Oct-Dec, 2011 - Indian Journal of Pharmacy Practice

More documents

Recommendations

Info

Satyanarayana V - Evaluation of the Impact of a Therapeutic Management and Effect of Pharmacist Intervention on Children with AsthmaTable 4: Prescription Analysis (II) by pre-intervention and post-intervention dataArea of Pre- Post- F-test t-test ResultIntervention Intervention Intervention (p>0.05) (95%(n=50) (n=50) C.I)Number of drugs 330 283 0.5775 1.12 to1.37 NSNumber of drugs prescribed in generics 220 227 0.4421 1.21 to 1.55 NSNumber of antibiotics 100 92 0.3021 1.38 to 1.44 NSNumber of Tablets 110 74 0.0274 1.22 to 1.66 NSNumber of Nebulizations 100 100 0.5141 1.11 to o.99 NSNumber of Cough syrups 22 19 0.2412 0.21 to 0.14 NSNumber of Oxygen inhalations 50 50 0.2141 0.12 to 0.11 NSNumber of Irrational prescribing 161 93 9.22 0.87 to 0.66 SANOVA: Degree of freedom =49; Table value of F-test=3.76 at 95% confidence limits, N/S =Not Significant;S=Significant. No. of irrational prescribed – is determined based on WHOFig. 3: Prescription Analysis (iI) by pre-intervention andpost-intervention datagroup compared to the control group. The data suggest thathaving pharmacists provide pharmaceutical care for pediatric32patients with asthma results in a favorable outcome .Lincy SL described that pediatric pharmaceutical care is still anew concept in the pharmacy profession. In an effort to rectifythis situation metered-dose inhaler technique, to determinefrequency of MDI assessment and teaching behavior and toassess the effect of asthma pharmaceutical care educational33programmers .D Barbanel et al; 2003, was undertaken a randomizedcontrolled study to determine whether a communitypharmacist could improve asthma control using selfmanagementadvice for individuals recruited during34attendance at a community pharmacy .Koffi N. et.at, conducted study to assess the role ofpharmacists in management of asthma in Africa. Thisquestionnaire survey was conducted. Participation rate was88.69%. In case of acute episodes, care is provided by thepharmacists in 59.80% of the cases. Aerosol devices are mostwidely used. For chronic care corticosteroids are widely35delivered .Christine et at; 2005 conducted a study to measure the effectof an asthma intervention on the functional status andmorbidity of children with undiagnosed asthma by using datafrom a randomized trial to compare outcomes at baseline andfollow-up for children with undiagnosed and diagnosedasthma. They studied 510 symptomatic children withdiagnosed asthma (diagnosed) and 299 children withsymptoms but no diagnosis (undiagnosed). Children withundiagnosed asthma were generally Nona topic, althoughsome had symptoms at a level comparable to children with adiagnosis. The intervention successfully improved functional36status as well as for children with diagnosed asthma . In mostof those studies, compared with usual care, school-basedasthma education improved knowledge of asthma (7 of 10studies), self-efficacy (6 of 8 studies), and self-managementbehaviors (7 of 8 studies). Fewer studies reported favorableeffects on quality of life (4 of 8 studies), days of symptoms (5of 11 studies), nights with symptoms (2 of 4 studies), and37school absences (5 of 17 studies) .Inferences from the patient knowledge, attitude andpractice questionnaire (Study group and Control Group)In our study it was observed that the active involvement ofpharmacist in healthcare team can improve patient'sknowledge, attitude and practice on management of bronchialasthma. For that we conducted an intervention based study,revealed that patients in study group improve their knowledgesignificantly after single education meeting with pharmacist.It was found that the mean knowledge score increased from7.47 to 21.87 in study group after the intervention (i.eCounseling by clinical pharmacist). Out of 15 questions 7individual questions improved significantly in study group.Indian Journal of Pharmacy Practice Volume 4 Issue 4 Oct - Dec, 2011 44
Satyanarayana V - Evaluation of the Impact of a Therapeutic Management and Effect of Pharmacist Intervention on Children with AsthmaStudy GroupOut of 50 patients, 24% were aware of the fact that they arehaving bronchial asthma. 25% were unaware about theirdisease and are of opinion that they are having some problemslike allergy, oesinophilia or bronchitis occurring occasionallyor regularly. After counseling 52% could name their disease.Before counseling 4% of the patients were properly awarethat asthma is a disease of the airways in the lungs. Aftercounseling 12% of the patients could answer correctly.Before counseling 28% of the patients were aware of the factthat the asthma attack is occurring after exposure to asthmatrigger factors like smoke, dust and cold items. Aftercounseling 62% of the patients had the opinion that apart fromtaking medicines, controlling of asthma trigger is alsoimportant for proper maintenance of therapy. So as a patientcounselor I could advice about the importance of avoidingasthma triggers.Before counseling 36% of the patients were known about thesymptoms of asthma such as cough and breathlessness. Aftercounseling 72% of the patients could answer all