The Effects of Counseling and Drug Information Services by Pharmacist to Medication Adherence and Therapy Outcomes on Sciatica Patients at Dr. Suyoto Hospital, Jakarta

People suffered from sciatica, pain along the sciatic nerve, require therapy up to 4 months or longer to achieve controlled-pain. The main treatment for sciatica is physiotherapy; medication is only secondary therapy. This quasi-experimental study aimed to investigate the effects of counseling and drug information services (DIS) by pharmacist on medication adherence and duration of therapy. In the study conducted in March‒July 2018, 128 ambulatory sciatica patients newly diagnosed at Dr. Suyoto Hospital, Jakarta, were divided randomly into two groups, each of 64 patients. The intervention group was given counseling and DIS by clinical pharmacists (3 times with interval of 4 weeks) as well as brochures. Primary data on medication adherence were obtained prospectively through interviews using a validated questionnaire, before the intervention and 4 weeks after the last counseling and DIS by clinical pharmacists. Secondary data (up to 16 weeks), including pain scores, were obtained from medical records and the patient administrative data. The results showed that sociodemographic characteristics as well as distribution of initial adherence and initial pain levels of the two groups were not significantly different (Mann-Whitney test, p>0.05). After the last intervention, the proportion of patients with high-adherence in the intervention group (12.5%) was higher than in the control group (6.3%), as was the proportion of patient achieved controlled-pain (84.4% versus 76.6%). The results of survival analysis showed that the duration of treatment by which 50% of patients achieved controlled-pain (median survival) was significantly shorter in the intervention group (85 days) than in the control group (92 days), while the probability of achieving controlled-pain (hazard ratio) in the intervention group was 1.7 times of that in the control group. In conclusion, counseling and DIS by pharmacist can improve the effectiveness of sciatica treatment, although the main therapy for the nerve pain is not medication.

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National Survey of Drug Information Centers practice: Leadership and Practice management at Ministry of Health Hospital in Saudi Arabia

Research in Pharmacy and Health Sciences ◽

10.32463/rphs.2018.v04i03.17 ◽

2018 ◽

Vol 4 (3) ◽

pp. 497-503

Author(s):

Yousef Ahmed Alomi ◽

Saeed Jamaan Alghamdi ◽

Radi Abdullah Alattyh

Keyword(s):

Saudi Arabia ◽

National Survey ◽

Drug Information ◽

Information Services ◽

Practice Management ◽

Full Time ◽

Drug Information Services ◽

Ministry Of Health ◽

Patient Counselling ◽

Health Hospital

Objective: To explore the National Survey of Drug Information Centers practice in Saudi Arabia: Leadership and Practice management at Ministry of Health hospital. Method: It is a cross-sectional four months national survey of Drug Information Services at Ministry of Health hospital. It contained ten domains with 181 questions designed by the authors. It was derived from Internal Pharmaceutical Federation, American Society of Health-System Pharmacists best practice guidelines. This survey was distributed to forty hospital pharmacies that run drug information services. In this study, domain of Drug Monitoring and Patient Counselling System explored and analyzed. It consisted of eight questions about the written policy and procedure and application methods for Leadership and Practice management in the drug information centers. All analysis was done through survey monkey system. Results: The survey distributed to 45 of hospitals, the response rate, was 40 (88.88%) hospitals. The highest score of the DIC had policy and procedures with a clear mission, vision, and values were Evidence of valid Saudi Council of Health Specialties license to practice in Saudi Arabia did not exist in 3 (7.5%) hospitals while 30 (75%) of hospitals 100% applied the elements. The highest score of the Drug information centers had a space, adequate furniture, hours of operation were determined and announced as well as there was a qualified and licensed staffing. All Drug Information Centers staff had valid licenses from Saudi Commission for Health Specialties to practice in Saudi Arabia, did not exist in 6 (15%) hospitals while 30 (75%) of hospitals 100% applied the elements. The highest score of the Drug Information Centers Supervisor, reports workload statistics to the appropriate and leadership number of Full Time Employee staff and actual workload published was the answering question depends on the priority of the question did not exist in 6 (15%) hospitals while only 22 (55%) of hospitals 100% applied the elements. The highest score of the Drug Information Centers showed evidence of Quality Improvement, and the process for Drug Information Centers Networking. The reporting any questionable drug quality to Pharmacy director, did not exist in 4 (10 %) hospitals while only 25 (62.5%) of hospitals 100% applied the elements. Conclusion: There were an acceptable implementation leadership and practice management in drug information centers practice. The drug information centers workload analysis and quality management should improve. Drug information centers network indication required an implementation to improve the services at Ministry of Health hospital in Kingdom of Saudi Arabia.

