Vol 10, Issue 2, 2017 Online - 2455-3891 Print - 0974-2441 THE ROLE OF PHARMACISTS IN EVALUATING AND INTERVENING THE PATIENTS WITH DIABETIC NEUROPATHY SESILIA ANDRIANI KEBAN 1 *, NAJUAH NAJUAH 2 , SYAMSUDIN ABDILLAH 1 1 Department of Clinical and Community Pharmacy, Faculty of Pharmacy, Pancasila University, Jl. Srengseng Sawah, Jagakarsa, South Jakarta, Indonesia. 2 Postgraduate of Hospital Pharmacy, Faculty of Pharmacy, Pancasila University, Jakarta, Indonesia. Email: sesil.ffup@gmail.com Received: 20 August 2016, Revised and Accepted: 27 October 2016 ABSTRACT Objective: The purpose of this study was to estimate the prevalence and risk factors for diabetic peripheral neuropathy, to evaluate the score of neuropathy, and to determine the effect of pharmacist intervention toward diabetic neuropathy (DN) patients at Gatot Soebroto Hospital, Jakarta, in 2013. Methods: An analytic research was conducted using cross-sectional approach to find out the effect of pharmacist intervention toward DN risk factors and prevalence. Toronto clinical scoring system was used to score the symptoms and physical examination results. Data about sociodemographic characters, age, duration of diabetic, blood glucose, blood pressure, cardiovascular diseases, lifestyle, body mass index (BMI), and smoking were collected. Pharmacist intervention was given to increase patient information about DN and its risks factors. Results: There were 59 respondents involved in this study. It can be found that 15.3% respondents had mild diabetic peripheral neuropathy, 1.7% had moderate diabetic peripheral neuropathy, 1.7% had severe diabetic peripheral neuropathy, and as much as 81,4% respondents had no neuropathy. There was a correlation (but not statistically significant) between diabetic peripheral neuropathy and its’ risks factors such as ages, duration of diabetes, sex, cardiovascular disease (hypertension and cardiac disease), and lifestyle (smoking habit and BMI). Conclusion: Pharmacist intervention showed an increase on the patient’s knowledge about DN and also a significant decrease on the patient’s blood glucose level (p˂0.05). Keywords: Diabetic neuropathy, Pharmacist role, Prevalence, Score, Risk factors, Blood glucose. INTRODUCTION Diabetes mellitus (DM) is a metabolic disorder, which is characterized by hyperglycemia [1]. The prevalence keeps increasing with time. In 1995, it was oleh 4.0%, and in 2015, it is predicted to reach a level of 5.4%. In 1995, there were around 135 million of diabetes mellitus cases, and in 2015, it is predicted to increase to 300 million of cases [2]. The 2012 report of patients’ data at the Internal Department of Gatot Soebroto Hospital, Jakarta, showed that diabetes mellitus ranked the first with 14.508 cases, followed by hypertension with 5.875 cases and dyspepsia syndrome with 1.008 cases. Diabetes mellitus is a chronic disease that needs continuous treatment and education for the patients to prevent acute complication and to reduce the risk of long- term complication [3]. Long-term complication from diabetes includes retinopathy, which can lead to vision loss, nephropathy that leads to renal failure, peripheral neuropathy followed by the risks of foot ulcer, amputation, and charcot joins, as well as autonomous neuropathy that leads to disorders in the gastrointestinal and urogenital tracts, cardiovascular symptoms, and erectile dysfunction [1]. Diabetic neuropathy (DN) is the presence and/or signs of peripheral nervous dysfunctions in patients with diabetes after the exclusion of other causes. About 60-70% of diabetic patients suffer from moderate to severe nervous system damage [4]. Diabetic peripheral neuropathy occurs in 50% of diabetic patients [5]. Duration of the disease is one of the factors that lead to increasing morbidity and mortality rates [6]. The prevalence of DN is 11.1% in the population at the age of 23-40 ages. It increased to 32.3 years in the patients at the age of 60-80 years. When it comes to duration, 14.1% of the patients who had diabetes for <5 years developed neuropathy and 29.2% of diabetic patients who have diabetes for 9-11 years developed neuropathy [7]. Another research even found that 73.9% of the patients who had diabetes for <5 years had neuropathy and 100% of the patients who have diabetes for >15 years had neuropathy [8]. Almost 30% of the diabetic patients at the age of 40 years or more had sensational impairment on legs, which is the severest form of DN and the main contributor for amputation. More than 60% of non-traumatic amputations occurred in diabetic patients [4]. Patients with diabetes mellitus and peripheral neuropathy were at increased risk for developing tissue damage, which was followed by diabetic feet, diabetic ulcers, and even foot amputation [9]. These situations are the major causes of morbidity and mortality. The incidence rate can be reduced when the peripheral neuropathy can be detected at the earliest stadium possible [5]. Risk factors for diabetic peripheral neuropathy include improper blood sugar control, duration of the disease, hyperlipidemia, elevated albumin excretion, smoking habit, alcohol, low economic status, renal failure, and increased body mass index (BMI). Diabetic peripheral neuropathy is frequently associated with cardiovascular diseases, mortality, and microangiopathy [5,10-12]. The examination is necessary to prevent and treat nerve damage as the first step in identifying the symptoms in the sensor and motor systems, which are caused by the DN, after the exclusion of other causes. Clinical evaluation includes foot examination for foot pain, numbness, tingling, weakness and ataxia, and upper limb, examination for sensory system, which includes pinprick, temperature, light touch, vibration, and position sense, and examinations for Achilles reflex, and Patella reflex using reflex hammer [13]. © 2017 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons. org/licenses/by/4. 0/) DOI: http://dx.doi.org/10.22159/ajpcr.2017.v10i2.14796 Research Article