What do persons with diabetes want from community pharmacies? A qualitative study

Main Article Content


COVID-19, Vaccination, Side effects


Background: Diabetes is a demanding disease with a complex treatment regimen. Many persons with diabetes have difficulty managing their disease and taking medication as prescribed, possibly because they lack knowledge and sometimes misinterpret medical benefits. Community pharmacies continuously provide professional counselling to persons with diabetes. Objective: This study aimed to explore 1) which services adults with type 1 and type 2 diabetes want from community pharmacies and 2) how pharmacies can meet these wishes. Methods: A qualitative, explorative study design using focus group interviews was chosen. Informants were recruited from Region Zealand in Denmark. Data were digitally recorded, transcribed verbatim and analyzed by means of thematic analysis. Results: Thirteen adults (11 female) with the mean age of 66.2 years (range 49–81 years) participated in one physical (n=6) or one online (n=7) focus group interview. Ten had type 2 diabetes, three had type 1 diabetes. The average duration of participants’ diabetes was 13.4 years (range 2.3–33.0 years). The analysis revealed three overall themes of the functions which the informants would like community pharmacies to fulfil: 1) raise awareness of pharmacies’ counselling service and competences; 2) act as a dialogue partner; 3) be a source of information and guidance about local activities and support. Conclusion: The informants did not regard community pharmacies as a natural part of the healthcare system or as a place where they would expect counselling. They would like the community pharmacy to make their medical competences and services obvious and the community pharmacy staff to act as a dialogue partner and provide competent counselling. The informants would like to have a contact person with diabetes competences with whom they can book an appointment to complement over-the-counter counselling. They experience a gap in their care between routine visits in the healthcare system and suggest that community pharmacies counselling services become a natural supplement and that healthcare professionals in the primary and secondary sectors inform patients about the services - especially for patients newly diagnosed with diabetes. Finally, they would like a formal collaboration between diabetes associations and community pharmacies to make their competences, services and information visible.


Download data is not yet available.
Abstract 266 | PDF Downloads 206


1. International Diabetes Federation. IDF Diabetes Atlas 2019. Available from: https://www.diabetesatlas.org/en/.
2. Draznin Boris, Aroda Vanita R, Bakris George, et al. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(1):S17-S38. https://doi.org/10.2337/dc22-S002
3. Holt Richard IG, DeVries, J Hans, et al. The management of type 1 diabetes in adults. A consensus report by the AmericanDiabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2021;44(11):2589-2625. https://doi.org/10.2337/dci21-0043
4. Dansk Selskab for Almen Medicin. Farmakologisk behandling af type 2 diabetes. Fælles retningslinje fra DES og DSAM 2022(The Danish College of General Practitioners. Pharmacological treatment of type 2 diabetes. Guidelines) [cited 2022 0406].Available from: https://vejledninger.dsam.dk/fbv-t2dm/.
5. Payal HM, Gao, Helen X, et al. American Diabetes Association Standards of Medical Care in Diabetes 2017. Wiley OnlineLibrary. 2017.
6. Meneghini Luigi. Medical Management of Type 2 Diabetes: American Diabetes Association. 2020.
7. Dansk Selskab for Almen Medicin. Type 2 diabetes opfølgning og behandling (The Danish College of General Practitioners, Type2 diabetes, follow-up and treatment) 2022 [cited 2022 0404]. Available from: https://vejledninger.dsam.dk/type2/.
8. Sohal TanveerSohal Parmjit King-Shier, et al. Barriers and facilitators for type-2 diabetes management in South Asians: asystematic review. PloS one. 2015;10(9):e0136202. https://doi.org/10.1371/journal.pone.0136202 
9. Khan Hamida, Lasker Shawarna S, et al. Exploring reasons for very poor glycaemic control in patients with type 2 diabetes.
