Impact of pharmacist intervention on appropriate insulin pen use in older patients with type 2 diabetes mellitus in a rural area in Iran

Forough, Aida Sefidani; Esfahani, Parsa Riazi

doi:10.4103/jrpp.jrpp_16_151

Cited by 11 publications

(17 citation statements)

References 22 publications

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“…Majority of patients who have been advised on proper disposal got this information from their nurse or physician, and only 9% of them received such instruction from pharmacists. One study in Iran found that pharmacists can play an important role in safe and efficient use of insulin pen in elderly diabetic patients including its proper disposal as well ( 16 ). Pilot study conducted in Guyana found that, with training, nurses and pharmacists were able to counsel clients successfully resulting in insulin needle re-use declined from 87% to 8% with the provision of full supply and clients felt safer using a single needle for each injection, disposing used syringes into containers and returning full containers to facilities for disposal ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

Disposal of Used Pens and Needles from Diabetes Patients` Perspective

2020

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Introduction: Diabetes as lifelong chronic disease requires pharmacological treatment using plastic pens and needles. Proper disposal of used pens and needles have impact not just on health but environment as well. In 2020 there will be 3.2 million pens used and disposed in Bosnia and Herzegovina resulting in over 600 tons of this waste. Worldwide problem is related to proper disposal of used insulin pens and sharps. Aim: To investigate and evaluate what are the attitudes, knowledge and practices on insulin pens and needles disposal among diabetes patients in Bosnia and Herzegovina. Methods: The research was conducted in five cities in Bosnia and Herzegovina in period December 2019–January 2020 using questionnaire consisted of 28 questions distributed among patients with diabetes through their local patient associations. Results: Total 250 diabetes patients participated. 40.4% inject medicines for 2 times per day and 37.6% for three and more times a day. Patients have not been instructed on proper disposal of used pens or needles in 67.6% and 66% respectively. The most appropriate place to dispose used pens is pharmacies and 90% of respondents would participate in program of collecting used pens if one exists. 75.6% of respondents consider improper disposal of pens and needles as healthcare problem, 18.8% see this as ecological problem and for 4% of them this is not a problem at all. Conclusion: Current practice of disposing used insulin pens and sharps is improper. Patients are aware of health and environmental risk. There is a huge opportunity for pharmacists and other healthcare provides to provide better information and counseling diabetes patients on this topic.

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Section: Discussionmentioning

confidence: 99%

Disposal of Used Pens and Needles from Diabetes Patients` Perspective

2020

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“…Healthcare professionals should educate and reinforce patients and their relatives about the correct use of insulin pens during their first visit and subsequent follow-ups. They can play a significant role in safe and efficient use of insulin pens in diabetic patients [ 31 ]. Our study had few limitations.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Insulin Injection Practice among Diabetes Patients in a Tertiary Healthcare Centre in Nepal: A Preliminary Study

Poudel

Shrestha

Piryani

et al. 2017

Journal of Diabetes Research

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Introduction Proper insulin injection practice is essential for better diabetic control. This study aims to assess the insulin injection practice of patients with diabetes. Materials and Methods A cross-sectional study was conducted at Chitwan Medical College Teaching Hospital, Bharatpur, Nepal, from February 2017 to May 2017. Patients injecting insulin through insulin pens (n = 43) for a minimum of 4 weeks were consecutively recruited. Patients' baseline characteristics, current insulin injection technique, insulin transportation practice, complications of insulin injection, disposal practice of used needle, and acceptability of insulin were recorded. Descriptive statistics were performed using IBM-SPSS 20.0. Results The insulin injection technique of patients and their relatives was inadequate. The majority of patients and their relatives (25, 58.1%) mentioned that they transport their insulin cartridge without maintaining cold chain. Thirteen patients (30.2%, n = 43) reported complications of insulin injection and the most common complication among those patients was bruising (10, 76.9%, n = 13). Almost all patients disposed the used needle improperly, and the common method was disposing the needle in a dustbin and then transferring to municipal waste disposal vehicle. Insulin was accepted by just 16 (37.2%) patients. Conclusion There was a significant gap between the insulin delivery recommendation through insulin pen and current insulin injection practice.

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“…Educational interventions with pharmacists also has an important role in ensuring appropriate insulin practices. [32] As seen in our study, certain practices such as use of re-suspension technique and systemic site rotation was practiced by only 50% of the nurses in the first observation period. Even though, there was a significant increase in these were practices, the proportion remained lower compared with other practices.…”

Section: Discussionmentioning

confidence: 50%

A study to assess the effectiveness of a structured teaching programme on knowledge and practice of safe insulin administration among nurses in a tertiary care hospital: A pre-post design

Punjot¹,

Thomas²,

Vinodkumar³

et al. 2019

JNEP

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Background and objective: Diabetes Mellitus (DM) is not only a health issue but also an economic issue in India. Incorrect insulin injection techniques can lead to side effects such as pain, lipohypertrophy, and poor glycemic control. We designed the present study to assess nurses’ knowledge about safe insulin administration and evaluate the role of a planned teaching programme on knowledge and practices of safe insulin injection techniques in a group of nurses in tertiary care hospital.Methods: This is a pre-post design to study the effectiveness of the structured training programme - one hour of didactic lecture followed by demonstration of safe injection practices. Demographic data and knowledge about safe insulin practices were collected at baseline. We conducted two post training assessments–day one and three months after training. The injection practices were assessed using a check-list. We used the random effects linear regression model to identify factors associated with change in scores over these three observations.Results: The mean (SD) scores for insulin knowledge at baseline was 6.81 (2.28). It significantly increased to 16.85 (1.84) immediately after training (p < .001). These scores reduced significantly after three months compared with post-training scores (14.18 [2.14]; p < .001). A significantly higher proportion of nurses had used re-suspension technique for insulin injection after three months (76.3% vs 52.5%, p = .003) and cleaned the injection site with alcohol swab before injection (93.8% vs. 75.0%, p = .001). On an average, knowledge scores changed by -0.15 (95% CI: -0.29, -0.02; p = .03) with each unit increase in age (years). The average score in nurses with a degree was significantly higher compared with those who had a diploma (1.02, 95% CI: 0.28, 1.76; p = .007).Conclusions: The study demonstrated that insulin injection practices improve with adequate guidance and information. However, there is a need to have a regular training programme to sustain the practices. Certain practices such as site rotation and assessing lipo-hypertrophy, and the relation between these two should be emphasized in these sessions.

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Impact of pharmacist intervention on appropriate insulin pen use in older patients with type 2 diabetes mellitus in a rural area in Iran

Cited by 11 publications

References 22 publications

Disposal of Used Pens and Needles from Diabetes Patients` Perspective

Disposal of Used Pens and Needles from Diabetes Patients` Perspective

Assessment of Insulin Injection Practice among Diabetes Patients in a Tertiary Healthcare Centre in Nepal: A Preliminary Study

A study to assess the effectiveness of a structured teaching programme on knowledge and practice of safe insulin administration among nurses in a tertiary care hospital: A pre-post design

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