School Of Pharmacy, Faculty of Health and Medical Science, Taylor's University, Selangor, Malaysia.
Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
PLoS One. 2022 Feb 18;17(2):e0263412. doi: 10.1371/journal.pone.0263412. eCollection 2022.
Patients requiring hemodialysis (HD) often have several chronic comorbidities, which necessitate the use of several medications and hence put them at high risk of polypharmacy. Medication-related problems (MRPs) among HD patients are a serious issue as they can increase morbidity and nonadherence with medications. To overcome this issue, a unique pharmacy practice model including medication review (MR) and motivational interviewing (MI) is needed to improve medication adherence, by reducing MRPs and optimizing therapeutic outcomes. The present study aims to assess the effectiveness of MR and MI in improving medication adherence, quality of life (QOL) and clinical outcomes among end-stage renal disease (ESRD) patients who are on dialysis.
This pre-post study will be conducted prospectively among patients with ESRD who have been on dialysis at the Hemodialysis Unit, Hospital Kuala Lumpur and the Hemodialysis Affiliated Centers of the University Malaya Medical Centre, from August 2020 till August 2021. Medication adherence will be assessed using the General Medication Adherence Scale (GMAS), whilst patients' HRQOL will be assessed using the Kidney Disease Quality of Life Short Form 36 (KDQOL-36). Clinical parameters such as blood glucose level, calcium, phosphate, hemoglobin and serum low-density lipoprotein (LDL) levels will be obtained from medical records. A total of 70 patients will be recruited.
We hypothesize that the implementation of pharmacy-based MR and MI may expect an increase in medication adherence scores and increase in HRQOL scores from baseline as well as achieving the clinical lab parameters within the desired range. This would indicate a need for a pharmacist to be involved in the multidisciplinary team to achieve a positive impact on medication adherence among hemodialysis patients.
Ethical approval has been obtained from the National Medical Research and Ethics Committee NMRR: 20-1135-54435 and Medical Research Ethics Committee, University Malaya Medical Centre MREC ID NO: 202127-9811.
需要进行血液透析（HD）的患者通常患有多种慢性合并症，这需要使用多种药物，因此使他们面临高度的药物滥用风险。HD 患者的药物相关问题（MRP）是一个严重的问题，因为它们会增加发病率和对药物的不依从性。为了克服这个问题，需要一种独特的药房实践模式，包括药物审查（MR）和动机访谈（MI），以通过减少 MRP 和优化治疗结果来提高药物依从性。本研究旨在评估 MR 和 MI 在提高正在接受透析的终末期肾病（ESRD）患者的药物依从性、生活质量（QOL）和临床结局方面的有效性。
这项前瞻性的研究将在 2020 年 8 月至 2021 年 8 月期间，在吉隆坡医院血液透析科和马来亚大学医学中心附属血液透析中心接受透析治疗的 ESRD 患者中进行。使用一般药物依从性量表（GMAS）评估药物依从性，而患者的 HRQOL 将使用肾脏病生活质量简表 36 项（KDQOL-36）进行评估。从病历中获得临床参数，如血糖水平、钙、磷、血红蛋白和血清低密度脂蛋白（LDL）水平。将招募 70 名患者。
我们假设，实施基于药房的 MR 和 MI 可能会期望从基线开始，药物依从性评分增加，HRQOL 评分增加，并达到所需范围内的临床实验室参数。这表明需要药剂师参与多学科团队，以对血液透析患者的药物依从性产生积极影响。
已获得国家医学研究和伦理委员会 NMRR：20-1135-54435 和马来西亚大学医学中心医学研究伦理委员会的伦理批准，MREC ID NO：202127-9811。
