{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T05:09:50Z","timestamp":1739250590361,"version":"3.37.0"},"reference-count":16,"publisher":"American Society of Consultant Pharmacists","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["sr care pharm"],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"<jats:p><jats:bold>Objective<\/jats:bold> To describe a successful pharmacist-led intervention to effectively and safely provide education and pharmacotherapy management for an older patient with uncontrolled type 2 diabetes mellitus (T2DM) who failed to remove the needle shield on insulin pens for injection.\n  <jats:bold>Setting:<\/jats:bold> Family medicine residency clinic.  <jats:bold>Practice Description:<\/jats:bold> The clinic, part of a major urban health system, consists of 27 medical residents, 15 attending physicians, and 1 ambulatory care pharmacist managing chronic diseases collaboratively. It primarily\n serves low-income patients in a Midwest city.  <jats:bold>Practice Innovation:<\/jats:bold> A 93-year-old White female with T2DM, receiving insulin therapy, was referred to the ambulatory care pharmacist by her physician for diabetes management. The patient had been hospitalized recently for hyperosmolar\n hyperglycemic state with a hemoglobin A1c of 15.9%. The pharmacist identified a failure to remove the needle shield on the insulin pen resulting in ineffective insulin administration, which caused persistent hyperglycemia and subsequent hospitalizations. This also posed a safety concern for\n severe hypoglycemia if proper administration resumed without adjusting the inflated dosing. The pharmacist used demonstration devices and the teach-back method to provide education and implement pharmacotherapy adjustments, resulting in effective and safe insulin administration.  <jats:bold>Main\n Outcome Measurements:<\/jats:bold> Change in diabetes medication regimen, home blood glucose readings including continuous glucose monitor data, hemoglobin A1c results, frequency of hypoglycemic episodes, and number of hospitalizations for T2DM.  <jats:bold>Results:<\/jats:bold> Over seven months, dose\n adjustments to basal insulin, combined with proper administration technique and the addition of empagliflozin, resulted in a hemoglobin A1c below 7%, with no severe hypoglycemia or diabetes-related hospitalizations.  <jats:bold>Conclusion:<\/jats:bold> Medication errors, including insulin administration\n errors, highlight the need for thorough education in insulin therapy management. Education and monitoring empower older patients to self-manage diabetes safely and effectively, aligning with guidelines. Further research is required to identify optimal strategies for educating older patients\n on self-managing T2DM with insulin therapy.<\/jats:p>","DOI":"10.4140\/tcp.n.2025.64","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T09:18:41Z","timestamp":1738574321000},"page":"64-71","source":"Crossref","is-referenced-by-count":0,"title":["Insulin Pen Administration Efficacy and Safety in an Older Patient"],"prefix":"10.4140","volume":"40","author":[{"given":"Dylan K.","family":"Montgomery","sequence":"first","affiliation":[{"name":"1 Ascension Via Christi, Wichita, Kansas."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiffany R.","family":"Shin","sequence":"additional","affiliation":[{"name":"2 The University of Kansas School of Pharmacy, Wichita, Kansas."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley J.","family":"Newell","sequence":"additional","affiliation":[{"name":"2 The University of Kansas School of Pharmacy, Wichita, Kansas."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2625","reference":[{"key":"ref1","first-page":"2024","article-title":"Diabetes Statistics Report. 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