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Original Article
- 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
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- 2 Web of Science
- 2 Crossref
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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. -
SummaryKey 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.Citations
Citations to this article as recorded by
- Determination, Validation, and Development of Prediction Scores Related to Hypoglycemia Risk Factors Among Ambulatory Type 2 Diabetes Mellitus Patients in Bali, Indonesia
Made Krisna Adi Jaya, Fita Rahmawati, Nanang Munif Yasin, Zullies Ikawati
Current Diabetes Reviews.2026;[Epub] CrossRef - Pharmacist-led interventions for optimizing type 2 diabetes mellitus management and medication safety in Southeast Asian countries: A systematic review and meta-analysis
Made Krisna Adi Jaya, Fita Rahmawati, Nanang Munif Yasin, Zullies Ikawati
International Journal of Diabetes in Developing Countries.2026; 46(3): 664. CrossRef
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