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Effectiveness of a web-based medication adherence tool with patient centered communication: Results of a clustered randomized controlled trial (Preprint)

10.2196/preprints.16141 ◽

2019 ◽

Author(s):

Jan van Lieshout ◽

Joyca Lacroix ◽

Aart van Halteren ◽

Martina Teichert

Keyword(s):

Randomized Controlled Trial ◽

Medication Adherence ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Community Pharmacies ◽

Web Based ◽

Randomized Controlled ◽

Tailored Interventions ◽

Increased Risk

BACKGROUND Growing numbers of people use medication for chronic conditions; non-adherence is common, leading to poor disease control. A newly developed web-based tool to identify an increased risk for non-adherence with related potential individual barriers might facilitate tailored interventions and improve adherence. OBJECTIVE To assess the effectiveness of the newly developed tool to improve medication adherence. METHODS A cluster randomized controlled trial assessed the effectiveness of this adherence tool in patients initiating cardiovascular or oral blood glucose lowering medication. Participants were included in community pharmacies. They completed an online questionnaire comprising an assessments of their risk for medication non-adherence and subsequently of barriers to adherence. In pharmacies belonging to the intervention group, individual barriers displayed in a graphical profile on a tablet were discussed by pharmacists and patients at high non-adherence risk in face to face meetings and shared with their general practitioners and practice nurses. Tailored interventions were initiated by the healthcare providers. Barriers of control patients were not presented or discussed and these patients received usual care. The primary outcome was the difference in medication adherence at 8 months follow-up between patients with an increased non-adherence risk from intervention and control group, calculated from dispensing data. RESULTS Data from 492 participants in 15 community pharmacies were available for analyses (intervention 253, 7 pharmacies; control 239, 8 pharmacies). The intervention had no effect on medication adherence (-0.01; 95%CI -0.59 – 0.57; P= .96), neither in the post hoc per protocol analysis (0.19; 95%CI -0.50 – 0.89; P=.58). CONCLUSIONS This study showed no effectiveness of a risk stratification and tailored intervention addressing personal barriers for medication adherence. Various potential explanations for lack of effect were identified. These explanations relate for instance to high medication adherence in the control group, study power and fidelity. Process evaluation should elicit possible improvements and inform the redesign of intervention and implementation. CLINICALTRIAL The Netherlands National Trial Register: NTR5186. Date: May 18, 2015 (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5186)

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Benefit of a pharmacist-led intervention for medication management of renal transplant patients: a controlled before-and-after study

Therapeutic Advances in Chronic Disease ◽

10.1177/20406223211005275 ◽

2021 ◽

Vol 12 ◽

pp. 204062232110052

Author(s):

Jeremy Chambord ◽

Lionel Couzi ◽

Pierre Merville ◽

Karine Moreau ◽

Fabien Xuereb ◽

...

Keyword(s):

Medication Adherence ◽

Immunosuppressive Therapy ◽

Medication Management ◽

Intervention Group ◽

Knowledge Score ◽

Control Group ◽

Patient Knowledge ◽

Transplant Patients ◽

Before And After ◽

High Level

Aims: To assess the effect of a pharmacist-led intervention, using Barrows cards method, during the first year after renal transplantation, on patient knowledge about their treatment, medication adherence and exposure to treatment in a French cohort. Methods: We conducted a before-and-after comparative study between two groups of patients: those who benefited from a complementary pharmacist-led intervention [intervention group (IG), n = 44] versus those who did not [control group (CG), n = 48]. The pharmacist-led intervention consisted of a behavioral and educational interview at the first visit (visit 1). The intervention was assessed 4 months later at the second visit (visit 2), using the following endpoints: treatment knowledge, medication adherence [proportion of days covered (PDC) by immunosuppressive therapy] and tacrolimus exposure. Results: At visit 2, IG patients achieved a significantly higher knowledge score than CG patients (83.3% versus 72.2%, p = 0.001). We did not find any differences in treatment exposure or medication adherence; however, the intervention tended to reduce the proportion of non-adherent patients with low knowledge scores. Using the PDC by immunosuppressive therapy, we identified 10 non-adherent patients (10.9%) at visit 1 and six at visit 2. Conclusions: Our intervention showed a positive effect on patient knowledge about their treatment. However, our results did not show any improvement in overall medication adherence, which was likely to be because of the initially high level of adherence in our study population. Nevertheless, the intervention appears to have improved adherence in non-adherent patients with low knowledge scores.

