Pharmacist Counseling Research Articles

Pharmacist-led medication for pain in France: What population are we talking about? Results of the Optymed study

Self-medication for alleviating pain is very prevalent in most countries. While safe self-medication is supposed to be dependent on both patient's behaviour and pharmacist's counselling, little is known about the context of the delivery of analgesics available without prescription. The primary objective of the study was to define sociodemographic profiles and behaviours of patients seeking non-prescribed analgesics in French community pharmacies. Secondary objectives included the assessment of pharmacist management and identification of risk-associated patients. This is a cross-sectional, national and multicentre study, including adults who asked for a prescription-free medication for acute or chronic physical pain. Information was collected through separate patient and healthcare professional (HCP) questionnaires. The analysis was based on 1215 and 1271 patient and HCP questionnaires, respectively, collected from 164 pharmacies. The patient population consisted in women and men (ratio 6:4), mainly (71%) under 60 years old. Headaches, rheumatologic and musculoskeletal pains were the most frequent reasons for getting analgesics, with a median pain intensity of 6 on a scale graded from 0 (no pain) to 10 (intolerable pain). The main reasons guiding self-medication were time saving, a well-known pain and a well-known product. The mean time allocated to delivery was 4.7minutes. Indications, dose and posology were almost systematically addressed by the pharmacy staff, while contra-indications, drug-drug interaction or safety were mentioned in around two-third of cases. The proportion of patients identified at risks due to an inappropriate context of self-medication was 15.5%. This study shows a great heterogeneity of the population asking for non-prescribed analgesics in French community pharmacies. While pharmacists were able to identify patients at risks, a significant part may have 'slipped through the net'. The results support further studies to better define patient care pathway and optimize pharmacist-led medication.

An intervention to improve the quality of medication abortion knowledge among pharmacists in India.

To test an infographic two-pager on medication abortions (MA) aimed to improve pharmacists counseling in India. A quantitative baseline survey was conducted among 283 pharmacists in three districts around Lucknow, Uttar Pradesh in January 2018. The intervention (infographic) was given to 117 of these pharmacists a few weeks later and a follow-up survey was conducted 3months later with 281 pharmacists. In addition, mystery clients were sent to 115 of the pharmacists. A statistically significant improvement in knowledge post-intervention was found, compared to pre-, for almost all quality items measured. Difference-in-difference estimators showed a difference in knowledge among indicators related to misoprostol in particular. However, mystery client reports showed few differences in pharmacist behaviors between intervention and control pharmacists. This simple, paper-based intervention, which required no training, showed a significant improvement in pharmacists' knowledge and was welcomed by the providers. Translating knowledge into behavior change, however, seems more difficult to impact. Adapting this simple intervention to motivate providers to change behaviors could improve the quality of care provided by pharmacists in India.

A targeted approach to reducing rates of discontinuation and dose reduction in patients receiving sorafenib or regorafenib

Background: Sorafenib and regorafenib are oral multikinase inhibitors used to treat some cancers, but adverse events for both drugs are common and often cause patients to discontinue therapy or reduce their dose within several months of initiating therapy. Pharmacists have the potential to prevent discontinuation by closely monitoring and addressing patients’ adverse reactions. Aims: To assess whether a pharmacist-initiated tailored intervention reduced patient discontinuations and dose reductions due to adverse reactions from sorafenib and regorafenib. Methods: We conducted a historically controlled intervention (initiated Aug 2017) to detect and address adverse events in patients prescribed sorafenib and regorafenib. All patients who initiated therapy after August 2017 were in the intervention group (IG); at treatment initiation, IG patients received initial pharmacist counseling and a welcome kit containing educational materials, urea based creams, therapeutic socks and pill container (sorafenib only). During the 90 days after initiating treatment, pharmacists called IG patients six times to conduct assessment questionnaires, designed to detect common adverse reactions at each interval. Pharmacists addressed adverse events by providing additional counseling, referring patients for clinic appointment or requesting ancillary medications. The comparison group (CG) patients initiated therapy between September 2016 and August 2017. CG patients only received pharmacist counseling at treatment initiation. We collected patient demographics and treatment indication, and compared how many patients discontinued or reduced dose in the IG vs the CG. Results: We assessed 33 patients (16 IG vs 17 CG). Most were female (61%) and White (88%); median age 53 years. Common indications were hepatocellular carcinoma (36%), acute myeloid leukemia (30%) and desmoid tumor (21%). In the 90 day follow-up, IG had lower rates of treatment discontinuation (13% vs 29%) and dose reduction due to side effects (13% vs 18%) than CG. Combined events of either discontinuation or dose reduction due to side effects were less frequent in the patients in the IG than the CG (25% vs 65%). Conclusions: Patients treated with sorafenib or regorafenib were less likely to discontinue therapy or reduce doses due to adverse reactions after receiving a pharmacist-led phone intervention. Findings suggest tailored phone assessments are effective in detecting and treating adverse reactions, thus enabling patients to remain on therapy longer and without dose modification.

