Oct-Dec, 2011 - Indian Journal of Pharmacy Practice

Satyanarayana V - Evaluation of the Impact of a Therapeutic Management and Effect of Pharmacist Intervention on Children with AsthmaØ Exclusion Criteria· Patients associated with another diseases like cardiacproblem, liver diseases, Central nervous system diseases.Intervention study: The present study was mainly dividedinto two parts for pointing out the deviations from standardtreatment guidelines for promoting rational use of drugs in thepediatric units of Gandhi hospital.1. Pre-intervention data.2. Pot-intervention data.ANOVA test was carried out 50 case sheets were randomlycollected to generate pre intervention data for planning anintervention data. For post intervention data 50 case sheetswere collected and analyzed.The following method is followed for intervention.1. Review of medication orders everyday in pediatricwards.2. Comparison of medication orders with standardtreatment guidelines.3. Detection and verification of medication errors byreferring unbiased reference resources ( Micheal T.Respp et al., 1992; De varies et al., 1994; Michael R.Cohen, 1999; Dinesh K. Mehta, 2001; AFHS DrugInformation, 2001; Government of India, 2002;Sangeetha Sharma et al., 2005.4. Critical examination of medication order for examining– excessive use of drugs, over use of antibiotics andexcessive injection practice.5. Assurance of the revised medication order inconsultation with prescriber.6. Documentation of findings.The case records of patients were examined for details ofprescription, to fill the data collection form. The doctors onduty/ concerned pediatrician were consulted for clarificationwhenever required.The study procedure:Ø Patient enrollment: The patient who has been diagnosedas bronchial asthmatic was sent to the clinical pharmacist bythe doctors. About 100 patients , who are satisfying studycriteria were included in the study to assess patientknowledge.Ø Collection of data: Patient data collection form includeddemographic details, co- morbid condition, past medical andpast medication history, family history, life style, laboratorydetail etc.Measuring knowledge, attitude and practice onmanagement of bronchial asthma:Patient knowledge about bronchial asthma was assessed byusing patient knowledge attitude and practice questionnaire.This questionnaire assesses the patient basic knowledgeabout bronchial asthma, its risk factors, completion andlifestyle modification necessary in bronchial asthma patient.All the questions were closed ended questions. Thisquestionnaire contains 15 scored questionnaire andmaximum score was 15 higher score indicate a greaterknowledge.An intervention based randomized study was designed toevaluate the effect of patient counseling in the studypopulation.All the bronchial asthma patient who were meeting inclusioncriteria and admitted in inpatient ward were included in thestudy after getting consent from patient and by standers.Patients were randomized as control and study group. Total ofabout 100 completed the study, out of that 50 were in studygroup and 48 in the control group. Two patients in the controlgroup didn't complete the study because patients wereimmediately shifted from the hospital. The base lineknowledge was measured using patient knowledge, attitudeand practice assessment questionnaire. The study group wasprovided with written and verbal information about bronchialasthma and its management by clinical pharmacist aftertaking baseline knowledge. On an average 30-45 minutes wasspend with each patient depending on their education leveland understanding capability. To the control group noinformation was provided by the clinical pharmacist.On the day of discharge the same knowledge attitude andpractice assessment questionnaire was administered againand patient knowledge was assessed about bronchial asthmain both groups. The base line and final knowledge aboutbronchial asthma was compared in both control and studygroup.Statistics:Ø Statistical Methods:Student test (paired) has been used tofind the significance of total answers (correct) between beforeand after intervention. Effect size due to cohen (d) has beenused to find the effect of intervention. Difference ofpercentage (Before-After) are computed using on-line javascripttests on difference (Before-After test on proportion).Ø Effect Size:No effectMild effectd