Expanding access to early diabetes detection: a pharmacy-based screening pilot in rural New South Wales

Background and Aims: Type 2 diabetes mellitus remains a major public health challenge in Australia. This cross-sectional pilot feasibility study evaluated the feasibility of pharmacy-led diabetes screening in rural New South Wales and examined diabetes knowledge, AUSDRISK, and follow-up behavior after referral. Methods: This was a 5-month (January–May 2023) cross-sectional pilot feasibility study conducted across community pharmacies within Western New South Wales LHD. Pharmacies were enrolled, into the study following expression of interest. Point-of-care HbA1c and/or random blood glucose (RBG) testing was conducted for eligible participants. All individuals with abnormal results were referred to general practitioners (GP) and followed up by a clinician. Descriptive analysis was performed using R (version 4.3.1). All tests were two-sided with α = 0.05. Results: Of the 17 enrolled pharmacies, 9 completed the study with a total of 116 adults recruited from the participating pharmacies. Ninety-five participants completed the Diabetes Knowledge Questionnaire and AUSDRISK assessment. Seventy-six percent (76.6% [95% CI: 67.1%, 84.0%]) were classified as high risk using AUSDRISK. Fifty-seven percent (57.7% [95% CI: 47.7%, 67.2%]) had elevated HbA1c and/or RBG levels. Following GP referral, only 15% attended follow-up testing. Among attendees, 44% were diagnosed with diabetes. Conclusion: Pharmacy-based diabetes screening is operationally feasible in rural Australia and identifies substantial undiagnosed diabetes. However, effective linkage to primary care remains a significant challenge.