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Motivational Interviewing to Support Oral AntiCoagulation adherence in patients with non-valvular Atrial Fibrillation (MISOAC-AF): a randomised clinical trial

European Heart Journal ◽

10.1093/ehjci/ehaa946.0641 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A Tzikas ◽

A Samaras ◽

A Kartas ◽

D Vasdeki ◽

G Fotos ◽

...

Keyword(s):

Atrial Fibrillation ◽

Medication Adherence ◽

Medical Care ◽

Oral Anticoagulation ◽

Intervention Group ◽

Control Group ◽

Motivational Intervention ◽

Clinical Events ◽

Secondary Outcomes

Abstract Background Oral anticoagulation (OAC) is paramount to effective thromboprophylaxis; yet adherence to OAC remains largely suboptimal in patients with atrial fibrillation (AF). Purpose We aimed to assess the impact of an educational, motivational intervention on the adherence to OAC in patients with non-valvular AF. Methods Hospitalised patients with non-valvular AF who received OAC were randomly assigned to usual medical care or a proactive intervention, comprising motivational interviewing and tailored counseling on medication adherence. The primary study outcome was adherence to OAC at 1-year, evaluated as Proportion of Days Covered (PDC) by OAC regimens and assessed through nationwide prescription registers. Secondary outcomes included the rate of persistence to OAC, gaps in treatment, proportion of VKA-takers with labile INR (defined as time to therapeutic range<70%) and clinical events. Results A total of 1009 patients were randomised, 500 in the intervention group and 509 in the control group. At 1-year follow-up, 77.2% (386/500) of patients in the intervention group had good adherence (PDC>80%), compared with 55% (280/509) in the control group (adjusted odds ratio 2.84, 95% confidence interval 2.14–3.75; p<0.001). Mean PDC±SD was 0.85±0.26 and 0.75±0.31, respectively (p<0.001). Patients that received the intervention were more likely to persist in their OAC therapy at 1 year, while usual medical care was associated with more major (≥3 months) treatment gaps [Figure]. Among 212 VKA-takers, patients in the intervention group were less likely to have labile INR compared with those in the control group [21/120 (17.1%) vs 34/92 (37.1%), OR 0.33 95% CI 1.15–0.72, p=0.005]. Clinical events over a median follow-up period of 2 years occurred at a numerically lower, yet non-significant, rate in the intervention group [Table]. Conclusions In patients receiving OAC therapy for non-valvular AF, a motivational intervention significantly improved patterns of medication adherence, without significantly affecting clinical outcomes. Primary and secondary outcomes Funding Acknowledgement Type of funding source: None

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DRUG INFORMATION SERVICES IN NEW SOUTH WALES

The Medical Journal of Australia ◽

10.5694/j.1326-5377.1981.tb135292.x ◽

1981 ◽

Vol 1 (1) ◽

pp. 41-44

Keyword(s):

Drug Information ◽

New South ◽

New South Wales ◽

Information Services ◽

Drug Information Services ◽

South Wales

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83 A Medication Self-Management Intervention to Improve Medication Adherence For Older People with Multimorbidity: A Pilot Study

Age and Ageing ◽

10.1093/ageing/afab030.44 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

pp. i12-i42

Author(s):

C Yang ◽

Z Hui ◽

S Zhu ◽

X Wang ◽

G Tang ◽

...

Keyword(s):

