A service improvement opportunity for pharmacist independent prescribers? A literature review examining the relationship between poor diabetes control and the co-existence of mental health issues

Abstract

Diabetes and mental illness are clinically managed by diverse pathways. However, an association between the two has been observed and evidence is growing that when poorly addressed, therapy adherence is low and outcomes are poor. To date, no intervention has been shown to provide sustained improvements in adherence, outcome, quality of life or provider cost savings. This literature review was undertaken as a foundation to a research project to examine whether there is an opportunity for current independent prescriber pharmacists, with or without further training, could as part of a primary care team, contribute their expertise to achieving better and sustainable outcomes for these conditions, where current treatment models are heavily medication-dependent. It reinforces the idea that these conditions are interlinked but by poorly understood mechanisms and suggests that a new approach is required in order to improve outcomes for this complex patient group.