Dhandapani, C (2017) The Implementation and Evaluation of Pharmaceutical Care Plans for Diabetic Populations at Multispecialty Hospital. Doctoral thesis, The Tamilnadu Dr.M.G.R. Medical University, Chennai.
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Abstract
Chronic disease management of Type II Diabetes Mellitus requires a mix of strategies that deliver optimum pharmacotherapy, patient education and self-management support to the patient over the course of their disease. To achieve the treatment targets required to prevent complications and maintain a good quality of life for the patient, a team approach is needed and pharmacist by virtue of their accessibility, medication expertise, good relationship and frequent contact with patients should become active members of the diabetes care team. Pharmaceutical care appears to increase the information given to patient about medications, promote more effective self-administration of medications by encouraging patients to use systematic remainders and increase awareness of medication side effects. To reap the benefits of modern medical therapies, more efficient and effective interventions are needed to aid people. The present study has clearly demonstrated the value of comprehensive pharmaceutical care provision to the patient group. The main strengths of the study are the diverse outcome measures used and the low-down dropout rate. However, it covered a period of only 9 months. The pharmacist counseledthe patients on the following areas: pharmaceutical care in general, education on medication adherence, insulin, its side effects and interactions, physical activity, diet, diabetic emergency management, individual treatment goals, and general perception of the pharmaceutical care service and its influence on glycemic control. Studies have confirmed that the complications of diabetes can be reduced by proper control of blood glucose, which in turn dependent on the patient's adherence to medications and life style modifications. PPCP is a process through which a pharmacist co-operates with a patient and other health care professionals in designing implementing and monitoring a therapeutic plan that can produce specific outcomes such as improving glycemic control in Diabetes Mellitus patients. PPCP reviewed and monitored all aspects of the patient’s management for 9 months at 3 months’ interval. In our study the PPCP reduces the Drug related, Disease related and Patient related complications. PPCP provides important medication information and counseling to the patients, resulted in changes to drug therapy. By reducing the DTPs and improving the medication adherence, the drug related problems were decreased significantly for the PPCP group patients. Disease related problems deals with macro vascular and micro vascular complications. In macro, vascular complication, there was a significant reduction in 10-year risk of having a CHD event, for patients with no previous CHD. There was a continuous monitoring of glycemic control, lipid profile and Blood pressure has been done to attain beneficial outcomes. It can be influenced by proper education and counseling of the patient. These improvements persisted after adjustment for demographic variables, intensification of pharmacotherapy and patient education. In addition, the Diabetes, if untreated, can lead to various complications such as neuropathy, retinopathy, nephropathy, diabetic foot ulcers, hyperlipidemia, infections, etc. These complications adversely affect the quality of life of the patient. This study has helped to identify the areas where there were gaps in patient knowledge. By raising the awareness for the patients, the knowledge of Type II Diabetes Mellitus, Foot and oral care was increased significantly for PPCP group patients. As a result, there was a considerable improvement in QoL of the patient. Achieving the target HbA1c (<7gm%) was the primary outcome of the study. The mean HbA1c values showed significant decline in the PPCP group compared to the UCP group. The controlled HbA1c level creates a positive impact on level of confidence, disease complications and medication issues. PPCP gives additional risks to the patients, like monitoring blood glucose level daily and doing physical activities. Benefits were considerably increased for the PPCP group compared to the UCP group. Pharmacist integration into a health care team has been shown to be effective in improving a number of clinical health outcomes. The research revealed that it is essential that patients develop a trusting and collaborative relationship with the pharmacist as well as other health care providers to achieve maximum pharmaceutical care and improve quality of life. In conclusion, anew innovative concept (PPCP) seems promising practice to improve the quality of pharmaceutical care.
| Item Type: | Thesis (Doctoral) |
|---|---|
| Additional Information: | 61622/2011 |
| Uncontrolled Keywords: | Implementation, Evaluation, Pharmaceutical Care Plans, Diabetic Populations, Multispecialty Hospital. |
| Subjects: | PHARMACY > Pharmaceutics |
| Depositing User: | Subramani R |
| Date Deposited: | 01 Jan 2019 13:22 |
| Last Modified: | 20 Oct 2022 07:10 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/10289 |
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