- 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
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Made Krisna Adi Jaya, Fita Rahmawati, Nanang Munif Yasin, Zullies Ikawati
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J Prev Med Public Health. 2025;58(1):52-59. Published online October 24, 2024
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DOI: https://doi.org/10.3961/jpmph.24.424
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 Abstract
Summary
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- 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.
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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.
- The Role of Pharmacists’ Interventions in Increasing Medication Adherence of Patients With Epilepsy: A Scoping Review
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Iin Ernawati, Nanang Munif Yasin, Ismail Setyopranoto, Zullies Ikawati
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J Prev Med Public Health. 2024;57(3):212-222. Published online April 25, 2024
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DOI: https://doi.org/10.3961/jpmph.23.592
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Abstract
Summary
PDF
- Objectives
Epilepsy is a chronic disease that requires long-term treatment and intervention from health workers. Medication adherence is a factor that influences the success of therapy for patients with epilepsy. Therefore, this study aimed to analyze the role of pharmacists in improving the clinical outcomes of epilepsy patients, focusing on medication adherence.
Methods
A scoping literature search was conducted through the ScienceDirect, PubMed, and Google Scholar databases. The literature search included all original articles published in English until August 2023 for which the full text was available. This scoping review was carried out by a team consisting of pharmacists and neurologists following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews and the Joanna Briggs Institute guidelines, including 5 steps: identifying research questions, finding relevant articles, selecting articles, presenting data, and compiling the results.
Results
The literature search yielded 10 studies that discussed pharmacist interventions for patients with epilepsy. Five articles described educational interventions involving drug-related counseling with pharmacists. Two articles focused on similar pharmacist interventions through patient education, both verbal and written. Three articles discussed an epilepsy review service, a multidisciplinary intervention program involving pharmacists and other health workers, and a mixed intervention combining education and training with therapy-based behavioral interventions.
Conclusions
Pharmacist interventions have been shown to be effective in improving medication adherence in patients with epilepsy. Furthermore, these interventions play a crucial role in improving other therapeutic outcomes, including patients’ knowledge of self-management, perceptions of illness, the efficacy of antiepileptic drugs in controlling seizures, and overall quality of life.
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Summary
Key Message
Epilepsy is a chronic neurological disease that requires long-term treatment and support from health workers, including pharmacists. Pharmacists can provide interventions independently or in collaboration with other health workers, including treatment education through counseling (essential information about the condition, insights into epilepsy, seizure triggers, and antiepileptic drugs) and education and training with therapy-based behavioral interventions (reminders and skill-based psychological support). Pharmacist intervention is known to increase medication adherence, which is an important factor in the success of therapy for epilepsy patients and can improve other therapy outcomes such as increasing knowledge of epilepsy, seizure control, and quality of life.
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Citations
Citations to this article as recorded by  - Knowledge of pharmacists about anti-epileptic drugs in Sudan: a cross-sectional analytical study
Fatima O. Abdelsalam, Shahd A. Mohamed, Asgad A. Altrafi, Doha E. Balla, Abdalrahman M. Abdalrahman, Awab K. Atta, Abdalfattah M. Abdelrahim, Salsabil A. SeedAhmed, Alhumaira Wedaa, Yousif B. Hamadalneel
Journal of Pharmaceutical Health Care and Sciences.2025;[Epub] CrossRef - The Impact of Drug Delivery Systems on Pharmacokinetics and Drug-Drug Interactions in Neuropsychiatric Treatment
Mohammad Nammas
Cureus.2025;[Epub] CrossRef - Implementation, barriers, solving strategies and future perspectives of reimbursed community pharmacy services - a nationwide survey for community pharmacies in Germany
Ann-Christin Kroenert, Thilo Bertsche
BMC Health Services Research.2024;[Epub] CrossRef
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