PP-8 Transition instead of transfer for drug treatment in adolescent diabetes type 1

Abstract

Background Diabetes mellitus is one of the most com-mon diseases in childhood and the incidence increased over the past 20 years about 3%–4%. Micro-and macrovas-cular complications, due to poor metabolic control, can lead to long-term complications such as high blood pres-sure. Especially in adolescence lower medication adher-ence is a huge risk for complications. The DIADEMA study, a randomised controlled trial, has shown that community pharmacists can have a positive impact on therapy ad-justment and glycemic control of adolescent diabetes patients The objective of this analysis was to understand how the intervention provided by the community phar-macist can help to support transition of the adolescent into adulthood regarding drug treatment. Method A quantitative, statistical analysis of the 39 inter-vention group patients case-report-forms was conduct-ed, to evaluate the impact of community pharmacists on the different outcomes e.g. fasting blood glucose levels. A Wilcoxon-signed-rank test or fisher-extact test were used to evaluate the difference in the amount of self-moni-toring of blood glucose (SMBG), daily insulin injections, average fasting blood glucose levels, insulintherapy ad-herence, daily insulin dose and number of patients, which are following their nutrition plan or doing exercise or hav-ing hypoglycemic episodes. Inconsistent and imprecise data were excluded from the statistical analysis. Missing data was marked with n.a. and before the analysis was conducted a significance level of alpha=0.05 was set. Results The statistical analysis revealed that pharma-ceutical care provided by community pharmacists can support transition of the adolescent regarding drug treatment becasue it resulted in more frequent SMBG, a greater amount of patients complying to their individual nutrition plan and injecting the correct insulin dose. Ad-ditionally, the insulintherapy adherence increased and resulted in lower fasting blood glucose levels. However, all these changes did not lead to an increase of hypogly-cemic episodes. Conclusion The DIADEMA study demonstrated that ad-olescent diabetes patients benefit from the community pharmacists´approach to guide transition of drug treat-ment into a self responsible behaviour. With this empow-erment patients achieved better glycemic control mea-sured by lower HbA1c-values (1). Better glycemic control can minimise the risk of short-and long-term diabetes related complications such as retinopathy or blindness.