Assessment of impact of clinical pharmacist intervention to improve quality of life and medication adherence in pediatric type-1 diabetic patients

Abstract

Type 1 diabetes in children and adolescents is a challenging management problem for patients and their families. Childhood and adolescence are periods of constant and rapid change, hence adherence to medications and maintaining Quality of life are more difficult than adults. There are only limited studies on medication adherence and Quality of life (QOL) in pediatric type 1 diabetic patients especially from India. Together with adherence and glycemic control, patients can attain a better quality of life. An Interventional study was carried out in endocrinology department and patients were selected based on inclusion and exclusion criteria. The patients were randomized using graph pad method. Control group received standard clinical based care and intervention group received additional input from clinical pharmacist. Medication Adherence and QOLwere measured using Morisky (MMAS) and Peds Ql
questionnaires respectively. The scores of baseline and follow up visits were compared. The adherence scores for intervention group improved significantly during follow up visit. Statistically significant improvement (p value less than 0.05) in QOL in intervention group of both child and parent report were noted compared to baseline. This study suggests that clinical pharmacist intervention made a significant influence for improvement in medication adherence and quality of life of patients.Due to lack of awareness and motivation among patients and caregivers, health policy makers should consider placing a clinical pharmacist in paediatric diabetes clinics, whose service in association with other health care providers can indeed provide solutions for improving adherence and quality of life of 
patients.