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Gastroesophageal reflux disease is a set of ailments caused by the pathological regurgitation of food content from the stomach into the oesophagus. GERD occurs in 20 - 40% of developing countries, in Poland in about 34% of the population, which is a serious epidemiological problem. Gastroesophageal reflux disease is not only connected to a high physical burden, but also reduces the quality of life of patients, thus contributing to poorer functioning in the sphere of professional, social and family life. Effective GERD therapy is based on pharmacotherapy and modification of the patient's diet and lifestyle. Proton pump inhibitors (PPIs) remain the basis of pharmacotherapy of gastroesophageal reflux disease. Due to the high morbidity and recurrence of the disease, and on the other hand, easy access to PPIs as part of OTC sales, which allows patients to continue their own therapy, often without monitoring, there is an increasing risk of incorrect use and even abuse of these drugs, which can have dangerous consequences for health. The aim of the study was to assess the impact of pharmaceutical care on the efficacy and safety of gastroesophageal reflux disease therapy in patients taking proton pump inhibitors or antagonists of H2 receptor. The project was an open intervention study conducted in a community pharmacy, the intervention was the pharmaceutical care service. The interve ; ntion was conducted between June, 30th 2014 and December, 31st 2017. The total number of patients recruited to the study was 98, 61 of them were women, the mean age of the patient was 49 years. The main inclusion criteria was using proton pump inhibitors or antagonists H2 receptor prescribed by physician. The pharmaceutical care process was divided into several multi-stage meetings, during which the pharmacist assessed the knowledge, quality of life of patients and using various types of questionnaires, leaflets the education process was conducted. The main point of the study was to carry out drug reviews, identify and solve drug related problems, and set individual goals for the pharmaceutical care plan. The study involved 98 people who suffered from a total of 214 chronic diseases and took 532 medications, which gives an average of over 2 chronic diseases and over 5 drugs per patient. The number of chronic diseases increased with patient’s age and patients over 65 years used almost twice more medications compared to younger patients. 633 drug problems were identified, which means an average of at least 6 drug problems per patient. More than 92% of problems were solved completely or partially. The 633 drug problems detected during the analyses were caused by 1378 causes, and the pharmacist undertook a total of 1224 interventions to solve drug related problems. On average, ther ; e were 6.46 drug problems, 14.06 causes, and 12.49 interventions per patient. The most commonly identified drug related problems in patients with GERD were: effect of drug treatment not optimal (36%), untreated indication (33%) and wrong effect of drug treatment (25%). During the study, the pharmacist undertook a total of 1431 therapeutic goals with patients, which were achieved in over 77%. Due to the education carried out by the pharmacist, patients increased their knowledge about the disease, methods of treatment, recommended diet and lifestyle as well as proper use of medicines – an average increase in knowledge of 31% was observed. The quality of life of patients with GERD was also assessed. After the intervention, an improvement in the quality of life was observed on mental and physical scale of SF-36, as well as in all domains of QOLRAD. The pharmacist's personality analysis confirmed the propensity for personality type A traits such as competition, haste and dominance in patients with GERD. In addition, the CECS survey results confirmed these patients' tendency to strongly suppress emotions. Providing pharmaceutical care has positively impacted the health of patients with GERD, improved their knowledge about the disease, the recommended diet and medications used and improved their quality of life, especially in mental sphere. The pharmacist's intervention involving a d ; rug review made it possible to detect and solve drug problems. The pharmacist can independently propose and implement covering measures that solve a significant part of the detected drug problems without involving the doctor and other therapeutic team members. In the process of pharmaceutical care for patients with GERD, in addition to activities related to the detection and resolution of patient drug problems, it is also essential to take into account and conduct a comprehensive assessment of the patient's lifestyle and personality, which may affect the effectiveness of the interventions undertaken.
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Rada Dyscypliny Nauki farmaceutyczne
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Aug 6, 2024
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Apr 8, 2024
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http://dl.cm-uj.krakow.pl:8080/publication/5064
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| Edition name | Date |
|---|---|
| ZB-139415 | Aug 6, 2024 |
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