Cancer patients’ perspectives on participating in a community pharmacy-based hyperglycaemia screening service – A qualitative exploration of enablers and barriers

Background: Patients diagnosed with cancer are often treated with high dose glucocorticosteroids, increasing their risk of developing hyperglycaemia or steroid-induced diabetes, which can be reduced by regular monitoring of blood glucose levels. Community pharmacies can provide easily accessible monitoring services to patients, but may not be convenient or acceptable for people with a cancer diagnosis.Objectives: To explore patients' motivations, perceptions of benefits and barriers influencing their decisions to participate in a novel community pharmacy-based hyperglycaemia screening and monitoring program.Methods: Patients initiated on high-dose-glucocorticosteroids at a quaternary cancer centre, who were meeting risk factor-based inclusion criteria and offered participation in a community-based blood glucose monitoring program, were purposively recruited to semi-structured interviews. Interview transcripts were analysed using content analysis and the Framework Method.Results: Twenty-four patients participated in the interviews, of whom eighteen enrolled into the monitoring program and six declined participation. Interview analysis identified themes of motivators and barriers which were interpreted within the Health Belief Model. Patients individually balanced perceptions of risk and susceptibility to hyperglycaemia with the illness and treatment burden of a cancer diagnosis and the ability to access the program. Health concerns, accessibility of the community pharmacy, trust in healthcare professionals and altruism of patients (giving back) were identified as enablers to enrol. Barriers were inaccessibility of the community pharmacy, extra burden to deal with monitoring appointments, and initial misunderstandings about the screening and monitoring program.Conclusion: Ascertaining individual tipping points based on motivators or enablers and barriers with subsequent tailoring of supportive care programs will be more likely to meet patients' individual needs and may increase the likelihood of delivering appropriate care via community pharmacies.