Document Type
Article (Restricted)
Publication Date
1-1-2012
Abstract
BACKGROUND: The roles of pharmacists have evolved from product oriented, dispensing of medications to more patient-focused services such as the provision of pharmaceutical care. Such pharmacy service is also becoming more widely practised in Malaysia but is not well documented. Therefore, this study is warranted to fill this information gap by identifying the types of pharmaceutical care issues (PCIs) encountered by primary care patients with diabetes mellitus, hypertension or hyperlipidaemia in Malaysia. METHODS: This study was part of a large controlled trial that evaluated the outcomes of multiprofessional collaboration which involved medical general practitioners, pharmacists, dietitians and nurses in managing diabetes mellitus, hypertension and hyperlipidaemia in primary care settings. A total of 477 patients were recruited by 44 general practitioners in the Klang Valley. These patients were counselled by the various healthcare professionals and followed-up for 6 months. RESULTS: Of the 477 participants, 53.7 had at least one PCI, with a total of 706 PCIs. These included drug-use problems (33.3), insufficient awareness and knowledge about disease condition and medication (20.4), adverse drug reactions (15.6), therapeutic failure (13.9), drug-choice problems (9.5) and dosing problems (3.4). Non-adherence to medications topped the list of drug-use problems, followed by incorrect administration of medications. More than half of the PCIs (52) were classified as probably clinically insignificant, 38.9 with minimal clinical significance, 8.9 as definitely clinically significant and could cause patient harm while one issue (0.2) was classified as life threatening. The main causes of PCIs were deterioration of disease state which led to failure of therapy, and also presentation of new symptoms or indications. Of the 338 PCIs where changes were recommended by the pharmacist, 87.3 were carried out as recommended. CONCLUSIONS: This study demonstrates the importance of pharmacists working in collaboration with other healthcare providers especially the medical doctors in identifying and resolving pharmaceutical care issues to provide optimal care for patients with chronic diseases.
Keywords
Diabetes Mellitus/*drug therapy Drug Therapy/methods *Drug-Related Side Effects and Adverse Reactions Female Humans Hyperlipidemias/*drug therapy Hypertension/*drug therapy Malaysia Male Middle Aged Patient Care Team Pharmaceutical Services *Pharmacists Professional Role
Divisions
fac_med
Publication Title
BMC Health Services Research
Volume
12
Publisher
BMC
Additional Information
Chua, Siew Siang Kok, Li Ching Yusof, Faridah Aryani Md Tang, Guang Hui Lee, Shaun Wen Huey Efendie, Benny Paraidathathu, Thomas eng Clinical Trial Research Support, Non-U.S. Gov't England 2012/11/14 06:00 BMC Health Serv Res. 2012 Nov 12;12:388. doi: 10.1186/1472-6963-12-388.