Tags

Type your tag names separated by a space and hit enter

Impact of a pharmacist consult clinic on a hospital-based geriatric outpatient clinic in Singapore.
Ann Acad Med Singapore 2004; 33(2):220-7AA

Abstract

INTRODUCTION

We study the impact of a pharmacist consult clinic on the care of elderly outpatients based on the Health Belief Model that the perceived benefits (improvement in medication knowledge, clinical status and perception) and attached barriers (cost and number of medication and adverse drug reactions) can influence health behaviour (medication compliance).

MATERIALS AND METHODS

A randomised controlled study of 136 eligible patients with risk factors for non-compliance, using Zelen's design, was conducted in a hospital-based geriatric outpatient clinic from November 2001 to June 2002. All patients were assessed for outcome variables at baseline and 2 months later.

RESULTS

One hundred and twenty-six patients were included in the intention-to-treat analysis. There were 104 pharmacist interventions with a physician acceptance rate of 76%. There was a significant improvement in medication knowledge with regards to indication (P = 0.03) and the composite dose, frequency and indication score (P = 0.06), as well as a decrease in residual adverse drug reactions that persisted at month 2 and cost avoidance of dollars 387.28 over 2 months. There was no significant difference in perception, clinical status or decrease in number of medications. The intervention group showed an improvement in adjusted compliance (odds ration [OR] = 2.52; 90% confidence interval [CI], 1.09 to 5.83) based on the ordered logistic regression model. Perception of severity of illness at baseline (OR = 1.30; 90% CI, 1.04 to 1.62), number of medication remembering methods (OR = 1.87; 90% CI, 1.08 to 3.25) and the use of routine habits (OR = 4.48; 90% CI, 1.51 to 13.28) and medication aids (OR = 3.68; 90% CI, 1.04 to 13.06) significantly affected compliance.

CONCLUSION

The addition of a pharmacist consult clinic to the management of selected geriatric outpatients can improve compliance, with the attendant benefits of improving medication knowledge, cost avoidance and reducing residual adverse drug reactions.

Authors+Show Affiliations

Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore. Wee_Shiong_Lim@ttsh.com.sgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15098638

Citation

Lim, W S., et al. "Impact of a Pharmacist Consult Clinic On a Hospital-based Geriatric Outpatient Clinic in Singapore." Annals of the Academy of Medicine, Singapore, vol. 33, no. 2, 2004, pp. 220-7.
Lim WS, Low HN, Chan SP, et al. Impact of a pharmacist consult clinic on a hospital-based geriatric outpatient clinic in Singapore. Ann Acad Med Singap. 2004;33(2):220-7.
Lim, W. S., Low, H. N., Chan, S. P., Chen, H. N., Ding, Y. Y., & Tan, T. L. (2004). Impact of a pharmacist consult clinic on a hospital-based geriatric outpatient clinic in Singapore. Annals of the Academy of Medicine, Singapore, 33(2), pp. 220-7.
Lim WS, et al. Impact of a Pharmacist Consult Clinic On a Hospital-based Geriatric Outpatient Clinic in Singapore. Ann Acad Med Singap. 2004;33(2):220-7. PubMed PMID: 15098638.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of a pharmacist consult clinic on a hospital-based geriatric outpatient clinic in Singapore. AU - Lim,W S, AU - Low,H N, AU - Chan,S P, AU - Chen,H N, AU - Ding,Y Y, AU - Tan,T L, PY - 2004/4/22/pubmed PY - 2004/7/16/medline PY - 2004/4/22/entrez SP - 220 EP - 7 JF - Annals of the Academy of Medicine, Singapore JO - Ann. Acad. Med. Singap. VL - 33 IS - 2 N2 - INTRODUCTION: We study the impact of a pharmacist consult clinic on the care of elderly outpatients based on the Health Belief Model that the perceived benefits (improvement in medication knowledge, clinical status and perception) and attached barriers (cost and number of medication and adverse drug reactions) can influence health behaviour (medication compliance). MATERIALS AND METHODS: A randomised controlled study of 136 eligible patients with risk factors for non-compliance, using Zelen's design, was conducted in a hospital-based geriatric outpatient clinic from November 2001 to June 2002. All patients were assessed for outcome variables at baseline and 2 months later. RESULTS: One hundred and twenty-six patients were included in the intention-to-treat analysis. There were 104 pharmacist interventions with a physician acceptance rate of 76%. There was a significant improvement in medication knowledge with regards to indication (P = 0.03) and the composite dose, frequency and indication score (P = 0.06), as well as a decrease in residual adverse drug reactions that persisted at month 2 and cost avoidance of dollars 387.28 over 2 months. There was no significant difference in perception, clinical status or decrease in number of medications. The intervention group showed an improvement in adjusted compliance (odds ration [OR] = 2.52; 90% confidence interval [CI], 1.09 to 5.83) based on the ordered logistic regression model. Perception of severity of illness at baseline (OR = 1.30; 90% CI, 1.04 to 1.62), number of medication remembering methods (OR = 1.87; 90% CI, 1.08 to 3.25) and the use of routine habits (OR = 4.48; 90% CI, 1.51 to 13.28) and medication aids (OR = 3.68; 90% CI, 1.04 to 13.06) significantly affected compliance. CONCLUSION: The addition of a pharmacist consult clinic to the management of selected geriatric outpatients can improve compliance, with the attendant benefits of improving medication knowledge, cost avoidance and reducing residual adverse drug reactions. SN - 0304-4602 UR - https://www.unboundmedicine.com/medline/citation/15098638/Impact_of_a_pharmacist_consult_clinic_on_a_hospital_based_geriatric_outpatient_clinic_in_Singapore_ L2 - http://www.annals.edu.sg/pdf200403/V33N2p220.pdf DB - PRIME DP - Unbound Medicine ER -