Pharmacist intervention in home care program for diabetes patients

Abstract

Majority of research reports identified moderate reduction in glycated haemoglobin with education interventions regardless of age group. Our study objective was to evaluate the pharmacist interventions in providing patient home care. A 24-week longitudinal quasi-experimental-pretest/post-test study design was used to assess the effectiveness of a diabetes education program to enhance self-care practices. A doubleblinded randomized study design was considered but was not feasible as the investigator was responsible for implementing the intervention and collecting data on outcomes. Since this was a longitudinal study a 25% attrition rate was included in the calculation of sample size. Hence the sample size for the proposed study was 106 subjects with 53 subjects in each group. All analyses were done using SPSS version 18 ® . The level of significance was set at 0.05. The Research Ethics Committee of hospital and the Malaysian Medical Research and Ethics Committee approved the study. Of the 109 subject who met the study-entry criteria, 3 subjects declined to participate due to lack of time and interest. There was no significant relationship between the demographic and clinical characteristic of participants who completed the study. No significant relationship between the intervention and control groups who completed the study in demographic, clinical and psychosocial contexts. Of the 47 subjects from the intervention group who reported adherent to their daily medication intake after the education intervention, 51 subjects (31.9%) reported taking their medication at the wrong time. The recommended times for oral anti-hyperglycemic medication (OAM) are: sulphonylureas 30 minutes before food, acarbose with food, metformin with or within 30 minutes after food. This research has shown a brief structured education program that incorporated behavior science specifically selfefficacy was effective in enhancing self-care practices (SMBG and medication adherence) and improving glycaemic control in the intervention group.

The value of fast-acting insulin aspart compared with insulin aspart for patients with diabetes mellitus treated with bolus insulin from a UK health care system perspective

“…Many people with diabetes fail to deliver their bolus insulin doses accurately, 58 , 59 and further improvements in the flexibility of the timing of mealtime insulin administration would be beneficial. Human insulin should be administered 30 min prior to eating and a rapid-acting insulin analogue within 10 min prior to eating, 60 – 63 however, approximately 40% of patients fail to comply either all or part of the time, and have a higher risk of forgetting to take insulin.…”

A qualitative study to explore the perception and behavior of patients towards diabetes management with physical disability

“…Several studies have documented the relationship between knowledge and self-care practices including; physical activity and adherence to diet. All of them focused on either general population or type 2 diabetes patients but none of them have ever discussed the practices among physically disabled patient [16–19]. This study explores the patients’ practices and barriers to self-care practices.…”

Pengaruh Pelayanan Kefarmasian di Rumah pada Pasien Diabetes Melitus Tipe 2 di Puskesmas Wilayah Kota Yogyakarta

“…12 Kunjungan rumah yang berfokus pada pendidikan pasien dan intervensi perilaku membantu meningkatkan kontrol glikemik pada pasien diabetes. 13 Berdasarkan hasil pengolahan data skor pengetahuan diketahui nilai rerata skor pengetahuan 13 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) sebelum intervensi dan nilai rerata sesudah intervensi sebesar 18 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Dari hasil analisis statistik menggunakan uji Wilxcoxon diketahui terdapat perbedaan antara sebelum dan sesudah intervensi (tabel II).…”

“…Hasil penelitian ini sejalan dengan penelitian sebelumnya, bahwa kepatuhan pasien meningkat setelah mendapatkan intervensi dari apoteker. 11,16,17 Intervensi berupa kunjungan rumah mampu meningkatkan kepatuhan penggunaan obat sehingga dapat menunjang keberhasilan terapi pasien 18,19 Pengaruh Pelayanan Kefarmasian terhadap Tingkat Kepuasan Terapi Kepuasan terapi merupakan capaian dari usaha yang dilakukan pasien selama menjalani pengobatan. Kontrol gula darah yang terkendali secara tidak langsung akan meningkatkan kepuasan.…”