Opportunistic Risk Screening for Type 2 Diabetes: Exploring of Application of Diabetes Risk Assessment Tool in Community Pharmacy in Australia and Thailand

Abstract

Objective: To evaluate the feasibility of providing diabetes risk assessment at community pharmacy level in Australia and Thailand from organizational aspects.

Methods: The intervention study was conducted in eight community pharmacies in New South Wales, Australia, and six community pharmacies in Central Thailand. Diabetes risk assessment tools were applied to determine the risk of developing type 2 diabetes. An open-ended question was asked to solicit the willingness-to-pay value for the service. A semistructured interview was conducted with participating pharmacists to solicit the perceived facilitators and barriers in providing the service.

Results: There were a total of 132 and 185 participants, with the ratio of participants in the three risk categories of low, intermediate, and high being 1:4:11 and 2:1:1.5 for Australia and Thailand, respectively. More Thai participants were willing to pay for the service (72.4% vs. 18.9%; P = 0.0001). Pharmacists from both countries agreed that providing risk assessment would increase health awareness and assist in dampening the burden of disease. A major barrier is time and staff shortage. Support from the government and collaboration among health care providers were major facilitators from Thai pharmacists' perspective, whereas remuneration was a major facilitator from Australian pharmacists' perspective.

Conclusions: Pharmacists in both countries agreed that this intervention would contribute to produce positive health benefits. Differences in advantages and barriers as well as in the proportion of consumers willing to pay for the service demonstrated that it is essential for pharmacists (particularly in developing countries) to be aware of the pitfalls of copying practice initiatives in developed countries without any consideration of the local health care environment.

Keywords: community pharmacy; health promotion; pharmacy practice; prevention; risk assessment; type 2 diabetes.