This study is a pilot project of development of patient-centered pharmaceutical care (PC). The objectives were to explore patients’ medication experiences including attitude, understanding, expectation, concern and convenience or medication adherence and to assess medication therapy-related quality of life (MRQOL) using an individualized approach: the Patient-Generated Index (PGI). The research design is a practice research which provided PC at the MTM (Medication Therapy management) clinic at the community pharmacy, Osotsala, at the Faculty of Pharmaceutical Sciences, Chulalongkorn University between September 2010 and April 2011. Twenty-five participants joined the study. Eligible criteria were taking a medication at least one month, age ≥ 20 years old, understanding Thai and able to communicate, and willing to participate in the study. The data collection method was interview each of which took about 1-2 hours. The data were both qualitative and quantitative data. For patient characteristics, average age was 56.9±13.5(range: 24-79); females were 52% (N=13). Most patients had hypertension (84%), hyperlipidemia (52%), and diabetes (16%). Average number of medications and vitamins was 4.6±2.6 (range: 1-13). Results: As for the patients’ attitude toward medication therapy, they did not like to take it but took it necessarily. The reasons of taking medications included wanting their symptoms to be improved or cured or back to normal. The reasons that they did not like to take medications were fear of drug allergy and drug accumulation in liver and kidney, etc. In addition, half of the sample liked to use alternative treatments such as herbs, vitamins and food products, etc. Regarding the understanding, most patients knew how to take medications and its uses but did not know medication names and strengths, goals of medication therapy, and side effects. What they expected from taking medications were improving or curing their symptoms, not wanting to take medication lifelong, without side effects, and reasonable drug prices. What they concerned most was medications’ side effects. The problems of medication adherence assessed by the Morisky Medication Adherence Scale (MMAS) were forgetting to take (72%), followed by reducing medication doses or stopping when feeling worse about taking it (44%). Based on the MMAS scores, it could be classified as low adherence (MMAS<6)(44%), moderate adherence (6<MMAS<8)(52%), and high adherence (MMAS=8)(4%). Regarding the MRQOL, the most selected 5 domains were getting medication information fear of medication side effects, security/safety in life, medication dependence, and pain/discomfort. The MRQOL index score determined by the PGI was 0.57±0.24(range: 0.00-0.83). This MRQOL score means that taking medications reduce their quality of life from perfect physical and mental health (score=1). In conclusion, this pilot project of development of patient-centered PC made health care providers understand more about medication therapy-related problems from patients’ perspectives. This will lead to develop a solution plan as well as process and tools in providing PC in the future.
SUBJECT
การใช้ยา
การดูแลผู้ป่วย
Drug utilization
Care of the sick
pharmaceutical care
LOCATION
CALL#
STATUS
Pharmaceutical Sciences Library : Research Collection
