Effects of Pharmaceutical Care Using Telepharmacy Model for Diabetic Patients at Pathumrat Hospital, Roi Et Province

Abstract

Purposes: To compare the mean levels of glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), medication adherence scores, and drug-related problems between patients receiving telepharmacy services and those receiving conventional pharmaceutical care at Pathumrat Hospital, Roi Et Province.

Study design: A quasi-experimental research with two groups pre-post test design.

Materials and Methods: The study sample consisted of 68 diabetic patients receiving outpatient care at Pathumrat Hospital. Participants were selected by simple random sampling and divided equally into an experimental group (34 patients) and a control group (34 patients). The study period was from September 2024 to May 2025. Data were collected using several instruments: a general patient information form, the Medication Adherence Scale for Thais (MAST), a medication-related problems record based on the Pharmaceutical Care Network Europe (PCNE) guidelines, and HbA1C and FPG values extracted from patient medical records. The reliability of the questionnaires was confirmed with a Cronbach's alpha coefficient of 0.85. Data analysis included descriptive statistics such as frequency, percentage, mean, and standard deviation. Inferential statistics were performed using the independent t-test to compare mean differences between groups. Statistical significance was set at a 95% confidence interval

Main findings : After the intervention, it was found that diabetic patients who received pharmaceutical care through the telepharmacy service model had a reduction in hemoglobin A1C (HbA1C) levels compared to the control group. However, the difference was not statistically significant (p = .054), with a mean HbA1C reduction of 0.60 mg% (95%CI: 0.01, 1.21). For fasting plasma glucose (FPG), the intervention group showed a statistically significant reduction compared to the control group (p = .036), with a mean FPG reduction of 20.24 mg/dL (95%CI: 1.37, 39.10). In terms of medication adherence scores, the intervention group had significantly higher scores than the control group (p < .001), with an average increase of 3.12 points (95%CI: 2.21, 4.02). The most commonly identified drug-related problem was insufficient therapeutic effectiveness. In the intervention group, this issue was observed 40 times (93.00%), while in the control group, it was found 37 times (88.10%). The primary cause was patients taking less medication than prescribed: 37 occurrences (86.00%) in the intervention group and 31 occurrences (73.8%) in the control group. The most common solution provided was verbal counseling. This was given in 37 cases (86.00%) in the intervention group and 31 cases (73.80%) in the control group. The outcome of problem resolution showed that the intervention group had a significantly higher rate of successful problem resolution compared to the control group (p < .001). The intervention group resolved 35 cases (81.40%), whereas the control group resolved only 8 cases (19.04%).

Conclusion and Recommendations: Pharmaceutical care through telepharmacy services is a vital approach that enhances medication adherence, reduces drug-related problems, and leads to improved clinical outcomes for patients with diabetes. This model can also be adapted for other patient groups who have not yet achieved their treatment goals. To maximize effectiveness, long-term follow-up and development of a comprehensive care system are essential. This should go beyond medication management to include nutritional counseling and guidance on health behavior modification. Such an integrated approach helps empower patients to take continuous and sustainable care of their health at home.