Volume: 8, Issue: 10, October, 2018
A cross-sectional pilot study to investigate diabetic knowledge and pharmaceutical care practice among registered and unregistered pharmacists in IraqAuthor Affiliations
Pharmacists have crucial roles beyond dispensing medications. Hence, the present study aimed to assess the knowledge and pharmaceutical care practice towards diabetes mellitus (DM) among unregistered and registered community pharmacists in Iraq. An observational cross-sectional pilot study with a random cluster sampling method was carried out among registered and unregistered pharmacists in Baghdad. The study included three sections: the background and demographic information, diabetes knowledge test (DKT), and pharmaceutical care practice questionnaire. The mean total DKT, knowledge of general diabetes, and insulin use test subscales scores were 13.45 ± 3.36, 8.39 ± 2.22, and 5.06 ± 1.77, respectively, which revealed an inadequate knowledge. There were significant differences in the total DKT score with the university type and educational levels. Moreover, the diabetic care practice of the registered pharmacists were moderate (16.92 ± 4.28) and only 30.60% had positive practice. The highest and the lowest positive practice frequencies were found in blood glucose monitoring care (38.20%) and co-morbid DM disease management (21.20%), respectively. Furthermore, there were positive correlations between the total DKT and its subscales scores with the total diabetic care practice score. The results revealed that professional knowledge and practice toward DM among the sample population were inadequate. Hence, pharmaceutical care practices are a major concern in Iraq.
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Abdulameer SA. Knowledge and pharmaceutical care practice regarding inhaled therapy among registered and unregistered pharmacists: an urgent need for a patient-oriented health care educational program in Iraq. Int J Chron Obstruct Pulmon Dis, 2018; 13:879–88. https://doi.org/10.2147/COPD.S157403
Abdullah L, Margolis S, Townsend T. Primary health care patients' knowledge about diabetes in the United Arab Emirates. East Mediterr Health J, 2001; 7:662–70.
American Diabetes Association. Standards of medical care in diabetes—2014. Diabetes Care, 2014; 37:S14–80. https://doi.org/10.2337/dc14-S014
Babelgaith SD. Assessment of the knowledge and practice of health care professionals towards diabetes care in Mukalla, Yemen. IJPTP, 2013; 4:826–31.
Bisheya AF, El-Mijbri SA, Beshyah SA, Sherif IH. Community pharmacists' knowledge, attitudes and practices in diabetes care in tripoli, Libya. Ibnosina J Med Biomed Sci, 2011; 3:89–95. https://doi.org/10.4103/1947-489X.210877
Blenkinsopp A, Hassey A. Effectiveness and acceptability of community pharmacy-based interventions in type 2 diabetes: a critical review of intervention design, pharmacist and patient perspectives. Int J Pharm Pract, 2005; 13:231–40. https://doi.org/10.1211/ijpp.13.4.0001
Borges APDS, Guidoni CM, Freitas OD, Pereira LRL. Economic evaluation of outpatients with type 2 diabetes mellitus assisted by a pharmaceutical care service. Arq Bras Endocrinol Metabol, 2011; 55:686–91. https://doi.org/10.1590/S0004-27302011000900003
Borges APDS, Guidoni CM, Ferreira LD, Freitas OD, Pereira LRL. The Pharmaceutical care of patients with type 2 diabetes mellitus. Pharm World Sci, 2010; 32:730–6. https://doi.org/10.1007/s11096-010-9428-3
Brennan TA, Dollear TJ, Hu M, Matlin OS, Shrank WH, Choudhry NK, Grambley W. An integrated pharmacy-based program improved medication prescription and adherence rates in diabetes patients. Health Aff (Millwood), 2012; 31:120–9. https://doi.org/10.1377/hlthaff.2011.0931
Chen H-Y, Lee T-Y, Huang W-T, Chang C-J, Chen C-M. The short-term impact of a continuing education program on pharmacists' knowledge and attitudes toward diabetes. Am J Pharm Educ, 2004; 68:121. https://doi.org/10.5688/aj6805121
Chow EP, Hassali MA, Saleem F, Aljadhey H. Effects of pharmacist-led patient education on diabetes-related knowledge and medication adherence: a home-based study. Health Educ J, 2016; 75:421–33. https://doi.org/10.1177/0017896915597021
Cochran WG. Sampling techniques. John Wiley & Sons, New York, NY, 1977.
El Hajj MS, Abu Yousef SE, Basri MA. Diabetes care in Qatar: a survey of pharmacists' activities, attitudes and knowledge. Int J Clin Pharm, 2018; 40:84–93. https://doi.org/10.1007/s11096-017-0562-z
Erku DA, Belachew SA, Mekuria AB, Haile KT, Melaku B, Tegegn HG, Ayele AA. The role of community pharmacists in patient counseling and health education: a survey of their knowledge and level of involvement in relation to type 2 diabetes mellitus. Integr Pharm Res Pract, 2017; 6:137–43. https://doi.org/10.2147/IPRP.S140777
Guariguata L, Whiting D, Hambleton I, Beagley J, Linnenkamp U, Shaw J. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract, 2014; 103:137–49. https://doi.org/10.1016/j.diabres.2013.11.002
Hermansen-Kobulnicky CJ, Worley MM. Exploring the patient perspective regarding community pharmacists' educational roles in diabetes medication and blood glucose management. Int J Pharm Pract, 2008; 16:81–90. https://doi.org/10.1211/ijpp.16.2.0005
Ibrahim IR, Al Tukmagi HF, Wayyes A. Attitudes of Iraqi society towards the role of community pharmacists. Inov Pharm, 2013; 4:1–10. https://doi.org/10.24926/iip.v4i2.296
International Diabetes Federation. The IDF Middle East and North Africa (MENA) Region. 2017. Available via https://www.idf.org/our-network/regions-members/middle-east-and-north-africa/members/36-iraq. html (Accessed 20 December 2017).
