Exploring ambulatory care pharmacists’ beliefs and confidence in managing diabetes in perinatal women: A qualitative study guided by the Theory of Planned Behavior

PURPOSE: To describe ambulatory care pharmacists' beliefs and confidence in managing diabetes in perinatal women through guided interviews based on the Theory of Planned Behavior (TPB). METHODS: This qualitative study consisted of a web-based presurvey and semistructured virtual interviews with ambulatory care pharmacists practicing at a federally qualified health center (FQHC) system to elicit salient beliefs about managing diabetes in perinatal women using the following TPB constructs: behavioral beliefs (BB), normative beliefs (NB), and control beliefs (CB). Descriptive statistics were conducted for quantitative data. Interviews were transcribed and analyzed by 2 independent researchers. RESULTS: The pharmacist participants (N = 8) were all female and predominantly white (62.5%) and 35 to 44 years of age (87.5%). The majority (87.5%) were board certified in ambulatory care pharmacy, with 6 or more years of experience (75%). When the pharmacists were asked to rate the frequency of their involvement in managing diabetes in perinatal women in current or previous practice settings on a 5-point Likert scale (1 = never, 2 = rarely, 3 = sometimes, 4 = often, 5 = always), the mean (SD) score was 2.9 (1.1). When the pharmacists were asked to rate their confidence in their ability to manage diabetes in perinatal populations on a different Likert scale, the mean (SD) score of 3.8 (1.0) indicated a moderate level of confidence. Thirteen salient beliefs emerged (BB, n = 5; NB, n = 4; CB, n = 4), and pharmacists had positive BB, positive NB, and negative CB toward managing diabetes in perinatal women. "Improved patient outcomes" was the most prevalent BB. For NB, all participants expressed that patients would be in support of pharmacists managing their diabetes in pregnancy. For CB, restrictive collaborative practice agreements emerged as the most salient barrier. CONCLUSION: Pharmacists who participated in this study were not routinely involved in perinatal diabetes management despite being moderately confident in their ability to provide such services, having positive BB, and believing their patients would be supportive. Pharmacists had negative CB, and future interventions can focus on addressing these barriers.