Medication Adherence ◽

Pilot Study ◽

Older People ◽

Intervention Group ◽

Self Management ◽

Control Group ◽

Medication Knowledge ◽

Management Intervention ◽

Patient Reported

Abstract Introduction Medication self-management support has been recognised as an essential element in primary health care to promote medication adherence and health outcomes for older people with chronic conditions. A patient-centred intervention empowering patients and supporting medication self-management activities could benefit older people. This pilot study tested a newly developed medication self-management intervention for improving medication adherence among older people with multimorbidity. Method This was a two-arm randomised controlled trial. Older people with multimorbidity were recruited from a community healthcare centre in Changsha, China. Participants were randomly allocated to either a control group receiving usual care (n = 14), or to an intervention group receiving three face-to-face medication self-management sessions and two follow-up phone calls over six weeks, targeting behavioural determinants of adherence from the Information-Motivation-Behavioural skills model (n = 14). Feasibility was assessed through recruitment and retention rates, outcome measures collection, and intervention implementation. Follow-up data were measured at six weeks after baseline using patient-reported outcomes including medication adherence, medication self-management capabilities, treatment experiences, and quality of life. Preliminary effectiveness of the intervention was explored using generalised estimating equations. Results Of the 72 approached participants, 28 (38.89%) were eligible for study participation. In the intervention group, 13 participants (92.86%) completed follow-up and 10 (71.42%) completed all intervention sessions. Ten participants (71.42%) in the control group completed follow-up. The intervention was found to be acceptable by participants and the intervention nurse. Comparing with the control group, participants in the intervention group showed significant improvements in medication adherence (β = 0.26, 95%CI 0.12, 0.40, P < 0.001), medication knowledge (β = 4.43, 95%CI 1.11, 7.75, P = 0.009), and perceived necessity of medications (β = −2.84, 95%CI -5.67, −0.01, P = 0.049) at follow-up. Conclusions The nurse-led medication self-management intervention is feasible and acceptable among older people with multimorbidity. Preliminary results showed that the intervention may improve patients’ medication knowledge and beliefs and thus lead to improved adherence.

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SHPA Standards of Practice for Drug Information Services

The Australian Journal of Hospital Pharmacy ◽

10.1002/jppr1999293171 ◽

1999 ◽

Vol 29 (3) ◽

pp. 171-176 ◽

Cited By ~ 10

Author(s):

◽

Judith M Bingham ◽

Helen Matthews ◽

Alan Saunders ◽

Graeme Vernon ◽

...

Keyword(s):

Drug Information ◽

Information Services ◽

Drug Information Services ◽

Standards Of Practice

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Abstract P112: Changes in Lifestyle Behavior to Reduce Uncontrolled Blood Pressure in the Faith Trial

Circulation ◽

10.1161/circ.131.suppl_1.p112 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Kristie J Lancaster ◽

Antoinette M Schoenthaler ◽

William Chaplin ◽

Gbenga Ogedegbe

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Medication Adherence ◽

Lifestyle Modification ◽

Intervention Group ◽

Black Americans ◽

Control Group ◽

Lifestyle Behaviors ◽

Uncontrolled Blood Pressure ◽

Faith Based

Introduction: Modifying lifestyle behaviors is a key method for controlling hypertension. This strategy is extremely important for hypertensive Black Americans, as they are more likely to have uncontrolled blood pressure (BP), have a higher risk of complications, and poorer outcomes. To address this need, we conducted a cluster-randomized controlled trial to reduce BP through lifestyle modification that was delivered by lay health advisors in Black churches. The Faith-based Approaches in the Treatment of Hypertension (FAITH) trial was designed to evaluate the effectiveness of a 12-week faith-based lifestyle intervention and subsequent 3-month motivational interviewing vs. health education control on BP reduction among hypertensive Black adults. This study examines the change in lifestyle behaviors during the trial from baseline to 6 months. Methods: We recruited 373 Black Americans with uncontrolled hypertension from 32 urban churches. BP was considered to be uncontrolled if systolic BP (SBP)≥140 mmHg or diastolic BP (DBP)≥90 mmHg, or DBP≥130 mmHg or DBP≥80 mmHg for participants with self-reported diabetes or kidney disease The primary outcome was within-participant change in BP from baseline to 6 months. Lifestyle data collected included the NCI fruit/vegetable intake screener and % calories from fat screener, the International Physical Activity Questionnaire (IPAQ), medication adherence, and measured height and weight. Results: Participants’ mean age was 63.4 y, 76.4% were female, and 96.1% reported being of African descent. The mean BMI was 32.1 kg/m2. At 6 months, the intervention was associated with significant reduction in SBP but not DBP compared with the control group (-16.0 mmHg vs -10.3 mmHg, p=0.017). There was no significant change in number of servings of fruits and vegetables consumed, minutes walked per day, or weight for either group. However, the intervention group had a slight but significantly greater decrease of 1.08 % calories from fat over time compared with the control (p=0.018), but that change was not related to change in SBP. Most notably, there was a significant months x treatment interaction on medication adherence the intervention group had a greater decrease in non-adherence score than the control (-0.84 vs -0.30, p=0.28). This improvement in adherence was related to decrease in SBP (p=0.019). Conclusion: Community-based lifestyle modification program led to significantly reduced systolic BP; and this intervention effect was mediated by improved medication adherence. However, the 12-week intervention resulted in little change in key diet and physical activity behaviors found in other trials to positively affect BP.

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