Impact Of Pharmacist Homecare Service On Medication Adherence And Knowledge Among Hypertensive Patients In Seremban
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Date
2010-03
Authors
Supian, Azuwana
Journal Title
Journal ISSN
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Publisher
Universiti Sains Malaysia
Abstract
Hypertension is one of the major public health problems in Malaysia due to its high prevalence (42.6% in 2006), lack of awareness amongst the general population, its poor control and its impact on cardiovascular morbidity and mortality. A common reason for inadequate control of hypertension is low adherence with antihypertensive medicine regimen. Therefore, this research was conducted to assess and evaluate patients’ adherence and to examine the impact of “Pharmacist Homecare Service (PHS)” provision on the patients’ adherence, blood pressure reduction and knowledge among hypertensive patients. The research was conducted from April to November 2007 in Seremban, Negeri Sembilan. A total of 121 patients from Hospital Tuanku Jaafar Seremban were interviewed using a validated structured questionnaire and blood pressure was measured with a calibrated automated device (Microlife BP, model 2BH0). Upon consent, 60 patients were recruited into the normal counselling group (control group) and the other 61 patients were recruited into the PHS group (intervention group). At the end of study period, only 103 participants completed the 6 months study, 53 in the intervention group and the rest in the control group. The mean (SD) age of the study population was 62.2 (10.1) years for the intervention group and 59.4 (9.4) years in the control group. Most of the patients were female (56.3%) and Malay ethnics constituted the majority of patients
(59.2%). In the intervention group, percentage of adherence increased by 7.6% after normal counselling during recruitment; and increased by 30.1% after education session during home visit. The increment of adherence from recruitment to final assessment (home visit 2) was 37.7%. Whereas in the control group, percentage of adherence only increased by 4.0% after normal counselling during recruitment. There were no significant different in mean blood pressure of control group (p>0.05) whereas in the intervention group there was significant reductions (p<0.05) in the systolic blood pressure mean (SD) from 147.0 mmHg (23.9) to 135.9 mmHg (21.8) p<0.05 and diastolic blood pressure mean from 86.8 mmHg (17.7) to 81.5 mmHg (14.2) p<0.05. For awareness and knowledge of disease and therapy, the intervention group showed significant difference between the knowledge assessments with regard to the consultation, counselling and patients’ education in the intervention group. The percentage of knowledge for all questions was increased by more than 30%. Therefore, a pharmacy care program such as “Pharmacist Homecare Service” leads to increases in medication adherence, medication persistence, knowledge and clinically reductions in blood pressure among hypertensive patients in Seremban.
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Keywords
The impact of “Pharmacist Homecare Service , provision on the patients’ adherence