IMPACT OF CLINICAL PHARMACIST PROVIDED EDUCATION ON MEDICATION KNOWLEDGE AND ADHERENCE OF HEMODIALYSIS PATIENTS IN A SOUTH INDIAN UNIVERSITY HOSPITAL
Keywords:
adherence, knowledge, hemodialysis, medicationAbstract
Objective: To evaluate the medication knowledge of the patients on maintenance hemodialysis, their adherence to drug therapy and to assess the effect of patient counselling in improving their medication knowledge and adherence.
Â
Methods: Data was obtained from the patients by medical history interview and review of their medical records. The medication knowledge was assessed using Medication knowledge assessment questionnaire (MKAQ) and their medication adherence behaviour using Brief Medication questionnaire (BMQ). Patients were counseled both verbally and by distribution of education leaflets regarding their disease, dialysis procedure, the drugs, diet and fluid restrictions on regular dialysis days and the effect of patient counselling in improving their medication knowledge and adherence was assessed using the respective questionnaires at the baseline, after 6and 12 weeks. The mean scores were subjected to statistical analysis.
Â
Results: 85 patients (57 males and 28 females; mean age 50.52±13.28years) were included and 79% were on twice weekly and 21% were on thrice weekly dialysis. The average number of drugs prescribed for a patient was found to be 6.47±1.57. Hypertension was found to be the major co-morbidity in 52.94% patients and antihypertensives were the most prescribed drugs (75.3%). Based on the mean MKAQ score, there was a significant increase in the medication knowledge from baseline of 14.30±6.97 to 19.32±6.61 at the end of sixth week (p=0.000) and to 33.62±7.76 at the end of twelfth week of counseling (p= 0.000). The mean BMQ score was 4.26±0.95 at the baseline, 2.99±0.82 on the sixth week and 1.73±0.94 on the twelfth week of counseling, indicating a significant improvement in medication adherence with continuous patient counseling (p=0.000).
Â
Conclusion: The study emphasized that provision of constant patient education to hemodialysis patients would increase the medication knowledge of the patients and improve their adherence.
Â
Downloads
References
Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, et al. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 2003;139:137-147.
Fincham D, Moosa MR. Dietary and fluid adherence among hemodialysis patients attending public sector hospitals in the westerncape. S Afr J Clin Nutr 2008;21(2):7-12.
Tozawa M, Iseki C, Oshiro S, Higashiuesato Y, Yamazatao M, Tomiyama N, Tana T and Takishital S. Analysis of drug prescriptions in chronic hemodialysis patients. Nephrol Dial Transplant 2002; 17:1819.
Kris D, Dominique M, Fabienne D, Daniela G, Christa N, Sabina DG. Prevalence and consequences of nonadherence to hemodialysis regimen. Am J Crit Care 2007;16:222-235.
Kaplan B, Manson NA,Shimp LA, Ascione FJ. Chronic hemodialysis patients. Part I: Characterization and drug-related problems. Ann Pharmacother 1994;28:316.
Sathvik BS, Seema M, Narahari MG, Gurudev KC, Parthasarathi G. Medication knowledge of hemodialysis patients and influence of clinical pharmacist provided education on their knowledge. Indian J Pharm Sci 2007;69(2):232-239.
Sandra B, Darryl W, Ellen B, Oralia B, Juan T, Theresa A., et al. Correlates of medication knowledge and adherence: Findings from the residency research network of South Texas. Family Medicine 2005;37(10):712-718.
Sathvik BS, Narahari MG, Gurudev KC, Parthasarathi G. Impact of clinical pharmacist- Provided education on medication adherence behavior in ESRD patients on Hemodialysis. Iranian Journal of Pharmaceutical sciences 2009;5(1):21-30.
Svarstad BL, Chewning BA, Sleath BL, Claesson C. The Brief Medication Questionnaire: a tool for screening patient adherence and barriers to adherence. Patient Educ Couns. 1999 Jun;37(2):113-24.
Cleary DJ, Matzke RG, Alexander AC, Joy MS. Medication knowledge and compliance among patients receiving long-term dialysis. Amer J Health Syst Pharm 1995;52:1895.
Lim A. ASHP Midyear clinical meeting 1999;34:42.
Lipton HL, Bird JA. The impact of clinical pharmacists’ consultations on geriatric patients’ compliance and medical care use: a randomized controlled trial. Gerontologist 1994;34(3):307-15.
Makaryus AN, Friedman EA. Patients’ understanding of their treatment plans and diagnosis at discharge. Mayo Clin Croc 2005;80:91-4.
Rosner F. Patient noncompliance:Causes and solutions. Mount Sinai J Med 2006;73:553-559.
Burgoon JK, Pfau M, Parrott R, Birk T, Coker R, Burgoon M. Relational communication, satisfaction, compliance gaining strategies and compliance in communication between physicians and patients. Commun Monogr 1987;54:307-324.
Jean LH, Cathy CD. Why all prescribed medications are not taken: Results from a survey of chronic dialysis patients. Advances in peritoneal dialysis 2006;22:162-166.
McDonald HP, Garg AX, Haynes RB. Interventions to enhance patient adherence to medication prescriptions. Journal of the American Medical Association 2002;288(22):2868-79.
Published
How to Cite
Issue
Section
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.