Improvement in patient medication compliance & treatment outcome through Home Medication Review (HMR) conducted by pharmacist at primary health clinic in State of Selangor
M. Dziehan, Wong Yee Cheat, Kobu a/l Thiruvanackan, Azlina Sariam
1. KK Telok Panglima Garang, PKD Kuala Langat
2. KK Bukit Kuda, PKD Klang
3. KK Kelana Jaya, PKD Petaling
4. KK Sungai Besar, PKD Sabak Bernam
Abstract
Introduction; Poor medication compliance among chronic disease patient leads to poor treatment outcome although best medication treatment prescribed to them. Based on preliminary study we found that only 41.37% of medication prescribed consume by patient and patient medication knowledge is poor (21.92% DFIT score). Patient treatment outcome is still not achieving the standard Aims; This study conducted to evaluate the impact of Home Medication Review (HMR) by pharmacist toward improvement of patient medication compliance as well as medication knowledge. This study also focuses on improvement toward patient treatment outcome and improvement toward number of drug-related problems identified and number of recommendation of intervention by the pharmacist through HMR program Methods; This is a retrospective and prospective study performed in four health clinics in Selangor where pre remedial and post remedial action taken. Improvement on medication compliance, medication knowledge and treatment outcome were examined. Patient recruited (FMS/MO referred patient based on selection criteria) and the data collected are from August 2006 until April 2007. This program focuses on uncontrolled Diabetes Mellitus and or uncontrolled Hypertension patient which the home visit will be made on the 1st and 5th month. Then final evaluation on patient treatment outcome will be done on the 8th month (final month). In between the visits, assessment on patient understanding and compliance will be conducted at the respective clinic according to the physician appointment date (every 2 months). Result; In post remedial result there is improvement on patient medication compliance base on pill count where the result show 80.21% of medication prescribed consume by patient (standard patient compliance: >80% prescribe medication consume) and patient medication knowledge improve when DFIT score increase to 91.27% (standard patient medication knowledge: 100% score of DFIT). Post remedial action result also show improvement of treatment outcome when there is improvement of BP reading and HbA1c level near to target value. There is 205 finding on drug related problem with 257 recommendation intervention done by pharmacist from this HMR program. Conclusion; This study proves that HMR program conducted at primary health clinic in Selangor as a good preventive program and contribution of clinical knowledge of pharmacist in this program help to improve treatment outcome
