Self management of type 2 diabetes by Maltese immigrants in Australia: can community pharmacies play a supporting role?



Professor Ines Krass, Faculty of Pharmacy, University of Sydney, Room S346, Pharmacy Building A15, Sydney, NSW 2006, Australia. Email:



This study aimed to identify issues in diabetes self-management in an Australian Maltese community with type 2 diabetes mellitus, and to identify opportunities for community pharmacies to offer self-management support to these populations.


Individual, semi-structured interviews were conducted. A maximum variation sample was recruited from La Vallette Social Centre, Sydney, and interviewed by the investigator. Interviews were audio recorded, transcribed verbatim, and iteratively coded into themes by constant comparison using computer software. Cultural predictors of adherence were analysed.

Key findings

Twenty-four participants were interviewed. Themes included diabetes knowledge, self-management behaviours, cultural predictors of adherence and interest in community pharmacy disease management services. Diabetes knowledge was generally limited. Although most participants practised some self-monitoring of blood glucose they lacked knowledge of practice recommendations. Participants generally undertook regular physical activity, though adherence to diet varied according to social influences. Cultural influences on perceptions included attitudes to practitioners, treatment and peer experiences. Enablers included attitudes towards financial independence and social integration while nurturers included family and community support. Participants expressed interest in accessing more support from their community pharmacy due to ease of access and interest in learning more about diabetes.


Patients from different backgrounds experience unique barriers to care, including poor written literacy and limited access to diabetes education, many of which are unrecognised by patients or practitioners. Pharmacists should become more proactive in offering culturally appropriate diabetes self-management support to these populations. Research into pharmacist perspectives of patient issues could identify training needs and guide strategies to improve their cultural competence.