To evaluate the effects of pharmaceutical care on selected humanistic outcomes in patients with hypertension or chronic obstructive pulmonary disease (COPD).
Clinic patients with hypertension or COPD were randomly assigned to a treatment group (pharmaceutical care) or a control group (traditional pharmacy care) over a six-month period. Clinical pharmacists and pharmacy residents conducted the protocols. There were 133 evaluable patients (63 treatment, 70 control) in the hypertension study arm and 98 evaluable patients (43 treatment, 55 control) in the COPD study arm. The Pharmaceutical Care Questionnaire evaluated patient satisfaction with care. Tests specific to the disease states assessed disease and disease management knowledge. Quality of life (QOL) was evaluated using the Health Status Questionnaire 2.0 (HSQ 2.0) in the COPD arm; in the hypertension arm, the Hypertension/Lipid TyPE Specification Form 5.1 was used.
Ambulatory care centers of 10 Department of Veterans Affairs (DVA) medical centers and 1 university medical center.
Patient-centered pharmaceutical care model (employing standardized care) implemented by clinical pharmacy residents.
Satisfaction with pharmaceutical care, disease and disease management knowledge, and QOL.
Statistically significant differences in most satisfaction items were found, with treatment patients expressing greater satisfaction. Treatment groups in both arms strongly agreed that pharmacists helped them with confidence in use of their medication and understanding of their illness, gave complete explanations about their medications, made them feel that their care was a priority, and followed up on their questions and concerns. In the hypertension arm, treatment patients demonstrated significant increases in knowledge scores. Trends in QOL were positive for both hypertension groups, with a significant decrease found in number of treatment patients reporting problems with sexual function. In the COPD arm, improvement trends were significantly stronger for treatment patients.
Although patients were not dissatisfied with traditional pharmacy care, they were more satisfied overall with the pharmaceutical care model.
"We hypothesized that consultations would increase adherence as had been previously reported. Gourley et al., for example, showed that for hypertensive patients receiving five consultations over a period of 6 months was more effective on adherence and general health than receiving just two consultations in the same time period . One explanation for why our results did not match those of Gourley et al. could be that there was only one consultation in our study. "
[Show abstract][Hide abstract] ABSTRACT: To evaluate the use of patient self-completion concordance forms and to determine the effect of patient counselling by using concordance forms on adherence to chronic medication.
Patients with a prescription for new chronic treatment were randomised in an intervention or control group. The intervention group received a concordance form to fill in at home and to discuss during a consultation 2 weeks later in the pharmacy. The control group received the usual information and instruction on how to use the medicine. Afterwards, all patients were asked to fill in a questionnaire about their use of medicines and contact with the pharmacy employees. Adherence to the medicine was determined using rates of prescription refills after 6 months of use.
The questionnaires showed that patients were satisfied about the concordance model. After 6 months of use, 79% of the patients from both intervention and control group were defined as adherent.
There was no significant difference found in adherence between intervention and control group.
Use five selected questions from the concordance form which provided most answers. Focus on one drug group and have more consultation moments.
[Show abstract][Hide abstract] ABSTRACT: Summary Clinical Pharmacy, also called Pharmaceutical care, aims to maximise therapeutic effect, to minimise risk, to minimise cost, and to respect patient choice. North American countries and the United Kingdom have a large experience of pharmaceutical care, and this service is complementary to the activities performed by physicians, nurses, and other healthcare professionals. Experimental studies have shown that clinical pharmacy brings a definite added value in terms of the quality of use of medicines in various settings (hospitals, retail pharmacies, and outpatient clinics. These studies also demonstrate the economical bene- fits of pharmaceutical care. Clinical phar- macy is now under development in Belgium, and the pilot projects launched since 2000 have been well accepted. This has triggered the University Hospitals and the Faculties to launch actions oriented towards both edu- cation and research. Changes introduced in the educational curriculum of pharmacy students make them more alert to their future pharmaceutical care activities. A specific post-graduate program is now developed and implemented in two universities. The profes- sional organizations also organize postgradua- te training in pharmaceutical care. In the near future, an official recognition at the National level will be important to create the necessary framework in which Clinical Pharmacy can develop in Belgium. The combination of our local experience with the demonstrated advantages of Clinical Pharmacy (as seen from foreign studies) makes this project more and more realistic in our country. La pharmacie clinique, encore appelée "soins pharmaceutiques", vise à assurer une thérapie médicamenteuse sûre, efficace, et d'un bon rapport coût/bénéfice, tout en respectant les choix du patient. L'Angleterre, les Etats-Unis et le Canada ont une grande expérience des soins pharmaceutiques. La pharmacie clinique y est un élément complémentaire et souvent jugé essentiel aux soins prodigués par les médecins et le personnel infirmier. Les études montrent que la mise en place de services de pharma - cie clinique apporte une valeur ajoutée réelle tant en milieu hospitalier que dans le cadre des officines ouvertes au public et des consultations pharmaceutiques pour patients ambu -
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