Evaluation Of The Impact Of Home Medication Review Program On Adherence Among Patients Diagnosed With Schizophrenia At Kinta District, Malaysia
Loading...
Date
2015-07
Authors
YEE MUN, TAN
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Home medication review (HMR) program is to provide continuity of patient‟s care from healthcare institutions to patients‟ home. However, little is known about the actual impact of the HMR program in Malaysia. This study was to evaluate the impact of HMR program on schizophrenia patients‟ medication adherence, knowledge, quality of life, satisfaction to the program and the total cost saving from overstocked medications. This prospective longitudinal study was conducted from September 2012 to December 2013 and involved a convenience sampling of 133 schizophrenia patients under follow up of the home care team of Hospital Bahagia Ulu Kinta. After attaining written informed consent, patients were visited by the pharmacist to perform comprehensive medication review and provide individualized medication counseling at home. Standardized data collection forms were used to collect data from patient during the first visit (baseline), second visit (after one month), third visit (after three months) and fourth visit (after six month). Medication adherence was evaluated by validated medication adherence rating scale (MARS) and pill count method. Patient‟s knowledge of antipsychotics and satisfaction towards HMR program were assessed by standardized questionnaires formulated by the researcher of this project. Quality of life was measured by the Sheehan Disability Scale (SDS). Any overstocked medications were collected and recorded for cost saving analysis. Friedman ANOVA test was used to compare the differences of the
outcome measured at baseline, one month, three months and six months follow up visit. The mean age of 133 patients was 41.76 (SD 8.86) years, with approximately equal ratio of males to females (54.9% vs 45.1%). MARS score showed medication adherence was significantly improved at all time points [first visit: median MARS = 9 (IQR 3) vs fourth visit: median MARS = 10 (IQR 1), p < 0.001] while pill count method also revealed that percentage of doses taken had a highly significant improvement after the fourth visit [first visit: median = 67.1% (IQR 92.1%) vs fourth visit: median = 97.5% (IQR 14.3%), p < 0.001]. The knowledge score had also improved considerably after the implementation of HMR program [first visit: 5 (IQR 2.5) vs fourth visit: 8 (IQR 1.0), p<0.001]. Regarding patient‟s quality of life, there was a significant improvement for „social‟ and „family‟ components after fourth visit (p 0.001). However, no difference was seen for overall quality of life of the patients, p=0.600 and for the „work‟ component (p = 0.486). The reduction of medication wastage was 26.5% after six months of HMR program. At the end of the study, patients generally showed positive satisfaction and acceptance towards HMR program provided by pharmacist. In conclusion, the HMR program has positive impact on schizophrenic patient‟s medication adherence, knowledge of antipsychotics, medication wastage reduction, service satisfaction and quality of life on „social‟ and „family‟ component.
Description
Keywords
Evaluation Of The Impact Of Home Medication Review Program On Adherence , Among Patients Diagnosed With Schizophrenia At Kinta District, Malaysia