Article Text
Abstract
Background and Importance Diabetes continues to affect an increasing number of Canadians each year and threatens the sustainability of our healthcare system. Early detection is key to improved health outcomes, yet access to testing was limited during the global pandemic. Point-of-care HbA1C screening technology allows for detection of diabetes and pre-diabetes in the community pharmacy setting.
Aim and Objectives To evaluate the effectiveness of a standardised community pharmacist-directed point-of-care HbA1C screening program and to identify the prevalence of diabetes and pre-diabetes in previously undiagnosed patients.
Material and Methods Patients 40 years or older with no diabetes diagnosis or HbA1C result in the last 6 months were offered a complimentary HbA1C test across 40 community pharmacies in Alberta (15) and Ontario (25). They provided a sample of peripheral blood via finger-prick and HbA1C and lipids were reported by a point-of-care testing device (Abbott Affinion 2™ analyser). Once results were available, the pharmacist conducted a comprehensive review with the patient and recommended certain follow-up actions if appropriate.
Results 9041 participants were screened over a 13-week period between 18 June and 15 September 2023. 6% of patients were identified with undiagnosed diabetes (HbA1C value equal to or greater than 6.5%) while 13% presented with HbA1C values consistent with pre-diabetes (HbA1C value between 6.0% – 6.4%). Pharmacist conducted Framingham® risk assessments revealed 24% of patients at moderate to high risk of a cardiovascular event over the next 10 years. Of those screened, 62% were attached to a regular primary care physician and 38% were unattached. The detection rate for pre-diabetes and diabetes was 18.2% in attached patients and 18.5% in unattached patients.
Conclusion and Relevance These results illustrate the prevalence of abnormal glycaemic control among undiagnosed- community pharmacy patients. Pharmacists, as the most accessible healthcare practitioners, are ideally positioned to utilise novel point-of care technologies to improve access to HbA1C screening and increase awareness around the importance of early detection of diabetes.
Conflict of Interest No conflict of interest.