Irons BK, Lenz RJ, Anderson SL, Wharton BL, Habeger B, Anderson HG. A retrospective cohort analysis of the clinical effectiveness of a physician-pharmacist collaborative dsrug therapy management diabetes clinic. Pharmacotherapy, 2002; 22:1294–300. https://doi.org/10.1592/phco.22.15.1294.33476
Karter AJ, Parker MM, Duru OK, Schillinger D, Adler NE, Moffet HH, Adams AS, Chan J, Herman WH, Schmittdiel JA. Impact of a pharmacy benefit change on new use of mail order pharmacy among diabetes patients: the Diabetes Study of Northern California (DISTANCE). Health Serv Res, 2015; 50:537–59. https://doi.org/10.1111/1475-6773.12223
Kraemer DF, Kradjan WA, Bianco TM, Low JA. A randomized study to assess the impact of pharmacist counseling of employer-based health plan beneficiaries with diabetes: the EMPOWER study. J Pharm Pract, 2012; 25:169–79. https://doi.org/10.1177/0897190011418513
Leal S, Glover JJ, Herrier RN, Felix A. Improving quality of care in diabetes through a comprehensive pharmacist-based disease management program. Diabetes Care, 2004; 27:2983–4. https://doi.org/10.2337/diacare.27.12.2983
Mansour AA, Al-Maliky AA, Kasem B, Jabar A, Mosbeh KA. Prevalence of diagnosed and undiagnosed diabetes mellitus in adults aged 19 years and older in Basrah, Iraq. Diabetes Metab Syndr Obes, 2014; 7:139–44. https://doi.org/10.2147/DMSO.S59652
Odili V, Oparah A. Immediate impact of a diabetes mellitus education programme on the knowledge of pharmacists. West Afr J Pharm, 2013; 24:58–63.
Perez A, Doloresco F, Hoffman JM, Meek PD, Touchette DR, Vermeulen LC, Schumock GT. Economic evaluations of clinical pharmacy services: 2001–2005. Pharmacotherapy, 2009; 29:128. https://doi.org/10.1592/phco.29.1.128
Pinto SL, Lively BT, Siganga W, Holiday-Goodman M, Kamm G. Using the Health Belief Model to test factors affecting patient retention in diabetes-related pharmaceutical care services. Res Social Adm Pharm, 2006; 2:38–58. https://doi.org/10.1016/j.sapharm.2005.11.001
Shareef J, Nandakumar U, Bhat M. A study on assessment of adverse drug reactions in patients with Tuberculosis in a tertiary care teaching hospital. J Appl Pharm Sci, 2018; 8:99–104.
Shatnawi A, Latif DA. A qualitative assessment of West Virginia pharmacist activities and attitude in diabetes management. J Eval Clin Pract, 2016; 23:586–92. https://doi.org/10.1111/jep.12677
Shrestha M, Maharjan R, Prajapati A, Ghimire S, Shrestha N, Banstola A. Assessment of knowledge and practice of community pharmacy personnel on diabetes mellitus management in Kathmandu district: a cross sectional descriptive study. J Diabetes Metab Disord, 2015; 14:71. https://doi.org/10.1186/s40200-015-0205-7
Simpson SH, Haggarty S, Johnson JA, Schindel TJ, Tsuyuki RT, Lewanczuk R. Survey of pharmacist activities and attitudes in diabetes management. Can Pharm J (Ott), 2009; 142:128–34. https://doi.org/10.3821/1913-701X-142.3.128
Smith M. Pharmacists' role in improving diabetes medication management. J Diabetes Sci Technol, 2009; 3:175–9. https://doi.org/10.1177/193229680900300120
Struijs JN, Baan CA, Schellevis FG, Westert GP, Van Den Bos GA. Comorbidity in patients with diabetes mellitus: impact on medical health care utilization. BMC Health Serv Res, 2006; 6:84. https://doi.org/10.1186/1472-6963-6-84
Touchette DR, Doloresco F, Suda KJ, Perez A, Turner S, Jalundhwala Y, Tangonan MC, Hoffman JM. Economic evaluations of clinical pharmacy services: 2006–2010. Pharmacotherapy, 2014; 34:771–93. https://doi.org/10.1002/phar.1414
Turnacilar M, Sancar M, Apikoglu-Rabus S, Hursitoglu M, Izzettin FV. Improvement of diabetes indices of care by a short pharmaceutical care program. Pharm World Sci, 2009; 31:689–95. https://doi.org/10.1007/s11096-009-9333-9
Wertz D, Hou L, Devries A, Dupclay Jr L, Mcgowan F, Malinowski B, Cziraky M. Clinical and economic outcomes of the Cincinnati Pharmacy Coaching Program for diabetes and hypertension. Manag Care, 2012; 21:44–54.