Development of a Pharmaceutical Care Model Using Diabetes Medication Therapy Management (DMTM) for Patients with Diabetes Receiving Insulin Therapy at Na Chueak Hospital, Maha Sarakham Province

Abstract

        This study aimed to examine the effectiveness of developing a pharmaceutical care model using Diabetes Medication Therapy Management (DMTM) among diabetes patients receiving insulin therapy at Na Chueak Hospital, Maha Sarakham Province, Thailand. The study employed an action research design. The participants consisted of 15 multidisciplinary healthcare professionals and 150 diabetes patients receiving insulin therapy. Research instruments included a diabetes knowledge test, the EQ-5D-5L health-related quality of life questionnaire, a satisfaction questionnaire for multidisciplinary healthcare professionals, focus group discussions, and in-depth interviews. Quantitative data were analyzed using descriptive statistics and paired t-tests, while qualitative data were analyzed using content analysis.

The results revealed the following findings.

        1.The identified problems among insulin-treated diabetes patients included insufficient knowledge and skills regarding insulin use, inappropriate medication-use behaviors, and low self-management confidence, resulting in suboptimal glycemic control. In addition, the existing care process lacked a systematic medication review, and the role of pharmacists in managing medication-related problems was not clearly defined.

        2.Problem-solving was conducted through the development of a DMTM-based pharmaceutical care model via multidisciplinary workshops. The model focused on systematic medication review, identification and resolution of drug-related problems, individualized counseling, and continuous follow-up, with an emphasis on enhancing patients’ knowledge, skills, and participation in self-management.

        3.Following the implementation of the DMTM model, patients demonstrated significantly improved knowledge regarding diabetes and insulin use. HbA1c levels significantly decreased, and health-related quality of life significantly improved. Furthermore, multidisciplinary healthcare professionals reported a high to very high level of satisfaction with the DMTM pharmaceutical care model.