Prevalence and Predictors of Diabetes Distress in Hospitalized Patients: A Pharmacist‐Led Intervention

ABSTRACT Introduction Diabetes distress (DD) is an emotional response to the demands of diabetes mellitus (DM) management and is associated with poor glycemic control, reduced self‐care, and lower quality of life. Despite its significance, DD remains under‐recognized in hospitalized patients where acute illness may intensify the emotional burden. Hospitalization offers an opportunity for identification, but routine practices are lacking. This study assessed the prevalence and predictors of DD using a pharmacist‐led screening approach among hospitalized adults with DM. Methods This prospective, single‐center, quality improvement initiative was conducted at a small community hospital. Pharmacists and trained pharmacy students administered the validated 17‐item Diabetes Distress Scale (DDS) to eligible inpatients with DM. A mean DDS score ≥ 2.0 indicated moderate‐to‐high DD. The primary outcome was the prevalence of moderate‐to‐high DD; secondary outcomes included contributing domains and associated patient characteristics. Descriptive statistics and logistic regression were performed using SAS v9.4 ( p < 0.05). Results Of 301 patients surveyed, 103 (34%) reported moderate‐to‐high DD. The median overall score with an interquartile range (IQR) was 2.71 (2.29–3.41) in the moderate‐to‐high DD group, compared with 1.26 (IQR 1.06–1.53) in the none‐to‐low group. Emotional burden and regimen distress were the most common contributing domains. Independent predictors of moderate‐to‐high DD included a hemoglobin A1c (HbA1c) ≥ 9%, a history of depression, number of insulin injections daily, diabetic retinopathy, and any diabetes‐related complications. Prior DD screening was reported by 12%. Of 126 patients requesting support, 78% received a referral to the outpatient diabetes clinic. Conclusion Pharmacist‐led screening identified one‐third of hospitalized DM patients who were experiencing moderate‐to‐high DD, and most were never previously assessed. While routine hospital‐based screening for DD is not a standard practice, implementing such screening could enhance DM care.