Patient-centered Pharmacist Care in the Hemodialysis Unit: a quasi-experimental interrupted time series study
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Le résumé fourni par la source
BACKGROUND: Nonadherence to medications by patients requiring hemodialysis (HD) leads to unfavorable clinical outcomes. Limited data exist to demonstrate the effect of incorporating patient-centered interventions using concepts of medication therapy management and motivational interview by pharmacists on pharmacoadherence in patients requiring HD. Therefore, we assessed the impact of patient-centered pharmacist care on pharmacoadherence and its outcomes in patients requiring HD. METHODS: Adult patients who had received outpatient HD for at least 3 months were enrolled. The study was conducted from October 2016 to April 2017. Pharmacists interviewed the patients at month 1, 2, 4 and 6, and the intervention (comprehensive review) occurred at months 3 and 5. The primary outcome was the change in pharmacoadherence as assessed by pre-HD serum phosphate levels and the differences in the number of medications between patient' self-report and medications records at the electronic healthcare records (EHRs). The secondary outcomes included changes in systolic blood pressure (SBP), glycosylated hemoglobin levels, serum low-density lipoprotein (LDL) levels, and the prevalence and types of medication-related problems (MRPs). RESULTS: Seventy-two patients were enrolled. Their median age was 59 (interquartile range: 47-67.5) years, and 53% were men. Pre- and post-intervention pharmacoadherence, as indicated by serum phosphate levels and the differences in the number of medications between patient' self-report and the medication records at the EHRs, did not significantly differ (p = 0.682 and 0.348, respectively). Mean SBP and mean LDL did not significantly change post-intervention. The median number of MRPs declined between Months 3 and 5 (p = 0.002): the prevalence of MRPs at Month 3 was 44.9% (95 confidence interval [CI]: 40.4-49.3) and decreased to 29.8% (95 CI: 25.6-34.3) at Month 5. Drug use without indication was the most frequent MRP (23.9%). CONCLUSIONS: Patient-centered pharmacist care did not result in significant changes in pharmacoadherence. However, its clinical utility as a tool to identify and mitigate MRPs in patients requiring HD is indisputable. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03576404 (retrospectively registered on July 3rd, 2018).
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Patient-centered Pharmacist Care in the Hemodialysis Unit: a quasi-experimental interrupted time series study
- Date Crossref
- 13/11/2019
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Harvard University pays non établi dans la noticeUniversité ou école supérieure
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King Saud bin Abdulaziz University for Health Sciences King Abdullah International Medical Research Center pays non établi dans la noticeUniversité ou école supérieure
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King Abdullah International Medical Research Center pays non établi dans la noticeStructure de recherche
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National Guard Health Affairs pays non établi dans la noticeÉtablissement de santé
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Mass General Brigham pays non établi dans la noticeÉtablissement de santé
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Brigham and Women's Hospital pays non établi dans la noticeÉtablissement de santé
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Harvard T. H. Chan School of Public Health pays non établi dans la noticeUniversité ou école supérieure
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Partners Healthcare System pays non établi dans la noticeInstitution
Harvard University, King Abdullah International Medical Research Center — King Saud bin Abdulaziz University for Health Sciences et King Abdullah International Medical Research Center, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.