Isan Journal of Pharmaceutical Sciences, IJPS (Isan J Pharm Sci)

The Impact of Pharmaceutical Care on the Efficacy of Direct-Acting Antivirals for Hepatitis C Patients at Mukdahan Hospital

2026-02-12T10:41:34+07:00

International studies have confirmed the efficacy of pharmaceutical care in the treatment of hepatitis C; however, data within the Thai context remain limited. Objective: This study aimed to compare the sustained virological response at 12 weeks (SVR12) between the pharmaceutical care (PC) group and the control group, and to evaluate, within the PC group, medication adherence, drug-related problems (DRPs), and safety. Methods: A quasi-experimental study with a historical control group was conducted among hepatitis C patients receiving direct-acting antivirals (DAAs) at the Hepatitis Clinic, Mukdahan Hospital. Patients were divided into a historical control group receiving standard care (1 August 2023 – 31 July 2024) and a PC group receiving pharmacist-delivered care (1 October 2024 – 30 September 2025), which comprised medication history review, patient education, assessment of medication adherence using the Medication Adherence Scale for Thais (MAST), identification and management of drug interactions, DRP management, and monitoring of adverse drug events (ADEs). Results: The PC group (n = 74) had an SVR12 rate of 98.65% compared with 97.18% in the control group (n = 71) (risk difference, 1.47%; 95% CI, -4.79 to 8.44). After adjusting for sex and baseline white blood cell count using multivariable logistic regression, SVR12 did not differ significantly between groups (adjusted OR, 2.25; 95% CI, 0.18–28.37; p = 0.532). The PC group demonstrated medication adherence (median MAST score = 40; IQR = 0; range, 35–40). Fifteen DRPs were identified in 14 patients (18.92%); all pharmacist interventions were accepted, and all DRPs were resolved. No severe ADEs (Grade 3–5) were observed. Conclusion: The SVR12 rate did not differ significantly between the PC and control groups. Within the PC group, patients demonstrated medication adherence, drug-related problems were fully resolved, and no severe adverse events were observed. However, these outcomes were not compared with the control group.

Vaccination Coverage of Influenza and Pneumococcal Vaccine Among Patients with Chronic Obstructive Pulmonary Disease (COPD) in Srinagarind Hospital: A Retrospective Study

2026-03-23T13:52:12+07:00

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable condition. Streptococcus pneumoniae and Haemophilus influenzae are major pathogens associated with acute exacerbations. Vaccination against pneumococcal disease and influenza reduces community-acquired pneumonia, acute exacerbations, hospitalization, and mortality. Methods: A mixed-methods study was conducted among patients with COPD attending the COPD clinic at Srinagarind Hospital between October 1, 2020 and September 30, 2024. Retrospective hospital data were analyzed alongside questionnaire-based data collection. Descriptive statistics were used to summarize patient characteristics and vaccination coverage. Pearson’s chi-square test or Fisher’s exact test was applied to assess associations, with p < 0.05 considered statistically significant. Results: A total of 272 patients were included. Influenza vaccination coverage was 61.4% (n=167), while pneumococcal vaccination coverage was 15.8% (n=43). No significant associations were found between sex, age, or comorbidities and influenza vaccination (p > 0.05). Sex was significantly associated with pneumococcal vaccination (p = 0.010), with higher uptake among females. Limited access to services was the main barrier to influenza vaccination (48%), whereas lack of awareness of the need for vaccination was the primary reason for pneumococcal non-vaccination (71%). Conclusion: Vaccination coverage among patients with COPD remains suboptimal. These findings highlight gaps in healthcare access and patient awareness, underscoring the need for improvements in clinical practice and health policy to enhance vaccination uptake in this high-risk population.

The effect of pharmaceutical care on quality of life and severity of adverse events from chemotherapy in chemotherapy patients at PhraChomKlao Hospital, Phetchaburi

2026-04-08T14:31:57+07:00

Oncology pharmacists play a critical role in providing pharmaceutical care to assess, prevent, and mitigate adverse drug reactions (ADRs), thereby enhancing the safety and quality of life (QoL) of cancer patients. Methods: This pre-experimental, one-group pretest-posttest study evaluated quality of life (QoL) and ADR severity among chemotherapy patients receiving pharmaceutical care at Phrachomklao Hospital, Phetchaburi Province. A total of 90 patients enrolled in the “Pharmaceutical Care Program for Chemotherapy Patients” between January 1 and October 31, 2024. QoL was assessed using the standard EQ-5D-5L questionnaire, which measures health utility scores and self-reported health status via the Visual Analogue Scale (VAS) before and after chemotherapy cycles and the Common Terminology Criteria for Adverse Events (CTCAE) version 5 to grade ADR severity. Results: No significant differences in QoL were observed between pre- and post-chemotherapy regarding mobility, self-care, and usual activities. Post-chemotherapy, pain/discomfort increased, whereas anxiety/depression decreased. While utility values remained stable, VAS scores demonstrated a significant upward (p=0.009) trend (77.01+13.11, 79.70+13.87,79.78+12.89 and 81.04+16.41, respectively), with significant improvements from baseline to cycle 1–3, and cycle 3 scores were significantly higher than cycle 2 (p < 0.05). Common mild ADRs included alopecia (74.5%), fatigue (64.8%), and peripheral neuropathy (37.8%). Severe ADRs were limited to seven cases: myalgia (5) and nausea/vomiting (2). Conclusion: Pharmaceutical care significantly enhances QoL and reduces ADR severity. Continuous pharmaceutical care is recommended throughout treatment to ensure sustainable safety and efficacy in oncological care.

