation programs. 13 While inadBackground: 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.
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