Opportunistic screening for type 2 diabetes in community pharmacies. Results from a region-wide experience in Italy.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
19
12
2019
accepted:
15
02
2020
entrez:
19
3
2020
pubmed:
19
3
2020
medline:
21
7
2020
Statut:
epublish
Résumé
Given the paucity of symptoms in the early stages of type 2 diabetes, its diagnosis is often made when complications have already arisen. Although systematic population-based screening is not recommended, there is room to experience new strategies for improving early diagnosis of the disease in high risk subjects. We report the results of an opportunistic screening for diabetes, implemented in the setting of community pharmacies. To identify people at high risk to develop diabetes, pharmacists were trained to administer FINDRISC questionnaire to overweight, diabetes-free customers aged 45 or more. Each interviewee was followed for 365 days, searching in the administrative database whether he/she had a glycaemic or HbA1c test, or a diabetologists consultation, and to detect any new diagnosis of diabetes defined by either a prescription of any anti-hyperglycaemic drug, or the enrolment in the register of patients, or a hospital discharge with a diagnosis of diabetes. Out of 5977 interviewees, 53% were at risk of developing diabetes. An elevated FINDRISC score was associated with higher age, lower education, and living alone. Excluding the number of cases expected, based on the incidence rate of diabetes in the population, 51 new cases were identified, one every 117 interviews. FINDRISC score, being a male and living alone were significantly associated with the diagnosis. The implementation of a community pharmacy-based screening programme can contribute to reduce the burden of the disease, particularly focusing on people at higher risk, such as the elderly and the socially vulnerable.
Sections du résumé
BACKGROUND AND AIMS
Given the paucity of symptoms in the early stages of type 2 diabetes, its diagnosis is often made when complications have already arisen. Although systematic population-based screening is not recommended, there is room to experience new strategies for improving early diagnosis of the disease in high risk subjects. We report the results of an opportunistic screening for diabetes, implemented in the setting of community pharmacies.
METHODS AND RESULTS
To identify people at high risk to develop diabetes, pharmacists were trained to administer FINDRISC questionnaire to overweight, diabetes-free customers aged 45 or more. Each interviewee was followed for 365 days, searching in the administrative database whether he/she had a glycaemic or HbA1c test, or a diabetologists consultation, and to detect any new diagnosis of diabetes defined by either a prescription of any anti-hyperglycaemic drug, or the enrolment in the register of patients, or a hospital discharge with a diagnosis of diabetes. Out of 5977 interviewees, 53% were at risk of developing diabetes. An elevated FINDRISC score was associated with higher age, lower education, and living alone. Excluding the number of cases expected, based on the incidence rate of diabetes in the population, 51 new cases were identified, one every 117 interviews. FINDRISC score, being a male and living alone were significantly associated with the diagnosis.
CONCLUSIONS
The implementation of a community pharmacy-based screening programme can contribute to reduce the burden of the disease, particularly focusing on people at higher risk, such as the elderly and the socially vulnerable.
Identifiants
pubmed: 32187210
doi: 10.1371/journal.pone.0229842
pii: PONE-D-19-35176
pmc: PMC7080237
doi:
Substances chimiques
Blood Glucose
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0229842Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Recenti Prog Med. 2017 Apr;108(4):168-171
pubmed: 28492584
BMJ. 1998 Aug 1;317(7154):307-12
pubmed: 9685274
Endocrinol Nutr. 2016 Oct;63(8):387-96
pubmed: 27481442
Eur J Public Health. 2018 Dec 1;28(6):1127-1132
pubmed: 29408980
BMJ Open. 2016 Feb 08;6(2):e010155
pubmed: 26857106
Nutr Metab Cardiovasc Dis. 2008 Dec;18(10):678-82
pubmed: 18395428
Diabetologia. 2012 Jun;55(6):1651-9
pubmed: 22237689
Diabetes. 2004 Jul;53(7):1782-9
pubmed: 15220202
Pharm World Sci. 2006 Jun;28(3):171-9
pubmed: 17004016
Gac Sanit. 2013 Nov-Dec;27(6):494-501
pubmed: 23643719
Cardiovasc Diabetol. 2007 Feb 15;6:5
pubmed: 17302977
Nutr Metab Cardiovasc Dis. 2018 Mar;28(3):219-225
pubmed: 29337018
BMJ Open. 2017 Dec 27;7(12):e017725
pubmed: 29284715
Can Pharm J (Ott). 2018 Jan 02;151(1):4-5
pubmed: 29317929
Diabet Med. 2007 Feb;24(2):200-7
pubmed: 17257284
PLoS One. 2014 Apr 01;9(4):e91157
pubmed: 24690919
Int J Public Health. 2018 Apr;63(3):325-335
pubmed: 29383384
Lancet. 2017 Jun 3;389(10085):2239-2251
pubmed: 28190580
BMC Public Health. 2010 Aug 20;10:506
pubmed: 20727141
Health Technol Assess. 2013 Aug;17(35):1-90
pubmed: 23972041
Diabetes Care. 2003 Mar;26(3):725-31
pubmed: 12610029
Diabetes Care. 2005 May;28(5):1187-94
pubmed: 15855587
Eur J Public Health. 2019 Feb 1;29(1):17-23
pubmed: 30239673
Eur J Cancer Prev. 2016 Nov;25(6):538-46
pubmed: 26999379
Eur J Public Health. 2014 Apr;24(2):280-5
pubmed: 24008553
BMC Public Health. 2014 May 22;14:487
pubmed: 24885099