Habeeba, Rahmathulla Chalilakath (2017) The Impact of Follow-Up Telephone Calls on Nonadherence and Treatment Satisfaction in Hypertensive Patients. Masters thesis, J. K. K. Nattraja College of Pharmacy, Komarapalayam.
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Abstract
INTRODUCTION: Adherence can be defined as the extent to which patients follow the instructions they are given for prescribed treatments. The term, adherence, is intended to be non-judgmental, a statement of fact rather than of blame of the patient, prescriber, or treatment. Adherence is not the same as “concordance”, which includes a consensual agreement about treatment taking established between patient and practitioner. Many reasons exist for non-adherence to medical regimens, including (but not restricted to) problems with the regimen (such as adverse effects), poor instructions, poor provider-patient relationship, poor memory, and patients’ disagreement with the need for treatment or inability to pay for it. Assessing the evidence concerning reasons for low adherence is beyond the scope of this review; the interested reader is referred to other sources.1Low adherence with prescribed treatments is very common. Typical adherence rates for prescribed medications are about 50%with a range from 0% to over 100%.2 To the extent that treatment response is related to the dose and schedule of a therapy; non-adherence reduces treatment benefits and can bias assessment of the efficacy of treatments. With increasing numbers of efficacious self-administered treatments, the need is apparent for better understanding and management of nonadherence. In previous reviews, we examined the accuracy of clinical measures of non-adherence, interventions to improve attendance at appointments for needed medical services, and interventions to enhance medication adherence. We found inconsistent evidence of effects on adherence, and even more limited evidence of effects on patient outcomes. The current version of review updates 2005 version (which included 57 trials) with 21 new studies.3-5Ethical standards for adherence research dictate that attempts to increase adherence must be judged by their clinical benefits, not simply their effects on adherence rates. Accordingly, we included only studies in which both adherence and treatment effects were measured. AIM OF THE STUDY: To study the Impact of follow-up telephone calls made by pharmacists to the hypertensive patients on Nonadherence and Treatment Satisfaction. OBJECTIVES OF THE STUDY: 1. To study the demographic details of hypertensive patients 2. To analyze the adherence rates of the hypertensive patients. 3. To assess the treatment satisfaction of hypertensive patients. 4. To improve the treatment satisfaction and medication adherence in the selected non adherent patients by providing telephonic counselling. DISCUSSION: The aim of the study is to assess and improve the medication adherence and treatment satisfaction of hypertensive patients by follow-up counselling. A total of 250 hypertensive patients were included in this study. The patients’ details were collected using specially designed patient data collection form. In this study, hypertension reporting an age group between 45-64 years is higher (45-64%). This may be the fact that age probably represents accumulation of environmental influences and the effect of genetically programmed senescence in the body systems. Majority of the study population from village for (52.8%) and majority of the patient had primary level of education (57.4%), so there is a positive deviation between education and hypertension. Employed patients (46.7%) significantly associated with hypertension in this reported by Rowaet al.93Stress can cause hypertension through repeated blood pressure elevations as well as stimulation of nervous system. In the study population 96.4% people were married, 55.2% of the people had low income less than 1000 per month. In our study, majority (54.8 %) of patients were non-adherent, in that males (59.2%) were found to be low adherent. Study like Raniah et al,94 proved that adherence was found to be positively correlated with age and duration of illness. In this study younger age between 45-64 years were found to be low adherent. The patients who came from village were found low adherent. Illiteracy was most prominent among the low adherent patients. Patients who had high level of education were adherent47.2% patients were having hypertension past 5 years or more were found to be low adherent. Also the patients having low adherence due to their presence of co-morbid disease. It is due to their Living in a village compared to city was a reason for poor adherence this may be also related to lower levels of education, low income and also in addition to reaching doctor.93 Married patients were found adherent when compared to single. CONCLUSION: In the current study we found a significant increase in-patient compliance with the recommendations of the physicians after the intervention of the telephone follow-up. In the counselingcalls the pharmacists assess and address possible barriers including lack of knowledge, concerns about medication and low necessity beliefs. Our hypothesis is that this type of counseling will improve knowledge, reduce concerns about medication and improve necessity beliefs. This may ultimately improve medication adherence. Although this effect of the intervention on adherence is important, it is as important to assess the impact on the pathway that ultimately leads to adherent behavior. This is because it is this pathway where the pharmacist addresses the needs of each individual patient and where the actual intervention takes place. The results of this study suggest that counselling through telephone calls provided by pharmacists improves the medication adherence and treatment satisfaction. Pharmacists should find strategies to direct this intervention to patients who are most likely to benefit. Attention should be paid how to reach more patients although the intervention is relatively easy to implement. Patients need information about their medicines for safe and effective use. This includes practical instructions on usage but also information about possible side effects, the expected pharmacological action and what happens if a patient does not take the medication. Physicians and pharmacists play an important role in providing counselling about benefits, risks and correct use of medication. Studies show that information needs of patients are not always met because part of the information is forgotten or remembered incorrectly after consultation. Considering barriers that hamper implementation of counselling by pharmacies, a counselling by telephone may improve safe and effective use of medications.
| Item Type: | Thesis (Masters) |
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| Additional Information: | REG.No.261540204 |
| Uncontrolled Keywords: | Telephone Calls ; Nonadherence ; Treatment Satisfaction ; Hypertensive Patients |
| Subjects: | PHARMACY > Pharmacy Practice |
| Depositing User: | Ravindran C |
| Date Deposited: | 12 Apr 2018 05:28 |
| Last Modified: | 12 Apr 2018 05:28 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/6946 |
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