Forough Aida Sefidani, Esfahani Parsa Riazi
School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
Department of Pharmaceutical Care, Amiralmomenin Hospital, Khodabandeh, Iran.
J Res Pharm Pract. 2017 Apr-Jun;6(2):114-119. doi: 10.4103/jrpp.JRPP_16_151.
The aim of this study was to evaluate the impact of pharmacist-conducted educational intervention on reducing errors related to inappropriate insulin pen use.
This was a prospective, before-after study with an educational intervention component. The study was conducted on 122 elderly diabetic patients. Data were collected through interviews using researcher-administered questionnaires as well as patients' medical records. Patients were asked about the preparation, injection, and storage techniques, they followed when using insulin pens. Blood glucose parameters were extracted from laboratory records. After the detection of errors, patients and their caregivers were instructed about the insulin pen use by the pharmacist. Patients were reevaluated after 12 weeks.
Patients' mean age was 67.2 ± 3.5 with male: female ratio of 71:51. Mean diabetes duration was 7.1 ± 2.8 years. Fifty-four patients (44.2%) stated that they had received instructions for insulin pen use previously. The majority of this group (24 cases, 44.4%) reported that the instructions were given by a pharmacist. The mean number of errors decreased from 3.99 ± 0.22 errors per patient to 1.49 ± 0.13 errors (odds ratio: 0.28, 95% confidence interval: 0.23-0.33, < 0.05). Of eleven evaluated insulin pen-related medication error items, nine items experienced a significant decrease after patient education. Fasting plasma glucose (FPG) levels decreased significantly from 161.7 ± 12.5 to 147.3 ± 13.1 mg/dL ( < 0.05). However, glycated hemoglobin levels did not change significantly after 3 months ( = 0.18). Controlled FPG had a significant rise from 45% before education to 63.9% postintervention ( < 0.05).
Pharmacists can play an important role in safe and efficient use of insulin pen in elderly diabetic patients by minimizing the likelihood of medication errors associated with insulin pen use.
本研究旨在评估药剂师开展的教育干预对减少与胰岛素笔不当使用相关错误的影响。
这是一项带有教育干预成分的前瞻性前后对照研究。研究对象为122名老年糖尿病患者。通过使用研究人员管理的问卷进行访谈以及查阅患者病历收集数据。询问患者使用胰岛素笔时的准备、注射和储存技术。从实验室记录中提取血糖参数。在检测到错误后，药剂师对患者及其护理人员进行胰岛素笔使用方面的指导。12周后对患者进行重新评估。
患者的平均年龄为67.2±3.5岁，男女比例为71:51。平均糖尿病病程为7.1±2.8年。54名患者（44.2%）表示他们之前曾接受过胰岛素笔使用的指导。该组中的大多数（24例，44.4%）报告指导是由药剂师提供的。平均错误数量从每位患者3.99±0.22个错误降至1.49±0.13个错误（优势比：0.28，95%置信区间：0.23 - 0.33，<0.05）。在评估的11项与胰岛素笔相关的用药错误项目中，9项在患者教育后显著减少。空腹血糖（FPG）水平从161.7±12.5显著降至147.3±13.1mg/dL（<0.05）。然而，糖化血红蛋白水平在3个月后没有显著变化（=0.18）。血糖得到控制的患者比例从教育前的45%显著上升至干预后的63.9%（<0.05）。
药剂师通过将与胰岛素笔使用相关的用药错误可能性降至最低，可在老年糖尿病患者安全有效使用胰岛素笔方面发挥重要作用。
