ต้นทุน-ประสิทธิผลของการบริบาลทางเภสัชกรรมผู้ป่วยเบาหวานที่โรงพยาบาลเสนา / สุภัทรชา ไชยรักษ์ = Cost-effectiveness of pharmaceutical care in diabetic patients at Sena Hospital / Supataracha Chaiyarak
The purpose of this study was to compare cost-effectiveness of the conventional versus pharmceutical care service in which pharmacist evaluate the patient before refill the same medication in diabetic patient. The study is a before and after experiment with one control group. Assessment was based on an evaluation of the outcome after the new system was applied. The study was conducted between October 2001 and February 2002 at diabetic out patient department of Sena hospital. Only patients, who willingly joined the program, were included. These patients were screened and selected by an internist based on accepted criteria. One hundred and four patients were randomly assigned to the study and control groups. Patients in the study and control group were monitored by the same pharmacist throughout a period of 3 months. However, the frequency of monitoring was once a month in the former versus once at the end of study period in the latter. Base on hospital perspective and patient perspective, expenses in the study group were higher than those in the control group (288.31 and 181.39; 812.35 and 425.91). However, when cost derived from medications/ visit was excluded, there was no difference among the study and control groups (44.48 and 31.77 baht, respectively). It was found that the mean fasting plasma glucose (FPG) in the study (148.02+-45.02 mg/dL) and control groups (142.12+-37.69 mg/dL) at the end of this 3-month study was not signifincantly different(P > 0.05). However, when using the upper limit FPG of 150 mg/dL, there were 20 patients who fell off this limit (7 in the study versus 13 in the control groups). Sixteen patients in the study group were referred to physician during first and second follow up visits due to an emergence of the complications related to diabetes or to their higher than hazardous levels of < 80 or > 200. Almost all patients were satisfied with the pharmacist managed care program. These could be explained by a shortened waiting time and the convenience in receiving medications as well as increased knowledge in drug use information as provided by pharmacist.