Effects of Pharmaceutical Pictograms on Medication Adherence in Elderly Patients with Chronic Diseases at Primary Health Care Center in Hat Yai, Songkhla

2021 ◽  
Vol 104 (3) ◽  
pp. 482-488

Objective: To compare drug adherence with or without pharmaceutical pictograms in the elderly with chronic diseases. Materials and Methods: The present study was a randomized controlled trial conducted between April 2019 and June 2019 at a primary health care center in Hat Yai, Songkhla, Thailand. The elderly patients with chronic diseases were randomly allocated to the experimental group (n=25) and the control group (n=25). The experimental group received pictogram labels, text labels, and verbal information on the consumption of medications from the pharmacist. The control group received text labels and verbal information from the pharmacist. Both groups received follow-up home visits two weeks later. Results: The present study results showed that medication adherence using pill counts in the experimental group was significantly higher than in the control group. The median medication adherence scores from pill counts was (interquartile range, IQR) 100 (100, 100) versus 95.56 (90.25, 100), respectively, p=0.011. The medication adherence with the medication taking behavior measure for Thai patients (MTB-Thai) significantly increased in the experimental group (100.0%) compared with the control group (45.8%) (p=0.0002). Conclusion: The present study showed that medication adherence is greatly improved when the medication instruction is supplemented with pictograms. Therefore, medication should include pictograms on labels to better convey medical instructions to elderly patients with chronic diseases. Keywords: Pharmaceutical pictograms, Medication adherence, Chronic disease, Elderly patients

2021 ◽  
Vol 32 (4) ◽  
pp. 577-582
Author(s):  
Mahacita Andanalusia ◽  
Yunita Nita ◽  
Umi Athiyah

Abstract Objectives Nonadherence to a long-term therapy, including diabetes mellitus, is one of the global problems that need to be overcome. This study aims to determine the effect of pillbox use and education by pharmacists toward medication adherence in patients with diabetes mellitus in a Primary Health Care Center in Mataram. Methods This research was an experimental research design with pretest-posttest with control group design. The study was conducted from October to December 2019 at Tanjung Karang Primary Health Care Center, Mataram. Measurement of adherence was done using the Adherence to Refill and Medication Scale questionnaire. The higher the score, the more nonadherence the patients. Patients were divided into three groups, which were the control group, educational intervention group, and pillbox and educational intervention group. Each group consisted of 11 patients. Results Patients’ medication adherence increased from 19.54 (SD 4.37) to 15.18 (SD 2.64) in the education and pillbox intervention group (p=0.004). Whereas, in the education and control group, the adherence did not provide a significant change (p>0.05). Based on the difference in adherence scores, it was known that what contributed to changes in compliance was refilling medicine and intentional nonadherence in taking medicine subscale (p=0.024). Conclusions Providing education and pillbox done by pharmacists at the Primary Health Care Center can increase adherence to the therapy of diabetes mellitus patients. Pharmacists at the Primary Health Care Center can use the intervention model to improve the level of adherence of patients with chronic illness.


Author(s):  
Mahacita Andanalusia ◽  
Umi Athiyah ◽  
Yunita Nita

Abstract Background The prevalence of diabetes mellitus continues to increase every year, including in Indonesia. To prevent complications of diabetes mellitus, patients need to adhere to therapy. The aim of this study was to assess patient adherence to diabetes mellitus drug therapy at Tanjung Karang Primary Health Care Center, Mataram. Methods A total of 60 participants were recruited in April–May 2019. The inclusion criteria of respondents were patients who were diagnosed with diabetes mellitus, treated at Tanjung Karang Primary Health Care Center for more than 1 month, and aged at least 18 years. Assessment of adherence to therapy was carried out using a validated questionnaire, which was the Adherence to Refill Medication Scale (ARMS) questionnaire. The scale used was the Likert scale (1–4) with a score range of 12–48. The higher the total score, the lower the compliance. Results The average age of the respondents was 54.97 years. The average ARMS score was 19.52 ± 5.688 with the lowest score of 12 and the highest score of 33. Among all respondents, only 8.3% had good adherence (total score of 12). Based on the subscales, the average score for refilling medicine and intentional nonadherence in taking medicine was 7.18 ± 2.383, the unintentional nonadherence in taking medicine was 8.13 ± 2.764, and the persistence in refilling medicine was 4.12 ± 1.738. Conclusions Patient medication adherence to the treatment of diabetes mellitus needs to be improved. An approach through healthcare professionals can be achieved so that the therapeutic outcome will be achieved.


