Endocrine Abstracts

Introduction: Increasing the prevalence of chronic diseases, including diabetes, is an important public health issue. Beyond the actions already carried out in pharmacies, the place of the pharmacist is essential in the therapeutic education (ETP) and the actions of accompaniment of the patients. The objective of our work was to evaluate the level of education of patients in insulin therapy at the pharmacy level and to deduce the reasons for poor compliance.

Patients and Methods: Prospective study conducted over 3 months in patients presenting themselves voluntarily in several pharmacies of Casablanca. The variables studied were the characteristics of diabetes and the level of education in insulin therapy. The data was analyzed by SPSS version 25.

Results: Our series included 50 diabetic patients, mean age 51.3±17.2 years, sex ratio 0.72 H/F, married (56%), mean BMI 25.3 kg/m² and predominant type 2 diabetes (70%). An average HbA1c of 8.5±1.72%. Degenerative complications were retinopathy (6%), neuropathy (2%), hypertension (9%), dyslipidemia (11%). The type of insulin used was analogs (94%), human insulin (6%). An education on insulin therapy received by the attending physician (78%) and the nurse (22%). The glycemic imbalance was strongly correlated with the frequency of hypoglycemia (78.5%, RR 0.09, 95% confidence interval [CI]: −0.53 to −0.02, P=0.04, r=-0.3). Therapeutic compliance related to confidence in the efficacy of treatment (good 48%, P=0.04) and knowledge about the rules of insulin therapy (76%, P <0.0004). The factor of poor compliance was mainly bleeding from the injection mark (64.7%, P=0.012).

Conclusion: Our study found that the pharmacist-led drug dependence monitoring program can improve optimal diabetes management by involving patients in the health care team. The ability of the clinical pharmacist to build trusting relationships with patients and providers is critical to the success of such a program.