Department of Pharmacology and Therapeutics, State University of Maringá, Avenue Colombo 5790, Maringá, PR 87020-290, Brazil.
Int J Clin Pharm. 2011 Aug;33(4):642-9. doi: 10.1007/s11096-011-9518-x. Epub 2011 May 5.
The primary objective of this study was to evaluate the effect of a pharmaceutical care program on pharmacotherapy adherence in elderly diabetic and hypertensive patients. The clinical outcomes of this pharmacotherapy adherence approach were the secondary objective of the study.
Public Primary Health Care Unit in a municipality in the Brazilian State of Sao Paulo.
A 36-month randomized, controlled, prospective clinical trial was carried out with 200 patients divided into two groups: control (n = 100) and intervention (n = 100). The control group received the usual care offered by the Primary Health Care Unit (medical and nurse consultancies). The patients randomized into the intervention group received pharmaceutical care intervention besides the usual care offered.
Pharmacotherapy adherence (Morisky-Green test translated into Portuguese and computerized dispensed medication history) and clinical measurements (blood pressure, fasting glucose, A1C hemoglobin, triglycerides and total cholesterol) were evaluated at the baseline and up to 36 months. A P value <0.05 was considered statistically significant.
A total of 97 patients from the intervention group and 97 patients from the control group completed the study (n = 194). Significant improvements in the pharmacotherapy adherence were verified for the intervention group according to the Morisky-Green test (50.5% of adherent patients at baseline vs. 83.5% of adherent patients after 36 months; P < 0.001) and the computerized dispensed medication history (52.6% of adherent patients at baseline vs. 83.5% of adherent patients after 36 months; P < 0.001); no significant changes were verified in the control group. Significant improvements in the number of patients reaching adequate values for their blood pressure (26.8% at baseline vs. 86.6% after 36-months; P < 0.001), fasting glucose (29.9% at baseline vs. 70.1% after 36 months; P < 0.001), A1C hemoglobin (3.3% at baseline vs. 63.3% after 36 months; P < 0.001), triglycerides (47.4% at baseline vs. 74.2% after 36 months; P < 0.001) and total cholesterol (59.8% at baseline vs. 80.4% after 36 months; P = 0.002) were verified in the intervention group, but remained unchanged in the control group.
These results indicated the effectiveness of pharmaceutical care in improving pharmacotherapy adherence, with positive effects in the clinical outcomes of the patients studied.
本研究的主要目的是评估药学保健方案对老年糖尿病和高血压患者药物治疗依从性的影响。该药物治疗依从性方法的临床结果是本研究的次要目的。
巴西圣保罗州一个直辖市的公立基层医疗保健单位。
进行了一项为期 36 个月的随机、对照、前瞻性临床试验，共有 200 名患者分为两组：对照组（n=100）和干预组（n=100）。对照组接受基层医疗保健单位（医疗和护士咨询）提供的常规护理。随机分配到干预组的患者除接受常规护理外，还接受药学保健干预。
药物治疗依从性（Morisky-Green 测试翻译成葡萄牙语和计算机化配药记录）和临床测量（血压、空腹血糖、A1C 血红蛋白、甘油三酯和总胆固醇）在基线和 36 个月时进行评估。P 值<0.05 被认为具有统计学意义。
干预组和对照组各有 97 名患者完成了研究（n=194）。根据 Morisky-Green 测试，干预组的药物治疗依从性显著改善（基线时 50.5%的患者依从，36 个月时 83.5%的患者依从；P<0.001）和计算机化配药记录（基线时 52.6%的患者依从，36 个月时 83.5%的患者依从；P<0.001）；对照组没有明显变化。干预组血压达到适当值的患者人数显著增加（基线时 26.8%，36 个月时 86.6%；P<0.001）、空腹血糖（基线时 29.9%，36 个月时 70.1%；P<0.001）、A1C 血红蛋白（基线时 3.3%，36 个月时 63.3%；P<0.001）、甘油三酯（基线时 47.4%，36 个月时 74.2%；P<0.001）和总胆固醇（基线时 59.8%，36 个月时 80.4%；P=0.002），但对照组没有变化。
这些结果表明，药学保健在提高药物治疗依从性方面是有效的，并对研究患者的临床结果产生了积极影响。
