Impact of Clinical Pharmacist Intervention on Medication Adherence and Its Association with Clinical Outcomes in Chronic Kidney Disease in Islamabad
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 130
- 试验地点
- 1
- 主要终点
- Patients Medication Adherence.
研究概览
简要总结
The purpose of this research study is to evaluate the impact of clinical pharmacist interventions on treatment outcomes, health-related quality of life (HRQoL),and medication adherence among chronic kidney disease patients.
Pharmacist's intervention aim to answer:
- How a clinical pharmacist intervention program impact medication adherence in chronic kidney disease?
- To assess how patients' counseling and medication adherence impact patient health-related quality of life?
- How a clinical pharmacist intervention program improves clinical outcomes of chronic kidney disease patients?
详细描述
This is a randomized, pharmacist-led, two-group, longitudinal descriptive intervention study performed at a private hospital nephrology department. The study included the introduction of clinical pharmacist interventions to improve adherence to prescribed medications, health-related quality of life, and clinical outcomes in patients with Chronic Kidney Disease(CKD).
Recruited patients were randomly divided into two groups; the basic intervention group and the advanced intervention group.
The basic intervention group received routine counseling. An advance intervention group was provided in addition to the usual counseling, education about Chronic Kidney Disease, hypertension or other comorbidity and management, as well as medication adherence, and renal diet (educational infographic for Chronic Kidney Disease patients) at three follow-up intervals after every 2 months. Both groups were followed up for a period of 6 months.
Pre-validated questionnaires will be used for the assessment
- Medication Adherence Rating Scale (MARS): to evaluate medication adherence
- MOS 36-Item Short Form Survey Instrument (SF-36): For evaluation of health related quality of life.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Single (Participant)
盲法说明
Patients were not informed of which groups they belonged to and what type of intervention is provided.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •All male and female inpatients and outpatients with chronic kidney disease defined as a creatinine clearance (CrCl) less than 60 ml/min/l, 73 m2
- •over the age of 18 years , will be included in study.
- •Patient who are on maintenance hemodialysis also included.
排除标准
- •Patients with acute renal failure
- •Patients who are receiving renal transplants will not be included.
- •Patients who will refuse to participate in study will not be included.
研究组 & 干预措施
Basic
Basic intervention included the usual counselling by a clinical pharmacist e.g.
- Patients Education
- Pharmacist counseling regarding their disease type and severity
- Pharmacist counseling (15- to 20-minute sessions) on the proper use of medication
- Pharmacist counseling regarding the importance of their therapy (treatment)
- Labeling of medication packs to assist pill sorting. Labels included instructions on dose and frequency/ timing of medication doses
- Optimizing therapy monitoring
- Prescription information quality (incomplete prescription)
- wrong dose
- wrong frequency etc.
干预措施: Pharmacist counselling (Behavioral)
Advanced
In addition to Basic Intervention:
- Preventing drug interactions :
• Detection or assessment of potential DDIs by a pharmacist prior to the start of treatment and recommendations for their management. 2. Patient Education regarding Medications :
- Pharmacist counseling (15- to 20-minute sessions) on the proper use of medication.
- Pharmacist counseling on the safe use of medication (self-medication or over-the-counter [OTC] medicines)
- Preventing an adverse drug event
• Monitoring, and prompt detection of adverse drug events (ADEs) 4. Education on lifestyle modifications
- Education on lifestyle e.g. regarding exercise
- Renal diet plan will be given to patients
- Renal Dose Adjustments :
- Detection or assessment of potential nephrotoxic drugs by a pharmacist prior to start of treatment and recommendations for their renal dose adjustment.
干预措施: Pharmacist counselling (Behavioral)
结局指标
主要结局
Patients Medication Adherence.
时间窗: 6 months
The primary aim of this study will be to evaluate the effectiveness/impact of a clinical pharmacist intervention program on medication adherence in chronic kidney disease. Adherence will be measured using Medication Adherence Repoting Scale (MARS-10). This scale describes three-dimension ,medication adherence behaviour (1-4),attitude towards taking medication (5-8),negative side effects and attitudes to psychotropic medication (9-10). Each question has Yes and No response, a response with medication adherence coded as 1 and with non-adherence coded as 0. higher the score higher will be adherence and vice versa.score \<6 showes poor adherence and \> 8 showes good adherehnce.
Health related Quality of Life
时间窗: 6 months
Patients health related quality of life will be assessed using pre-validated tool RAND-36
次要结局
- Serum Creatinine(6 months)
- Haemoglobin(6 months)
- Blood Pressure(6 months)
研究者
Matti Ullah
Assistant Professor
Hamdard University