Background: Studies on a structured method used by pharmacists to provide comprehensive,
evidence-based diabetes care are lacking. The aim of this study was to prioritise, rank and
construct validate indicators categorised as seven treatment factors utilised in the management of type
2 diabetes namely: Cholesterol, blood pressure and glycaemia control; medication and lifestyle management;
cardiovascular risk management and patient education using the Delphi process.
Methods: A Delphi questionnaire consisted of 29 Part 1 and nine Part 2 indicators which were incorporated
into a tool called Simpler™. The indicators were mainly sourced from American, Australian and
Malaysian diabetes management guidelines. Diabetes experts were asked to rank indicators in the order
of importance in Part 1. In Part 2, indicators had to be chosen for inclusion into Simpler™ using a fivepoint
Likert scale. The consensus level was pre-set at 60%.
Results: A three round Delphi process was used to validate all 38 indicators by 12 experts from Australia
and Malaysia: five pharmacists, four doctors, two endocrinologists and a diabetes nurse. Consensus
was reached for 93.1% (27/29) of the Part 1 indicators and all nine Part 2 indicators (100%). Five out
of nine indicators in Part 2 questionnaire obtained consensus disagreement for inclusion into the Simpler
Conclusion: The Simpler™ tool is the first structured diabetes multifactorial tool to address all seven
evidence-based factors. The tool was refined and validated by multi-disciplinary health professionals
from Australia and Malaysia. Pharmacists can use the Simpler™ tool to facilitate evidence-based comprehensive
individualised care among type 2 diabetes patients.