PHARMACISTS’ ROLES IN DIABETES CARE IN INDIGENOUS COMMUNITIES IN SASKATCHEWAN
Date
2025-06-18
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
ORCID
0000-0002-2171-5764
Type
Thesis
Degree Level
Masters
Abstract
Diabetes mellitus presents a significant and growing public health burden globally and in Canada, with Indigenous peoples experiencing disproportionately higher prevalence and poorer outcomes due to systemic, social, and historical inequities. Pharmacists, given their accessibility and expertise in medication management, chronic disease prevention, and health promotion, are uniquely positioned to support diabetes care in underserved Indigenous communities. However, there is limited evidence on their specific roles and experiences in this context within Canada. This research aimed to identify knowledge gaps in the literature, assess pharmacists’ current roles in Indigenous diabetes care in Saskatchewan, and explore the barriers and facilitators influencing their service delivery. This study employed a critical review of existing literature and an explanatory sequential mixed-methods approach, consisting of a cross-sectional survey and qualitative interviews. The critical review synthesized international evidence on pharmacist involvement in Indigenous diabetes care and was guided by the Two-Eyed Seeing Framework and the Framework for Diabetes in Canada. A cross-sectional survey of Saskatchewan pharmacists captured the scope of services provided, perceived barriers and facilitators, and professional characteristics. Qualitative interviews with selected participants provided greater insight into pharmacists’ lived experiences and contextual understanding and were guided by the Framework for Diabetes in Canada. Three major findings were identified. First, the critical review highlighted pharmacists’ involvement in medication management, patient education, and interprofessional collaboration, while also revealing a lack of Canadian-based research. Second, survey findings showed pharmacists frequently provide diabetes-related services: 83% (39/47) “Often/Always” counsel on the use of blood or continuous glucose monitors, and 88.6% (39/44) “Often/Always” provide dietary counseling. Key barriers included patient receptiveness (72.1%; 31/43) and access to communities (65.1%; 28/43), while facilitators included positive patient/community feedback (78.6%; 33/42) and personal commitment (76.2%; 32/42). Third, qualitative interviews revealed pharmacists’ roles in device education, medication management, lifestyle counseling, and management of hyperglycemia and related conditions. Barriers were categorized into four themes: patient-related, systemic and workforce limitations, accessibility challenges, and interprofessional barriers. Facilitators included pharmacist empowerment, patient engagement, improved access, and trust-building within communities. Recommendations for future policy, practice, and research include expanding pharmacist involvement in Indigenous health, enhancing cultural competency training, and supporting interprofessional collaboration. In conclusion, pharmacists play a valuable role in diabetes care for Indigenous peoples in Saskatchewan, but systemic reforms and culturally responsive strategies are essential to maximizing their impact.
Description
Keywords
Pharmacists, diabetes, Indigenous peoples, barriers, facilitators, recommendations, Saskatchewan
Citation
Degree
Master of Public Health (M.P.H.)
Department
School of Public Health
Program
Public Health