Effect of Patient Education for Diabetic Outpatients by a Hospital Pharmacist: A Retrospective Study.

The number of patients with diabetes continues to increase in Japan, which means that education in disease management is important. However, there have been few investigations into the importance of hospital pharmacists performing outpatient education for diabetes mellitus in Japan. In the diabetes outpatient department of Kitakyushu City Moji Hospital, a pharmacist commenced patient education using check sheets before patients saw the physicians from 2012. We divided the patients into groups with an increase or decrease of hemoglobin A1c (HbA1c) level after 6 months from the start of patient education. To assess the factors related to a decrease of HbA1c level, we compared background factors, and laboratory values between these two groups. In the patients whose HbA1c level decreased, the level was high at the start of patient education and they had less knowledge about their medications. To evaluate the impact of this patient education, we compared HbA1c values before patient education and after 6 months to determine the effect of providing education in the diabetes outpatient department. In the HbA1c≥8% group, the HbA1c level decreased significantly during 6 months of patient education. These results suggest that patient education by hospital pharmacists can be effective if HbA1c level is high at the start of education. This is the first report about the usefulness of patient education by a hospital pharmacist for improvement of HbA1c level in diabetic outpatients in Japan.

[A case of hypothyroidism due to hashimoto disease that presented elevations of free T3 and free T4 by thyroid hormone autoantibodies].

When we commonly evaluate the thyroid function, we measure TSH, free T3 and free T4. However, there are some cases that are difficult to diagnose because of the existence of thyroid hormone autoantibodies. We experienced a case of a 14-year-old girl with diffuse struma whose TSH, free T3 and free T4 were elevated by detected with Amerlex M free T3 and free T4 kits, although she did not have any symptoms. As the free T4 level was low by the equilibrium dialysis method, we diagnosed this case as hypothyroidism due to chronic thyroiditis. Because we found thyroid hormone antibodies in her serum, we thought that this case presented pseudoelevations of free T3 and free T4 by the analogue method.