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CRO Pharma Diab Program - Croatian Pharmacists in Diabetes Care Team - New Apples on the Pharmacy Services Tree

Diabetes mellitus is a major and growing world health problem, a problem at all ages and in all countries. It causes prolonged ill-health and early death. It is within the power of national Governments and Health Departments to create conditions in which a major reduction in this heavy burden of disease and death can be achieved. Countries should give formal recognition to the diabetes problem and deploy resources for its solution. Plans for the prevention, identification and treatment of diabetes and particularly its complications: blindness, renal failure, gangrene and amputation, aggravated coronary heart disease and stroke – should be formulated at local, national and international levels. Investment now will earn great dividends in reduction of human misery and in massive savings of human and material resources. The pharmacists has an excellent opportunity to assist the diabetic patient by assessing the patient’s ability for self-care, providing education related to self-care measures, monitoring those measures, reinforcing instructions, highlighting warning signs, and verifying that the patient understands the information provided. Additionally, the pharmacists can become a consultant and information source to both the physician and the patient concerning not only the disease but also whatever drugs, devices, and monitoring systems are used in treatment. By sharing the pharmacy knowledge about diabetes the pharmacist is able to prevent the diabetic’s long-term complication illnesses. By participating as part of the care team in the treatment of the diabetic, the pharmacist is able to contribute to health promotion both health and health economy wise. How Croatian pharmacists joined in fight against diabetes mellitus, and what do they plan for the future? Croatia has a population of 4.8 million and 116.295 diabetics. The average incidence is 2.35%. The “Croatian model” of organisation of health care for diabetic patients was included into the St. Vincent Declaration in 1989. Croatian pharmacists have been involved in the current National Program for the Protection from Diabetes Mellitus since November 1997. Some important steps preceded the implementation of the CRO PharmaDia Program at the national level. The Program was developed pursuant to the National Program requirements and following the guidelines of the EFPA project “Diabetes care” and was well received, particularly by the patients. Thus far, we have implemented the Phase I of the Program, aimed at updating the pharmacists’ knowledge of diabetes and adequate pharmacotherapy. For this purpose, several two-day courses have been organised so far in conjunction with the “Vuk Vrhovac” University Clinic for Diabetes, Endocrinology and Metabolic Diseases (Country and Regional Centre for Diabetes) - a scientific and education institution and WHO Collaborating Centre). More than 300 pharmacists from all over the country have been included in the Project and have attended the courses. The courses were organised according to modern educational standards and comprised lectures, workshops and a test to evaluate the acquired knowledge. The evaluation was primarily aimed at determining the pharmacists’ interest in and willingness to take an active part in diabetic patient counselling. A survey was also conducted among diabetic patients to find out how satisfied they were with the pharmacists’ services and what they expected from pharmacists included in the diabetes care team. The results of the survey showed that diabetics expect more information about antidiabetic drugs, drug interactions, diet and physical activity. Most of them would like to be able to have their blood glucose and blood pressure controlled at the pharmacy, where they would also be provided with educational and informative materials about diabetes. Most complaints were about not being able to get all the required drugs and medical appliances all times and from all pharmacies. The next step will comprise the pharmacy network development with counselling service to diabetic patients, further education of pharmacists in the field of early detection, therapy and preventing the diabetes complications, as well as providing of additional services to diabetic patients, such as blod glucose measurement when it would be possible according to our health legislation. 1. M. Jadrijevic-Mladar, M. Jaksevac-Miksa, I. Fritsch and T. Blazekovic, CRO PharmaDiab Program – Pharmacists’ response to diabetics expectations in Croatia, 59th International Congress of FIP, 5-10 September 1999, Bacelona (Spain), Book of Abstracts CPS-P-325. 2. M. Jadrijevic-Mladar, I. Fritsch, M. Jaksevac-Miksa and T. Blazekovic, What diabetics expect from pharmacists in Croatia?, Diabetes Care and Research in Europe: St. Vincent Declaration ten years on The Thargets, The Progres, The Vision, 9-12 October 1999, Istanbul (Turkey) Abstracts 27; Diabetes, Nutrition & Metabolism, Clinical and Experimental, Vol. 12 (3) 1999, S-27, p. 209.

Pharmaceutical care; Diabetes mellitus; Diabetes care team; CRO PharmaDiab Program

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