- Development and Validation of an Instrument to Assess the Safe Use of Antidiabetic Medication to Prevent Hypoglycemia Requiring Hospitalization Among Ambulatory Patients With Type 2 Diabetes Mellitus in Bali, Indonesia
-
Made Krisna Adi Jaya, Fita Rahmawati, Nanang Munif Yasin, Zullies Ikawati
-
J Prev Med Public Health. 2025;58(1):52-59. Published online October 24, 2024
-
DOI: https://doi.org/10.3961/jpmph.24.424
-
-
 Abstract
Summary
 PDF
- Objectives
Ambulatory patients with type 2 diabetes mellitus (T2DM) require special attention when being discharged from the hospital with anti-diabetes medication. This necessity stems primarily from the risk of adverse drug reactions, particularly hypoglycemia. However, this risk is significantly influenced by the patients’ knowledge and behavior regarding their medication use. This study aimed to develop instrument to assess the risk of medication-related hypoglycemia in ambulatory T2DM patients by clinical pharmacists.
Methods
The study was conducted using an observational design that included multiple stages. These stages involved item development through focus group discussions (FGDs), content validation by clinical pharmacists, and criterion and construct validation by ambulatory T2DM patients using a cross-sectional approach.
Results
A total of 10 question items were developed for assessment by clinical pharmacists following FGDs and content validation. Criterion and construct validation identified 8 valid question items through multivariate analysis (p<0.05). The scoring system developed demonstrated a linear relationship between the score and the number of items at risk in the instrument (p<0.05, R²=0.988). Additionally, the instrument was named “Medication-related Hypoglycemia Risk Score Assessment Tools (HYPOGLYRISK).”
Conclusions
The findings of this study suggest that HYPOGLYRISK may serve as a useful tool for clinical pharmacists to evaluate the risk of medication-related hypoglycemia in ambulatory T2DM patients. Additionally, this instrument could assist clinical pharmacists in identifying priority patients and tailoring educational services to meet their specific goals and needs.
-
Summary
Key Message
- HYPOGLYRISK is an instrument that can be used to assess the risk of hypoglycemia requiring hospitalization in T2DM patients. This instrument met all the requirements for psychometric properties testing in this study.
- Patients discharged on antidiabetic medications can be screened for risk of severe hypoglycemia using HYPOGLYRISK, specifically by pharmacists, during drug dispensing.
- Patients with T2DM must be ensured to have knowledge related to the five dimensions of medication safety to avoid the risk of hypoglycemia requiring hospitalization.
- Theory-Based Interventions to Improve Medication Adherence Among Patients With Hypertension in Primary Healthcare and the Community: A Systematic Review
-
Tri Yulianti, Anna Wahyuni Widayanti, Susi Ari Kristina, Nanang Munif Yasin
-
Received October 28, 2024 Accepted February 3, 2025 Published online February 17, 2025
-
DOI: https://doi.org/10.3961/jpmph.24.651
[Accepted]
-
-
Abstract
PDF
- Objectives
Numerous interventions have been implemented to enhance adherence to antihypertensive medications, yet only a few have utilized health behavioral theories. The research quality and efficacy of these theory-based studies remain undetermined. This systematic review aimed to provide a thorough description of research that employed health behavior theories to improve medication adherence in patients diagnosed with hypertension, particularly in primary healthcare and community settings.
Methods
PubMed and Scopus were searched for randomized clinical trials that employed health behavioral theories to improve medication adherence in patients with hypertension, published in English between 2013 and 2023. Data were extracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Joanna Briggs Institute (JBI) critical appraisal tool was used to evaluate the risk of bias.
Results
Of the 446 studies initially identified, only 10 met the inclusion criteria and were included in this systematic review. Eight studies employed a single theory, and 2 applied a combination of theories, with Social Cognitive Theory and the Transtheoretical Model being the most predominant. Six trials demonstrated a notable enhancement in medication adherence, while 5 studies were assessed to have a high risk of bias.
Conclusions
Although not all studies employed a complete theoretical framework, the majority indicate that utilizing theory can enhance medication adherence.
-
Summary
- Effective Education Methods to Improve Glycemic Control in Type 2 Diabetes Mellitus Patients: A Systematic Review
-
Ika Mustikaningtias, Anna Wahyuni Widayanti, Pugud Samodro, Nanang Munif Yasin
-
Received January 9, 2025 Accepted April 21, 2025 Published online June 4, 2025
-
DOI: https://doi.org/10.3961/jpmph.25.025
[Accepted]
-
-
Abstract
PDF
- Objectives
Education for patients with type 2 diabetes mellitus (T2DM) is essential for reinforcing adherence and engagement to achieve therapeutic objectives, given the chronic nature of the treatment. Appropriate strategies for delivering education effectively are crucial. This study aimed to identify effective educational strategies for improving clinical outcomes in patients with T2DM.
Methods
The literature search included original publications from Science Direct, PubMed, and Scopus, published in English between 2015 and February 2024, for which full-text access was available. This review was performed by a team consisting of pharmacists and internists following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Results
From the initial search yielding 105 articles, 17 met the inclusion criteria. Of these 17 studies, 9 demonstrated significant improvements in clinical outcomes. Not all studies incorporated control groups for comparative analysis during the implementation of educational interventions. Most interventions were delivered via direct face-to-face methods, although there was considerable variation across studies in terms of program duration, intervention frequency, session length, education providers, and educational content.
Conclusions
Studies demonstrating improvements in clinical outcomes predominantly utilized direct face-to-face education methods, typically in sessions lasting between 30 and 60 minutes, with the majority of programs extending over approximately 6 months. Pharmacists contribute significantly to the success of educational programs by providing tailored instructional information that aligns with established protocols while addressing individual patient needs.
-
Summary
|
KSPM