The perspectives of patients and physicians on the role of pharmacists in improving medication adherence in type 2 diabetes: a qualitative study.

BackgroundPharmacy practice has been expanded to include responsibility for the outcomes of medication therapy. However, in developing countries the pharmacist’s role is still limited to dispensing medications. The aim of this study is to explore the perspectives of patients and physicians on the pharmacist’s role in improving medication adherence in type 2 diabetes.MethodsData were collected via semi-structured interviews with patients and physicians. The interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis.ResultsA total of 40 patients and 21 physicians were interviewed. The interviews revealed different pharmacy-related issues that negatively affected patients’ adherence, such as a lack of pharmacist counselling and inappropriate scheduling of refills. Various recommendations to improve adherence were emphasised such as dedicating some pharmacists to counselling patients and providing pharmacists with the appropriate training.ConclusionFrom the perspectives of patients and physicians, the pharmacist’s role in the management of type 2 diabetes is still limited to dispensing medications. In order to improve medication adherence and consequently patient outcomes, policy-makers need to be aware of the importance of supporting pharmacists and providing them with the appropriate training.

Impact of pharmacist educational intervention on disease knowledge, rehabilitation and medication adherence, treatment-induced direct cost, health-related quality of life and satisfaction in patients with rheumatoid arthritis: study protocol for a randomized controlled trial

BackgroundThe objective of this study is to evaluate the effectiveness of pharmacist intervention in improving disease knowledge, adherence to treatment, health-related quality of life (HRQoL) and direct cost of treatment. The study also documents patient satisfaction with pharmacist counselling as a quality control measure.Methods/designThis is a randomized, single-blind, two-arm, controlled trial in patients with rheumatoid arthritis visiting outpatient rheumatology clinics in Karachi, Pakistan. We will enroll patients with established diagnosis of rheumatoid arthritis over 3 months. The patients would be randomized through a computer-generated list into the control group, i.e., usual care or into the intervention group, i.e., pharmaceutical care, in a ratio of 1:1, after providing signed written consent. The study will take place in two patient-visits over the course of 3 months. Patients in the intervention group would receive intervention from the pharmacist while those in the control group will receive usual care. Primary outcomes include change in mean score from baseline (week 0) and at follow up (week 12) in disease knowledge, adherence to medications and rehabilitation/physical therapy. The secondary outcomes include change in the mean direct cost of treatment, HRQoL and patient satisfaction with pharmacist counselling.DiscussionThis is a novel study that evaluates the role of the pharmacist in improving treatment outcomes in patients with rheumatoid arthritis. The results of this trial could set the foundation for future delivery of care for this patient population in Pakistan. The results of this trial would be published in a peer-reviewed journal.Trial registrationClinicalTrials.gov, NCT03827148. Registered on February 2019.

Counseling interactions between patients living with persistent pain and pharmacists in Australia: are we on the same page?

