Objective:
To evaluate diabetes patients’ self-monitoring of blood glucose
using a community pharmacy-based quality assurance procedure,
to investigate whether the procedure improved the quality of the
patient performance of self monitoring of blood glucose, and to
examine the opinions of the patients taking part in the study.
Methods: The results of patient blood glucose measurements were
compared to the results obtained with HemoCue Glucose 201+ by
pharmacy employees in 16 Norwegian community pharmacies. Patient
performance was monitored using an eight item checklist. Patients
whose blood glucose measurements differed from pharmacy measurements
by more than 20% were instructed in the correct use of their glucometer.
The patients then re-measured their blood glucose. If the results
were still outside the set limits, the control procedure was repeated
with a new lot of glucometer strips, and then with a new glucometer.
The patients returned for a follow-up visit after three months.
Results: During the first visit, 5% of the 338 patients had measurements
that deviated from pharmacy blood glucose values by more than
20% and user errors were observed for 50% of the patients. At
the second visit, there was no significant change in the analytical
quality of patient measurements, but the percentage of patients
who made user errors had decreased to 29% (p < 0.001). Eighty-five
percent of the patients reported that they used their blood glucose
results to adjust medication, exercise or meals. Fifty-one percent
of the patients reported a greater trust in their measurements
after the second visit. Eighty percent of patients wished to have
their measurements assessed yearly. Of these patients, 83% preferred
to have the assessment done at the community pharmacy.
Conclusion: A community pharmacy-based quality assessment procedure
of patients’ self monitoring of blood glucose significantly reduced
the number of user errors. The analytical quality of the patients’
measurements was good and did not improve further during the study.
The high analytical quality might be explained by a selection
bias of participating patients. Patients also reported increased
confidence in their blood glucose measurements after their measurements
had been assessed at the pharmacy.
