Effects of Pharmacist’s Education Provision for Caregivers of Schizophrenic Patients at their Homes

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ปิยธิดา รักพงศ์
สายทิพย์ สุทธิรักษา
จันทร์ทิพย์ กาญจนศิลป์

Abstract

Objective: To study the effects of pharmacists’ education provision to caregivers of schizophrenic patients at their home. Method: The research was a prospective randomized controlled study. Subjects were 57 caregivers of schizophrenic patients at home. The subjects were randomized into a control group and an experimental group. Control group (n=29) were those accompanying the patients to the hospital and receive regular services.  The study groups (n=28) received one time of education on schizophrenia, treatment and medication, and received a booklet during the first home visit by a pharmacist. The researcher collected data for 3 times, including before and after intervention for 1 and 3 months. Results: Before the study, various characteristics of caregivers in both groups were not different (P >0.05). The majority of the caregivers were female, being mother of the patients, with the mean age of 52.04±13.09 years. After intervention for 1 and 3 months, study group had a higher level of knowledge than control group did (P=0.005 and P<0.001 respectively). Their quality of life was also significantly better at the third month (P=0.017). Their perceived burden was significantly lower in the first and third month (P=0.012 and P=0.008 respectively). Comparison of outcomes between pre and post intervention within the study group showed that the caregivers had a significantly increased level of knowledge (P<0.001 in both periods) and a significantly lower level of perceived burden (P=0.033 and P=0.008, respectively) in the first and the third month after intervention. Their quality of life significantly increased in the third month (P=0.003). Their stress also significantly reduced in the third months (P=0.024). Compared to baseline, control group showed an increased level of knowledge on the first and third months (P<0.001 and P=0.001 respectively), an unchanged level of quality of life and stress (P >0.05), and a higher level of burden both in the first and third months (P=0.013 and P=0.033 respectively). Conclusion: Pharmacist’s education provision for caregivers of schizophrenic patients during home visit increases knowledge and quality of life, reduces perceived burden and stress when compared to the caregivers not receiving intervention.

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References

1. World Health Organization. Schizophrenia [online]. 2018 [cite May 11, 2017]. Available from: www.who. int/ mental_health/management/schizophrenia/en/

2. Kilbourne AM, Morden NE, Austin K, Ilgen M, McCarthy JF, Dalack G, Blow FC. Excess heart-disease-related mortality in a national study of patients with mental disorders: identifying modifia- ble risk factors. Gen Hosp Psychiatry. 2014; 31: 555–63.

3. Bushe CJ, Taylor M, Haukka J. Mortality in schizophre- nia: a measurable clinical endpoint. J Psychopharma col. 2010; 24: 17–25.

4. Hennekens CH, Hennekens AR, Hollar D, Casey DE. Schizophrenia and increased risks of cardiovascular disease. Am Heart J 2005; 150: 1115–21.

5. Marsh DT. Serious Mental Illness: Opportunities for Family Practitioners. Fam J 1999; 7: 358–66.

6. Sangsirilak S. Burden among caregivers of schizophre nia patient. Sisaket Surin Buriram Hosp J. 2016; 3:139–48.

7. Yusuf AJ, Nuhu FT, Akinbiyi A. Caregiver burden among relatives of patients with schizophrenia in Katsina. South African J Psychiatry. 2009; 15: 43–7.

8. Lacro JP, Dunn LB, Dolder CR, Leckband SG, Jeste DV. Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: A comprehensive review of recent literature. J Clin Psychiatry. 2002; 63: 892–909.

9. Sun SX, Liu GG, Christensen DB, Fu AZ. Review and analysis of hospitalization costs associated with antipsychotic nonadherence in the treatment of schizophrenia in the United States. Curr Med Res Opin. 2007; 23: 2305–12.

10. Masand P, Narasimhan M. Improving Adherence to Antipsychotic Pharmacotherapy. Curr Clin Pharmacol. 2006; 1: 47–56.

11. Jittra K, Kanjanasilp J, Lelatanaruk A, Juthamanee D. The effects of pharmaceutical care in schizophre nia patients with caregivers education. J Psychiatr Assoc Thai. 2011; 11: 40–50.

12. Hasan AA, Callaghan P, Lymn JS. Evaluation of the impact of a psycho-educational intervention for people diagnosed with schizophrenia and their primary care givers in Jordan: a randomized controlled trial. BMC Psychiatry 2015; 15: 72. doi: 10.1186/s12888-015-04 44-7.

