• Rosa Lemmens-Gruber, Christine Hahnenkamp, Ulrike Gössmann, Jürgen Harreiter, Majid-Reza Kamyar, Barbara Julienne Johnson, Steve Hudson, and Alexandra Kautzky-Willer.
• Department of Pharmacology and Toxicology, University of Vienna, Vienna, Austria. rosa.lemmens@univie.ac.at
• Int J Clin Pharm. 2012 Jun 1; 34 (3): 490-500.

BackgroundEffective control of diabetes mellitus type 1 (DM1) and type 2 (DM2) can reduce the development and progression of diabetic complications. Therefore, patient education should be considered as an integral part of diabetes management.ObjectiveThe aim of the study was to assess DM patients' perception of knowledge for their medication and attitude towards self-management and pharmacist's role.SettingThe study was conducted at the diabetes out-patient clinic at the Vienna General Hospital (AKH), Division of Endocrinology and Metabolism, Department of Internal Medicine III, Austria.MethodThe study was a cross sectional survey using patient data from a validated patient questionnaire and medical records. Medical records were evaluated by applying a medication assessment tool.Main Outcome MeasureTo assess the quality of diabetes self management the following outcome measures are considered: HbA1c levels, pre- and post-prandial blood glucose levels, prevention of acute episodes of hypo- and hyperglycaemia, reduction of macrovascular risk factors, short term quality of life, adverse effects and treatment tolerance.ResultsThe present study comprised 225 patients with DM1 and 201 patients with DM2, respectively. In comparison to DM2 patients, cardio- and cerebrovascular diseases were diagnosed very rarely in patients with DM1. The risk for these diseases was higher in patients with other factors of the metabolic syndrome, in addition. Overall, 118 of these patients participated in the questionnaire. The level of positive response on diabetes self-care and knowledge with respect to medication for the prevention of diabetes complications, glycaemic control, and treatment goals in diabetes was 81.8 %. The comparison of patients' perceptions of diabetes self-care and knowledge showed differences among subgroups. Higher perceived knowledge and self-care apparently was associated with DM1. Additional findings of this study indicate that patients do not expect community pharmacists to be integrated in a multidisciplinary diabetes care team.ConclusionAlthough the level of positive response was found to be high there is still a minority of patients whose level of comprehension appears to be insufficient. Intense pharmaceutical care including patients' education within a multidisciplinary team could contribute to improvements in those patients.

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