Development of an Insulin Injection Training Model Combined with Pharmaceutical Care to Enhance Knowledge and Skills among Patients with Uncontrolled Type 2 Diabetes
Abstract
Abstract
This action research aimed to study the situational context, develop an integrated education and pharmaceutical care model, and evaluate its effectiveness among type 2 diabetes patients using insulin syringes. The study was conducted in three phases at the Non-Communicable Diseases (NCD) Clinic, Community Health Center, Kosum Phisai Hospital. The participants included 30 patients and 12 healthcare professionals. Research instruments consisted of an insulin injection skill assessment, the 8-item Morisky Medication Adherence Scale (MMAS-8), and a knowledge assessment form. Data were analyzed using descriptive statistics and paired t-tests.
The initial phase identified significant situational barriers, including patients’ misconceptions regarding insulin therapy and a lack of proper administration skills, particularly in dose preparation, air bubble removal, and improper insulin storage. Consequently, the "PITT DM Model" was developed, comprising five key components: Prescribing (identifying drug-related problems), Introduction (providing in-depth information and attitude adjustment), Teaching/Testing (active skill training and demonstration), Dispensing (providing medication with supporting tools), and Monitoring (continuous proactive follow-up). After implementing the model, the results showed that the patients' mean scores for knowledge, medication adherence, and injection skills significantly increased (p < 0.001). Clinical outcomes also markedly improved, with the mean HbA1c level decreasing from 10.57% to 9.03% and the mean Fasting Blood Sugar (FBS) dropping from 208.70 to 171.20 mg/dL (p < 0.001). Overall, the patients reported a high level of satisfaction with the model. In conclusion, the PITT DM model effectively bridges the gap in medication administration through proactive pharmaceutical care, leading to sustainable improvements in glycemic control for patients with type 2 diabetes.
Keywords : Type 2 diabetes, Insulin injection, Pharmaceutical care, Injection skills
