Pharmacist counseling intervention to improve patient antibiotic compliance
DOI:
https://doi.org/10.53638/phpma.2018.v6.i2.p10Keywords:
Pharmacist counseling, compliance, antibiotic useAbstract
Background and purpose: Reported microbial resistance to antibiotics is increasing. One of the main factors is patient noncompliance in use of antibiotics. The purpose of this study was to determine the effectiveness of pharmaceutical counseling in a pharmacy setting to increase compliance with antibiotic use.
Methods: A randomized controlled trial was conducted on 104 adult patients aged 18 years and over who purchased antibiotics by prescription at a pharmacy in Denpasar City, Bali Province. Subjects were divided into intervention and control groups using block randomization method. The intervention group was provided with pharmaceutical counseling by a pharmacist, while the control group was provided drug information according to the pharmacy service standard. Subject compliance was measured by telephone interview using the Morisky Medication Adherence Scale-8 questionnaire within 3-5 days after purchasing the medication. Statistical analysis with the Mann Whitney U Test was performed to determine the difference in mean rank of compliance scores. Logistic regression analysis was conducted to determine the adjusted compliance ratio.
Results: The number of subjects analyzed was 98, as five subjects could not be contacted by telephone and one subject was hospitalized. The mean rank of compliance scores in the intervention group (61.05) was significantly higher (p<0.01) than the comparison group (37.95). The proportion of compliance in the intervention group was 65.3% and the control group was 18.4%, with the proportion ratio (PR) of 3.56 (95%CI: 1.90- 6.64). Logistic regression analysis showed that variables which significantly increased compliance with antibiotic use were pharmacist counseling (APR=9.33; 95%CI: 3.24 26.87), frequency of taking medication (APR=6.94; 95%CI: 2.01-23.92) and method of payment (APR=4.30; 95%CI: 1.18-15.66).
Conclusion: Pharmaceutical counseling at a pharmacy setting was found to increase compliance of antibiotic use. Compliance of antibiotic use is also influenced by the frequency of taking medication and the method of payment. Pharmacist counseling when accessing medication at a pharmacy is crucial for improving patient compliance of antibiotic use.
References
WHO Regional Office for South East Asia. Situational analysis on antimicrobial resistance in the South-East Asia Region: Report 2016. 2016.
Al-Eidan F, Mcelnay J, Scott M, McConnel J. Management of Helicobacter pylori eradication – the influence of structured counselling and follow up. Clinical Pharmacology. 2002; 53(2): 163-71.
Muras M, Krajewski J, Nocun M, Godycki-cwirko M. A survey of patient behaviours and beliefs regarding antibiotic self-medication for respiratory tract infections in Poland. Archives of Medical Science. 2013; 9(5): 854-7.
Shah SJ, Ahmad H, Rehan RB, Najeeb S, Mumtaz, Jilani MH, et.al. Self-medication with antibiotics among non-medical university students of Karachi; a crosssectional study. BMC Pharmacology and Toxicology. 2015; 15:74.
Widayati A. Self medication with antibiotics in Yogyakarta City Indonesia. The University of Adelaide (dissertation); Adelaide; 2013.
Fernandes M, Leite A, Basto M, Nobre MA, Vieira N, Fernandes R, et.al. Non adherence to antibiotics therapy in patients visiting community pharmacy. International Journal of Clinical Pharmacy. 2014; 36(1): 86-91.
Wibowo R, Soedibyo S. Kepatuhan berobat dengan antibiotik jangka pendek di Poliklinik Umum Departemen Kesehatan Anak Rumah Sakit Dr. Cipto Mangunkusumo, Jakarta [Compliance in short term antibiotic use at General Polylinic, Department of Pediatrics Dr. Cipto Mangunkusumo Hospital]. Sari Pediatri. 2016; 10(3): 171-6.
Department of Health of Indonesia. Pedoman Konseling Pelayanan Kefarmasian di Sarana Kesehatan [Guidelines for counseling by pharmacist at health care services]. 2007. Department of Health of Indonesia. Jakarta.
Dewanti SW, Andrajati R, Supardi S. Pengaruh konseling dan leaflet terhadap efikasi diri, kepatuhan minum obat dan tekanan darah pasien hipertensi di dua puskesmas Kota Depok [The influence of counseling and leaflets on self-efficacy, compliance of medication and blood pressure of patients with hypertension at two public health centers in Depok City]. Jurnal Kefarmasian Indonesia. 2015; 5(1): 33-40.
Harijanto W, Rudijanto A, Alamsyah A. Pengaruh konseling motivational interviewing terhadap kepatuhan minum obat penderita hipertensi [The influence of counseling with motivational interviewing to compliance on anti-hypertension medication]. Jurnal Kedokteran Brawijaya. 2015; 28(4): 345-53.
Hynes RB, Yao X, Degani A, Kripalani S, Garg AX, McDonal HP. Interventions to enhance medication adherence. The Cochrane Database of Systematic Review. 2005; 4.
Kripalani S, Yao X, Haynes B. Intervention to enhance medication adherence in chronic medical conditions. Archive of Internal Medicine. 2007; 167 (6): 540-50.
McDonald HP, Garg AX. Clinician’s corner intreventions to enhance patient adherence. Scientific Review and Clinical Applications. 2016; 288(22): 2868-70.
Okumura LM, Rotta I, Correr CJ. Assesment of pharmacistled patient councelling in randomized controlled trials: a systematic review. International Journal of Clinical Pharmacy. 2014; 36(5): 882-91.
Purwanti A, Supardi S. Gambaran pelaksanaan standar pelayanan farmasi di apotek DKI Jakarta tahun 2003 [The implementation of pharmacy service standard at a pharmacy in Jakarta]. Majalah Ilmu Kefarmasian. 2004; 1(2): 102-15
Culig J, Leppee M. From Morisky to Hill-bone: Self-reports scales for measuring adherence to medication. Collegium Antropologicum. 2014; 38(1): 55-62.
Cals JWL, Hopstaken RM, Le Doux PHA, Driessen GA, Neleman PJ, Dinant G, et.al. Dose timing and patient compliance with two antibiotic treatment regimen for lower respiratory tract infections in primary care. International Journal of Antimicrobial Agents. 2008; 31(6): 531–536.
Llor C, Herna´ndez S, Bayona C, Moragas A, Sierra N, Herna´ndez N, et.al. A study of adherence to antibiotic treatment in ambulatory respiratory. International Journal of Infectious Diseases. 2013; 17(3): 168-172.
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