Academic journal article American Journal of Pharmaceutical Education

Diabetes and Hypertension Screening by Pharmacy Students in Thai Communities

Academic journal article American Journal of Pharmaceutical Education

Diabetes and Hypertension Screening by Pharmacy Students in Thai Communities

Article excerpt

INTRODUCTION

Diabetes mellitus and hypertension are major global health problems. The International Diabetes Federation estimated that in 2011, 366 million people worldwide had diabetes mellitus; its prevalence is expected to increase to 552 million by the year 2030. (1) Around 80% of people with diabetes are in low- and middle-income countries such as Thailand. (2) The World Health Organization reported that in 2011, 600 million people worldwide had hypertension, and that by the year 2025 they expect the prevalence of that disease to increase to 1.5 billion people. (3-5) Hypertension is the third leading cause of death in the world. Because the incidences of diabetes and hypertension are expected to increase and because serious complications from these diseases cause disability, reduction of quality of life, and global mortality, the diseases were identified as the most challenging health problems of the 21st century. (6) In Thailand, a country with middle to low income, the Ministry of Public Health (MoPH) reported that hypertension prevalence was 35.82% in people over 15 years of age (17.64 million people) and diabetes prevalence was 6% in Thai male adults and 7% in female adults. (7) The main problems for disease management were people's lack of concern and understanding about these diseases and lack of compliance with treatment. Thailand's national statistics center reported that among a sample of 100,000 Thai people, 71% were not concerned about their health and did not know whether they had hypertension. In a study of patients newly diagnosed with diabetes, more than 50% had not been previously diagnosed and only 34.2% knew and had subsequently been treated. (8,9)

The National Health Security Office (NHSO) proposed an improvement plan for health promotion and primary care services in Thailand. For the year 2008, they promoted a screening project through primary care services for early detection of people at risk for diabetes and/ or hypertension and to establish lifestyle modification services for those identified as being in the at-risk population. (10) Subsequently, the Thai government assigned health services throughout the country to campaign for disease prevention and health promotion in the general population. Screening for diabetes mellitus and hypertension was made a priority. Primary care personnel and health volunteers have been responsible for performing capillary fasting blood glucose tests and blood pressure measurements, while health care professionals such as nurses, pharmacists, and physicians have been responsible for monitoring and educating those patients identified as being at risk.

The Thai Pharmacy Council has cooperated with the Thai Food and Drug Administration to assess suitable pharmacies for accreditation to participate in the NHSO's primary care project. (11,12) An accredited pharmacy can screen people and refer those who are found to be at risk to a physician in a community hospital or medical health center for further evaluation. Patients who were diagnosed with diabetes and/or hypertension and controlled their blood sugar and/or blood pressure within normal limits would be referred back to a primary care provider at the primary care unit (PCU) or to the accredited community pharmacy for monitoring and medication refills. This would reduce the number of hospital visits by these patients.

The Faculty of Pharmacy, Mahasarakham University (MSU), 1 of 3 institutions producing qualified pharmacists in the Northeast region of Thailand, has accepted the concept of health promotion as its institutional mission and policy. Based on the faculty's philosophy of "be knowledgeable about medicines and able to lead people to promote their healthy lifestyles," we have integrated the health promotion concept into all courses in the doctor of pharmacy (PharmD) curriculum. This integration gives PharmD students a holistic viewpoint on health and will help them provide health promotion in their future workplace. …

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