Regional Influences on the Dispensing of Glucose Test Strips in Dutch Community Pharmacies
- 33 Downloads
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.
Key wordsCohort analysis Diabetes mellitus Blood glucose monitoring Pharmaceutical care Netherlands Glucose test strips
Unable to display preview. Download preview PDF.
This study was supported by an unrestricted grant from the Royal Society for the Advancement of Pharmacy (KNMP), the Hague, the Netherlands.
- 4.Wiersma TJ, Heine RJ and Rutten GHE (2006). NHG–Standard Diabetes mellitus type 2: Tweede herziening. Huisarts Wet 49: 137–152Google Scholar
- 6.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)
- 7.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)
- 8.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: 2709–2711Google Scholar
- 9.WINAp (2000) FPZ Standaard Diabetes Mellitus Type 2 [Pharmaceutical Care Standard Diabetes Mellitus Type 2]. Den Haag: WINApGoogle Scholar
- 22.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: 284–295Google Scholar
- 23.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: 170–180Google Scholar
- 24.Stichting Farmaceutische Kengetallen (2001) Farmacie in cijfers: toename in gebruik hulpmiddelen [Pharmacy in figures: rise in use of medical aids]. Pharm Weekbl 136: 829Google Scholar
- 25.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 90-313-3702-1Google Scholar
- 28.Berringer R et al. Outcomes of a community pharmacy-based diabetes monitoring program. J Am Pharm Assoc (Wash) 1999; 39: 791–797Google Scholar
- 29.Cioffi ST, Caron MF, Kalus JS, Hill P, Buckley TE. Glycosylated hemoglobin, cardiovascular, and renal outcomes in a pharmacist-managed clinic. 2004; 38: 771–775Google Scholar
- 30.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: 18–25Google Scholar
- 31.Stichting Farmaceutische Kengetallen (2003) Weer meer apotheken [Again, more pharmacies]. Pharm Weekbl 138: 128Google Scholar