BackgroundPeople living with persistent pain in Australia often cannot access adequate care to manage their pain. Therefore, as the most accessible healthcare professionals, community pharmacists have an important role to play in helping to improve patient outcomes. Hence, it is important to investigate patient needs and expectations in terms of counseling interactions with pharmacists, along with pharmacists’ approach to counseling interactions with these patients.MethodThe nature of patient–pharmacist counseling interactions was explored with seven patients (one focus group), and 10 practicing pharmacists (two focus groups, three semi-structured interviews). The themes identified informed the development of an online survey that was advertised online to patients and pharmacists across Australia.ResultsA total of 95 patients and 208 pharmacists completed the survey. Overall, more than half of patients (77/95) were satisfied with the care provided by their pharmacist, but only a third (71/205) of pharmacists were satisfied with the care they provided to patients. The majority of patients (67/94) reported that pharmacists provided good information about medications. This aligned with pharmacists’ responses, as most reported focusing on medication side effects (118/188) and instructions for taking pain medication (93/183) during patient interactions. However, when asked about empathy and rapport from pharmacists, only half to two-thirds (48–61/95) of patients expressed positive views. Overall, half of the patients (39/75) wanted a caring, empathetic, respectful, and private conversation with the pharmacist, and nearly half (40/89) perceived the pharmacist's role as providing (new) information on alternative pharmacological and non-pharmacological therapies, including general advice on pain management.ConclusionThere was a disparity in the nature of the interaction and information that patients wanted from pharmacists, compared to what was provided by pharmacists. Training and education may help pharmacists to better engage in patient-centered care when interacting with people living with persistent pain, thereby improving health outcomes for these patients.

Community pharmacist counseling in early pregnancy-Results from the SafeStart feasibility study.

BackgroundCommunity pharmacists are available to counsel women in early pregnancy, but no studies have assessed the feasibility of such a service.ObjectiveTo test the feasibility of a pharmacist consultation in early pregnancy and to inform the design of a definitive trial.SettingSix community pharmacies in Norway from Oct. to Dec. 2017.MethodWe evaluated recruitment approaches and an automatic data preprocessing system (ADPS) to enroll, assign participants, and distribute questionnaires. Women (≥18 years) in early pregnancy were eligible for inclusion. Participants were assigned to a pharmacist consultation (intervention group) or standard care (control group). The intervention aimed to address each woman’s concerns and needs regarding medications and ailments in pregnancy, and was documented on a standard form. The women’s acceptability of the intervention was measured by a questionnaire.Main outcome measuresAppropriate recruitment approaches, workflow of the ADPS, and women’s acceptability of the intervention.ResultsOf the 35 participants recruited, 19 were recruited through Facebook. The ADPS worked well. Treatment of nausea and vomiting (NVP) (10/11) and general information about medications (8/11) were frequently discussed during the consultations (n = 11). The women reported high satisfaction with the consultation. Having the option of telephone and follow-up consultations was important to the women.ConclusionIt is feasible to provide community pharmacist consultations in early pregnancy. In a definitive study, the consultations should focus on NVP and general medication use and further explore social media as a recruiting tool. Both in-pharmacy and telephone consultations should be offered to deliver the intervention.

Cost utility analysis of pharmacist counseling care for breast cancer chemotherapy outpatients.

Chemotherapy for cancer is increasingly implemented in the outpatient setting. Pharmacists contribute to cancer treatment by conducting counseling during outpatient chemotherapy visits. They provide guidance on drug treatment, side effects, and side effect countermeasures on every visit. However, there have been few economic evaluations of pharmacist involvement in outpatient chemotherapy. Therefore, we performed a cost utility analysis. We assigned usual care (control) and pharmacist counseling to two groups of 19 patients receiving outpatient chemotherapy for breast cancer at Gifu Municipal hospital. Quality of life was measured at three timepoints before and during chemotherapy treatment using the EuroQol 5 dimension instrument (EQ-5D). EQ-5D values across the timepoints were 0.831, 0.757, and 0.791 for the control group, and 0.882, 0.883, and 0.921 for the pharmacist counseling group. The additional cost in the pharmacist counseling group was 2,227 yen per counseling session. The change in quality-adjusted life years (QALY) was a maximum of -0.021±0.186 in the control group and 0.007±0.199 in the pharmacist counseling group. The maximum cost for one QALY was 1,360,558 yen (≈12,460 US dollars). Pharmacists' counseling in outpatient cancer chemotherapy for breast cancer patients had an acceptable incremental cost-effect ratio, contributing to improved patient quality of life without significant additional expenditure to healthcare.

