Evaluating Pharmacist-Driven CGM Services in Community, Ambulatory Care Settings
Although investigators found a lack of strong evidence to support CGM programs in community pharmacy settings, studies in ambulatory care settings suggest that these programs are both feasible and beneficial.
Editor's note: The summary of this article (above) has been updated to more accurately reflect the findings from the study.
The implementation of continuous glucose monitor services that are led by pharmacists could have a beneficial impact in the ambulatory care setting, according to new research published in the Journal of the American Pharmacists Association.1
Continuous glucose monitors have been available for over 20 years and are known to improve clinical endpoints for patients with diabetes, including hemoglobin A1c and time in the target glycemic range. Despite these known benefits, their use remains low in clinical settings and uptake among patients is poor.
As trusted health care professionals, pharmacists in both the community and ambulatory care settings are well positioned to increase the use of continuous glucose monitors. But there is currently a lack of data on the known outcomes and barriers to implementation of services led by pharmacists.
A team of investigators from the University of Florida and University of South Florida conducted a scoping review to identify opportunities and barriers to implementing pharmacist-driven continuous glucose monitors services in the community and ambulatory care setting. Data was gathered from Ovid Medline, Cochrane Central, Embase, Web of Science, Scopus, and International Pharmaceutical Abstracts databases.
The review initially identified 942 citations describing pharmacist or pharmacy-based continuous glucose monitor programs. Of those, 249 passed the screening process and 11 were included in the study. Only 1 of the studies were conducted in a community pharmacy setting, while 10 were done in an ambulatory care setting.
The review was done by a research and education librarian who specialized in pharmacy from the databases’ inception through December 2, 2022. No publication type, date limits, language restrictions, or other filters were applied during the search.
Investigators found that there was a lack of strong evidence to support the use of continuous glucose monitor programs in the community pharmacy setting. However, the studies done in ambulatory care settings did suggest that pharmacist-driven programs were feasible and beneficial. Positive outcomes included improved patient quality of life, increased empowerment, and improved glycemic control.
Additionally, the researchers found that the largest barriers to initiating pharmacist-led glucose monitor programs were educational, logistical, workflow, and financial incentive. The researchers noted that any pharmacist-driven programs would need to include overcoming these barriers.
“Future research is needed to clarify the role pharmacists can serve in helping people with diabetes optimize use of glucose monitors, how and where pharmacist-driven glucose monitors should be implemented, and the benefits of pharmacist-driven glucose monitors,” the authors concluded.1 “Such research needs to include an adequate control group as well as sufficient sample size, follow-up, and duration.”
