Pharmacist’s Intervention on Managing Drug Related Problems in Easy Asthma Clinic, Srinagarind Hospital

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Sunee Lertsinudom
Watchara Boonsawat
Chanee Samosorn
Suthan Chanthawong

Abstract

Background: Easy Asthma Clinic (EAC) at Srinagarind Hospital, Khon Kaen University, Thailand was established in February 2004. EAC is an ambulatory asthma clinic which implemented the Global Initiative for Asthma (GINA) guidelines and it has been incorporated into the practice. The goal of EAC is to improve the quality of care for asthmatic patients utilizing multidisciplinary approach involving physicians, nurses and pharmacists; however drug related problems (DRPs) have been still occurred because asthma is a chronic disease which requires long term medication therapy and special technique, these lead to the decrease in effectiveness of therapy. Therefore, pharmacist has an important role in managing these DRPs in order to improve the drug therapy in asthmatic patients. Objective: To study DRPs and pharmacist’s intervention on managing DRPs in EAC. Method: The descriptive and retrospective study design was conducted for patients in EAC, Srinagarind Hospital during 1st July 2005 to 30th June 2007. The selection criteria were patients who have been followed up at least two times. The outcomes of pharmacist’s intervention were evaluated in the following appointment. Result: There were 303 patients recruited, of which 111 (36.6 %) were males and 192 (63.4%) were females with their mean age of 54 years old. Numbers of visits were 906 (3 times per person). There were 225 patients (74.3%) with DRPs, 591 problems in total. The most DRPs were non-compliance (62.9%) and adverse drug reactions (ADRs) (36.2%). In terms of non-compliance, most highly occurred problems were incorrect technique of administrations (62.9%) and under dosage of medication (32.0%). A pharmacist resolved or prevented DRPs by counseling patients (98.7%) and consulting physicians (1.3%). Pharmacist’s interventions improved patient compliance (36.3%) by describing disease and the importance of using medications, teaching appropriate technique of administration (22.8%), counseling on management and prevention of ADRs (20.4%) and educating lifestyle modification (20.6%). Pharmacist’s intervention could resolve the problems (48.1%). Non-compliance was resolved 49.2%, ADRs were resolved 44.9% and other DRPs, which were discussed with the physician, were totally resolved. Conclusion: Pharmacist’s intervention on managing DRPs could resolve DRPs, and help patients to use their medications appropriately.

Article Details

Section
Pharmacy

References

Armour C, Bosnic-Anticevich S, Brillant M, et al. 2007. Pharmacy asthma care program (PACP) improves outcomes for patients in the community. Abstract. Thorax 62(6): 496-592.

Balkrishnan R and Guniganti P. Noncompliance with medication regimens and complementary and alternative medicine use in asthma. http://www.chestnet.org. Accessed Jan 22, 2006.

Barbanel D, Eldridge S, Griffiths C. 2003. Can a self-management program delivered by a community pharmacist improve asthma control? A randomized trial. Thorax 58: 851-54.

Bednall R, McRobbie D, Hicks A. 2003. Identification of medication-related attendances at an A&E department. J Clin Pharm Ther 2003(28): 41-45.

Boonsawat W, Charoenphan P, Kiatboonsri S, et al. 2004. Survey of asthma control in Thailand. Respirology 2004(9): 373-378.

Burkhart PV, Rayens MK, Oakley MG, et al. 2007. Testing an intervention to promote children’s adherence to asthma self-management. J Nurs Sch 39(2): 133-140.

CipolleRJ, StrandLM, MorleyPC.1998. Pharmaceutical care practice. Graw-Hill. New York. Cochrane MG. 2000. Inhaled Corticosteroids for Asthma Therapy: Patient Compliance, Devices, and Inhalation Technique. Chest 117: 542-550.

Cordina M, McElnay JC, Hughes CM. 2001. Assessment of a community pharmacy-based program for patients with asthma. Pharmacoherapy 21: 1196-1203.

Dent LA, Stratton TP, and Cochran GA. 2002. Establishing an on-site pharmacy in a community health center to help indigent patients’ access medications and to improve care. Abstract. J Am Pharm Assoc (Wash)42(3): 497-507.

Herborg H, Soendergaad B, Froekjaer B, et al. 2001. Improving drug therapy for patients with asthma-part 1: patient outcomes. J Am Pharm Assoc 41: 539-550.

National Heart, Lung and Blood Institute / World Health Organization. 2006. Global initiative for asthma. Bethesda MD. National Institute of Health. National Heart, Lung and Blood Institute.

Pauley TR, Magee MJ, Cury JD. 1995. Pharmacist-managed, physician-directed asthma management program reduces emergency department visits. Ann pharmacother 29: 5-9.

Rea HH, Scragg R, Jackson R, et al. 1986. A case-control study of deaths from asthma. Thorax 41: 833-839.

Vlasnik JJ. 2005. Medication Adherence: Factors Influencing Compliance with Prescribed Medication Plans. TCM; March/April 2005.

Weinberger M, Murray MD, Marrero DG, et al. Effectiveness of pharmacist care for patients with reactive airway disease: a randomized controlled trial. 2002. JAMA 288(13): 1594-1602.