Study of counseling activities of pharmacists in southern Khorasan province to patients in 2017

Introduction: The role and place of pharmacists 'services as one of the main pillars of the patients' treatment chain is definitely unhelpful. Research in this area suggests that pharmacist counseling leads to positive therapeutic outcomes and improves the quality of life, awareness of drug use, and patient satisfaction. This study was conducted to investigate the activities of pharmacists counseling in southern Khorasan province in 2017. Materials: and Methods: This is a cross-sectional descriptive-analytic study. The statistical population of the present study was two groups of pharmacies and patients. All 84 pharmacies operating in Southern Khorasan Province were included in this study. In this research, two main types of tools for recording counseling behaviors, views, and opinions were used. The first evaluation tool was taken by the patients at the pharmacy at each visit. The second tool was a questionnaire, which was adapted from a questionnaire made by Allajil and Al-Banemi in Saudi Arabia. In order to close the content of the questionnaire and obtain more accurate information, This questionnaire was first reviewed by the professors and consultants, and then it was adjusted and localized by two experienced pharmacists of South Khorasan, Spearman, Kolmogorov-Smirnov, Kruskal-Wallis and Manviteni tests. Results: The results showed that there was a significant relationship between drug counseling and satisfaction rate of the patients in the 3rd and 4th scenario at level of .05. All the relationships between the amount of drug counseling and the patient's satisfaction with counseling were significant at each level of 0.05. There was an indirect relationshiop between scenarios one and two and direct linear relationship between scenarios three and four. Conclusion: Regarding the fact that the overall satisfaction of the patients from all scenarios is above 50%, it can be claimed that patients received a fairly good counseling.

Interaction between phytotherapy and oral anticancer agents: prospective study and literature review.

Cancer is becoming more prevalent in elderly patient. Due to polypharmacy, older adults with cancer are predisposed to drug-drug interactions. There is also an increasing interest in the use of complementary and alternative medicine (CAM). Thirty to seventy percent of patients with cancer have used CAM. Through pharmaceutical counseling sessions, we can provide advices on herb-drug interactions (HDI). All the patients seen in pharmaceutical counseling sessions were prospectively included. Information was collected during these sessions: prescribed medication (oral anticancer agents (OAA) and other drugs), CAM (phytotherapy especially), and use of over-the-counter (OTC) drugs. If pharmacist considered an interaction or an intervention clinically relevant, the oncologist was notified. Then, a literature review was realized to identify the potential HDI (no interactions, precautions for use, contraindication). Among 201 pharmacist counseling sessions, it resulted in 104 interventions related to 46 HDI, 28 drug-drug interactions and 30 others (wrong dosage, omission…). To determine HDI, we review 73 medicinal plants which are used by our patients with cancer and 31 OAA. A total of 1829 recommendations were formulated about 59 (75%) medical plants and their interaction with an OAA. Herb-drug interactions should not be ignored by healthcare providers in their management of cancer patients in daily practice.

Willingness to Pay Pelayanan Konseling Apoteker di Apotek di Kecamatan Polokarto Tahun 2016

Counseling is one part of the clinical pharmacy service at the pharmacy that is the responsibility of the pharmacist to achieve therapeutic goal. Community needs for counseling have increased so that the active participation of pharmacists is needed through the provision of professional services. This research needs to be done to find out the amount of counseling services by pharmacists who are willing to be paid by patients with a WTP (Willingness to Pay) value parameter. In addition, the value of WTP can also describe the indirect benefits felt by the community towards counseling services by pharmacists at the pharmacy. This research is a descriptive observational research through a survey. The study was conducted at the pharmacy in the Polokarto sub-district of Sukoharjo regency in January – February 2016 with pharmacy visitor respondents who received counseling services by pharmacists. A total of 82 patients participated in this study. The amount of WTP is determined based on the average WTP value chosen by the patients with the payment card method. The result showed that the average WTP value of pharmacist counseling services at pharmacies in Sukoharjo regency was Rp. 15,892.

