Chambord Jeremy, Couzi Lionel, Merville Pierre, Moreau Karine, Xuereb Fabien, Djabarouti Sarah
Clinical Pharmacy, Bordeaux Hospital University, France.
Department of Nephrology and Renal Transplantation, CHU Bordeaux, Bordeaux, Aquitaine, France.
Ther Adv Chronic Dis. 2021 Apr 5;12:20406223211005275. doi: 10.1177/20406223211005275. eCollection 2021.
To assess the effect of a pharmacist-led intervention, using Barrows cards method, during the first year after renal transplantation, on patient knowledge about their treatment, medication adherence and exposure to treatment in a French cohort.
We conducted a before-and-after comparative study between two groups of patients: those who benefited from a complementary pharmacist-led intervention [intervention group (IG), = 44] those who did not [control group (CG), = 48]. The pharmacist-led intervention consisted of a behavioral and educational interview at the first visit (visit 1). The intervention was assessed 4 months later at the second visit (visit 2), using the following endpoints: treatment knowledge, medication adherence [proportion of days covered (PDC) by immunosuppressive therapy] and tacrolimus exposure.
At visit 2, IG patients achieved a significantly higher knowledge score than CG patients (83.3% 72.2%, = 0.001). We did not find any differences in treatment exposure or medication adherence; however, the intervention tended to reduce the proportion of non-adherent patients with low knowledge scores. Using the PDC by immunosuppressive therapy, we identified 10 non-adherent patients (10.9%) at visit 1 and six at visit 2.
Our intervention showed a positive effect on patient knowledge about their treatment. However, our results did not show any improvement in overall medication adherence, which was likely to be because of the initially high level of adherence in our study population. Nevertheless, the intervention appears to have improved adherence in non-adherent patients with low knowledge scores.
评估在法国队列中，肾移植后第一年由药剂师主导、采用巴罗斯卡片法进行的干预措施对患者治疗知识、用药依从性及治疗暴露情况的影响。
我们在两组患者之间进行了一项前后对比研究：一组为受益于药剂师主导的补充干预措施的患者[干预组（IG），n = 44]，另一组为未受益的患者[对照组（CG），n = 48]。药剂师主导的干预措施包括在首次就诊（就诊1）时进行行为和教育访谈。4个月后在第二次就诊（就诊2）时评估干预效果，使用以下终点指标：治疗知识、用药依从性[免疫抑制治疗的覆盖天数比例（PDC）]和他克莫司暴露情况。
在就诊2时，IG组患者的知识得分显著高于CG组患者（83.3%对72.2%，P = 0.001）。我们未发现治疗暴露或用药依从性存在差异；然而，该干预措施倾向于降低知识得分低的非依从患者比例。根据免疫抑制治疗的PDC，我们在就诊1时确定了10名非依从患者（10.9%），在就诊2时确定了6名。
我们的干预措施对患者的治疗知识产生了积极影响。然而，我们的结果并未显示总体用药依从性有任何改善，这可能是因为我们研究人群的初始依从性水平较高。尽管如此，该干预措施似乎改善了知识得分低的非依从患者的依从性。
