Diabetes in children: impact of an innovative pharmaceutical care programme and links with concurrent illnesses

Diabetes mellitus (DM) is highly prevalent in Qatar. Poor treatment adherence in diabetes is a major problem. Pharmaceutical care interventions show promise for improving treatment adherence in adults with DM, however, evidence in children is lacking. <br/> <br/>The main aim of the work presented in this thesis was to determine whether a one-year pharmaceutical care programme delivered through a pharmacist-managed clinic in Qatar, improved long-term glycaemic control compared to usual care alone for children from 0 to 18 years of age with type 1 diabetes mellitus.<br/><br/>The main body of work was a randomised controlled trial carried out at Hamad General Hospital (HGH), Qatar. This study included 212 children ≥ 18 years of age with T1DM (Chapter 2). Those randomised to a pharmacist-managed clinic received education from a pharmacist on their condition, treatment and self-management in a structured fashion, while those in the control group received routine care. Both groups were followed up every two months for one year. Those randomised to the control group received routine care. The primary outcome was glycated haemoglobin. The vitamin D work (Chapter 3) was designed as a case-control study with a matching ratio of 1:1. Chapter 4 (link of diabetes and hypothyroidism) was designed as a retrospective, longitudinal, cross-sectional study. <br/> <br/>Over the study period (12 months) of the randomised, controlled clinical trial (Chapter 2), intervention patients showed significant (P&lt;0.05) improvements in a range of outcome measures, including glycaemic control. Vitamin D inadequacy was present in 91% of children and adolescents with TD1M vs. 80.4% of children and adolescents without T1DM (P&lt;0.05) (Chapter 3). Approximately one in every twenty (5.8%) children and adolescents with T1DM in Qatar developed AIH during a mean follow-up period of 10 years (Chapter 4).<br/><br/>The data obtained from the present research shows for the first time the impact of pharmaceutical care on the outcomes of children with T1DM. <br/>

Name dc:type.qualificationname

Doctor of Philosophy

Level dc:type.qualificationlevel

Doctoral Thesis

Grantor dc:publisher.institution

Queen's University Belfast

Year dc:date.issued

2022

Author dc:creator

• Badran, Hoda

Advisors dc:contributor.advisor

• Parsons, Carole
• McElnay, James

Language dc:language

eng

Identifier

oai:pure.qub.ac.uk/portal:studenttheses/0acce45a-1855-48c7-a2bd-0ee976323d6a

OAI identifier oai:identifier

oai:pure.qub.ac.uk/portal:studenttheses/0acce45a-1855-48c7-a2bd-0ee976323d6a