Development of Telepharmacy Care for Diabetic Patients on Insulin Therapy after Discharge from Kosumphisai Hospital

Abstract

     This study was an action research based on the concept of Kemmis & McTaggart (1988) under the Quality Development Cycle (Plan-Act-Observe-Reflect: PAOR), utilizing a single-group pretest-posttest research design. The purposes were to study the problem situations of diabetic patients receiving insulin injections after discharge, to develop telepharmacy care guidelines for diabetic patients receiving insulin injections after discharge, and to evaluate the results of the developed telepharmacy care by comparing blood glucose levels before and after the telepharmacy care. The operation began from October 2024 to March 2026, divided into 3 phases: preparation phase, implementation phase, and evaluation phase. Purposive sampling was used to select type 2 diabetic patients receiving insulin injections who were hospitalized in the male or female wards at Kosum Phisai Hospital with hyperglycemia or hypoglycemia during March 2025 - March 2026. Patients were tracked and evaluated from admission to the inpatient ward until discharge from the hospital, and treatment was followed up through the telepharmacy service system for 5 times over a period of 3 months.

     The study results revealed that the sample was female at 63.34 % and male at 36.66% , with an average age of 62 years. Eighty percent completed primary education, and mainly engaged in agriculture at 43.33% (13 cases). The proportion of patients with hypoglycemia was 53.34 % and hyperglycemia was 46.66% . After participating in the telepharmacy care system, it was found that the average medication adherence score increased from 5.16 to 7.29 points (p < 0.001). The average knowledge score about diabetic medications increased from 13.81 to 18.73 points (p < 0.05). Blood glucose levels were at an appropriate level (average 175.68–184.28 mg/dL). The average hemoglobin A1c (HbA1c) level significantly decreased from 12.33 (±2.07) to 10.73 (±1.48) with statistical significance at p < 0.001. The satisfaction of patients and relatives of patients toward telepharmacy care was at a very satisfied level at 88.78%, and the satisfaction of staff providing telepharmacy care was at a very satisfied level at 88.00%.