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临床药师提供药物治疗管理的慢性肾脏病与依从性改善项目:患者自我护理认知与实践的准实验评估

Chronic kidney disease and adherence improvement program by clinical pharmacist-provided medication therapy management; a quasi-experimental assessment of patients' self-care perception and practice.

作者信息

Mohammadnezhad Ghader, Ehdaivand Sadaf, Sebty Mehrshad, Azadmehr Behniya, Ziaie Shadi, Esmaily Hadi

机构信息

Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

BMC Nephrol. 2024 Dec 18;25(1):463. doi: 10.1186/s12882-024-03902-6.

Abstract

RATIONALE

One of the critical roles of pharmacists in the field of community and hospitals is to provide medication therapy management (MTM) services and reconciliation.

OBJECTIVES

This study aimed to assess the perceptions, adherence, and performance of the patients with chronic kidney disease (CKD) to the clinical pharmacist-provided MTM before and after receiving this service.

METHOD

A cross-sectional survey was conducted from June 2023 to January 2024. A validated questionnaire assessed patients' knowledge, attitude, and performance, and the Morisky medication adherence scale evaluated the medical adherence of the patients before and after the clinical pharmacist-provided MTM. Inclusion criteria were patients with CKD according to NKF KDOQI guidelines and GFR < 60 mL/min/1.73 m. Before and after the MTM service, CKD patients' knowledge, attitude, performance, and adherence to their pharmacotherapy were assessed.

RESULTS

A total of 100 patients enrolled in the study and completed the questionnaire. Before and after the MTM service, total knowledge was 3.38 ± 1.82 and 7.59 ± 1.11, respectively. Before and after the MTM service, the attitude score was 54.53 ± 5.05 and 59.24 ± 4.68, respectively. Before and after the MTM service, the mean performance score was 30.15 ± 4.27 and 34.54 ± 2.56, respectively. Adherence score to medications before and after the MTM service was 4.86 ± 1.99 and 6.22 ± 1.39, respectively. In all fields, outcomes significantly improved (P < 0.05).

CONCLUSION

The current study showed the critical role of clinical pharmacists in training patients about medications and improving adherence to their pharmacotherapy.

摘要

理论依据

药剂师在社区和医院领域的关键作用之一是提供药物治疗管理(MTM)服务和药物重整。

目的

本研究旨在评估慢性肾脏病(CKD)患者在接受临床药剂师提供的MTM服务前后对该服务的认知、依从性和执行情况。

方法

于2023年6月至2024年1月进行了一项横断面调查。一份经过验证的问卷评估了患者的知识、态度和执行情况,Morisky药物依从性量表评估了临床药剂师提供MTM服务前后患者的药物治疗依从性。纳入标准为根据NKF KDOQI指南诊断为CKD且肾小球滤过率(GFR)<60 mL/min/1.73 m²的患者。在MTM服务前后,评估CKD患者对药物治疗的知识、态度、执行情况和依从性。

结果

共有100名患者纳入研究并完成问卷。MTM服务前后,总知识得分分别为3.38±1.82和7.59±1.11。MTM服务前后,态度得分分别为54.53±5.05和59.24±4.68。MTM服务前后,平均执行得分分别为30.15±4.27和34.54±2.56。MTM服务前后的药物治疗依从性得分分别为4.86±1.99和6.22±1.39。在所有方面,结果均有显著改善(P<0.05)。

结论

本研究表明临床药剂师在培训患者用药知识和提高药物治疗依从性方面具有关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ac6/11658402/898e2b71477c/12882_2024_3902_Fig1_HTML.jpg

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