The Outcomes of Pharmaceutical Care and Development of Dispensing System Collaborated by Pharmacists and Interdisciplinary Team in Na Pho hospital, Buriram Province

Abstract

Background: Asthma, which is a chronic respiratory disease, impacts adversely to the quality of life of patients and caregivers leading to problem of health, social, and economic loss.
Objective: To analyze the outcomes of pharmaceutical care and develop a collaborative dispensing system collaborated by pharmacists and interdisciplinary team in the asthma clinic in Na Pho hospital, Buriram province.
Methods: This work is a comparative and retrospective study recruited total 362 cases of asthma patients. The clinical outcomes were analyzed including hospital admissions due to asthma exacerbations, readmissions within 72 hours due to exacerbations, emergency room visits due to exacerbations, and death from respiratory failure and medication-related problems. Herein, there are two statistics were used including descriptive statistics and inferential statistics of Pearson’s Chi-square test (X²) for testing in the outcomes between pre- and post-intervention groups.
Results: There were a total of 362 asthma patients including 194 patients with 89 men or 45.9% and 105 women or 54.1% in pre-intervention group and 168 patients with 56 men or 33.3% and 112 women or 66.7% in post-intervention group. The patients were mostly female. In pre-intervention, the proportion of female patients had statistically lower with p-value < 0.05 (54.1% and 66.7%, respectively). Comparing between pre- and post-intervention group, the result revealed a reduction of hospital admissions due to asthma exacerbations, from 17.0% into 8.9% (p-value < 0.05). For other outcomes, there were probably decreased, even non-statistical significances were found. Moreover, the proportion of patients requiring readmission within 72 hours was decreased from 10.3% into 5.9%, whereas emergency room visits was from 8.8% into 4.8%. Expectedly, the mortality rates were dropped from 2.1% into none. Problems with inappropriate medication usage were significantly decreased (p-value < 0.05) from 39.7% into 19.6%; however, all problems were resolved. Additionally, the proportion of patients who adhered to using inhalers increased from 88.7% into 94.6%, and the proportion of patients who passed the medication use assessment increased from 60.7% into 92.7%.
Conclusions: This study indicated that the implementation with comprehensive asthma care system of pharmaceutical care provided by pharmacists in Na Pho hospital, Buriram province could reduce inappropriate medication usage to patients and could practically decrease clinical problems, such as hospital admissions and emergency room visits.