Prescription Analysis, Drug Interaction Checking And Impact Of Patient Counseling By A Clinical Pharmacist In Type Ii Diabetes Mellitus Patients In A Tertiary Care Hospital-A Prospective Study

Objective: To evaluate the clinical pharmacist role in the prescription analysis, drug interaction and the impact of patient counseling in type 2 diabetes mellitus patients. Methods: A prospective study was conducted in 203 type II Diabetes Mellitus patients for a period of 6 mo in the Diabetology department. Prescriptions were analyzed and self-care assessment for good health practices were collected using a questionnaire and the adherence scores were calculated. Patient counseling was provided to the patient and a follow up was done using the same self care assessment questionnaire. Results: Out of 203 patients, 86 multiple therapy, 68 dual therapy and 49 monotherapy were observed. Glimepiride+Metformin (54), a combination of short acting and intermediate-acting insulin (41) was the most commonly prescribed drugs. Out of 1102 drugs, 488 were anti diabetic drugs, 35 were antibiotics, 579 were other drug classes prescribed. The drug interactions were reported. The adherence score shows a highly significant impact after counseling. Conclusion: The results of the current study helps to understand the changes in prescription pattern, drug interactions and the impact of patient counseling by a clinical pharmacist.

Clinical Pharmacist-Led Program On Medication Reconciliation And Patient Counseling In The Department Of Gastroenterology

Objective: To study the effects of medication reconciliation and patient counseling on the overall health benefits of the patients in the department of gastroenterology. Methods: This study is a prospective interventional study, was conducted in a 500 bedded MNR Hospital. The sample size taken was 150 patients and the study population comprised of patients aged 18-80 y, admitted in the hospital during the study period of six months. Results: Out of 150 patients, there were 98 (65.33%) male patients and 52 (34.67%) female patients. Patients between 18 and 30 y of age were 29(19.33%), between the age of 30 and 50 y were 71 (47.33%) and above 50 were 50(33.33%). Pancreatitis was most prevalent with 21% of total prevalence, followed by CLD and cholelithiasis with 17%, then IBD 16%, PUD and Gastritis 5%, GERD 4% and other diseases 15%. Conclusion: The basic role of the pharmacist, is to help in minimizing the errors and to perform medication reconciliation. In patient counseling, pharmacists provide information about the disease, and the medications to increase patient safety and the changes in the behavior for the better outcome.

Managing gestational diabetes: the role of patient counselling

Background: Unmanaged gestational diabetes mellitus (GDM) increases the risk of neonatal and fetal complications and the risk of congenital malformations. Apart from the medications used, non-pharmacological agents such as diet modification, exercise, and patient education can improve the quality of life in GDM patients. The present study was aimed to evaluate the role of patient counselling in the management of GDM in patents.Methods: Unmanaged gestational diabetes mellitus (GDM) increases the risk of neonatal and fetal complications and the risk of congenital malformations. Apart from the medications used, non-pharmacological agents such as diet modification, exercise, and patient education can improve the quality of life in GDM patients. The present study was aimed to evaluate the role of patient counseling in the management of GDM in patents.Results: The result showed that there is a slight increase in the QOL of test population with GDM. i.e., there is no significant progression in the disease condition. The result showed that each domain, physical, psychological, social and environmental conditions were improved a lot when compared with the control group.Conclusions: Results suggests a positive impact of patient counseling on the management of GDM in patients.

Evaluating effectiveness of patient counseling, teach back versus standard method

Background: The aim of the study was to assess memory retention of new prescription education by comparing Teach back method and standard counseling method. And also to evaluate association of age, sex, drug use in past and education in memory retention.Methods: A prospective experimental study was carried out for a period of six months. Eligible subjects visiting pulmonary medicine outpatient department were screened and grouped into standard groups and teach back group. Patients in the standard group are taught eight counseling points about the drugs by one way dialogue method and asked at the end if there are any questions. while patients in the teach back method builds on the standard method by asking three open ended questions to recall what was taught and correcting any misunderstandings by two way dialogue method.Results: The demographic information (age, sex, education, current prescription use) are collected from both groups. The post counseling score is assessed by evaluator using a scoring sheet. Scores were analyzed using Mann Whitney U test Teach back group shows statistically significant (p value = 0.0001) increase in score compared to standard group. The mean value of teach back scoring is 6.28 while that of standard is 4.44.Conclusions: All the demographic parameters (Age, sex, drug use in past three months and education) do not show any significant association with scoring and memory retention (p value >0.05 for chi square test). The group that received teach-back method of counseling showed a significant improvement in patient knowledge and memory retention.

Reliability of “Google” for obtaining medical information.

Internet is used by many patients to obtain relevant medical information. We assessed the impact of “Google” search on the knowledge of the parents whose ward suffered from squint. In 21 consecutive patients, the “Google” search improved the mean score of the correct answers from 47% to 62%. We found that “Google” search was useful and reliable source of information for the patients with regards to the disease etiopathogenesis and the problems caused by the disease. The internet‑based information, however, was incomplete and not reliable with regards to the disease treatment.