2020 ◽  
Vol 11 (3) ◽  
pp. 4603-4607
Author(s):  
Muhammad Faisal ◽  
Rahayu Indriasari ◽  
Meta Mahendradatta ◽  
Rukman Abdullah ◽  
Masrianih ◽  
...  

Aloe is a medicinal plant in Indonesia, which is often used as traditional medicine. The purpose of this study was to find out the influence of Aloe juice administration on changes in lipid profile (HDL, LDL, Triglycerides) in East Pontianak Primary Health Care Center. This study used quasi-experimental. This study used sampling on 36 people in 2 groups. In the treatment group, there was Aloe juice administration of 250 ml/day for 15 days while in the control group there was no Aloe juice administration. HDL level in the intervention group had an increase of 14.89 mg/ whereas in the control group had an increase of 1.22 mg/, where there was no significant difference between the intervention group and control group (p> 0.05), LDL level in the intervention group had a decrease of 10.56 mg/ while the control group had a decrease of 5.94 mg/ where there was no significant difference between the intervention group and the control group (p> 0.05) and triglyceride level in the intervention group had a decrease of 8.78 mg/ whereas in the control group had a decrease of 3.50 mg/ where there was no significant difference between the intervention group and the control group (p> 0.05) which means intervention group and control group had no significant differences. The mean HDL level had an increase while the LDL level and triglyceride level had a decrease.


Author(s):  
Kastubi Kastubi ◽  
Minarti Minarti ◽  
Noer Saudah

Stress stimulates the sympathetic nervous encouraging the heart and cause an increasing blood pressure. Efforts to reduce hypertension pharmacological and non-pharmacological. Non-pharmacological experiment of which is hypnosis. The research objective was to analyze the decrease of stress to elderly hypertensive therapy with hypnotherapy. The research design used experimental pretest - Posttest with Control Group. The population were all the elderly with hypertension in the elderly health care center PacarKeling , and Kemayoran Surabaya with 35 elderlies. Number of sample 15 intervention group, 15 control group. The sampling technique used Simple Random Sampling. Variable intervention was therapeutic applications of hypnosis to elderly hypertensive. The dependent variable was the stress in elderly hypertensive. The statistical test used paired t-test. It showed changes in stress to the control group -7.33, while the experminent group amounted to 14.60. Results can reduce stress in the group treated with hypnotherapy an average decrease of 14.6. Results showed that there were differences in the level of stress control and experiment groups with significant value of p = 0.000 (p <0.05), The effect of hypnotherapy was also shown in the systolic blood pressure change between control and experiment groups showed a mean difference of ranks. In the control group 20.8, while in the experimental group 10.2. Mann Whitney test results obtained by the significant value of p = 0.000 (p <0.05) in mean systolic blood pressure differences between control and experiment groups. Hypnotherapy can reduce stress and blood pressure in the experiment group. Causes of stress on the individual such as physical pain, and the outside factor could be due to family problems, economic. Suggestions that hypnosis can be used as a new experiment method stress problem in the elderly


Author(s):  
RR Anugrah Wiendyasari ◽  
Hari Kusnanto ◽  
Tunjung Wibowo

ABSTRACTBackground: At the Community and Primary Health Care Center in Bantul, the number of paramedics receiving Integrated Management of Childhood Illness (IMCI) training is very limited and not evenly distributed. With the low number of IMCI trained officers, this affects the skill of the officers in conducting the IMCI. Fewer skills affect the handling of sick children including the recognition of general danger signs, classification, designing appropriate action, as well as providing treatment and counseling.Objective: This study aimed to know the effectiveness of IMCI Mini Training intervention to improve health workers’ skills in handling sick children with IMCI.Methods: This research was a quasi-experimental study with a non-equivalent pre-post control group design. The sample of this study was a group of health workers who implement IMCI in daily work at 20 Community and Primary Health Care Centers in Bantul. Data were collected by observing 20 health workers in the control group and 20 health workers in IMCI treatment group before and after receiving IMCI Mini Training. Data results were analyzed using univariate, bivariate and multivariate statistical tests.Results: Using t-test analysis the mean value of health worker’s pretest and posttest skill scores in implementing IMCI in control group showed no significant difference (p=0.857) while in the treatment group, the mean value of pretest and posttest score showed a significant difference (p=0.000). In the treatment group, the improvement of sign recognition skills was significant (p=0.000) compared with the classification (p=0.148), treatment (p=0.009), communication and counseling (p=0.005). Multivariate analysis of linear regression showed that IMCI Mini Training was significant in improving the skill of health workers (p=0.000) compared with variables: age (p=0.970), duty (p=0.425), IMCI training history (p=0.686), category of Community and Primary Health Care Center (p=0.409) and education (p= 0.474). IMCI Mini Training improved significantly the sign recognition skills (p=0.000), classification (p=0.001) as well as communication and counseling (p=0.011) but was not significant in treatment skill (p=0.093). IMCI Mini Training can be done in a shorter time and more interactive method by using ICATT.Conclusion: This study showed that IMCI Mini Training increased health workers’ skills in IMCI implementation with the advantages of shorter course time, lower cost, and more interactive methods. The IMCI skills were enhanced by the provision of IMCI Mini Training which includes skills in the recognition of common signs, classifications as well as providing appropriate communication and counseling.


