Pharmaceutical care of children with type I diabetes mellitus in Republic of Moldova

Abstract

Introduction. Prevalence of type I diabetes mellitus (T1DM) among children and adolescents in Republic of Moldova presents 397 cases, signalling an annual increase of 5,8%. Poorly managed diabetes leads to serious complications and early death. Aim of the study. Evaluation of pharmacists competencies in providing pharmaceutical care to children with type I diabetes and establishing the direction to improve level of competencies of them. Materials and methods. As a method of study, has been used the quantitative analysis through the closed questionnaire, sample size: 100 pharmacists. Results. As a result of the review of the literature has been identified the following competencies necessary for the pharmacists to provide pharmaceutical care to children with T1DM: general knowledge, blood glucose monitoring, drug administration, premedical and medical care, healthy eating, physical activity, prevention of late complications. Pharmacists have general knowledge about the notion of T1DM (73%); 71% of those surveyed know that T1DM cannot be prevented and 86% know that this disease is manifested in children, adolescents and young adults. Blood glucose monitoring: 43.3% of respondents think, that the glycaemic targets in children is 3.8 and 8.3 mmol/l. Insulin injection sites: 55% of the pharmacists had answered to the abdomen, and as modern medical devices used, 50% know about the glucose meter. The treatment for T1DM involves: insulin injections and periodic self-monitoring of insulin (84.8%) and an average of 28% know all types of insulin. If a patient with hypoglycaemia is present in the pharmacy, 77% responded that they would call the ambulance and offer sugar to the patient. Speaking about healthy eating, 78% can provide nutrition counselling and on average 30% recommend fibers and protein. In T1DM, physical effort is recommended after the peak of insulin action (50 %)and they recommend walking and running (94%). On average 14% of pharmacists know all the longterm complications of diabetes and 87% would like to be trained to provide counselling to these patients. Conclusions. Pharmacists could provide counselling to children with type T1DM about: healthy eating, physical activity, adherence to treatment, monitoring, problem solving, reducing risks. Fewer competencies are attested about: glycaemic targets in children, the types of insulin, the duration of their action, insulin injection sites, long-term complications. As the level of care increases, pharmacists’ knowledge increases through experience, continuing education, individual study, and mentorship. There is a need of more strong collaboration with physicians, diabetes associations and development of special training courses for pharmacists.