Pharmacy Department, Bahagia Ulu Kinta Hospital, Ministry of Health Malaysia, Jalan Besar, 31250, Tanjung Rambutan, Perak, Malaysia.
Pharmacy Department, Seri Manjung Hospital, Ministry of Health Malaysia, Seri Manjung, Perak, Malaysia.
BMC Health Serv Res. 2022 Jun 1;22(1):726. doi: 10.1186/s12913-022-08069-0.
Proper home medication management plays a role in improving medication adherence, preserving drug efficacy and ensuring safe medication practices, which is crucial to establish positive treatment outcomes. However, no published studies are available on home medication management among psychiatric patients. The study aimed to identify home medication management problems among psychiatric patients in Malaysia and to examine the associations of inappropriate medication storage and lack of a medication administration schedule with sociodemographic factors, disease insight, number of medications and type of home care pharmacy services (HCPS).
This multicentre cross-sectional study was conducted among psychiatric patients using HCPS in six government hospitals in western Malaysia. Data were extracted from the HCPS form used for each visit as per the protocol published by the Pharmaceutical Services Division, Ministry of Health Malaysia. A minimum sample size of 169 was needed. Proportional random sampling was applied. The associations of inappropriate medication storage and lack of medication administration schedule with study parameters were analysed using multiple logistic regressions.
A total of 205 home visits were conducted with 229 home medication management problems identified; inappropriate medication storage and lack of medication administration schedule topped the list. Inappropriate medication storage was significantly associated with low income [AOR = 4.34 (95% CI 1.17:15.98), p = 0.027], alcohol consumption [AOR = 14.26 (95% CI 1.82:111.38), p = 0.011], poor insight [AOR = 2.34 (95% CI 1.08:5.06), p = 0.030] and part-time HCPS [AOR = 2.60 (95% CI 1.20:5.67), p = 0.016]. Lack of administration schedule was significantly associated with low income [AOR = 6.90 (95% CI 1.46:32.48), p = 0.014], smoking [AOR = 2.43 (95% CI 1.20:4.92), p = 0.013], poor insight [AOR = 5.32 (95% CI 2.45:11.56), p < 0.05] and part-time HCPS [AOR = 2.96 (95% CI 1.42:6.15), p = 0.004].
Inappropriate medication storage and a lack of a medication administration schedule are common among psychiatric patients. The study also highlighted the potential of HCPS to improve disease insight and home medication management among psychiatric patients if the service is utilized fully.
适当的家庭用药管理对于提高用药依从性、保持药物疗效和确保安全用药至关重要，这对于建立积极的治疗结果至关重要。然而，目前尚无关于精神科患者家庭用药管理的研究。本研究旨在确定马来西亚精神科患者的家庭用药管理问题，并探讨不适当的药物储存和缺乏药物管理计划与社会人口因素、疾病认识、药物数量和家庭护理药房服务类型之间的关联。
本多中心横断面研究在马来西亚西部 6 家政府医院使用家庭护理药房服务对精神科患者进行。数据是根据马来西亚卫生部药剂服务司发布的方案从每次就诊的家庭护理药房服务表中提取的。需要至少 169 名患者的样本量。应用比例随机抽样。使用多元逻辑回归分析不适当的药物储存和缺乏药物管理计划与研究参数之间的关联。
共进行了 205 次家庭访问，发现了 229 个家庭用药管理问题；不适当的药物储存和缺乏药物管理计划位居榜首。不适当的药物储存与低收入显著相关 [优势比 (AOR) = 4.34 (95%置信区间 1.17:15.98)，p = 0.027]、饮酒 [AOR = 14.26 (95%置信区间 1.82:111.38)，p = 0.011]、疾病认识差 [AOR = 2.34 (95%置信区间 1.08:5.06)，p = 0.030] 和兼职家庭护理药房服务 [AOR = 2.60 (95%置信区间 1.20:5.67)，p = 0.016]。缺乏管理计划与低收入显著相关 [AOR = 6.90 (95%置信区间 1.46:32.48)，p = 0.014]、吸烟 [AOR = 2.43 (95%置信区间 1.20:4.92)，p = 0.013]、疾病认识差 [AOR = 5.32 (95%置信区间 2.45:11.56)，p < 0.05] 和兼职家庭护理药房服务 [AOR = 2.96 (95%置信区间 1.42:6.15)，p = 0.004]。
不适当的药物储存和缺乏药物管理计划在精神科患者中很常见。该研究还强调，如果充分利用家庭护理药房服务，家庭护理药房服务有可能改善精神科患者的疾病认识和家庭用药管理。