Primary Care Diabetes. 2011;5(4):251-255. https://doi.org/10.1016/j.pcd.2011.07.001
10. van Dijk Marloes, Blom Lyda, et al. Patient–provider communication about medication use at the community pharmacy counter. International Journal of Pharmacy Practice. 2016;24(1):13-21. https://doi.org/10.1111/ijpp.12198
11. Blom Lyda, Wolters Majanne, et al. Pharmaceutical education in patient counseling: 20 h spread over 6 years? Patient Education and Counseling. 2011;83(3):465-471. https://doi.org/10.1016/j.pec.2011.05.018
12. Alkhawajah AM, Eferakeya AE. The role of pharmacists in patients’ education on medication. Public Health. 1992;106(3):231- 237.
13. Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):533-543.
14. Pharmaceutical Group of the European Union (PGEU) Annual Report 2019. [cited 2021 3/9]. Available from: https://www.pgeu.eu/wp-content/uploads/2020/03/200402-PGEU-Annual-Report-2019.pdf.
15. Dhippayom Teerapon, Krass Ines. Supporting self-management of type 2 diabetes: is there a role for the community pharmacist?Patient preference and adherence. 2015;9:1085. https://doi.org/10.2147/PPA.S88071
16. Doucette WR, Witry MJ, Farris KB, et al. Community pharmacist-provided extended diabetes care. Ann Pharmacother.2009;43(5):882-889. https://doi.org/10.1345/aph.1L605
17. Seidman Kimberly, Fit Kathy E. Areas for improving care of type 1 diabetes: A role for pharmacists. Journal of the American Pharmacists Association. 2008;48(3):333-334. https://doi.org/10.1331/japha.2008.08041
18. Hansen Rikke , Nørgaard Lotte S, et al. Integration of and visions for community pharmacy in primary health care in Denmark.Pharmacy Practice. 2021;19(1).
19. Kjeldsen LJ, Bjerrum L, Dam P, et al. Safe and effective use of medicines for patients with type 2 diabetes - A randomizedcontrolled trial of two interventions delivered by local pharmacies. Research in social & administrative pharmacy: RSAP.2015;11(1):47-62. https://doi.org/10.1016/j.sapharm.2014.03.003
20. Mossialos Elias, Courtin Emilie, et al. From “retailers” to health care providers: transforming the role of community pharmacists in chronic disease management. Health Policy. 2015;119(5):628-39. https://doi.org/10.1016/j.healthpol.2015.02.007
21. Agomo CO. The role of community pharmacists in public health: a scoping review of the literature. Journal of Pharmaceutical
Health Services Research. 2012;3(1):25-33.
22. Community Pharmacy Forward view. Voice Pharmacy. [cited 2020 September 16th]. Available from: https://psnc.org.uk/national-pharmacy-services/community-pharmacy-forward-view/
23. Next Steps on the NSH. Five Year Forward View 2017. England NSH. [cited 2020 September 16th]. Available from: https://psnc.org.uk/national-pharmacy-services/community-pharmacy-forward-view/.
24. Hindi Ali MK, Schafheutle Ellen I, et al. Community pharmacy integration within the primary care pathway for people with longterm conditions: a focus group study of patients’, pharmacists’ and GPs’ experiences and expectations. BMC Family Practice. 2019;20(1):26. https://doi.org/10.1186/s12875-019-0912-0
25. Pousinho Sarah, Morgado Manuel, et al. Clinical pharmacists´ interventions in the management of type 2 diabetes mellitus: a systematic review. Pharmacy Practice. 2020;18(3):2000. https://doi.org/10.18549/PharmPract.2020.3.2000
26. Hindi Ali MK, Jacobs Sally, et al. Solidarity or dissonance? A systematic review of pharmacist and GP views on community pharmacy services in the UK. Health & Social Care in the Community. 2019;27(3):565-598.
