The role of pharmacists in diabetes care:a case study in Zanzibar and Dar es Salaam region, Tanzania.

Abstract

ABSTRACT SETTINGS <, , The study was conducted in public diabetes clinics, hospital and community pharmacies closest to diabetes clinics in Dar es Salaam and Zanzibar.

,

OBJECTIVE To investigate the role of pharmacists in diabetes care. DESIGN Cross sectional descriptive study. METHODOLOGY Face to face interviews were conducted with diabetic patients, health staff and pharmacists working in hospital and community pharmacies closest to the clinics. RESULTS Eighteen health workers were interviewed in seven diabetes clinics. No pharmacist was found to work in the diabetes clinics. Insulin (human and animal) and limited oral antidiabetics were found in four clinics. Drugs were dispensed by doctors and nurses, while pharmacists were found to manage drug ordering, preparing drug budgets and disposal of expired drugs. The sources of the drugs for people living with diabetes were hospital pharmacy, donations and procurement mainly from MSD.

Vlll Respondents were 115 patients aged between 10 and 80 years of whom 68 were females and 47 males. 31.3% of them were on insulin, 61.7% were on oral antidiabetics, 0.9% on both (insulin and oral antidiabetics) and 6.1% were on diet. Majority of patients on insulin (97.3%) and of those on oral antidiabetics (42%) knew the names of the drugs they used. ( All patients knew how to use their medicines. Most patients (91.8%) on insulin stored it correctly, 83.7% knew the units of insulin they were using but only 21.6% were able to mention the type/source of insulin they were using. 40% of patients said drugs were available at the clinic, but only 17.4% of these said drugs were always available. Most patients(76%) knew the risks of not taking their medication and majority knew the symptoms of hypoglycaemia (63.5%) and hyperglycaemia (76%). The complications of diabetes were known to 64% of patients and 72% could tell what can improve their health as diabetic patients. Majority of patients mentioned doctors and nurses to be their source of health education about the disease while pharmacists were mentioned on storage and use of drugs. A total of 51 pharmacies were visited, where 96% of the interviewees were pharmacists. A variety of oral antidiabetics were found in stock and 63% of the pharmacies stocked insulin (animal and human). 11.8% pharmacists had attended training in diabetes after graduating. Majority (99.6%) knew the major types of diabetes and the suggested treatment. They knew the primary system that is affected (61 %), the gland (84%) and

IX the hormone (94%) that is affected. Pharmacists also knew the complications of diabetes, risks and the advice they can give a patient to reduce the risks. CONCLUSION

,

There were no pharmacists working in any of the diabetes clinics that were visited. Most patients on oral antidiabetics did not know the names of the medicines while most of those on insulin knew the name, the units, how to store it correctly and a few knew the source ofthe insulin they were using. They all knew how to use their medication in terms of doses and frequency. Pharmacists were found to be involved in educating patients about their medicines. Most patients obtained medicines from community pharmacies. Very few patients were found to have spoken to a pharmacist about their disease. Most pharmacists had knowledge needed to educate patients about their medication and their disease. There is a need to find a way of incorporating pharmacists in rendering holistic care to people living with diabetes.