| Issue | Barrier level | Proposed solution | Evidence |
|---|---|---|---|
| Costs of drugs and supplies | Patient | New program to pay for test strips for patients taking insulin Potential reductions in copayments for some diabetes drugs Provision of insurance for uninsured people with diabetes* | Austvoll-Dahlgren et al.19 |
| Difficult to stay motivated, follow a healthy diet | Patient | Patients at low risk Create a standard care pathway for primary care networks involving patient education and promoting self-management Patients at high risk Case management and multidisciplinary teams | Tricco et al.11 |
| Timely access to providers | Patient and provider | Increased use of “navigators” to facilitate referral of patients to appropriate resources | Tricco et al.11 Manderson et al.20 |
| Lack of resources/allied health providers | Provider | Pay pharmacists to develop comprehensive care plans in collaboration with multidisciplinary physician-led teams† Increase scope of practice for allied health practitioners for patients at highest risk | Tricco et al.11 |
| Need for improved communication and system navigation/lack of consistent guidance and standards | Provider | Develop an enhanced care map that is fully integrated within electronic medical records | Shojania et al.21 |
| Lack of allied care provider accountability | System | Enhance the role for pharmacists, including the ability to write prescription refills, administer injections and modify prescriptions† | Tricco et al.11 |
*The Government of Alberta has announced that universal pharmacare will be implemented in 2014. †In 2012, the Government of Alberta began a program to reimburse pharmacists for developing comprehensive care plans for patients with specific combinations of chronic diseases, including diabetes.