The effects of multifactorial pharmacist-led intervention protocol on medication optimisation and adherence among patients with type 2 diabetes: A randomised control trial

F1000Research Pub Date : 2024-05-17 DOI:10.12688/f1000research.146517.1

Marwan El-Deyarbi, Luai Ahmed, Jeffrey King, Syed Abubackar, Ahmed Al Juboori, Nirmin A. Mansour, Salahdein Aburuz

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Abstract

Background Patient-related factors and limited medication adherence in patients with chronic diseases, are associated with poor clinical outcomes, long-term complications, and increased overall disease costs. Many methods have been tested with mixed results, and innovative approaches are needed to encourage patients to adhere to their prescribed drug regimens. Methods This randomised controlled trial examined a new multifactorial pharmacist-led intervention protocol (MPIP), including a medication therapy management (MTM) program with face-to-face counselling, patient-specific medication booklets, and a mobile application, from July 2021 to September 2022 in the Oud Al Touba diagnostic and screening ambulatory centre in 192 patients with type 2 diabetes in the United Arab Emirates. Medication adherence was assessed using the fixed medication possession ratio of medication refills and the medication adherence questionnaire. Results At 12 months follow-up, participants in the MPIP showed significant improvement in overall medication adherence with total (composite) medication possession ratio (MPRt) of mean (±SD) 0.95 (±0.09) compared to 0.92 (± 0.09) in the control group with mean difference of 0.03 (95%, CI 0.01–0.06), P =0.02. In addition, improvement trend was evident in the MPIP group for all medication regimens with P value <0.01. Comparable results were noticeable in adherence questionnaire scores at the end of the study, with 66 participants in the intervention group scored zero on the questionnaire, suggesting high adherence to medication compared to the control group (48 participants only). The MTM program performed 41 clinical interventions on drug-related problems, compared to six interventions in the control group, and the use of mobile application and medication booklet have increased to 45.7% compared to 21.4% before study exit. Conclusions The pharmacy intervention protocol effectively improved medication adherence and optimised medication regimens in diabetic patients with chronic medication regimens in an ambulatory healthcare centre.

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以药剂师为主导的多因素干预方案对 2 型糖尿病患者用药优化和依从性的影响：随机对照试验

背景慢性病患者与患者相关的因素和服药依从性有限，与不良临床疗效、长期并发症和总体疾病成本增加有关。许多方法已经过测试，但结果喜忧参半，因此需要创新的方法来鼓励患者坚持按处方用药。方法该随机对照试验于 2021 年 7 月至 2022 年 9 月在阿拉伯联合酋长国的 Oud Al Touba 诊断和筛查门诊中心对 192 名 2 型糖尿病患者进行了一项新的多因素药剂师主导干预方案 (MPIP)，包括一项药物治疗管理 (MTM) 计划，其中包括面对面咨询、患者专用药物手册和移动应用程序。用药依从性评估采用的是固定持药率和用药依从性问卷。结果在12个月的随访中，MPIP参与者的总体用药依从性有明显改善，总（复合）药物持有率（MPRt）平均（±SD）为0.95（±0.09），而对照组为0.92（±0.09），平均差异为0.03（95%，CI 0.01-0.06），P =0.02。此外，MPIP 组的所有用药方案均有明显改善趋势，P 值小于 0.01。在研究结束时，依从性调查问卷的得分也出现了类似的结果，与对照组（仅有 48 名参与者）相比，干预组中有 66 名参与者的问卷得分为零，这表明他们的用药依从性很高。MTM项目针对药物相关问题进行了41次临床干预，而对照组仅进行了6次干预，移动应用程序和药物手册的使用率从研究结束前的21.4%提高到了45.7%。结论药学干预方案有效改善了非住院医疗中心长期用药糖尿病患者的用药依从性，优化了用药方案。

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