Effect of Pharmaceutical Care with Empowerment in Type 2 Diabetic Patients at Mettapracharak (Watraikhing) Hospital
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Abstract
Introductions: Empowerment process allows diabetic patients to discover their potential to control the disease and to increase their cooperation in the treatment while pharmaceutical care helps to find and solve drug therapy ploblems. Together, pharmaceutical care with empowerment may more effectively improve blood sugar control in diabetic patients with uncontrolled high blood sugar. Purpose: To compare clinical outcomes i.e. HbA1c and fasting plasma glucose (FPG), medication adherence, general knowledge about diabetes and quality of life in diabetic patients before and after a pharmaceutical care program with empowerment. Method: This one group pretest-posttest study was conducted in diabetic patients with HbA1c > 7% during April to December 2015. Twenty-nine outpatients were purposively recruited from diabetes mellitus clinic and were provided with a pharmaceutical care program based on Gibson’s empowerment framework. The program activity consisted of medication review for finding drug therapy problems and empowerment processes in four steps including 1) discovering reality, 2) critical reflection, 3) taking charge, and 4) holding on. Each visit was at least 1 month apart according to the doctor ‘s appointments. The main outcome was HbA1c. Medication adherences were determined using both percent pill count and Morisky Medication Adherence Scale-4 items or MMAS-4. General diabetes knowledge was measured by Supakit Wongwiwatthananukit ‘s quesionnaire and quality of life by Thai version of Diabetes-39 quesionnaire or D-39. Results: The mean HbA1c and FPG were significantly decreased from 9.4% to 8.0% and from 232 to 173 mg/dL. at the end of study, respectively (p < 0.001). In accordance with HbA1c and FPG, the medication adherence was significantly increased from 75% to 91% by average percentage pill count and from 1 to 4 by median MMAS-4 scores. The mean patient’s diabetes knowledge score was also increased from 15 to 21 (p < 0.001 for all tests). In addition, the D-39 quality of life scores were significantly improved in all 4 dimensions (p < 0.001) except sexual behavior dimension. Conclusion: The pharmaceutical care service with empowerment framework might help improve blood glucose control, medication adherence, general diabetes knowledge and quality of life in type 2 DM patients with high blood sugar.
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References
Aekplakorn W, Chariyalertsak S, Kessomboon P, et al. The Thai National Health Examination Survey IV Study Group. Prevalence and Management of Diabetes and Metabolic Risk Factors in Thai Adults: The Thai National Health Examination Survey IV, 2009: Diabetes Care ; 2011.
Amklang W, Muangsom N. Effectiveness of an Empowerment and Social Support Program on Self-Care in Diabetes Mellitus Type 2 Patients in Nongrua District, Khon Kaen Province. KKU Research Journal (GS) 10(4): October- December 2010. 87-96.
Balkrisnan R, Rajagopalan R, Camacho FT. Predictors of Medication Adherence and Associated Health Care Costs in an Older Population with Type 2 Diabetes Mellitus : a Longitudinal Cohort Study. Clin Ther 2003; 25(11): 2958-71.
Beckman HB, Frankel RM. The Effect of Physician Behavior on The Collection of Data. Ann Intern Med 1984; 101: 692-6.
Boonyuen N. The Effect of Empowerment Process on Self-Care Behaviors and Levels of Hemoglobin A1c in Elderly Diabetic. [Master of Nursing Science thesis]. Phitsanulok: Naresuan University; 2006.
Buraphan R, Muangsom N. Factors Affecting Uncontrolled Type 2 Diabetes Mellitus of Patients in Sangkhom Hospital, Udonthani Province. KKU Journal for Public Health Research 2013; 6 (3): 102-109.
Bureau of Non Communicable Disease. Non-Communicable-Disease-Data [Online]. 2013 [Cited 2015 DEC 20].Available from: http://www.thaincd.com/information-statistic/non-communicable-disease-data.php.
Chareansakkajon P. The Effect of Family Empowerment on The Diabetic Type 2 Patients’ HbA1c Levels, Readmission , Caregivers’ Powerlessness and Caring Behaviors. [Master of Nursing Science thesis]. Khon Kaen: Khon Kaen University ; 2007.
Choe HM, Mitrovich S, Dubay D, et al. Proactive Case Management of High-Risk Patients with Type 2 Diabetes Mellitus by a Clinical : A Randomized Controlled Trial. Am J Managed Care 2005; 11: 253-60.
Choowattanapakorn T, Suriyawong S. The View of Illness among Older Persons with Diabetes Mellitus. TJN C 2011; 26(4): 96-107.
Department of Medical Records. Mettapracharak (Watraikhing Hospital).
Gibson GH. The Process of Empowerment in Mothers of Chronically Ill Children. JAN 1995; 21(2): 1201-1210.
