The Impact of Comprehensive Medication Review by Pharmacist in Hemodialysis Patients: A Quasi Experimental Interrupted Time Series Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 72
- 主要终点
- Changes in pharmacoadherence of patients requiring HD using electronic medication refill from baseline
研究概览
简要总结
Nonadherence to medications by patients requiring hemodialysis (HD) leads to unfavorable clinical outcomes.Limited data exist on the influence of pharmacists on pharmacoadherence by patients requiring HD. Therefore, we assessed the impact of patient-centered pharmacist care through the implementation of concepts of Medication Therapy Management (MTM) and motivational interview (MI) on pharmacoadherence and its outcomes in patients requiring HD.
详细描述
Patients were assessed at baseline for baseline characteristics, dialysis-related factors, and medications records
- Pharmacists conducted brief monthly interview for patients to assess the medications they are receiving
- A comprehensive interview for patients occurred at month 3 and 5 including concepts of MTM and MI
- MTM included a review of each participant's medications and personal medication record to identify the use of any over-the-counter medications, design of their medication-related action plan, formulation of specific therapeutic interventions, and referrals for discussion with their physician and subsequent documentation and follow-up. The therapeutic interventions accepted by the physician were further discussed with each patient/caregiver using the MI technique to encourage adherence and this discussion was documented in each patient's medication record.
- MI incorporated the main components reported in the literature: rolling with resistance; expressing empathy; avoiding argumentative behavior; highlighting the discrepancy between patients' current attitudes compared with the desired therapeutic goals; and empowering patients' self-efficacy
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Other
- 盲法
- None
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
- •Patients (≥18 years of age)
- •Outpatient HD for at least 3 months before the study period
排除标准
- •Patients who refused to participate in the study
- •Patients without the capacity to understand or take responsibility for their medications
研究组 & 干预措施
Eligible participants
The intervention of patient-centered pharmacist care included a comprehensive interview patients conducted at month 3 and 5 ,which included and reviewing all their medications using concepts of MTM and MI All study participants were assessed at baseline and on monthly basis for the changes in the study outcomes.
干预措施: Patient-Centered Pharmacist Care (Other)
结局指标
主要结局
Changes in pharmacoadherence of patients requiring HD using electronic medication refill from baseline
时间窗: Monthly and up to 6 months
Comparing changes in self-reporting of number of medications with electronic prescribing during each of the six interviews
Changes in pharmacoadherence of patients requiring HD through the control of serum phosphate level (mmol/L) from baseline
时间窗: Monthly and up to 6 months
Changes in surrogate laboratory pre-HD serum phosphate level (mmol/L) from baseline
次要结局
- Changes in Systolic blood pressure (SBP) control in mmHg from baseline as a independent surrogate marker for administration of medications(Monthly and up to 6 months)
- Changes in serum low-density lipoprotein (LDL) levels in mmol/L from baseline as an independent surrogate marker for the administration of medications(Monthly and up to 6 months)
- Changes in Number of Medication-related problems (MRPs) from baseline at month 3 and month 5(At month 3 and month 5 of the study)
- Types of Medication-related problems (MRPs)(Total study duration: from month 1 to month 6)
- Number of accepted therapeutic interventions by the pharmacist(Monthly and up to 6 months)