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J Diabetes Sci Technol. 2017 May;11(3):553-557. doi: 10.1177/1932296816678427. Epub 2016 Nov 15.

Barriers to Patient Use of Control Solution for Glucose Meters: Surveys of Patients, Pharmacists, and Providers in a Metropolitan Area.

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1 Southwestern Oklahoma State University College of Pharmacy, Weatherford, OSU Physicians Department of Internal Medicine, Tulsa, OK, USA.
2 University of Oklahoma College of Pharmacy, Tulsa, OK, USA.
3 Choctaw Nation of Oklahoma, Talihina, OK, USA.
4 University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.



An important factor in controlling diabetes is self-monitoring of blood glucose. Manufacturers of glucose meters recommend routine use of control solution to ensure accuracy. Previous studies have demonstrated that glucose meters vary in accuracy and that patients are not using control solution as recommended. The purpose of this study is to identify potential barriers to control solution use from multiple perspectives including patient, pharmacist, and provider.


This study was a prospective, observational survey design. First, 25 randomly selected chain and independent pharmacies in the Tulsa metropolitan area were audited for control solution accessibility. These pharmacies were then used to survey pharmacists, via telephone, regarding control solution inventory and perception of importance of use. Next, providers were electronically surveyed on their routine practice recommendations, while 60 patients with diabetes were randomly selected for telephone survey on use and perceptions of control solution.


Twenty-five pharmacies were audited and 23 pharmacists, 60 patients, and 29 providers were surveyed. Only 39% of pharmacies stated they supplied control solution, however, only 1 pharmacy visibly stocked it. The only patient factor that appeared to have an impact on control solution usage was having type 1 versus type 2 diabetes (38% vs 15%). Providers are aware of what control solution is (62%), but only half felt it should be routine practice with 44% of those never recommending it.


This study raises awareness for the need to educate patients, providers, and pharmacists about use of control solution to ensure glucose meter accuracy.


accuracy; barrier; control solution; glucose meter; self-monitoring of blood glucose

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