27. Hall NJ, Donovan Gemma, et al. A qualitative synthesis of pharmacist, other health professional and lay perspectives on the role of community pharmacy in facilitating care for people with long-term conditions. Research in Social and Administrative Pharmacy. 2018;14(11):1043-1057. https://doi.org/10.1016/j.sapharm.2018.01.002
28. Hindi Ali MK, Schafheutle Ellen I, et al. Patient and public perspectives of community pharmacies in the United Kingdom: A systematic review. Health Expectations. 2018;21(2):409-428. https://doi.org/10.1111/hex.12639
29. Lutfun NH, Fernandez-Llimos Fernando, et al. Qualitative meta-synthesis of barriers and facilitators that influence the implementation of community pharmacy services: perspectives of patients, nurses and general medical practitioners. BMJ open. 2017;7(9):e015471. https://doi.org/10.1136/bmjopen-2016-015471
30. Halkier Bente. Fokusgrupper (Focusgroup). 3 ed: Samfundslitteratur; Denmark, 2016.
31. Dominik GC. What is going through your mind? Thinking aloud as a method in cross-cultural psychology. Frontiers in Psychology.2018;9:1292. https://doi.org/10.3389/fpsyg.2018.01292
32. Castensøe-Seidenfaden P, Teilmann G, Kensing F, Hommel E, Olsen BS, Husted GR. Isolated thoughts and feelings and unsolved concerns: adolescents’ and parents’ perspectives on living with type 1 diabetes–a qualitative study using visual storytelling. Journal of clinical nursing. 2017;26(19-20):3018-3030. https://doi.org/10.1111/jocn.13649
33. Norman KD, Lincoln Yvonna S. The Sage handbook of qualitative research: sage. 2011.
34. Braun Virginia, Clarke Victoria, et al. Thematic analysis. Handbook of Research Methods in Health Social Sciences. 2019;843-860.
35. Guba EG. Criteria for assessing the trustworthiness of naturalistic inquiries. Ectj. 1981;29(2):75-91.
36. Justitsministeriet. Bekendtgørelse om ændring af bekendtgørelse om undtagelse fra pligten til anmeldelse af visse behandlinger, som foretages for en privat dataansvarlig: BEK nr. 410 af 09/05/2012 [Decree amending the decree on exemption from the obligation to declare certain procedures which are made for a private data controller: order no. 410 of 09/05/2012][cited 2020
10th September]. Available from: https://www.retsinformation.dk/Forms/R0710.aspx?id=141758.
37. WMA Declaration of Helsinki - Ethical principles for medical research involvning human subjects. Association World Medical.[cited 2020 10th September]. Available from: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethicalprinciples-for-medical-research-involving-human-subjects/.
38. Abrahamsen Bjarke, Burghle Hassan A, Rossing C. Pharmaceutical care services available in Danish community pharmacies.International Journal of Clinical Pharmacy. 2020;42(2):315-320. https://doi.org/10.1007/s11096-020-00985-7
39. Naughton Cynthia A. Patient-centered communication. Pharmacy. 2018;6(1):18.
40. Wolters Majanne , Hulten V Rolf, et al. Exploring the concept of patient centred communication for the pharmacy practice.International Journal of Clinical Pharmacy. 2017;39(6):1145-1156. https://doi.org/10.1007/s11096-017-0508-5
41. Zoffmann Vibeke, Harder Ingegerd, et al. A person-centered communication and reflection model: sharing decision-making in chronic care. Qualitative Health Research. 2008;18(5):670-685. https://doi.org/10.1177/1049732307311008
42. Juul Lise , Maindal Helle T, Zoffmann Vibeke, et al. Effectiveness of a training course for general practice nurses in motivation
support in type 2 diabetes care: a cluster-randomised trial. PloS one. 2014;9(5):e96683. https://doi.org/10.1371/journal.pone.0096683
43. Husted GR, Esbensen BA, Hommel E, et al. Adolescents developing life skills for managing type 1 diabetes: a qualitative,realistic evaluation of a guided self‐determination‐youth intervention. Journal of Advanced Nursing. 2014;70(11):2634-2650.https://doi.org/10.1111/jan.12413
44. Perrault Evan K, Newlon Jenny L. Patients’ knowledge about pharmacists, technicians, and physicians. American Journal ofHealth-System Pharmacy. 2019;76(18):1420-1425. https://doi.org/10.1093/ajhp/zxz169
45. Lee Lyn E, Wong Se P, et al. What role could community pharmacists in Malaysia play in diabetes self‐management education and support? The views of individuals with type 2 diabetes. International Journal of Pharmacy Practice. 2018;26(2):138-147.https://doi.org/10.1111/ijpp.12374
46. McMillan Sara S, Kelly Fiona, Sav A, et al. Consumer and carer views of Australian community pharmacy practice: awareness,experiences and expectations. Journal of Pharmaceutical Health Services Research. 2014;5(1):29-36.
