Efeito do aconselhamento farmacêutico na adesão à medicação do paciente e na erradicação do Helicobacter Pylori em pacientes ambulatoriais jordanianos / Effect of pharmacist counseling on patient medication compliance and helicobacter pylori eradication among jordanian outpatients

ABSTRACT Background: To examine the impact of pharmacist counseling and follow-up on patient's medication compliance and Helicobacter Pylori (H. pylori) eradication and evaluate the efficiency of an eradication regimen consisting of Clarithromycin 500 mg, Amoxicillin 1 g, and Lansoprazole 30 mg, twice daily for 14 days. Methods: Two hundred patients undergoing endoscopy and positive rapid urease tests were included in the present study. Patients were randomly divided into two groups: an intervention group (n=100) and a control group (n=100). The intervention patients obtained their medications from the hospital pharmacist and received sufficient counseling and follow-up. On the other hand, the control patients received their medications from another hospital pharmacist and went through the routine hospital procedure without good counseling and follow-up. Results: The intervention resulted in a statistically significant improvement in outpatient compliance with medication (45.0% vs 27.5%; P<0.05) and eradication of H. pylori (28.5% vs 42.5%; P<0.05) among those patients. Conclusion: This study reflects the importance of pharmacist counseling and patient compliance to medication, as the patients who received pharmacist counseling exhibited perfect compliance to medication, which led to the successful eradication of H. pylori.

RESUMO Contexto: Analisar o impacto do aconselhamento e acompanhamento farmacêutico na adesão medicamentosa do paciente e na erradicação do Helicobacter Pylori (H. pylori) e avaliar a eficiência de um regime de erradicação composto por Claritromicina 500 mg, Amoxicilina 1 g e Lansoprazol 30 mg, duas vezes ao dia por 14 dias. Métodos Duzentos pacientes submetidos à endoscopia e testes rápidos de urease positivos foram incluídos no presente estudo. Os pacientes foram divididos aleatoriamente em dois grupos: um grupo intervenção (n=100) e um grupo controle (n=100). Os pacientes de intervenção obtiveram seus medicamentos do farmacêutico do hospital e receberam aconselhamento e acompanhamento suficientes. Por outro lado, os pacientes do grupo controle receberam seus medicamentos de outro farmacêutico hospitalar e passaram pelo procedimento hospitalar de rotina sem um bom aconselhamento e acompanhamento. Resultados: A intervenção do farmacêutico resultou em melhora estatisticamente significativa na adesão ambulatorial à medicação (45,0% vs 27,5%; P<0,05) e na erradicação de H. pylori (28,5% vs 42,5%; P<0,05) entre esses pacientes. Conclusão Este estudo reflete a importância do aconselhamento farmacêutico e da adesão do paciente à medicação, uma vez que os pacientes que receberam aconselhamento farmacêutico apresentaram perfeita adesão à medicação, o que levou à erradicação bem-sucedida da H. pylori.

Evaluation of the patient medication counseling services in the Philippine General Hospital using the CIPP model

@#<p style="text-align: justify;"><strong>Objectives.</strong> The patient medication counseling (PMC) services at Philippine General Hospital (PGH) started 21 years ago. While several changes have been incorporated into the program, no formal evaluation has been conducted to date. The objective of this evaluation was to assess the relevance, usefulness, responsiveness, acceptability, efficiency, impact, and sustainability of the service using the context, input, process (CIPP) model of Stufflebeam.</p><p style="text-align: justify;"><strong>Methods.</strong> The study utilized a mixed-methods study design. Interviews and surveys were conducted on pharmacist-counselors, a purposive sample of doctors, nurses, and other stakeholders. A review of records from the Department of Pharmacy of UP College of Pharmacy (UPCP) and PGH, such as patient and student satisfaction surveys and monthly reports of counseled patients served from 2015 to 2019, was conducted. The results were analyzed using descriptive statistics for quantitative data and content analysis for qualitative data.</p><p style="text-align: justify;"><strong>Results.</strong> Context evaluation revealed that the establishment of PMC resulted from informal interactions with hospitalized patients due to incorrect use of prescription medicines. Correct information was envisioned to address the irresponsible use of medicines. The input evaluation revealed that only 24% (N=75) of the pharmacists are involved in PMC, which comprise only 10% of their workload. There was also a lack of comprehensive training for counseling and insufficient physical facilities. The process evaluation identified lack of time (94%) as a significant limiting factor for the involvement of pharmacists in PMC. The interns became an additional workforce for the service, but scheduling and the consistent availability of both students and faculty-preceptors were experienced. The product evaluation revealed positive perceptions among the pharmacists, faculty, and student interns. From the patient satisfaction survey records of 5,071 patients counseled, 98 to 100% expressed high service satisfaction, and 100% were likely to recommend PMC to other patients. The pharmacists, interns, and faculty-preceptors suggested that PMC improved their confidence, communication skills, and decision-making.</p><p style="text-align: justify;"><strong>Conclusion.</strong> The PMC service is relevant and valuable to ensure patients' rational and quality use of medicines. As a value-added service to existing hospital pharmacy services, it serves as a venue for enhancing soft skills among pharmacists and students alike. However, physical and human resources and current processes need to be upgraded to improve efficiency, ensure sustainability, and expand service coverage to more patients.</p>

