Factors associated with KAP results, ADRs and glycemic control
status
We found a significant relationship between the patient’s better
knowledge and the patient’s longer duration of insulin therapy (≥ one
year) (p = 0.025) and receiving consultation from health professionals
(p = 0.001). Several recent studies have shown the importance of
hospital pharmacists performing patient education for diabetes
mellitus9,13,22.
Patients with longer insulin treatment are likely to have a more
positive attitude (p = 0.017). This result is similar to the study of
Cosson E.21 conducted
in France in 2019 patients after using insulin reported fewer negative
feelings and more positive feelings.
Our study also found that patients improved their attitude after changed
from vials to the use of a pen (p < 0.001). This is consistent
with Ramadan et al.’s
study23 in which 85.7%
of pen users found it more convenient shifting to pen and the insulin
pen was significantly less painful than the conventional vial/syringe.
Patients using insulin combined with oral anti-diabetic drugs (OAD) had
better attitude on insulin role (p=0.038). A similar KAP survey in
India6 found that
patient using insulin with longer duration of OAD use (≥ 3 years) was
associated with better perception on benefits of insulin use
(p < 0.001), awareness that insulin is not habit forming in
nature (P = 0.001), need for continuity in insulin use (p =
0.002), and the confidence for self-administration of insulin (p =
0.042).
Duration on insulin therapy (≥1 year) and patient’s good knowledge
significantly improved the patient’s practical skills (p = 0.042 and
<0.001, respectively). Then, patients with good injection
technique were less likely to get ADRs in injection sites (p=0.013).
Mitchell et al. reported that correct usage scores of insulin pens were
significantly higher if initial education on insulin pens was performed
by a pharmacist or
nurse9.
Our study found that KAP levels did not correlate with both FPG and
HbA1c control status. However, the study of Solanki et al. in
201724 recorded that
there was positive correlation between KAP score and glycemic control,
with significance for only glycosylated hemoglobin and not fasting blood
sugar, postprandial blood sugar. One of the reasons maybe that our KAP
questionnaire only focused on hypoglycemia and insulin pens but not
cover broad diabetic management.