Pharmacist intervention in home care program for diabetes patients

Syed Wasif Gillani, Syed Azhar Syed Sulaiman, Mirza Baig, Yelly Oktavia Sari, Siti Maisharah Sheikh Ghadzi, Sabariah Noor Haroon, Nur Hafzan Md Hanafiah
2012 Journal of Diabetes Mellitus  
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
more » ... tor 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. During the study, 11 subjects (23.4%) from the intervention group reported hypoglycaemic episodes that were confirmed by SMBG results. These subjects adjusted their own insulin dosage to avoid further hypoglycaemic episodes. Unpaired t-test was used to assess whether this influenced medication adherence. Subject with no previous hypoglycaemic episodes had higher medication adherence rate (M = 91.10, SD = 15.71) [72] Siegel, J. (1991) Barriers to the effective use of capillary blood glucose monitoring in extended care facilities. The Diabetes Educator, 17, 381-383. [97] Hassan, F. and Shaaban, J. (2005) Use of traditional/ complimentary medicine (T/CM) among adults patients attending family medicine clinic at
doi:10.4236/jdm.2012.23045 fatcat:wpptdonxsnd2nozdisyb3ov6j4