Insulin therapy is the cornerstone treatment of diabetic patients. Most diabetic patients cannot selfadministrate insulin due to various reasons to depend on caregivers. Objectives: To assess the knowledge, attitude, and practice (KAP) on insulin administration among diabetic patients and their caregivers. Methods: A prospective cross-sectional study was conducted for seven months. All diabetic patients age above 18 years who were on insulin therapy for more than six months were included in the study. Patient medical records were used to collect demographic information such as age, gender, educational status, occupation, socioeconomic class, HbA1c, and insulin duration. The validated KAP questionnaire was used for the assessment of KAP among patients or caregivers. Results: A total of 255 patients were included, out of which 163 (63.92%) were male and 92 (36.07%) were female. The mean KAP score was 65.05 ± 14. There is no significant correlation between the HbA1c levels with KAP scores among diabetic patients. There is a significant link between the knowledge, attitude, and Overall KAP patients with education qualification (p < 0.05), occupation (p < 0.05), economic class of the patients (p < 0.05), and duration of insulin treatment (p < 0.05). Conclusion:The patients average age was 55.74 years. The results showed that the mean KAP score was 65.05, which is less and most of the patients had not controlled their glycemic levels. Effective education regarding insulin administration and glycemic control improves the KAP among patients or caregivers.

Medication therapy management (MTM) was first implemented and introduced for chronically ill patients and those taking multiple prescription drugs. The MTM has five steps, namely medication therapy review (MTR), personal medication record (PMR), medication-related action plan (MAP), intervention or referral, and finally, documentation. After receiving MTM services, patients will gain knowledge on medicines, which may decrease non-adherence to treatment and increase its efficacy. Studies have shown the positive impact of MTM on geriatric, pediatric, and chronically ill patients and those on polypharmacy. MTM services may improve medication adherence, decrease healthcare costs, and improve the quality of life (QoL) of patients with chronic kidney disease (CKD) by addressing various issues like anaemia, metabolic acidosis, protein management, fluid management, electrolyte management, dosage adjustment based on eGFR, vaccination, and medication-related problems and intervening with the education about the disease, drugs, and lifestyle modifications.

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Background Patients treated with hemodialysis and renal transplant require complex therapy regimens that manage comorbid conditions such as diabetes, hypertension, and so on; as a result, they may develop drug-related issues. Inappropriate medication usage raises the risk of drug related problems, which can manifest as excessively extended hospital stays, higher expenses, and overuse of medical services. Prescribing pattern among the patients treated with hemodialysis and renal transplantation are not well characterized previously. Objectives The objective of the study is to investigate drug prescription trends in hemodialysis patients and to study the prescribing patterns of medications in kidney transplantation patients. Materials and methods The prospective observational study was conducted over a period of 8 months, i.e. from October 2021 to June 2022 in end stage CKD patients treating with maintenance hemodialysis and renal transplant. Different classes of drugs prescribed and percentage of drugs per prescription was estimated in this study. Data were analyzed descriptively. Results 105 patients recruited have been analyzed of which 76 (72.38%) were male and 29 (27.6%) were female. Polypharmacy (use of ≥5 medications) was observed in 91.5% in hemodialysis patients and 100% in renal transplant patients. The most prescribed drugs in hemodialysis patients were Cardiovascular Drugs 72 (100%), and in renal transplant patients, immunosuppressant were highly prescribed 33 (100%). Conclusion This study concludes that the cardiovascular agents and immunosuppressant were the most common drugs prescribed among the hemodialysis and renal transplant patients respectively. polypharmacy among overall patients were observed and it may initiate drug related problems.