EFFECT OF PHARMACEUTICAL CARE ON DRUG RELATED PROBLEMS IN HEMODIALYSIS PATIENTS AT HEMODIALYSIS DEPARTMENT, BUNTHARIK HOSPITAL

Abstract

     The main objective of this study was to evaluate the effects of pharmaceutical care on drug related problems (DRPs) in hemodialysis patients, comparing before and after pharmacist intervention. This quasi-experimental study was conducted at the hemodialysis center at Buntharik hospital. All hemodialysis patients were included. Data were collected between January to March 2021. Patients received pharmaceutical care including medication counseling, identifying, preventing, and resolving DRPs, and education on dietary and lifestyle modification. Each patient was followed-up every week for 4-12 weeks. Identified DRPs were categorized according to The Pharmaceutical Care Network Europe Foundation classification version 8.02 (PCNE V. 8.02) and compared clinical outcomes and quality of life (KDQOL-SF version 1.3) at before and after the provision of pharmaceutical care. The association between categorical variables was analyzed using the Chi-square test and Paired T-Test.

     30 hemodialysis patients were included. The mean age of the study population was 56.50±13.76 years, the patients took 8.50±1.92 medications daily. At the beginning of the study, it was found that 19 patients have DRPs (63%) and at the end of study period, the number of patients with DRPs was reduced to 12 patients have DRPs (40%). the non-compliance problem, when compared with the beginning of the study, there was significant reduction in the 30 hemodialysis patients were included. The mean age of the study population was 56.50±13.76 years, the patients took 8.50±1.92 medications daily. At the beginning of the study, it was found that 19 patients have DRPs (63%) and at the end of study period, the number of patients with DRPs was reduced to 12 patients have DRPs (40%). the non-compliance problem, when compared with the beginning of the study, there was significant reduction in the number of patients with non-compliance problem (36.67 % v.s. 13.33%, p-value=0.005). The most frequently found DRPs was untreated symptoms or indication (17 patients v.s. 11 patients). The second most common DRPs was no effect of drug treatment (2 patients v.s. 1 patients) when compared with the beginning of the study. It was found that intervention accepted and fully implemented were significantly increased when compared to before the pharmaceutical care (68.42 % v.s 91.67 % of all number of pharmaceutical care services, p-value =0.002). The problem totally solved significantly increased when compared to before the pharmaceutical care (73.68% v.s 83.33 %, p-value=0.002). Fasting blood sugar and serum phosphate were also significantly decreased when compared to the baseline value (P-value<0.05). The quality of life has been improved significantly in after the pharmaceutical care (p-value <0.001)