THE DEVELOPMENT OF MEDICATION THERAPY MANAGEMENT SYSTEM FOR DIABETIC OUTPATIENTS BY HOSxP PROGRAM AT WANG SAPUNG HOSPITAL, LOEI PROVINCE
DOI:
https://doi.org/10.14456/tbps.2018.20Keywords:
medication therapy management, diabetes, drug-related problems, HOSxPAbstract
This quasi-experimental prospective research with a pre- and post-test design aims to develop a medication therapy management (MTM) system for diabetic outpatients by using the HOSxP program to record drug-related problems and communicate them to a physician at Wang Saphung Hospital, Loei Province. The inclusion criteria were T2DM patients with fasting blood sugar (FBS) ≥ 190 mg/dl and with evidence of 3 consecutive visits for treatment and follow-up during the period from December 2015 to September 2016 (n = 692). Drug-related problems (DRPs), understanding of the drugs, diabetes, and self-care management were the primary outcomes while FBS and blood pressure (BP) were the secondary outcome parameters. Repeated measure one-way ANOVA and Pearson correlation coefficient tests were employed for statistical analysis. The results demonstrated that the MTM system could improve the patients’ knowledge of medication use, diabetes, and self-care management. The system also decreased the number of DRPs, and improved the clinical outcome at a statistically significant result (p-value < 0.01). The absolute difference in the numbers of patients with FBS ≤ 130 mg/dl and BP < 130/80 mmHg, according to AHA/ACC recommendations at the 1st and 2nd MTM, were 32 (4.6%) and 31 (4.5%) respectively. Meanwhile, the number of patients with FBS ≤ 130 mg/dl and BP < 140/90 mmHg according to the ADA at the 1st and 2nd MTM were 48 (6.9%) and 51 (7.4%) respectively. According to Pearson's product moment correlation, the knowledge of medications, diabetes, and self-care management (p < 0.01, r = 0.969, r2 = 0.94), and satisfaction with the pharmacists (p < 0.01, r = 0.728, r2 = 0.53) were correlated positively with the knowledge of self-care management regarding adverse drug reactions with a statistically significant difference. In summary, the MTM system can improve clinical outcomes, raise patients’ knowledge and self-care management, and decrease the number of drug-related problems.
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