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尼日利亚社区药房药师主导的高血压管理教育干预对健康结局的有效性:双臂平行单盲随机对照试验。

Effectiveness of a pharmacist-led educational intervention on health outcomes in hypertension management at community pharmacies in Nigeria: A two-arm parallel single-blind randomized controlled trial.

作者信息

Ayogu Ebere Emilia, Yahaya Rahmat Isa, Isah Abdulmuminu, Ubaka Chukwuemeka Michael

机构信息

Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria.

出版信息

Br J Clin Pharmacol. 2023 Feb;89(2):649-659. doi: 10.1111/bcp.15514. Epub 2022 Sep 10.

Abstract

AIMS

This study determined the impact of a pharmacist-led educational intervention on the health outcomes of hypertensive patients in community pharmacies.

METHODS

A 2-arm parallel single-blind randomized trial design was adopted among hypertensive patients in 4 pharmacies in Abuja and Lokoja, Nigeria. A pharmacist-led educational intervention was provided to the patients in the intervention group. The study outcomes, namely changes in adherence to medication, quality of life and cost of medication were measured using MARS-10, SF-12 and official price list, respectively. Independent and paired-sample t-tests were conducted on the data.

RESULTS

A total of 128 patients participated in the study. All of them completed the study and were included in the analysis: 70 in the control arm and 58 in the intervention arm. There was a significant improvement in components of Behaviour (2.57 vs. 2.98), Attitude (2.59 vs. 3.14) and Negative attitude (1.62 vs. 1.92). There was a better improvement in adherence in the intervention arm: 8.05 ± 1.32 vs. 6.55 ± 2.24; t = -4.65, P = .0001. There were no changes in the respondents' health status after intervention in both groups (P < .05). There was a weak inverse association between the physical health component and mental health component: R = -0.2, P = .04 and a positive association with overall adherence (R = 0.26, P = .004) in the intervention group, in whom the monthly cost of treatment decreased from N2233.1 to N2068.4.

CONCLUSION

Community pharmacy educational intervention improves health outcomes, particularly with adherence among patients with hypertension. Health-related quality of life of the patients improved, but the physical health component was better than that of the mental health component.

摘要

目的

本研究确定了由药剂师主导的教育干预对社区药房高血压患者健康结局的影响。

方法

在尼日利亚阿布贾和洛科贾的4家药房的高血压患者中采用双臂平行单盲随机试验设计。对干预组患者提供由药剂师主导的教育干预。分别使用MARS-10、SF-12和官方价格表来测量研究结局,即药物依从性的变化、生活质量和药物成本。对数据进行独立样本t检验和配对样本t检验。

结果

共有128名患者参与研究。他们均完成研究并纳入分析:对照组70名,干预组58名。行为(2.57对2.98)、态度(2.59对3.14)和消极态度(1.62对1.92)的各组成部分有显著改善。干预组的依从性改善更好:8.05±1.32对6.55±2.24;t = -4.65,P = .0001。两组干预后应答者的健康状况均无变化(P < .05)。在干预组中,身体健康组成部分与心理健康组成部分之间存在微弱的负相关:R = -0.2,P = .04,与总体依从性呈正相关(R = 0.26,P = .004),干预组的每月治疗费用从2233.1奈拉降至2068.4奈拉。

结论

社区药房教育干预可改善健康结局,尤其是高血压患者的依从性。患者与健康相关的生活质量得到改善,但身体健康组成部分优于心理健康组成部分。

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