Use the IDEA framework to integrate CGM into pharmacy practice diabetes care

A national multidisciplinary panel of experts specializing in diabetes management has developed a practical algorithm—called the IDEA framework—to guide pharmacists in screening for and initiating continuous glucose monitoring (CGM) for people with diabetes. The algorithm provides a structured approach for pharmacists to follow, to enhance CGM integration and streamline communication among healthcare professionals. The panel developed the IDEA framework using a modified Delphi process. The framework consists of four core domains that reflect key stages of pharmacist involvement in CGM care:Identification of the appropriate candidates for CGMDevice initiation and data-sharing setupEducation and support of a personalized care planongoing Assessment of CGM data. Two additional domains were later incorporated into the framework: Personalized hypoglycemia prevention plan Communication with the healthcare team.Identification of appropriate candidates for CGMThe panel discusses episodic versus continuous use of CGM. CGM should be considered for those who are willing and able to use the CGM data, including those with type 1 diabetes, those using insulin, those not meeting glycemic targets, those dealing with hypoglycemia (e.g., frequent events or impaired awareness), those who are pregnant or in safety-sensitive occupations requiring tighter glycemic control, and those seeking episodic CGM use to evaluate medication, lifestyle or behavioural interventions. CGM may be used on a continuous basis for individuals with ongoing glycemic risk (e.g., insulin use, hypoglycemia risk), or on an episodic basis to support assessment of glycemic patterns, treatment changes, or when access to uninterrupted CGM use is limited. Device initiation, data-sharing setupPharmacists should engage patients and/or caregivers in shared decision-making regarding glucose monitoring options, provide an overview of CGM cost and coverage options, and complete CGM initiation, including device setup, data sharing and configuration of alerts.Education and support of a personalized care plan, Assessment of dataPharmacists should provide education on CGM interpretation and actions to take based on data, schedule early follow-up after initiation, and conduct ongoing reviews at individualized intervals to support daily decision-making and glycemic optimization.Personalized hypoglycemia prevention planCGM data should be used to help create a personalized care plan, including medication review, and assessment of diet and physical activity, with review frequency adapted to individual glycemic patterns and clinical needs. Pharmacists should develop and regularly review individualized hypoglycemia prevention and management plans based on CGM data, including education on recognition and response to alerts, prevention strategies, safety considerations (e.g., driving), sick-day management, and access to rescue therapies when appropriate.Communication with the healthcare teamWith the patient’s consent, pharmacists should collaborate with other members of the diabetes care team when glycemic targets are persistently unmet or when medication adjustment or escalation of care is required.IDEA framework algorithmThe IDEA framework for pharmacist-led CGM implementation and follow-up is summarized in algorithm format. In the algorithm, the panel notes that certain CGM services delivered by pharmacists may be delegated to supervised team members (e.g., pharmacy students, interns and residents, or pharmacy technicians/assistants) depending on task complexity and local practice models. SummaryOverall, the IDEA framework is intended to provide a structured, pharmacy-specific operational model designed to support consistent implementation of CGM services within Canadian pharmacy practice operational workflows. The model is designed to be applicable across a variety of pharmacy practice settings, including community pharmacies and hospital-based ambulatory pharmacy services, and can also be adapted to hospital-based clinics and diabetes education centres. Successful implementation of the IDEA framework will rely on coordinated communication among pharmacists, primary care professionals, endocrinologists and other members of the diabetes care team. The authors point out that the IDEA framework requires further validation in larger cohorts and across diverse pharmacy practice settings. Evaluations of the model should include assessment of differences in A1C, person-centred measures, and outcomes such as reductions in micro- and macrovascular complications. Economic impacts, including reduced hospitalizations and emergency department visits, should also be examined to validate and refine the framework for broader implementation across Canada.Reference:Sihota A, Jain AB, Chin A, et al. The IDEA framework: a consensus-based model for integrating continuous glucose monitoring into pharmacy practice for diabetes care. (accessed April 14, 2026). Can J Diabetes 2026 Feb 2:S1499-2671(26)00025-0. (accessed April 16, 2026).

Use the IDEA framework to integrate CGM into pharmacy practice diabetes care

Register for free access or login.

Related Topics