Drugs at risk: assessing pharmacy and medical interns' knowledge of injectable antidiabetics
Résumé
Background and Objective: Insulin is one of the hight alert medications and errors related to its administration are among the list of Never events. In 2020, in the Institute for Safe Medications Practice study, insulin was the drug most frequently involved in errors related to care. In this context, it seems essential that all healthcare professionals involved in the medical management of patients have a correct level of knowledge of Injectable Anti Diabetics (IAD). In addition, in recent years, new insulins and other IAD (like GLP-1 analogs) have been introduced on the market, which may lead to prescription errors. The objective of this work is to carry out an inventory of the level of training and knowledge of medical interns (MED-INT) and pharmacy interns (PHA-INT) with regard to DAIs, particularly insulin.
Design: Development of a 27-item questionnaire on DAIs by clinical pharmacists in the cardiology department. The questionnaire was distributed to the MED-INT in cardiology and the PHA-INT in our hospital. The results are expressed as the average percentage of correct answers.
Results: A total of 16 MED-INT and 16 PHA-INT responded to the questionnaire. The overall Good Response Rate (GRR) was 75% for MED-INT and 85.5% for PHA-INT. For the items on knowledge of insulin as a risky drug, the GRR was 79.2% for the MED-INT and 95.8% for the PHA-INT. For the items on general knowledge of insulin, the GRR is 87.5% for MED-INT and 84.4% for PHA-INT. For the items on the insulin circuit (storage and dispensing) the GRR is 55.2% for MED-INT and 89.6% for PHA-INT. The GRR concerning good insulin administration practices was 87.5% for MED-INT and 89.1% for PHA-INT. Knowledge of the pharmaceutical specialties,the GRR is 65.63% for MED-INT and 68.7% for PHA-INT. Finally, concerning the feelings of the INTs, 90.6% felt that they did not have enough training time on insulins. Only 25% of the MED-INT and 37.5% of the PHA-INT were comfortable with the management of a diabetic patient on insulin and 84.3% of the INTs were interested or very interested in training on injectable drugs indicated in the management of diabetes.
Conclusion: This work shows that there are gaps, as INTs have partial knowledge of IAD, including the new therapies available and the different insulins. The majority of INTs feel that their training is lacking and few are comfortable with the management of diabetic patients on insulin. In order to reinforce the safety of the medication management of patients on IAD, an interactive hands-on training will be set up.