Department of Internal Medicine and Clinical Neuroscience, EMMS Nazareth-The Nazareth Hospital, Nazareth 16100, Israel.
J Transl Med. 2012 Mar 1;10:34. doi: 10.1186/1479-5876-10-34.
Medication non adherence is a global epidemic perplexing phenomenon that is eminent, but not insurmountable. Our first objective was to explore whether providing pharmacist's counseling to cardiac patients prior to discharge can increase patient's medication adherence, and our second objective was to assess whether better medication adherence leads to reduction of hospital readmissions.
Observational study was conducted among diagnosed cardiac patients using an intervention strategy at discharge from two hospitals in Israel; The Nazareth and the Haemek hospital. 74 patients were recruited between January 2010 and January 2011. Two separate groups were selected; intervention group: 33 patients who prior to discharge received nurse, pharmacist interventions, and control group: 41 patients who had received the nurse and hospital discharge counseling only.
Regression analysis for examining the first objective reflected significant effect when having a pharmacist interventions, which explains the increasing 11.6% of the variance in medication adherence, [F change (1,73) = 9.43, p < 0.003]. Stepwise regression analysis for examining the second objective demonstrated that the relation between medication adherence and readmissions was insignificant [F (1,73) = 9.43, n.s].
While physicians and nurses can have an impact on improving adherence, pharmacists have demonstrated the ability to inform, problem-solve and provide performance support directly to patients.
药物不依从是一种全球性的、令人困扰的普遍现象,但并非不可逾越。我们的首要目标是探讨在患者出院前为其提供药师咨询服务是否可以提高患者的用药依从性,我们的第二个目标是评估更好的用药依从性是否会降低医院再入院率。
在以色列的两家医院(拿撒勒医院和海马克医院)进行了一项观察性研究,采用出院干预策略对确诊的心脏病患者进行研究;2010 年 1 月至 2011 年 1 月期间共招募了 74 名患者。我们选择了两组患者:干预组(n=33)在出院前接受了护士和药师的干预,对照组(n=41)仅接受了护士和医院的出院咨询。
检验第一个目标的回归分析反映了药师干预的显著效果,这解释了用药依从性增加了 11.6%的方差[F 变化(1,73)=9.43,p<0.003]。检验第二个目标的逐步回归分析表明,用药依从性与再入院率之间的关系并不显著[F(1,73)=9.43,n.s]。
尽管医生和护士可以对提高患者的依从性产生影响,但药师已证明有能力向患者提供信息、解决问题和提供绩效支持。