Department of Health Services Research (HSR), Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, PO Box 616, Maastricht, MD, 6200, The Netherlands.
Department of Clinical and Community Pharmacy, Center for Medicines Information and Pharmaceutical Care (CMIPC), Faculty of Pharmacy, University of Surabaya, Surabaya, East Java, 60293, Indonesia.
BMC Health Serv Res. 2021 Nov 13;21(1):1227. doi: 10.1186/s12913-021-07242-1.
Various pharmacist services are available to improve medication adherence, including consultation, brochure, etc. Challenges arise on which services are best implemented in practice. Knowledge about patients' and pharmacists' preferences can help to prioritize services. This study explores the pharmacists' and patients' perceptions about the importance of pharmacist services to improve medication adherence among patients with diabetes in Indonesia.
This questionnaire-based cross-sectional study involved adult outpatients with diabetes type 2 and pharmacists from community health centers (CHCs) and hospitals in Surabaya, Indonesia. Random sampling was used to identify 57 CHCs in the study. In addition, based on convenient sampling, three hospitals participated. All pharmacists working at the CHCs and hospitals, who were willing to participate, were included in the study. For patients, minimum sample size was calculated using Slovin's formula. Patients and pharmacists were asked to rank five pharmacist service types (consultation, brochure/leaflet, patient group discussion, medication review, and phone call refill reminder) according to their importance to improve medication adherence. A face validity test of the self-developed questionnaire was conducted before the data collection. Rank ordered probit models were estimated (STATA 15th software).
A total of 457 patients from CHCs, 579 patients from hospitals, and 99 pharmacists from both medical facilities were included. Consultation (CHC patients 56.0% vs hospital patients 39.7% vs pharmacists 75.2%) and brochure (CHC patients 23.2% vs hospital patients 27.5% vs pharmacists 11.9%) were the most preferred pharmacist services. Patients with experience getting medication information from pharmacists valued consultation higher than brochure and patient group discussions. Older patients ranked a brochure higher than other services. Patients without formal education in CHCs had a lower probability of giving a high rank to a brochure to improve medication adherence. There was significant positive correlation between the ranking of phone call refill reminder and medication review (0.6940) for patients in CHCs.
For both patients and pharmacists, consultation, brochure, and group discussion were the highest-ranked services. Education, age, experience with pharmacist services, and medical facility features need to be considered when evaluating which pharmacist services to implement in Indonesia.
有多种药剂师服务可以提高药物依从性，包括咨询、宣传册等。在实践中，哪种服务最有效实施存在挑战。了解患者和药剂师对改善糖尿病患者药物依从性的药剂师服务的重视程度，可以帮助确定服务优先级。本研究旨在探讨印度尼西亚社区卫生中心（CHC）的患者和药剂师对提高糖尿病患者药物依从性的药剂师服务的重视程度。
本研究采用问卷调查的横断面研究方法，纳入印度尼西亚泗水市的成年 2 型糖尿病门诊患者和社区卫生中心（CHC）及医院的药剂师。采用随机抽样方法确定了研究中的 57 个 CHC。此外，还根据便利抽样法，选择了 3 家医院参与研究。所有愿意参与的 CHC 和医院药剂师均纳入研究。对于患者，根据 Slovin 公式计算最小样本量。患者和药剂师被要求根据提高药物依从性的重要性对五种药剂师服务类型（咨询、宣传册/传单、患者小组讨论、药物审查和电话提醒）进行排名。在收集数据之前，对自行开发的问卷进行了表面有效性测试。使用 STATA 15 软件对排序概率模型进行了估计。
共纳入来自 CHC 的 457 名患者、来自医院的 579 名患者和来自两个医疗设施的 99 名药剂师。咨询（CHC 患者 56.0% vs 医院患者 39.7% vs 药剂师 75.2%）和宣传册（CHC 患者 23.2% vs 医院患者 27.5% vs 药剂师 11.9%）是最受欢迎的药剂师服务。从药剂师那里获得药物信息的患者比从宣传册和患者小组讨论中获得的患者更重视咨询。年龄较大的患者对宣传册的评价高于其他服务。CHC 中没有接受过正规教育的患者对提高药物依从性的宣传册评价较低。CHC 患者对电话提醒和药物审查的排名呈显著正相关（0.6940）。
对于患者和药剂师而言，咨询、宣传册和小组讨论是排名最高的服务。在评估在印度尼西亚实施哪种药剂师服务时，需要考虑教育、年龄、药剂师服务体验和医疗设施特点。