Impact of pharmacist counseling and leaflet on the adherence of pulmonary tuberculosis patients in lungs hospital in Indonesia

BackgroundOne of the goals of counseling in patients with chronic diseases including tuberculosis patients is to improve adherence to taking medication. By patient adherence, therapeutic results are more optimal. Additional counseling alternatives such as leaflets may be needed to make easier for patients to obtain information about their treatment. This study aimed to analyze the effectiveness of counseling with and without leaflets on the adherence on taking tuberculosis (TB) drugs. MethodsThis study was a quantitative research conducted using a quasi-experiment method with a control group for pre-test and post-test design. Data was taken by consecutive sampling. The number of samples in this study was 75 respondents which divided into three groups: counseling, counseling with leaflets, and control that is a usual care in hospital. The inclusion criteria were patients diagnosed with pulmonary tuberculosis with age 25–55 years, who has been taking TB medicines for at least one month and can communicate well. Data was analyzed using Wilcoxon and Kruskal–Wallis with post hoc Mann–Whitney due to abnormality of the distributed data. ResultsBefore the intervention, of 20 respondents (42.6%) out of 75 respondents were obedient to their TB medicines, whereas after the intervention the number of obedient patients was 33 respondents (70.2%). There was a significant increase in adherence between before and after two weeks of counseling intervention with a p-value of 0.029 before and after two weeks of counseling with leaflets with a p-value of 0.003. Counseling and counseling with leaflets improved patients' adherence compare to control group with p-values of 0.028 and 0.001 respectively. ConclusionCounseling and counseling with leaflet impact in patients' adherence to tuberculosis medication.

Assessment of the impact of pharmacist-led face-to-face counselling on HIV/AIDS among school & college going students, and infected patients in south India

Problem consideredOver the past decade HIV/AIDS infection has tremendously increased among young people aged 15–24 years in the developing countries like India. By keeping this in mind, pharmacist counselling could be an essential asset that has been associated with improved health outcomes among public and infected patients as well. AimTo assess the impact of pharmacist-led counselling on HIV/AIDS among school & college going students and infected patients. MethodsA prospective intervention survey was conducted by using the simple random sampling technique. A total of 509 participants were sampled i.e., post-secondary school students (98), college students (364), and infected patients (47) respectively and interviewed by the student pharmacist using a pre-designed, semi-structured questionnaire to assess their knowledge regarding HIV/AIDS pre and post-test respectively. Verbal consent from all the participants was obtained before initiating the study. Responses were scored, analyzed and mean score and percentage were used to determine the level of knowledge pre and post-test. ResultsOf the total 509 survey participants, 246 (48.3%) were males, and 263 (51.7%) were females with a mean age and SD of 24.59 years ± 0.54. The study results noticed that the study participants, especially school students and infected patients were not attentive and conscious about the HIV/AIDS. ConclusionThe study results infer that there is an immense need for health education and prevention awareness camps for HIV/AIDS among school & college going students as well as the infected patients in south India.

Cost-Effectiveness Analysis of Pharmacist Counselling in Therapeutic Success and Quality of Life of Hypertensive Patients

This study aims to examine the pharmacoeconomic aspects of analyzing the cost-effectiveness of pharmacist counseling in therapeutic success and quality of life of hypertensive patients. This research conducted with cost data collection from the perspective of BPJS (Social Insurance Administration Organization in Indonesia) or INA-CBGs and The General Hospital of East Nusa Tenggara Province. The results showed that patients with controlled blood pressure (target range <140/90mmHg) in the counseling group (39 people/78%) were greater than the group without counseling (13 people/26%), The results of the cost-effectiveness analysis of the INA-CBGs perspective show that to get one patient with controlled blood pressure, the counseling group costs less (IDR. 6, 387,-) than the group without counseling (IDR. 57, 485,-); to increase one score of quality of life, the counseling group costs less (IDR. 4,-and IDR. 5,-) than the group without counseling (IDR. 96,-and IDR. 888-,); Cost-Effective Incremental Ratio of pharmacist counseling cost of the hospital perspective shows savings of IDR. 2, 296,-/person with controlled blood pressure and IDR. 1,-/increase in one score of improvement in the quality of life. Pharmacist counseling is more cost-effective than without counseling in therapeutic success and quality of life of hypertensive patients.

