1. Evaluation of Patient Insulin Injection Technique in a University-Affiliated Outpatient Continuity Clinic Shelley King, Pharm. D. Candidate 2011 1, Kathileen Boren, Pharm. D. Candidate 2011 1 Bradley M. Wright, Pharm. D., BCPS 2 1 Auburn University Harrison School of Pharmacy, Mobile AL; 2 Auburn University, Dept. of Pharmacy Practice Methods 1. Centers for Disease Control and Prevention. National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2007. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2008. 2. Coninck CD, Frid A, Gaspar R, Hicks D, Hirsch L, Kreugal G, et al. The 2008- 2009 insulin injection questionnaire survey: results and analysis. Journal of Diabetes 2010. 3. Partanen T-M, Rissanen A. Insulin Injection Practices. Pract Diab Int 2000;17(8)252-4 4. Strauss K, De Gols H, Hannet I, Partanten T-M, Frid A. A Pan-European Epidemiologic Study of Insulin Injection Technique in Patients with Diabetes. Pract Diab Int 2002;19(3)71-6 The objective of this prospective study is to assess patients’ baseline insulin injection technique/administration and knowledge This baseline information will help pharmacists provide better education and guidance to patients and health-care providers  New T1DM or T2DM patients referred to the clinical pharmacist’s service at Stanton Road Clinic that have been treated with at least 1 dose of insulin per day will be included in this prospective study  Exclusions include patients under the age of 19, pregnant women, and prisoners  Demographic information, including most recent HbA1c will be collected  The clinical pharmacist will interview the patient using a standard questionnaire for all patients and record all answers  All data collected will be non-identifiable, maintaining patient confidentiality  The data from the questionnaire will be analyzed by the investigator to obtain a baseline understanding of how patients inject insulin and to help direct patient and provider counseling Background  In 2007, the American Diabetes Association (ADA) reported that 27% of adults with Type 1 or Type 2 Diabetes Mellitus use insulin either alone or in combination with oral medications 1  Coninck CD, et al. 2 found that less than 80% of patients in their United States study population were educated in areas such as depth and angle of injection, pinching up and rotating injection sites  This study also found that less than or equal to 60% of patients were taught how long to leave the pen needle in and how to properly mix cloudy insulin 2  Partanen, et al. 3 found that patients were not rotating sites as they should, which was resulted in 29% of patients with lipohypertrophy of the injection sites  Strauss, et al. 4 showed that 22% of patients do not dispose of their needles properly Hypotheses  The patient population at Stanton Road Clinic is predominately underserved with a low level of education, therefore we expect to see deficiencies in insulin knowledge as well as insulin injection technique  There will be a positive correlation between poor insulin education and poor HbA1c  The information that this study provides will identify areas in which health care professionals can better educate patients regarding insulin and insulin administration  No patient identifiers (no follow up)  No randomization  Responder bias  Non-validated questionnaire Limitations  Appropriate patient population for study focus  Clinical pharmacist interviews patient using standard questionnaire for each patient Strengths Disclosures Authors of this presentation have the following to disclose concerning possible financial or personal relationships with commercial entitles that may have a direct or indirect interest in the subject matter of this presentation: Shelley King- Nothing to disclose Kathileen Boren- Nothing to disclose Bradley Wright- Nothing to disclose References Timeline  IRB applications submitted November 2010  With IRB approval, interview patients in Stanton Road Clinic December 2010- November 2011  Data analysis  Results are used to educate health care providers and patients  Study design and results are published in a peer-reviewed journal Objective