Abstract
Introduction: A pharmacist-led intervention in Community Health Centers (CHCs) in Indonesia targeted at patients with type 2 diabetes non-adherent to antihypertensive drugs resulted in a significant improvement in adherence to these drugs. The aim of this study was to evaluate the process of implementation this intervention intended to improve adherence to antihypertensive drugs from both the pharmacist and the patient perspective. Methods: Using the RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework, we conducted a focus group among pharmacists (N = 5) and a survey among patients with complete follow-up (N = 44) participating in the intervention group. Results: All pharmacists adopted the provided training and found support tools useful. The pharmacists implemented the intervention as intended (adequate intervention fidelity >69%). Factors relevant for implementation included having sufficient time and confidence, home visits for specific patients, multidisciplinary collaboration, and availability of a personal counseling room. To maintain the intervention, the need for practical guidance and support from health care authorities was mentioned. Most patients (96%) were satisfied with the information provided by the pharmacists and they believed the tailored counselling was helpful. Most patients (84%) reported that the duration of counselling was sufficient. The large majority of patients would like to receive the counselling regularly. Conclusion: Positive effects of the pharmacist-led intervention can be explained by adequate levels of reach, adoption and implementation in the participating CHCs. For successful implementation and maintenance in Indonesia or other low-and middle-income countries, sufficient training, resources, multidisciplinary collaboration, guidance and support from health care authorities are expected to be important.
Highlights
A pharmacist-led intervention in Community Health Centers (CHCs) in Indonesia targeted at patients with type 2 diabetes non-adherent to antihypertensive drugs resulted in a significant improvement in adherence to these drugs
Five pharmacists reporting on 57 enrolled intervention patients contributed to the process evaluation
The elements of the intervention were carried out by pharmacists as intended, and the patients reported that the tailored intervention improved their knowledge and opinion about antihypertensive drugs
Summary
A pharmacist-led intervention in Community Health Centers (CHCs) in Indonesia targeted at patients with type 2 diabetes non-adherent to antihypertensive drugs resulted in a significant improvement in adherence to these drugs. In 2019, we conducted a low-cost pharmacist-led intervention in Community Health Centers (CHCs) in Indonesia targeted at patients with type 2 diabetes non-adherent to antihypertensive medication (Alfian et al, 2021). This intervention resulted in a significant improvement in self-reported medication adherence to these antihypertensive drugs, but no significant changes in secondary outcomes, such as beliefs about antihypertensive drugs, were observed (Alfian et al, 2021). We aimed to evaluate the process of the implementation of this intervention intended to improve adherence to antihypertensive drugs using a structured evaluation
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
