Basheti Iman A, Ayasrah Shahnaz Mohammed, Ahmad Muayyad
Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan.
Department of Applied Science, Al-Balqa Applied University, Al-Salt, Jordan.
Saudi Pharm J. 2019 Feb;27(2):208-219. doi: 10.1016/j.jsps.2018.10.005. Epub 2018 Oct 19.
Stroke is a major cause of disability and one of the leading causes of death among the elderly. Treatment related problems can lead to undesirable consequences. The Medication Management Review (MMR) service is aimed at identifying, resolving and preventing TRPs, subsiding the undesirable outcomes associated with TRPs.
To explore the types, frequencies and severity of TRPs amongst post-stroke patients recruited through hospitals via conducting the MMR service by clinical pharmacists in Jordan. Associations between patient factors and the identified TRPs were explored.
This cross-sectional descriptive study was conducted over three months in 2017 in different geographical areas throughout Jordan. Randomly recruited patients were interviewed at the hospitals to collect their demographic data and clinical characteristics. Types/frequencies/severity of TRPs for each stroke patient were identified by a clinical pharmacist. Associations between the identified TRPs and patient's factors were explored through multiple regression analysis.Key findings:Out of 198 stroke patients (mean age: 56.6 ± 14.2) who completed the study, 110 (55.6%) were males. Many of the patients (82 (41.6%)) were smokers and 61 (69.2%) had hypertension and/or diabetes. The mean number of TRPs per patient was 2.5 ± 1.1. The most common TRP categories involved efficacy issues (198 (40.6%)), inappropriate drug adherence (136 (27.9%)) and inappropriate patient knowledge (114 (23.4%)). More than 70.0% (342/487) of the identified TRPs were of major severity. Higher number of TRPs was found to be associated with being a male, having a lower educational level, being a current smoker, having a higher number of drugs and a poorer quality of life.
Lack of drug efficacy, inappropriate drug adherence and patient knowledge were the major TRPs identified via delivering the MMR service to post-stroke patients. The identified TRPs highlights the importance of the MMR service, and supports planning future strategies aimed at decreasing the incidence of strokes.
中风是导致残疾的主要原因之一，也是老年人主要死因之一。与治疗相关的问题可能会导致不良后果。药物管理审查（MMR）服务旨在识别、解决和预防治疗相关问题（TRPs），减少与TRPs相关的不良后果。
通过约旦临床药剂师开展MMR服务，探讨通过医院招募的中风后患者中TRPs的类型、频率和严重程度。探索患者因素与已识别的TRPs之间的关联。
这项横断面描述性研究于2017年在约旦不同地理区域进行了三个月。在医院对随机招募的患者进行访谈，以收集他们的人口统计学数据和临床特征。由临床药剂师确定每位中风患者的TRPs类型/频率/严重程度。通过多元回归分析探索已识别的TRPs与患者因素之间的关联。
在完成研究的198名中风患者（平均年龄：56.6±14.2）中，110名（55.6%）为男性。许多患者（82名（41.6%））吸烟，61名（69.2%）患有高血压和/或糖尿病。每位患者的TRPs平均数量为2.5±1.1。最常见的TRP类别涉及疗效问题（198例（40.6%））、不适当的药物依从性（136例（27.9%））和患者知识不足（114例（23.4%））。超过70.0%（342/487）已识别的TRPs为严重程度。发现较高数量的TRPs与男性、教育水平较低、当前吸烟者、药物数量较多和生活质量较差有关。
通过为中风后患者提供MMR服务，发现缺乏药物疗效、不适当的药物依从性和患者知识是主要的TRPs。已识别的TRPs突出了MMR服务的重要性，并支持规划未来旨在降低中风发病率的策略。
