Pharmaceutical care issues identified by pharmacists in patients with diabetes, hypertension or hyperlipidaemia in primary care settings

Siew Siang Chua, Li Ching Kok, Faridah Aryani Md Yusof, Guang Hui Tang, Shaun Wen Huey Lee, Benny Efendie, Thomas Paraidathathu

    Research output: Contribution to journalArticle

    23 Citations (Scopus)

    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.

    Original languageEnglish
    Article number388
    JournalBMC Health Services Research
    Volume12
    Issue number1
    DOIs
    Publication statusPublished - 2012

    Fingerprint

    Pharmaceutical Services
    Hyperlipidemias
    Pharmacists
    Primary Health Care
    Hypertension
    Malaysia
    General Practitioners
    Diabetes Mellitus
    Pharmaceutical Preparations
    Patient Harm
    Medication Adherence
    Nutritionists
    Drug-Related Side Effects and Adverse Reactions
    Health Personnel
    Patient Care
    Chronic Disease
    Nurses
    Delivery of Health Care

    Keywords

    • Chronic disease
    • Drug-related problem
    • Intervention
    • Pharmaceutical care
    • Pharmacist

    ASJC Scopus subject areas

    • Health Policy

    Cite this

    Pharmaceutical care issues identified by pharmacists in patients with diabetes, hypertension or hyperlipidaemia in primary care settings. / Chua, Siew Siang; Kok, Li Ching; Md Yusof, Faridah Aryani; Tang, Guang Hui; Lee, Shaun Wen Huey; Efendie, Benny; Paraidathathu, Thomas.

    In: BMC Health Services Research, Vol. 12, No. 1, 388, 2012.

    Research output: Contribution to journalArticle

    Chua, Siew Siang ; Kok, Li Ching ; Md Yusof, Faridah Aryani ; Tang, Guang Hui ; Lee, Shaun Wen Huey ; Efendie, Benny ; Paraidathathu, Thomas. / Pharmaceutical care issues identified by pharmacists in patients with diabetes, hypertension or hyperlipidaemia in primary care settings. In: BMC Health Services Research. 2012 ; Vol. 12, No. 1.
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    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.",
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    AU - Chua, Siew Siang

    AU - Kok, Li Ching

    AU - Md Yusof, Faridah Aryani

    AU - Tang, Guang Hui

    AU - Lee, Shaun Wen Huey

    AU - Efendie, Benny

    AU - Paraidathathu, Thomas

    PY - 2012

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    AB - 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.

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    KW - Drug-related problem

    KW - Intervention

    KW - Pharmaceutical care

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