Challenges in Patient Counseling and Medication Reconciliation for Foreign Inpatients in Korea

OBJECTIVE: This study is to evaluate the awareness, needs, and barriers in patient counseling for hospitalized foreign patients. As the number of foreign population increases in Korea, demands on quality of Korean health services are rapidly increasing. Previously most of the studies have focused on the availability and utilization of healthcare service, and prevalence of disease for foreigners, however, no study has been conducted on quality of direct-patient care such as patient counseling. METHOD: In the present study, a survey was conducted on a total of 161 participants between March 7 and May 7 in 2014. The study subjects were consisted with 103 foreign patients who had experienced inpatient care within 1 year and 58 hospital pharmacists who work in the hospital with foreign inpatients. RESULTS: Firstly, the hospital pharmacists were highly aware of the necessity of counseling for foreign inpatients. Secondly, the largest portion of barrier to patient counseling service was accounted a lack of foreign language skills. Lastly, the monitoring of efficacy, potential adverse reactions and discharge follow-up were emphasized. CONCLUSION: Effective communication skills would be essential to improve pharmaceutical care services to foreign inpatients.

Evaluating the Rationality of Antibiotic Dispensing in Treating Common Cold Infections among Pharmacists in Baghdad – Iraq.

Background: Common cold is a self limited viral infection, which can be treated symptomatically without the need to antibiotics which are not effective or curative. This study aimed to evaluate the practices of community pharmacists in communicating, diagnosing, treating and counseling patients who are requesting antibiotics for their common cold treatment. Methods: A cross-sectional pilot exploratory study was done in Baghdad – Iraq at which a pharmacist acts as simulated person (SP) in order to collect the data. SP asks the pharmacist about the strongest antibiotic for common cold. SP observed and explored adherence of the pharmacist to law in dispensing over the counter (OTC) and prescription only medications (POM) drugs, patient’s counseling standards, and symptomatic diagnosis of common cold through using WWHAM (who is the patient, what are the symptoms, for how long, any action taken, any medication taken) technique. Results: More than 60% of pharmacists had failed to use WWHAM technique as a method for probing information about the patient and his/her case history. Furthermore there is a significant lack for asking the patients about their past medical history and drug allergy. 45% of Iraqi pharmacists supplied the SP with antibiotic for his common cold. Amoxicillin was the most commonly supplied (44.4%) antibiotic for common cold. Patients' counseling by pharmacists was mostly about the frequency of drug dosing. Conclusion: There are insufficient clinical and communication skills for Iraqi pharmacists who work in community pharmacies, this result not only in an irrational antibiotic dispensing but also in poor pharmacist's ability to counsel and educate the patient about the proper use of the dispensed medications.

Pharmacists’ Perceived Barriers to Patient Counseling.

The aim of this study was to investigate the prevalence and nature of patient counseling barriers as perceived by pharmacists. The data was collected by adding a question about the existence and nature of counseling barriers, if they exist, to the standard patient counseling form used by pharmacists. The prevalence of counseling barriers was 12.5%. The major counseling barrier was counseling the caregiver instead of the patient (27.8%), followed by low level of education, lack of privacy, lack of interest/time and partial consciousness of the patient (16.7% each) and hearing impairment (11.1%). Finally gender and delay of discharge order were the least reported (5.26% each). This study recommends that a special counseling protocol should be implemented for patients with low level of education and partial hearing impairment and that a proper setting for counseling and strict implementation of policies should be provided by the institution.

Knowledge, attitude and practice of patient medication counseling among drug dispensers in North West Ethiopia.

Patient medication counseling on dispensing of medicines should give the patient clear and complete instructions on how to take or use drugs. The way drugs are taken by the patient is often influenced by the way drugs are dispensed and the type of information given during dispensing. The objective of this study was to assess drug dispensers’ knowledge, attitude and practice of patient medication counseling in drug retail outlets of Gondar and Bahir Dar towns. A cross-sectional study was conducted on patient medication counseling by using a self-administered semi-structured questioner. The questionnaire was distributed to dispensers to fill in their home or at their free time and collected in the next day. Data were analyzed using SPSS for windows version 16.0. Forty (62.5%) of the dispensers believe that patient counseling is a shared responsibility of pharmacy professionals and physicians. Only 29.7% of the dispensers always update their knowledge on drugs and their most frequent source of drug information on drugs were leaflets. Forty nine (76.6%) of dispensers respond as they know the formal way and the information included in patient counseling. Lack of adequate knowledge on drugs and up-to-date drug information was major factor that prevent dispensers from counseling patients. Most of the dispensers are not accessible to up-to-date drug informations. The dispensers give less counseling. Lack of knowledge and update drug information was the major barrier of patient medication counseling dispensers faced. Formal education should include patient counseling and continuous training should be given to increase dispensers’ knowledge on patient counseling. Up to date and relevant drug information sources should be given to dispensers.