47. Bawab Noura, Zuercher Emilie, et al. Interest in and use of person-centred pharmacy services-a Swiss study of people with diabetes. BMC Health Services Research. 2021;21(1):1-10. https://doi.org/10.1186/s12913-021-06217-6
48. MacCallum Lori, Dolovich Lisa. Follow-up in community pharmacy should be routine, not extraordinary. SAGE PublicationsSage CA: Los Angeles, CA. 2018;151(2):79-81. https://doi.org/10.1177/1715163518756586 
49. Cheng AY. Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada. Introduction. Canadian Journal of Diabetes. 2013;37(1):S1-3. https://doi.org/10.1016/j.jcjd.2013.01.009
50. Reeves Landon, Robinson Kristian, et al. Pharmacist interventions in the management of blood pressure control and adherence to antihypertensive medications: a systematic review of randomized controlled trials. Journal of Pharmacy Practice.2021;34(3):480-492. https://doi.org/10.1177/0897190020903573
51. Lakey Hannah, Boehmer Kaci, et al. Impact of a Pharmacist-Led Group Diabetes Class. Journal of Pharmacy Practice.2020;35(1):54-56. https://doi.org/10.1177/0897190020948678
52. Smith AM, Hamann Gale L, et al. Evaluation of the Addition of Pharmacist Management to a Medication Assistance Program in Patients with Hypertension and Diabetes Resistant to Usual Care. Journal of Pharmacy Practice. 2021:08971900211002138. https://doi.org/10.1177/08971900211002138
53. Alsuwayni Bashayr, Alhossan Abdulaziz. Impact of clinical pharmacist-led diabetes management clinic on health outcomes atan academic hospital in Riyadh, Saudi Arabia: A prospective cohort study. Saudi Pharmaceutical Journal. 2020;28(12):1756-1759. https://doi.org/10.1016/j.jsps.2020.11.002
54. Frederick Amy, Juan Joyce, et al. Effect of Visit Frequency of Pharmacist-Led Diabetes Medication Management Program.Journal of Pharmacy Practice. 2022;35(1):70-74. https://doi.org/10.1177/0897190020948685
55. Shareef Javedh, Fernandes Jennifer, et al. Evaluating the effect of pharmacist’s delivered counseling on medication adherence and glycemic control in patients with diabetes mellitus. J Diabetes Metab. 2016;7(3):100654.
