Effects of Medication Therapy Management by Pharmacist on Medication Adherence in Patients with Ischemic Heart Disease and Atrial Fibrillation
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Abstract
Objective: To study the effect of Medication Therapy Management (MTM) by pharmacists on Medication Adherence (MA) and clinical outcomes including vital signs and control of international normalized ratio (INR) within target range among patients with ischemic heart disease and atrial fibrillation. Method: This quasi experimental study with a control group enrolled 60 eligible subjects chosen by purposive sampling. The subjects were allocated to two groups of 30 patients each. The experimental group (MTM group) received MTM services for 4 months, while the control group received standard services. Two MA measures were employed, namely pill count and the Medication Adherence Scale in Thais (MAST). The study compared differences between groups in terms of MA and clinical outcomes at month 4. Results: Both groups of subjects showed no differences in demographic variables, duration of disease, co-morbidity, and type of drugs taken (P>0.05). Means MA before study (month 0) as measured by pill count in control group and experimental group were not different (71.0%, 72.1%, respectively, P>0.05). At month 4, the MA assessed by pill count increased in both groups, with that in the MTM group significantly higher than that in the control group (90.6%, 86.0%, respectively, P<0.001). The result on MA measured by the MAST was consistent to that measured by pill count. The MTM group had a higher increase in proportion of patients with INR within target range and normal vital signs compared to that at the start of the study (P<0.05), but no differences were found when compared to that in the control group (P>0.05). Conclusion: Patients receiving MTM had a better MA at the 4th month compared to those receiving usual care. However, the clinical outcomes in the MTM group were not different from those in the control group.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
References
Strategy and Planning Division. Causes of deaths: Mortality rates by leading cause of death per 100,000 population, Thailand 2015 and 2019. Public Health Statistics AD2019. Nonthaburi: Ministry of Public Health; 2019. p. 70.
Kristensen SD, Aboyans V. 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 2018; 39: 119-77.
Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS): The Task Force for fhe Diagnosis and Management of Atrial Fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021; 42:373-498. doi: 10.1093/eurheartj/ehaa612.
Sathapornnanon N. Medication non-adherence. Thai Bulletin of Pharmaceutical Sciences 2013; 7: 23-39.
Naderi SH, Bestwick JP, Wald DS. Adherence to drugs that prevent cardiovascular disease: meta-analysis on 376,162 patients. Am J Med. 2012; 125: 882-7.
Shang P, Liu GG, Zheng X, Ho PM, Hu S, Li J, et al. Association between medication adherence and 1‐Year major cardiovascular adverse events after acute myocardial infarction in China. J Am Heart Assoc. 2019; 8: e011793.
Kanjanakiritamrog J, Reanmongkol W, Pongwecha rak J, Wanakamanee U. Assessment of non-com pliance, adverse drug reactions, and drug inter actions in patients with cardiovascular diseases admitted to medical wards at Songkhla hospital. Songklanagarind Medical Journal. 2005; 23: 229-40.
Homdee S. Pharmaceutical care for ishemic heart disease outpatients at Ratchaburi hospital [Master Thesis]. Bangkok: Chulalongkorn University; 2002.
Tantipiwatanaskul K. The influence of patient factors on medication adherence in ambulatory care unit at Bangplama Hospital, Suphunburi. Journal of Health Science 2019; 28: S107-S19.
Gast A, Mathes T. Medication adherence influencing factors—an (updated) overview of systematic reviews. Syst Rev 2019; 8: 112. doi: 10.1186/s13643 -019-1014-8.
Leslie K, McCowan C, Pell J. Adherence to cardio vascular medication: a review of systematic reviews. J Public Health (Oxf). 2019; 41: e84-e94.
Surasrisakul I, Ua-kit N. Predicting factors of medi cation adherence among myocardail infarction patients after underwent percutaneous coronary intervention [Master Thesis]. Bangkok: Chulalong- korn University; 2012.
Chalongsuk R. Management knowledge in pharmacy practice. Thai Bulletin of Pharmaceutical Sciences 2015; 10: 30-47.
Kulnawan N, Pattarateerakun N. Medication therapy management, MTM. Community Pharmacy Association Journal 2014; 13: 23-9.