Effect of hospital pharmacist counseling on clinical outcomes of type 2 diabetes mellitus outpatients

Objective:In Indonesia, the role of a hospital pharmacist in pharmaceutical care is still limited or even absent. This study aimed to determine whether counseling by a pharmacist could improve medication adherence, controlling the glycemic status, lipid profile, and blood pressure of type 2 diabetes mellitus (T2DM) outpatients.Methods:We conducted an interventional study at RSUD Kota Depok, a secondary public hospital, Indonesia, from April to October 2018. Counseling was given three times during the 4-month study. The study design was quasi-experimental with pretest-posttest group design on 77 respondents divided into intervention group (IGs) (n = 39 people) who received counseling and booklets from the hospital pharmacist and control group (CG) (n = 38 people) who were only given the booklets. We measured adherence with the Medication Adherence Questionnaire and conducted blood tests for fasting blood glucose (FBG), postprandial blood glucose (PPBG), glycosylated hemoglobin A1, lipid profiles (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and TG), and blood pressure measurements.Findings:In the IG, adherence parameters such as HbA1c and lipid profile improved, whereas in the CG, there were no statistically significant changes in clinical parameters and even nonadherence score increased (P = 0.008). IG showed statistically significant improvement in medication adherence, in parameters such as FBG, PPBG, and HbA1c, compared to CG. Based on the Chi-square test, IG also showed a statistically significant improvement in the number of controlled FBG (P = 0.05) and HbA1c (P < 0.001) compared to CG. In addition, a multivariate analysis showed that counseling by hospital pharmacist was 2.764 times (95% confidence interval [CI]: 1.096–6.794) and 9.964 times (95% CI: 3.434–28.917) better than no counseling in improvement of FBG and HbA1c, respectively. However, the significance disappeared after adjusted by type of medicine, duration of diabetes mellitus drug use, and medication adherence.Conclusion:Hospital pharmacist counseling is an important and significant factor in improving FBG and HbA1c levels of T2DM outpatients.

HIV-TB Treatment Pictogram Tool Designed from Semiotic Analysis for Community Pharmacists in India

A pictogram-based counselling pamphlet for pharmacists in India for HIV-TB co-infection and treatment was developed. Pictograms have been shown to improve health literacy and adherence by increasing retention and comprehension of health information, especially in persons with lower levels of literacy. The development of the draft pictogram pamphlet for HIV-TB treatment was based on semiology and adaptation of existing pictograms and incorporation of key counselling points identified in a literature review. A total of 103 articles were reviewed and 21 (n=9 for HIV; n=12 for TB) were identified as applicable to pharmacist counselling and were used in the development of key counselling points. Of the 22 pictograms in the draft pamphlet, n=5 were redesigned based on existing pictograms, n=11 were based on semiotic analysis of existing pictograms, n=5 were based on semiology of a web-based image search, and n=1 was developed in consultation with Indian pharmacists. The future goal is to validate the pictogram pamphlet as there is a scarcity and oversimplification of validated pictograms targeted to counselling patients with HIV-TB. Although validation of more complicated pictograms in a low-literacy population may be challenging, the aim of pictograms is to enhance recall and deliver the pictogram information in combination with verbal instruction in order to improve adherence and patient outcomes.