56. Jan JKL, Brammer Diane J, et al. Effectiveness of educational interventions to promote oral hypoglycaemic adherence in adults with type 2 diabetes: A systematic review. JBI Evidence Synthesis. 2011;9(9):269-312. https://doi.org/10.11124/01938924-201008081-00001
57. Deters MA, Laven Anna, et al. Effective interventions for diabetes patients by community pharmacists: a metaanalysisof pharmaceutical care components. Annals of Pharmacotherapy. 2018;52(2):198-211. https://doi.org/10.1177/1060028017733272
58. Fonseca Joseph, Violette Richard, et al. Helping Unlock Better Care (HUB| C) using quality improvement science in community pharmacies–An implementation method. Research in Social and Administrative Pharmacy. 2021;17(3):572-577. https://doi.org/10.1016/j.sapharm.2020.05.006
59. Houle Sherilyn KD, Grindrod Kelly A, et al. Paying pharmacists for patient care: a systematic review of remunerated pharmacyclinical care services. Canadian Pharmacists Journal/Revue des Pharmaciens du Canada. 2014;147(4):209-232. https://doi.org/10.1177/1715163514536678
60. Benrimoj Shalom I, Fernandez-Llimos Fernando. An international series on the integration of community pharmacy in primary health care. Pharmacy Practice (Granada). 2020;18(1):1878. https://doi.org/10.18549/PharmPract.2020.1.1878
61. Anderson Claire, Sharma Ravi. Primary health care policy and vision for community pharmacy and pharmacists in England. Pharmacy Practice (Granada). 2020;18(1):1870. https://doi.org/10.18549/PharmPract.2020.1.1870
62. Henman Martin C. Primary Health Care and Community Pharmacy in Ireland: A lot of visions but little progress. Pharmacy Practice. 2020;18(4):2224. https://doi.org/10.18549/PharmPract.2020.4.2224
63. Raiche Taylor, Pammett Robert, et al. Community pharmacists’ evolving role in Canadian primary health care: a vision of harmonization in a patchwork system. Pharmacy Practice. 2020;18(4):2171. https://doi.org/10.18549/PharmPract.2020.4.2171
64. Dineen-Griffin Sarah , Benrimoj Shalom I, et al. Primary health care policy and vision for community pharmacy and pharmacists in Australia. Pharmacy Practice (Granada). 2020;18(2):1967. https://doi.org/10.18549/PharmPract.2020.2.1967
65. Salgado Teresa M, Rosenthal Meagen M, et al. Primary healthcare policy and vision for community pharmacy and pharmacists in the United States. Pharmacy Practice (Granada). 2020;18(3):2160. https://doi.org/10.18549/PharmPract.2020.3.2160
66. Riberio Nadine, Mota-Filipe Helder, et al. Primary health care policy and vision for community pharmacy and pharmacists in Portugal. Pharmacy Practice (Granada). 2020;18(3):2043. https://doi.org/10.18549/PharmPract.2020.3.2043
67. Westerlund Tommy, Marklund Bertil. Community pharmacy and primary health care in Sweden-at a crossroads. Pharmacy Practice. 2020;18(2):1927. https://doi.org/10.18549/PharmPract.2020.2.1927
68. Armando Pedro D, Uema Sonia A, et al. Integration of Community pharmacy and pharmacists in primary health care policies in Argentina. Pharmacy Practice. 2020;18(4):2173. https://doi.org/10.18549/PharmPract.2020.4.2173
69. Hallit Souheil, Selwan Abou C, et al. Primary health care policy and vision for community pharmacy and pharmacists in Lebanon. Pharmacy Practice (Granada). 2020;18(2):2003. https://doi.org/10.18549/PharmPract.2020.2.2003
70. Hermansyah Andi, Wulandari Luh, et al. Primary health care policy and vision for community pharmacy and pharmacists in Indonesia. Pharmacy Practice (Granada). 2020;18(3):2085. https://doi.org/10.18549/PharmPract.2020.3.2085
71. Kingod N, Cleal B, Wahlberg A, et al. Online Peer-to-Peer Communities in the Daily Lives of People with Chronic Illness: A Qualitative Systematic Review. Qualitative health research. 2017;27(1):89-99. https://doi.org/10.1177/1049732316680203
72. The Association of Danish Pharmacies. Lægemidler i Danmark 2019-2020. Available in Danish at: https://www.apotekerforeningen.dk/publikationer/analyser-og-fakta/aarbog-laegemidler-i-danmark (accessed November 11th, 2020).2020.
73. Halliday Matthew, Mill Deanna, et al. Let’s talk virtual! Online focus group facilitation for the modern researcher. Research inSocial and Administrative Pharmacy. 2021;17(12):2145-2150. https://doi.org/10.1016/j.sapharm.2021.02.00

Most read articles by the same author(s)