Facilitators and barriers to implementing a digital health-supported, community pharmacy-based prediabetes management program (PRIME program) in Malaysia: a qualitative study of participants' and pharmacists' perspectives.

Abstract

Aim: This study aims to evaluate the facilitators and barriers to the implementation, adoption, and participation of these programs.

Background: The Prediabetes Intervention, Management, and Evaluation (PRIME) program is an initiative that integrates digital health tools with community pharmacy services to encourage lifestyle behaviour changes among participants with prediabetes. While PRIME demonstrates effectiveness in clinical outcomes, the integration of such programs into community pharmacy services remains limited.

Methods: In-depth focus group discussions and one-on-one interviews were conducted with participants and pharmacists who were involved in PRIME. The semi-structured interviews focused on the experiences and perceptions of the implementation of PRIME and its influence on behaviour change. All audio-recorded interviews were transcribed, coded, and analysed using thematic analysis techniques, leading to the development of major themes.

Findings: Seven focus groups and twenty interviews were conducted among 37 participants and 10 pharmacists. Five themes were developed: 1) Intrinsic motivations towards better health; 2) Influence of rapport building; 3) Improved convenience to healthcare access; 4) Resource and support; and 5) Innovation with digital health. Key barriers were related to the use of digital health tools (technical difficulties, lacking engaging functionalities) and resources (workload management, availability of prediabetes-specific guidelines). The participants perceived the blended approach of in-person support with technology-assisted interventions in PRIME as an effective way to build healthier lifestyles. While community pharmacy-based prediabetes management programs like PRIME can be effective in driving healthier lifestyles, several barriers hinder their broader adoption. Addressing these barriers could enhance the implementation and uptake of these programs.