Pharmacist counseling intervention to improve patient antibiotic compliance

Background and objectives: Reported microbial resistance to antibiotics is increasing. One of the main factors is patient non-compliance in use of antibiotics. Pharmacist counseling has been shown to be effective in increasing compliance with the use of several types of medications, but its effectiveness of on compliance with antibiotic use has not been widely published. The purpose of this study was to determine the effectiveness of pharmaceutical counseling in a pharmacy setting to increase compliance with antibiotic use.Method: A randomized controlled trial was conducted on 104 adult patients aged 18 years and over who purchased antibiotics by prescription at a pharmacy in Denpasar City, Bali Province. The number of subjects was determined with a confidence level of 95% and a power of 90% with the effect size of 20%. Subjects were divided into two groups using the block randomization method, namely 52 subjects in the intervention group and 52 subjects in the control group. The intervention group was provided with pharmaceutical counseling by a pharmacist at the time of delivery of the drug at the pharmacy, while the control group was provided drug information according to the pharmacy service standard. Subject compliance was measured by telephone interview using the Morisky Medication Adherence Scale-8 questionnaire within 3-5 days after purchasing the medication. Statistical analysis with the Mann Whitney U Test was performed to determine the difference in mean rank of compliance scores between the intervention group and the control group. The proportion of compliance among the intervention group was divided by proportion of compliance in the control group to get the compliance ratio. Logistic regression analysis was conducted to determine the adjusted compliance ratio.Results: The number of subjects analyzed was 98, as 5 subjects could not be contacted by telephone and 1 subject was hospitalized. The mean rank of compliance scores in the intervention group (61.05) was significantly higher (p&lt;0.001) than the comparison group (37.95). The proportion of compliance in the intervention group was 65.3% and the control group was 18.4%, with the proportion ratio (PR) of 3.56 (95%CI=1.90-6.64). Logistic regression analysis showed that variables which significantly increased compliance with antibiotic use were pharmacist counseling (APR=9.33; 95%CI: 3.24-26.87), frequency of taking medication (APR=6.94; 95%CI: 2.01-23.92) and method of payment (APR=4.30; 95%CI: 1.18-15.66).Conclusion: Pharmaceutical counseling at a pharmacy setting was found to increase compliance of antibiotic use. Compliance of antibiotic use is also influenced by the frequency of taking medication and the method of payment. Pharmacist counseling when accessing medication at a pharmacy is crucial for improving patient compliance of antibiotic use.

Pharmacist counseling intervention to improve patient antibiotic compliance

Pharmacist counseling intervention to improve patient antibiotic compliance

Screening for Adverse Drug Events: a Randomized Trial of Automated Calls Coupled with Phone-Based Pharmacist Counseling.

Medication adverse events are important and common yet are often not identified by clinicians. We evaluated an automated telephone surveillance system coupled with transfer to a live pharmacist to screen potentially drug-related symptoms after newly starting medications for four common primary care conditions: hypertension, diabetes, depression, and insomnia. Cluster randomized trial with automated calls to eligible patients at 1 and 4months after starting target drugs from intervention primary care clinics compared to propensity-matched patients from control clinics. Primary and secondary outcomes were physician documentation of any adverse effects associated with newly prescribed target medication, and whether the medication was discontinued and, if yes, whether the reason for stopping was an adverse effect. Of 4876 eligible intervention clinic patients who were contacted using automated calls, 776 (15.1%) responded and participated in the automated call. Based on positive symptom responses or request to speak to a pharmacist, 320 patients were transferred to the pharmacist and discussed 1021 potentially drug-related symptoms. Of these, 188 (18.5%) were assessed as probably and 479 (47.1%) as possibly related to the medication. Compared to a propensity-matched cohort of control clinic patients, intervention patients were significantly more likely to have adverse effects documented in the medical record by a physician (277 vs. 164 adverse effects, p < 0.0001, and 177 vs. 122 patients discontinued with documented adverse effects, p < 0.0001). Systematic automated telephone outreach monitoring coupled with real-time phone referral to a pharmacist identified a substantial number of previously unidentified potentially drug-related symptoms, many of which were validated as probably or possibly related to the drug by the pharmacist or their physicians. Multiple challenges were encountered using the interactive voice response (IVR) automated calling system, suggesting that other approaches may need to be considered and evaluated. ClinicalTrials.gov : NCT02087293.

Can Diabetes Self-Management Program Improve Patients’ Knowledge? A Real Life Evaluation Study of Lebanese Diabetic Adults

Objectives: The objective was to assess the effect of the Advanced National Standards for DSME program in improving the knowledge of Lebanese elderly diabetic patients. Secondary objectives were to test the influence of pharmacist counseling on managing these patients’ lifestyle and assess health perceptions that affect diabetic patients for effective management through the Health Belief Model (HBM). Methods: This cross-sectional study, conducted from February until May 2016 in different community pharmacies, enrolled 206 patients. Results: All knowledge items scores increased significantly from pre to post counselling (p Key words: DSME, Health belief model, Education, Program, Diabetes mellitus.