the symptomsof asthma attack. Before counseling none of the patients wereknown about the drugs to be avoided in asthma. Aftercounseling with the help of patient information leaflets 12 %of the patients could answer the medications to be avoided inasthma. Out of 50% patients 4% told they prefer aerosoltherapy. None of the patients prefer administering injections.Most of the patients were willing to take oral medicationrather than any other medications. In that maximum patientslike to take syrups and tablets. When patients were educatedabout the proper use of aerosol therapy and its advantage withlesser adverse effects, 30% of patients were willing to takeaerosol therapy rather than any other formulation. Beforeintervention 32% of the patients were aware about the fooditems to be avoided in asthma. After counseling 80% of thepatients could answer about the food items to be avoided inasthma. Before counseling 12 % patients were aware aboutthe importance of taking regular treatment of bronchialasthma. After counseling 78% was aware about importance oftaking regular treatment of bronchial asthma. Beforecounseling 100% of the patients were failed to identify thedrug properly. After counseling 14% of the patients wereproperly aware about the use of the drugs that have beenprescribed to them and remaining had some confusion withthe medications. Before counseling 100% of the patients hadan opinion that they will take the medication as per theprescription and if they cured, then no need of administeringthe same drugs. But after counseling 40% of the patients werechanged their opinion and decided to take treatment as perdoctor's and pharmacist's advice. Before counseling 12% ofthe patients were aware about the proper use of inhalertechniques. They got this knowledge from counseling 48% ofthe patients got idea regarding proper inhalation techniques.6% were aware about the management of severe or acuteasthma. They got this knowledge from doctors, pharmacists,nurses or might have used earlier. After counseling 24% gotthe proper ides regarding severe or acute asthmamanagement. Before intervention 6% of patients reportedthey experienced taste disturbances and tremor. Beforecounseling 44% of patients told they are satisfied to someextent. After counseling 88% of patients were completelysatisfied with the medication and 12% of the patients are not atall satisfied with the prescribed medication.In the study group out of 15 questions 7 questions showedsignificant improvement. The total effect was very large witheffect size (d) = 4.12 and P> 0.001. It was found that the meanknowledge increase from 7.47 to 21.87 in study group.(Table5).Control GroupEven though some questions showed improvement becauseof hospital stay, there is no significant improvement in controlgroup. It found that the mean knowledge score increase from7.87 to 8.8 in control group. It was found that intervention is3.25 times more effective in study group when compared tocontrol group. (Table 6)CONCLUSIONPresent study was done in pediatric division Gandhi Collegeand hospital, 1200 bedded multispecialty tertiary careteaching hospital.Findings of the project indicate a significant reduction inirrational prescribing which includes overdose, wrongduration, wrong frequency and multiple prescribing.However, though there was a reduction in number ofantibiotics, tablets, cough syrups and increase in genericprescribing in post intervention period, the data are notstatistically significant.Standard treatment guidelines for bronchial asthma weresupplied to all the doctors of paediatric division. A suggestionwas made to study the drug use problems in more detail andeducational, managerial, and legal investigation can beplanned to decrease drug use problems and promote rationaluses drugs.Besides assuring safe medication, the study has createdawareness among the medical practitioners on the necessityof clinical pharmacist in institutional healthcare setup toprevent irrational prescribing and to promote rational use ofdrugs.Indian Journal of Pharmacy Practice Volume 4 Issue 4 Oct - Dec, 2011 45
Page 1 and 2: Indian Journal of Pharmacy Practice
Page 3 and 4: Dear ReadersIndian Journal of Pharm
Page 5 and 6: Daxesh M P - Combating Antimicrobia
Page 13 and 14: J. Chang - India's Progress towards
Page 15 and 16: J. Chang - India's Progress towards
Page 17 and 18: Shobha C - Poison Information Cente
Page 25 and 26: Anantha Naik N -Health Related Qual
Page 33 and 34: Amrita P - Scenario of Pharmacovigi
Page 42 and 43: Satyanarayana V - Evaluation of the
Page 52 and 53: Dinesh KU - Evaluation of the Impac
Page 66 and 67: Pratham R - A Retrospective Study o
Page 70 and 71: Anoop P -Impact of Clinical Pharmac
Page 76 and 77: Singh B -Respiratory Tract Problems
Page 78 and 79: Singh B -Respiratory Tract Problems
Page 80 and 81: Mihir Y.P - Study of Prescribing Pa
Page 84 and 85: Ramanath K.V -Evaluation of the Imp
Page 86 and 87: Ramanath K.V -Evaluation of the Imp
Page 88 and 89: Instructions to AuthorsIntroduction
Page 90: Instructions to AuthorsElectronic j

Oct-Dec, 2011 - Indian Journal of Pharmacy Practice

Create successful ePaper yourself

Delete template?

Save as template?