Gibson GH. A Concept Analysis of Empowerment. JAN 1991; 16 (2): 354-361.
Helper CD, Strand LM. Opportunities and Responsibilities in Pharmaceutical Care. Am J of Hos Pharm 1990; 47(3): 533-543.
International Diabetes Federation (IDF). Diabetes Atlas Seventh Edition [Online]. 2015 [Cited 2015 DEC 20] Available from: http://www.diabetesatlas.org/.
Jaturapattarapong W, Sakthong P. Outcomes of Medication Management in Diabetic Outpatients. TPHSJ 2013; 8(4): 133-142.
Kerdsiri K. The Influence of Risk Factors for Drug-Related Problems on Clinical Outcomes in Diabetic Out Patients at Mahasarakham Hospital. [Master of Pharmacy]. Bangkok: Chulalongkorn University; 2006.
Khoyun S. Effects of Empowerment in Patients with Diabetes Melitus Type 2 and Their Families on Their Perception of Control in Illness Management. [Master of Nursing Science thesis]. Khon Kaen: Khon Kaen University; 2007.
Kozma CM, Reeder CE, Schulz RM. Economic Clinical and Humanistic Outcomes: A Planning Model for Pharmacoeconomic Research. Clin Ther 1993; 15(6): 1121-1132.
Mahawarakorn S. The Effectiveness of The Empowerment to Control Blood Sugar on Personal Self-Care with Diabetes Mellitus Type 2, and Complication Patients, Udornthani Hospital, Udornthani Province. [Master of Public Health thesis]. Khon Kaen : Khon Kaen University; 2008.
Muangkum A, Suttajit S. Effect of Patient Empowerment on Self-efficacy, Adherence and Glycemic Control in Patients with Type 2 Diabetes.TPHSJ 2013; 8(3): 104-111.
Odegard PS. Caring for Poorly Controlled Diabetes Mellitus: A Randomized Pharmacist Intervention. Ann Pharmacother 2005; (39): 433-440.
Pavasudthipaisit A, Awiphan R, Niwatananan K, et al. Explanatory Model for Caring Diabetic Patients by Clinical Pharmacists. THJHP 2009; 19(1): 28-42.
Poolsup N, Auyprasert P. Impact of Pharmaceutical Care on The Number of Drug-Related Ploblems and Fasting Plasma Glucose in Diabetic Patients. SWUJ Pharm Sci 2015; 10(1): 10-16.
Poolsup N, Luckanajantachote P, Suksomboon N, et al. Impacts of Self-efficacy Training Program on Glycemic Control in Type 2 Diabetic Patients. TJHP 2006; 16(1) Jan-April: 30-37.
Poolsup N, Suksomboon N, Intarates M. Effect of Pharmacist’s Interventions on Glycemic Control in Diabetic Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials. MUJPS 2013; 40(4), 17-30.
Potisat S, editor. Thailand Medical Service Profile (2011-2014) First edition Department of Medical Services. Ministry of Public Health : 6-15.
Sarinnapakorn V, editors. Case Approach for Diabetes Mellitus Management. Bangkok : Bangkok Wetchasan Printing House; 2013. 24-34.
Siri T. Empowerment Program with Goal Setting for Type 2 Diabetes Patients’ Self-care Behaviors at Somdejprajoataksinmaharaj Hospital, Tak province. [Master of Public Health Thesis]. Nakornpathom: Mahidol University; 2008.
Songraksa K, Lerkiatbundit S. Development of Disease Specific Quality of Life Instrument: Thai version of Diabetic-39. [Master of Pharmacy]. Songkla : Prince of Songkla University; 2009.
Suksomboon N, Luckanajantachote P, Poolsup N, et al. Effects of Training Programme on Perceived Self-Efficacy, Self-Care Behavior and Diabetes Knowledge Among Type 2 Diabetics. SWUJ Pharm Sci 2005; 10(2):145-53.
Suradechawut C, Amrumpai Y, Treesak C. Empowerment Process for Individual Diabetic Patients. [Master of Pharmacy]. Nakhonpathom: Silpakorn University; 2010.
WHO Thailand. WHO Statistical Profile [Online]. 2015 [Cited 2015 May 20]. Available from: http://www.diabassocthai.org/sites/default/files/tha.pdf.
WHO. Adherence to Long-term Therapies : Evidence for Action. 1st ed. Sabate E, ed. Switzerland: WHO Publication; 2003.
Wongwiwatthananukit S, Krittiyanunt S, Wannapinyo A. Development and Validation of an Instrument to Assess The General Knowledge of Patients with Diabetes. TJPS 2004; 28(1-2): 17-29.
Yoon KH, Lee JH, Kim JW, et al. Epidemic Obesity and Type 2 Diabetes in Asia. Lancet 2006; 368:1681-1688.