13. Ran MS, Xiang MZ, Chan CLW, Leff J, Simpson P, Huang MS, et al. Effectiveness of psychoeducational intervention for rural Chinese families experiencing schizophrenia - A randomised controlled trial. Soc Psychiatry Psychiatr Epidemiol. 2003; 38: 69–75.

14. Overall JE, Gorham DR. The Brief Psychiatric Rating Scale. Psychol Rep. 2011; 10: 799–812.

15. Suwanmaitee S, Aopatwattana C, Jarusirichaikul C. A manual for working with patient with serious mental illness with high risk to violence. Nontraburi: Prosper- ous Plus; 2018. p.94-5.

16. Viriyasakul T, Thachanun I, Kanjanasilp J, Suttiraksa S. The effects of pharmaceutical care in schizophre nia patient at outpatient department : randomized control trial. Thai Journal of Pharmacy Practice 2016; 2: 377–87.

17. Mahatnirunkhun S, Phoompaisan W, Tapunya P. Suanprung stress test. Suan Prung Hosp. 1997; 13: 1–20.

18. Mahatnirunkhun S, Tuntipiwatthanasakhun W PW. World Health Organization Quality of Life BREF. Chiangmai: Suan Prung hospital; 2002.

19. Winahyu KM, Hemchayat M, Charoensuk S. Factors affecting quality of life among family caregivers of patients with schizophrenia in Indonesia. J Health Res. 2015; 29: 77–82.

20. Grandón P, Jenaro C, Lemos S. Primary caregivers of schizophrenia outpatients: Burden and predictor variables. Psychiatry Res. 2008;158: 335–43.

21. Suwaluk Y, Yai H, Unit C, Rajanagarind S, Hospital P. Factors related to caregivers’ caring behaviors for chronic schizophrenic patients at home. Songkla Med J. 2003; 4: 249–58.

22. Sin J, Gillard S, Cornelius V, Chen T, Henderson C. Effectiveness of psychoeducational interventions for family carers of people with psychosis : A systematic review and meta-analysis. Clin Psychol Rev. 2017; 56: 13–24.

23. Seanlamul B, Kessomboon P. Effects of the education program for caregivers of patients with schizophrenia. Community Health Dev Q Khon Kaen Univ. 2015; 3: 274–83.

24. The Psychiatric Association of Thailand. Schizophre- nia. In: Udomrat P, Vasikanon S, editors. Textbook of schizophrenia. Bangkok: Chanmuang Printing; 2009. p. 271-80.

25. Worakul P, Thavichachart N, Lueboonthavatchai P. Effects of psycho-educational program on knowledge and attitude upon schizophrenia of schizophrenic patients’ caregivers. J Med Assoc Thai 2007; 90: 1199-204.

26. Akesuveerapong N, Kaseattud N. The factors influencing adherence in schizophrenia patient at Suansaranrom hospital. J Psychiatr Assoc Thai. 2007; 52:412–28.

27. Amika K, Dangdomyouth P, Aumtanee A. Selected factors relating to quality of life among caregivers caring for patients with schizophrenia at home. J Police Nurse 2015; 7:129–40.

28. Maeng S, Kim W, Kim J, Bae J. Factors affecting quality of life and family burden among the families of patients with schizophrenia. Korean Soc Schizophr Res. 2016; 19: 78–88.

29. Yesufu-Udechuku A, Harrison B, Mayo-Wilson E, Young N, Woodhams P, Shiers D, et al. Interventions to improve the experience of caring for people with severe mental illness: systematic review and meta-analysis. Br J Psychiatry. 2015; 206: 268–74.

30. Dyck DG, Short R, Vitaliano PP. Predictors of burden and infectious illness in schizophrenia caregivers. Psychosom Med. 1999; 419: 411–9.

31. Akesuveerapong N, Kasattud N. ansaranrom Hospital Factors affecting medication nonadherence Noppawan Eksuweerapong et al. in schizophrenic patients admitted at Suansaranrom Hospital. J Psychiatr Assoc Thai. 2007; 52:412–28.

32. Webb C, Pfeiffer M, Mueser KT, Gladis M, Mensch E, DeGirolamo J, et al. Burden and well-being of caregivers for the severely mentally ill: The role of coping style and social support. Schizophr Res. 1998; 34:169–80.

33. Mitsonis C, Voussoura E, Dimopoulos N, Psarra V, Kararizou E, Latzouraki E, et al. Factors associated with caregiver psychological distress in chronic schizo phrenia. Soc Psychiatry Psychiatr Epidemiol 2012; 47:331–7.

34. Luprasong S, Thanee S, Saithanu K, Choomuang K. Quality of life of psychiatric patients and their caregivers in Ubon ratchathani Province. Bull Suan- prung 2017; 33:175–88.