Puig-Moltó María, Lumbreras Blanca, López-Pintor Elsa
Department of Public Health, History of Science and Gynecology, Miguel Hernandez University, San Juan de Alicante, Spain.
CIBER of Epidemiology and Public Health, CIBERESP, Madrid, Spain.
Patient Prefer Adherence. 2024 Dec 18;18:2569-2580. doi: 10.2147/PPA.S485307. eCollection 2024.
Proton-pump inhibitor (PPI) therapy stands as the primary treatment for upper gastrointestinal symptoms, yet poor adherence often results in treatment failure. Given that patients experiencing these symptoms frequently seek assistance at community pharmacies, the development of collaborative tools with primary care is becoming imperative. The objective was to assess the effectiveness of a pharmaceutical intervention, as demonstrated by a collaborative model between primary care and community pharmacies, in enhancing adherence to PPI among patients experiencing upper gastrointestinal symptoms.
A Pre-post intervention study was carried out in Spanish community pharmacies (June-October 2022). During the baseline visit, patients' sociodemographic and clinical variables were evaluated. Patients were categorized as adherent or non-adherent using the Morisky Medication Adherence Scale (MMAS-4). In the follow-up visit (14 days later), the impact of the intervention was measured by changes in the Gastroesophageal Reflux Disease Impact Scale (GIS).
Of the 351 patients with an active PPI prescription, 178 (50.7%) were non-adherent. Nearly 70% of these patients (122, 68.5%) received an intervention to improve adherence. The overall GIS score improved after the intervention (mean 25.34, SD 5.66 vs mean 27.64, SD 5.63, p < 0.001). All GIS score items showed improvement after the intervention except for the item regarding the taking of additional medication different from that prescribed by the clinician (p = 0.200).
The pharmaceutical intervention had a positive impact on patients' symptom relief and overall quality of life, highlighting the significance and efficacy of a collaborative model between primary care and professional pharmaceutical services.
Clinical Trial Registration (NCT05162079).
质子泵抑制剂（PPI）治疗是上消化道症状的主要治疗方法，但依从性差常导致治疗失败。鉴于出现这些症状的患者经常在社区药房寻求帮助，与初级保健机构开发协作工具变得势在必行。目的是评估一种药物干预措施的有效性，该措施通过初级保健机构与社区药房之间的协作模式来体现，以提高上消化道症状患者对PPI的依从性。
在西班牙社区药房进行了一项干预前后研究（2022年6月至10月）。在基线访视期间，评估患者的社会人口统计学和临床变量。使用莫斯基 Medication 依从性量表（MMAS-4）将患者分类为依从或不依从。在随访访视（14天后），通过胃食管反流病影响量表（GIS）的变化来衡量干预的影响。
在351名有PPI有效处方的患者中，178名（50.7%）不依从。这些患者中近70%（122名，68.5%）接受了改善依从性的干预。干预后总体GIS评分有所改善（均值25.34，标准差5.66对均值27.64，标准差5.63，p<0.001）。除了关于服用与临床医生处方不同的额外药物的项目外，干预后所有GIS评分项目均有所改善（p = 0.200）。
药物干预对患者的症状缓解和总体生活质量有积极影响，突出了初级保健机构与专业药学服务之间协作模式的重要性和有效性。
临床试验注册（NCT05162079）。