Burns A. Medication therapy management in pharmacy practice: Core elements of an MTM service model (version 2.0). J Am Pharm Assoc. 2008; 48: 341-53.
Viswanathan M, Kahwati LC, Golin CE, Blalock SJ, Coker-Schwimmer E, Posey R, et al. Medication therapy management interventions in outpatient settings: a systematic review and meta-analysis. JAMA Intern Med. 2015; 175: 76-87.
Lekpet J, Pitchayapaibul S. Medication therapy management for type 2 diabetic out-patients by the pharmacist. Thai Pharmaceutical and Health Science Journal 2011; 6: 274-81.
Jalal ZS, Smith F, Taylor D, Finlay K, Patel H, Antoniou S. Impact of pharmacy care upon adherence to cardiovascular medicines: a feasibility pilot controlled trial. Eur J Hosp Pharm. 2016; 23: 250-6.
The Excellence Center for Depressive Disorder. Guidebook of depressive disorders surveillance and care. 3rd edition. Nonthaburi: Department of Mental Health of Ministry of Public Health; 2014.
Collet J-P, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhatt DL, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The task force for the management of acute coronary syndromes in patients presenting without persistent ST-segment Elevation of the European Society of Cardiology. Eur Heart J 2021: 42: 1289-367.
Suphachamroon A, Lerkiatbundit S, Saengcharoen W. Validity and reliability of the Medication Adherence Scale in Thais (MAST): testing in diabetes patients. Thai Journal of Pharmacy Practice 2018; 10: 607-19.
Jongwilaikasem K, Lerkiatbundit S. Developement of the Medication Adherence Scale for Thais (MAST). Thai Journal of Pharmacy Practice 2021; 13: 17-30.
Sompet N, Ruengorn C, Permsuwan U. The effects of telephone reminder on antihypertensive medi cation adherence. Songklanagarind Medical Journal 2007; 25: 89-97.
Sitthisook S. Guideline for atrial fbrillation (AF) (Thailand) Bangkok: Thai Heart Association of Thailand under the Royal Patronage; 2012.
Sitthisook S. Guideline for ishemic heart disease (Thailand) 2014. 2nd edition. Bangkok: Thai Heart Association of Thailand under the Rayal Patronage; 2014.
Yoodee V, Nimworapan M, Arunmanakul P, Chin wong S. Excellent pharmacy practice in cardiovas cular disease (EPIC) 2021. Chiangmai; Faculty of Pharmacy, Chiangmai University: 2021.
Fuller RH, Perel P, Navarro-Ruan T, Nieuwlaat R, Haynes RB, Huffman MD. Improving medication adherence in patients with cardiovascular disease: a systematic review. Heart. 2018; 104: 1238-43.
Chanchaichujit J, Sornlertlamvanich K. Desirable characteristics and clinical effectiveness of mobile application on medication adherence in patients over 50 years with metabolic syndrome. Thai Journal of Pharmacy Practice 2020; 12: 344-53.
Haynes RB, Taylor DW, Sackett DL, Gibson ES, Bernhoiz CD, J M. Can simple clinical measure ments detect patient noncompliance? Hypertension ;2: 757-64. doi: 10.1161/01.hyp.2.6.757.
Baumgartner PC, Haynes RB, Hersberger KE, Arnet I. A systematic review of medication adherence thresholds dependent of clinical outcomes. Front Pharmacol. 2018; 9: 1290.
Saengsuwan S, Tongbai S, Kangkan P, Apisakulroj S, Saramunee K, Phimarn W. Factors affecting INR level control and efficacy of pill boxex on medication adherence and INR level control in warfarin recieving patients. Thai Journal of Pharmacy Practice 2019; 11: 50-60.
Xu H, Zou J, Ye X, Han J, Gao L, Luo S, et al. Impacts of clinical pharmacist intervention on the secondary prevention of coronary heart disease: a randomized controlled clinical study. Front Pharma col. 2019; 10: 1112.
Hou K, Yang H, Ye Z, Wang Y, Liu L, Cui X. Effectiveness of pharmacist-led anticoagulation management on clinical outcomes: a systematic review and meta-analysis. J Pharm Pharm Sci 2017; 20: 378-96.
