Abstract
Background: Pharmacy practice guidelines promote the role of community pharmacies in self-monitoring of blood glucose. However, variations between Dutch pharmacies exist in the proportion of patients to whom test strips are dispensed. Objective: To assess whether variations between community pharmacies in dispensing of blood glucose test strips can be explained by differences in patient characteristics and the region in which the pharmacy is located. Setting: PHARMO-Record Linkage System containing drug dispensing histories from 40 community pharmacies of about 450,000 patients in the Netherlands. Method: We performed a retrospective cohort study. Data on prescription of all drugs and medical aids between 1991 and 2001 were extracted for all new users of antidiabetic drugs. Patients were excluded if the dispensing history did not allow classification of the type of diabetes or if the dispensing pharmacy could not be determined. The data were analysed using a Cox proportional hazard model. Main outcome measure: Time to first test strips dispensed. Results: We identified 8,233 starters of antidiabetic drugs. During a median follow-up of 2.1 years, 20% of the patients were dispensed test strips at least once. Community pharmacy was significantly associated with the dispensing of test strips after adjustment for patient characteristics. This association was less apparent when stratified for the geographical location of the pharmacy. Conclusion: Community pharmacy is an independent determinant of the start of use of test strips. Differences in dispensing of test strips between pharmacies are dependent on geographical region. This suggests that implementing practice guidelines for diabetes care in community pharmacy requires different approaches in different regions.
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References
Stratton IM (2000). Association of glycemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 321: 405–412
The DCCT Research Group (1993). The effect of intensive treatment of diabetes on the development and progression of long-term complications insulin-dependent diabetes mellitus. NEJM 329: 977–986
American Diabetes Association (2004). Standards of medical care in diabetes. Diab Care 27: S15–S35
Wiersma TJ, Heine RJ and Rutten GHE (2006). NHG–Standard Diabetes mellitus type 2: Tweede herziening. Huisarts Wet 49: 137–152
American Diaberes Association (2004). Tests of glycemia in diabetes. Diab Care 27: S91–S93
EuroPharmForum (2001) Improved quality in diabetes care: the pharmacist in St Vincent team: protocol and guidelines. http://www.euro.who.int/document/e75680.pdf (6 Jun. 2005)
Practice Guidance for Community Pharmacists on the Care of People with Diabetes. London: Royal Pharmaceutical Society of Great Britain. Nov 2004. http://www.rpsgb.org/pdfs/diabguid3.pdf#xml=http://www.rpsgb.org/search/pdfhi.php? all=l&filepath=../pdfs/diabguid3.pdf&search= diabetes (6 Jun. 2005)
American Society of Hospital Pharmacists (ASHP) (1995) Therapeutic position statement on strict glycemic control in selected patients with insulin-dependent diabetes mellitus. Am J Health-Syst Pharm 52: 2709–2711
WINAp (2000) FPZ Standaard Diabetes Mellitus Type 2 [Pharmaceutical Care Standard Diabetes Mellitus Type 2]. Den Haag: WINAp
Storimans MJ, Talsma H and Klungel OH (2004). Dispensing glucose test materials in Dutch community pharmacies. Pharm World Sci 32: 52–55
Scorpiglione N (1996). Epidemiology and determinants of blood glucose self-monitoring in clinical practice. Diabetes Res Clin Pract 34: 115–125
Karter AJ, Ferrara A, Darbinian JA, Ackerson LM and Selby JV (2000). Self-monitoring of blood glucose: language and financial barriers in a managed care population with diabetes. Diab care 23: 477–483
Arday DR, Fleming BB and Keller DK (2002). Variation in diabetes care among states: do patient characteristics matter?. Diab Care 25: 2230–2237
Herings R, Stricker B, Boer Ade, Bakker A and Sturmans F (1995). Benzodiazepines and the risk of falling leading to femur fractures. Dosage more important than elimination half-life. Arch Intern Med 155: 1801–1807
Herings R, Stricker B, Boer Ade, Leufkens H and Porsius A (1995). Hypoglycaemia associated with use of inhibitors of angiotensin converting enzyme. Lancet 345: 1195–1198
Erkens JA (2001). Cardiovascular drug use and hospitalisations attributable to type 2 diabetes mellitus. Diab Care 24: 1428–1432
Zgibor JC and Simmons D (2002). Barriers to blood glucose monitoring in a multiethnic community. Diab Care 25: 1772–1777
Harris MI, Cowie CC and Howie LJ (1993). Self-monitoring of blood glucose by adults with diabetes in the United States population. Diab care 16: 1116–1123
O’Connor GT (1999). Geographic variation in the treatment of acute myocardial infarction: the Cooperative Cardiovascular Project. JAMA 281: 627–633
Skinner J, Weinstein JN, Sporer SM and Wennberg JE (2003). Racial, ethnic, and geographic disparities in rates of knee arthroplasty among medicare patients. New Eng J Med 349: 1350–1359
Wennberg JE (1999). Understanding geographic variations in health care delivery. New Eng J Med 340: 52–53
Bell HM, McElnay JC and Hughes CM (1998). A qualitative investigation of the attitudes and opinions of community pharmacists to pharmaceutical care. J Soc Adm Pharm 15: 284–295
Odedina FT, Segal R and Hepler CD (1995). Providing pharmaceutical care in community practice: differences between providers and non-providers of pharmaceutical care. J Soc Adm Pharm 12: 170–180
Stichting Farmaceutische Kengetallen (2001) Farmacie in cijfers: toename in gebruik hulpmiddelen [Pharmacy in figures: rise in use of medical aids]. Pharm Weekbl 136: 829
Lutterman J (2002) Farmacotherapie bij diabetes mellitus: huidige situatie en toekomstverwachtingen [Pharmocotherapy of diabetes mellitus: current situation and projections]. In: Timmerman H, van den Bery Jeths A, editors. Volksgezondheid toekomst verkenningen. Bilthoven: RIVM. ISBN 90-313-3702-1
Cranor CW, Bunting BA and Christensen DB (2003). The Asheville Project: long-term clinical and economic outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc (Wash) 43: 173–184
Cranor CW and Christensen DB (2003). The Asheville Project: short-term outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc (Wash) 43: 149–159
Berringer R et al. Outcomes of a community pharmacy-based diabetes monitoring program. J Am Pharm Assoc (Wash) 1999; 39: 791–797
Cioffi ST, Caron MF, Kalus JS, Hill P, Buckley TE. Glycosylated hemoglobin, cardiovascular, and renal outcomes in a pharmacist-managed clinic. 2004; 38: 771–775
Wermeille J, Bennie M, Brown I, McKnight J. Pharmaceutical care model for patients with type 2 diabetes: integration of the community pharmacist into the diabetes team – a pilot study. Pharm World Sci 2004; 26: 18–25
Stichting Farmaceutische Kengetallen (2003) Weer meer apotheken [Again, more pharmacies]. Pharm Weekbl 138: 128
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This study was supported by an unrestricted grant from the Royal Society for the Advancement of Pharmacy (KNMP), the Hague, the Netherlands.
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Parts of this study have been published in Ann Pharmacother 2004: 38: 1751–1752.
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Storimans, M.J., Klungel, O.H., Talsma, H. et al. Regional Influences on the Dispensing of Glucose Test Strips in Dutch Community Pharmacies. Pharm World Sci 28, 26–32 (2006). https://doi.org/10.1007/s11096-005-2908-1
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DOI: https://doi.org/10.1007/s11096-005-2908-1