Author(s):  
Kastubi Kastubi ◽  
Minarti Minarti ◽  
Noer Saudah

Stress stimulates the sympathetic nervous encouraging the heart and cause an increasing blood pressure. Efforts to reduce hypertension pharmacological and non-pharmacological. Non-pharmacological experiment of which is hypnosis. The research objective was to analyze the decrease of stress to elderly hypertensive therapy with hypnotherapy. The research design used experimental pretest - Posttest with Control Group. The population were all the elderly with hypertension in the elderly health care center PacarKeling , and Kemayoran Surabaya with 35 elderlies. Number of sample 15 intervention group, 15 control group. The sampling technique used Simple Random Sampling. Variable intervention was therapeutic applications of hypnosis to elderly hypertensive. The dependent variable was the stress in elderly hypertensive. The statistical test used paired t-test. It showed changes in stress to the control group -7.33, while the experminent group amounted to 14.60. Results can reduce stress in the group treated with hypnotherapy an average decrease of 14.6. Results showed that there were differences in the level of stress control and experiment groups with significant value of p = 0.000 (p <0.05), The effect of hypnotherapy was also shown in the systolic blood pressure change between control and experiment groups showed a mean difference of ranks. In the control group 20.8, while in the experimental group 10.2. Mann Whitney test results obtained by the significant value of p = 0.000 (p <0.05) in mean systolic blood pressure differences between control and experiment groups. Hypnotherapy can reduce stress and blood pressure in the experiment group. Causes of stress on the individual such as physical pain, and the outside factor could be due to family problems, economic. Suggestions that hypnosis can be used as a new experiment method stress problem in the elderly


2019 ◽  
Vol 1 (1) ◽  
pp. 40-47
Author(s):  
Sumitra Shrestha ◽  
Renu Karki ◽  
Mamita Ghimire

Background: Poor adherence (compliance) is common with antihypertensive medications among elderly patients. As the elderly people are prone to multiple comorbidities, they are at higher risk of polypharmacy and therefore may present with a higher risk of non-adherence to medications compared to the younger population. The study was conducted to investigate the impact of pharmacist counseling on medication adherence among elderly hypertensive patients. Methods: The elderly hypertensive patients who visited the out-patient department at Chitwan Medical College (CMC) between August to November 2018. The face-to-face interview was conducted among 332 elderly hypertensive patients, selected with the purposive sampling technique. A paired t-test was used to show the difference between pre-test and post-test medication adherence. Results: It was found that 13.85% of patients were poor adherent and 86.14% low adherent in the intervention and the control group. The major reason for non-adherence was found to be carelessness about taking medicine (97%). The adherence score for intervention group changed from 1.60±0.83 to 3.95±0.56 (p-value < 0.001) while in the control group the average score before and after follow up was 1.48±0.77 and 1.51±0.80 (p=0.373) respectively. Blood pressure status improved in the intervention group than the control group (p<0.001). Polypharmacy was 27.71%, 15.66% of whom experienced adverse drug reactions. Conclusion: The patient medication counseling had a good impact on hypertensive patients. All factors of the Morisky Green Levine adherence scale improved after counseling and motivation. Pharmacist-led counseling improved medication adherence among elderly hypertensive patients. Keywords: Blood Pressure, Counseling, Elderly, Hypertension, Medication Adherence, Pharmacist


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