Effect of pharmacist-led patient education on adherence to tuberculosis treatment
Effect of pharmacist-led patient education on adherence to tuberculosis treatment
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DOI：
10.2146/ajhp050543
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发表时间：
2007-03-01
影响因子：
2.7
通讯作者：
Izzettin, Fikret Vehbi
中科院分区：
文献类型：
--
作者：
Clark, Philip M.;Karagoz, Turan;Izzettin, Fikret Vehbi
目的.本研究的目的是评估临床药师指导的患者教育计划对首次结核病（TB）患者治疗依从性的影响，并确定首次结核病和耐多药（MDR）-TB患者的主要药学服务需求和问题。在研究的第一部分，首次结核病患者被随机分配到无EDU组（n = 58），患者接受常规医疗和护理，或EDU组（n = 56），患者还提供临床药师指导的患者教育。通过计划访视的出席率、药物计数和异烟肼代谢物存在的尿液分析来评价患者对治疗的依从性。在研究的第二部分中，确定了首次结核病患者和耐多药结核病患者（n = 40）的药学服务需求和问题。接受药剂师指导的患者教育的患者的依从性大于未接受教育的患者。EDU组的计划访视和异烟肼代谢物存在的尿液分析在依从性方面产生了更好的结果（p < 0.05），而药物计数在两组之间没有差异。首次结核病患者的主要药学服务需求是疼痛控制、营养补充、适当处方、呼吸控制和糖尿病控制。耐多药结核病患者也有类似的结果。当药剂师向患者提供药物使用方面的教育并解决患者的药物护理问题时，患者对结核病治疗的依从性得到改善。
Purpose. The purpose of this study was to assess the effect of a clinical pharmacist-directed patient education program on the therapy adherence of first-time tuberculosis (TB) patients and to identify the major pharmaceutical care needs and issues of first-time TB and multidrug-resistant (MDR)-TB patients.Methods. In the first part of the study, first-time TB patients were randomized either to the No EDU group (n = 58) where patients received routine medical and nursing care or to the EDU group (n = 56) where patients were also provided with clinical pharmacist-directed patient education. The patient's adherence to treatment was evaluated by attendance at scheduled visits, medication counting, and urine analysis for the presence of isoniazid metabolites. In the second part of the study, the pharmaceutical care needs and issues were determined for first-time TB patients and for MDR-TB patients (n = 40).Results. The adherence of patients who received pharmacist-directed patient education was greater than that of patients who did not. The attendance at scheduled visits and urine analysis for the presence of isoniazid metabolites yielded better results in respect to adherence for the EDU group (p < 0.05), while medication counting did not differ between the two groups. The major pharmaceutical care needs of first-time TB patients were for pain control, nutrient replacement, appropriate prescribing, respiratory control, and diabetic control. Similar findings were recorded for MDR-TB patients.Conclusion. Patients' adherence to TB treatment improved when a pharmacist provided patient education on medication use and addressed patients' pharmaceutical care issues.