Medication use evaluation of oral vancomycin prescribing for treatment of Clostridioides difficile infection in a university hospital

2026-03-23T15:40:19+07:00

The rising incidence of Clostridioides difficile infection (CDI) necessitates the appropriate use of oral vancomycin, the first line treatment, to ensure optimal clinical outcomes and promote rational drug use. The objective of this research is to investigate patient characteristics, oral vancomycin prescribing patterns, appropriateness of medication use, and clinical outcomes of this infection. Methods: This retrospective descriptive study was conducted with patients receiving oral vancomycin at Srinagarind Hospital during the 2025 fiscal year. Data was retrieved from electronic databases and categorized based on laboratory results, appropriateness of drug use, and treatment outcomes. Data were analyzed using descriptive statistics, and inferential statistics were used to compare differences between groups. Results: A total of 145 patients met the inclusion criteria. The majority were male (60.7%), aged over 65 years (49.0%), and had underlying diseases (95.9%). There were 154 treatment episodes in total, most of which were initial infections (92.9%) and non-severe cases (39.0%). Among the 99 treatment episodes where therapy was indicated, the overall appropriateness of drug use across all domains was 52.5%. Regarding clinical outcomes, most patients showed a reduction in body temperature (90.5%) and stool frequency (62.9%). No significant differences in treatment outcomes were observed when categorized by laboratory results or appropriateness of drug use. Conclusion: Although oral vancomycin use was appropriate in all domains, only 52.5% of cases, clinical outcomes remained favorable. There were no significant differences in outcomes across infection categories. Nevertheless, further development of medication management protocols is recommended to enhance the rational use of medicines.

Factors associated with Psychiatric and Behavioral Adverse Events After Levetiracetam initiation in Psychiatric-Naïve Adults with Epilepsy: A Nested Case–Control Study

2026-05-19T16:07:09+07:00

Levetiracetam is a widely used first-line antiseizure medication. However, psychiatric and behavioral adverse events (PBAEs) have been reported, whereas evidence regarding risk factors in patients without prior psychiatric disorders remains limited. Objective: To evaluate factors associated with PBAEs following levetiracetam initiation in outpatient adults with epilepsy without a history of psychiatric disorders. Methods: A nested case–control study was conducted among outpatient adults (aged ≥18 years) with epilepsy who initiated levetiracetam for the first time and had no prior psychiatric history. Cases and controls were matched by sex and age at a ratio of 1:3. Cases were patients who developed PBAEs within 12 months of levetiracetam initiation, whereas controls were selected from those who did not. Baseline characteristics were collected at the time of levetiracetam initiation. Dose-related data, including daily dose and dose escalation, were collected before the event date for cases and before the corresponding index date for matched controls. Conditional logistic regression was used for data analysis. Results: Among 356 eligible patients, 34 patients developed PBAEs and were matched with 102 controls, comprising a total of 136 patients included in the analysis. Irritability was the most common PBAE. The median time to onset was 2.9 months (IQR 0.8-6.0). Levetiracetam dose escalation of at least 500 mg/day was significantly associated with an increased risk of PBAEs (adjusted OR 4.50; 95% CI 1.46–13.92; p = 0.009). Conclusion: Levetiracetam dose escalation was associated with PBAEs in patients with epilepsy without prior psychiatric disorders. Careful dose titration and close monitoring for psychiatric symptoms during the first 3 months after treatment initiation may improve treatment safety and continuity.

Effects of Pharmaceutical Care for Elderly Patients Receiving Warfarin in Chaiya Hospital

2026-06-02T15:39:25+07:00

Elderly patients receiving warfarin therapy are at an increased risk of suboptimal anticoagulation control and treatment-related complications. This study aimed to evaluate the effects of a pharmacist-led pharmaceutical care model on the effectiveness and safety of warfarin therapy among elderly patients at Chaiya Hospital. Methods: A retrospective pre-post analytical study was conducted using electronic medical records of elderly patients receiving continuous follow-up at the warfarin clinic between January 1, 2018 and June 30, 2024. A within-subject pre–post study was performed between a conventional pharmaceutical care model involving post-consultation alone and a developed model incorporating both pre- and post-consultation pharmacist interventions. Results: Sixty elderly patients met the inclusion criteria. Following the implementation of the developed pharmaceutical care model, the mean time in therapeutic range (TTR) increased significantly by 10.40% (95% CI: 3.58–17.21; p = 0.003). The incidence of a markedly subtherapeutic international normalized ratio (INR < 1.5) was significantly reduced (risk ratio = 0.53; 95% CI: 0.33–0.85; p = 0.009), accompanied by a significant reduction in minor bleeding events (risk ratio = 0.63; 95% CI: 0.42–0.95; p = 0.026). Thromboembolic complications showed a decreasing trend, whereas no significant differences were observed in a markedly supratherapeutic international normalized ratio (INR ≥ 5) or major bleeding events. Drug-related problems were identified in 11.45% of pharmaceutical care encounters, with medication nonadherence being the most common problem. Conclusion: The developed pharmacist-led pharmaceutical care model improved anticoagulation control and enhanced medication safety among elderly patients, thereby supporting the role of pharmacists in optimizing anticoagulation management in community hospital settings.