Scoping Review Identifies Opportunities and Barriers to Implementing Pharmacist-Driven CGM Services

According to a scoping review in the Journal of the American Pharmacists Association, “There is lack of strong evidence to support pharmacist-driven CGM [continuous glucose monitoring] in the community pharmacy setting. However, small studies suggest pharmacist-driven CGM is feasible and beneficial in the ambulatory care setting.”

A team of investigators from the Pharmacotherapeutics & Clinical Research Department at the University of South Florida sought to identify opportunities and barriers to implementing pharmacist-driven CGM services in community and ambulatory care settings, as well as examine the clinical outcomes resulting from pharmacist-driven CGM.

To compile a comprehensive understanding of the subject, a health librarian conducted an extensive search of several reputable databases, including Ovid MEDLINE, Cochrane CENTRAL, Embase, Web of Science, Scopus, and International Pharmaceutical Abstracts.

From an initial pool of 942 citations, 249 underwent abstract screening, with 11 ultimately selected for inclusion in the scoping review. These studies presented a varied landscape, with retrospective designs, diverse patient populations, inconsistent control groups, predominantly short-term follow-ups, and small sample sizes. Only 1 of the included studies evaluated pharmacist-driven CGM in a community pharmacy setting, while the remaining 10 were conducted in ambulatory care settings.

Barriers to implementing pharmacist-driven CGM services included educational, logistical, workflow, and financial challenges. The need for comprehensive training, logistical considerations related to device management, workflow modifications to accommodate CGM services, and financial incentives to motivate pharmacists all presented considerable challenges.

However, the reviewed studies consistently reported beneficial outcomes resulting from pharmacist-driven CGM services. These included improvements in the quality of life for individuals with diabetes, increased empowerment through better self-management, and enhanced glycemic control.

“There is lack of strong evidence to support pharmacist-driven CGM in the community pharmacy setting. However, small studies suggest pharmacist-driven CGM is feasible and beneficial in the ambulatory care setting,” the investigators wrote in conclusion. “Further exploration of how educational, logistical, workflow, and financial barriers can be overcome is warranted, given potential for improved clinical outcomes.”