Barriers and opportunities for collaboration between community pharmacists and nurses in the prevention and management of diabetic foot ulcers in South Africa

OBJECTIVES: Diabetes mellitus has become more prevalent over the years. This chronic disease can lead to complications, such as diabetic foot ulcers. The objective of this study was to explore the barriers and opportunities of community pharmacists and nurses collaborating on managing diabetic foot ulcers (DFUs) in community pharmacies in South Africa. METHODS: Two online focus group discussions were conducted in South Africa in 2023 on MS Teams®. Participants included community pharmacists, Primary Care Drug Therapy pharmacists, and academic nursing staff. KEY FINDINGS: Two themes emerged. The first theme was challenges in DFU management. Pharmacists reported firstly a need for coordinated, multidisciplinary care; secondly the time-intensive nature of DFU management, with limited capacity in community settings; and thirdly complex referral pathways that impede timely specialist access. The second theme was training for DFU management. Participants highlighted firstly cost-related constraints that hinder optimal care, particularly when specific competencies are lacking; and secondly a clear deficit in accessible, practice-oriented DFU training for community pharmacists. Overall, the findings indicated that structural (team-based), operational (time and referral), and educational (training availability) gaps collectively limit the quality and consistency of DFU care in community pharmacy. CONCLUSIONS: Pharmacist's involvement in offering advice on optimizing antidiabetic therapy to prevent DFUs is vital. The incidence of DFUs can potentially be decreased if community pharmacists and nurses collaborate.