Consejos farmacéuticos a pacientes con trastornos de humor / Pharmacist counseling for patients with mood disorders

Introducción: la atención farmacéutica consiste en la interacción directa del farmacéutico con el usuario a fin de lograr una farmacoterapia racional y obtener resultados definidos y mensurables, encaminados a la mejoría de la calidad de vida del paciente. La depresión es considerada una de las diez principales causas de incapacidad en el mundo, la cual limita el funcionamiento físico, personal y social. Sin embargo, pocas personas afligidas con estos problemas de salud reciben el tratamiento adecuado y orientaciones acerca de la enfermedad y tratamiento. Objetivo: evaluar el servicio de la atención farmacéutica mediante consejo farmacéutico sobre la efectividad y adhesión a la farmacoterapia. Métodos: se seleccionaron 19 pacientes, con edad entre 15 y 82 años, con trastornos de humor, atendidos en el Centro de Atención Psicosocial y Ambulatorio de UNIFENAS, Brasil. Se realizaron citas domiciliares, durante las cuales se les dieron a los pacientes orientaciones acerca de la enfermedad, reacciones adversas, interacciones medicamentosas, duración del tratamiento e importancia de adhesión a este. El inventario de depresión de Beck y la prueba de Morisky para evaluar la adhesión fueron aplicados antes y después del consejo farmacéutico. Resultados: la mayoría fueron mujeres, católicas, con hasta nueve años de estudio. Al comparar los resultados de la aplicación del inventario de depresión de Beck antes y después del consejo del farmacéutico, hubo una diferencia estadísticamente significativa (p= 0,0354), con reducción de aproximadamente 6 puntos en el escore de Beck (24,22 para 18). El nivel de adhesión entre los pacientes aumentó, pues el número de pacientes con alta adhesión pasó de 21,06 por ciento a 42,10 por ciento. Conclusiones: los resultados sugieren que el consejo farmacéutico puede ser útil para lograr mejores resultados de adhesión y efectividad al tratamiento(AU)

Introduction: pharmaceutical care is the direct interaction of the pharmacist and the user in order to achieve rational drug therapy and to obtain defined measurable results aimed at improving the life quality of the patient. Depression is considered one of the ten main causes of disability worldwide since it restricts the physical, social and personal functioning of the individual. However, few people having these health problems receive proper treatment and directions about their disease and therapy. Objective: to evaluate the pharmaceutical care service through counseling on the effectiveness of and adherence to drug therapy. Methods: nineteen patients were selected, aged 15 to 82 years and with mood disorders. They were all seen at the Psychosocial and Outpatient Care Center of UNIFENAS in Brazil. They were visited at home to give instructions to them about their disease, adverse reactions, and drug interactions, length of treatment and importance of adherence to therapy. Beck depression inventory and Morisky´s test were used to evaluate adherence to treatment before and after the pharmacist counseling. Results: most of patients were Catholic women, who had been under study for up to 9 years. When comparing the results of the application of the Beck depression inventory before and after the pharmacist counseling, there was observed an statistically significant difference ((p= 0.0354), with a reduction of roughly 6 point in Beck´s score (24,22 for 18). The adherence to treatment rate increased since the number of patients who showed high rate of adherence to therapy rose from 21.06 percent to 42.10 percent. Conclusions: the results suggest that the pharmacist counseling could be a useful method to achieve better outcomes in adherence to and effectiveness of treatment(AU)