Oct-Dec, 2011 - Indian Journal of Pharmacy Practice

Indian Journal of Pharmacy PracticeAssociation of Pharmaceutical Teachers of IndiaImpact of Clinical Pharmacists Counseling on Quality of Life in patients withCongestive Cardiac Failure.1 1 2 1 1 1Anoop P* , Radhika N , Selvamuthu K.S , Saravanakumar R.T , Madhusudhan S , Mohanta G.P .1Department of Pharmacy, Annamalai University, Annamalai Nagar, Tamilnadu.608002.2Associate Professor of Medicine, RMMC&H, Annamalai Nagar,Tamilnadu.608002A B S T R A C TSubmitted: 14/10/2011Accepted: 21/11/2011Quality of life is defined as “an individual perception of their position in life in the context of the culture and value systems in which they live and inrelation to their goals, expectations, standards and concerns.” Quality of life is a measure of a person's physical and psychological contentment.The study was conducted in order to study the impact of clinical pharmacist's counseling on Qol in patients with heart failure using Kansas CityCardiomyopathy Questionnaire (K.C.C.Q). The study was conducted on 70 patients and the influence of various intra and inter patientelements like age, gender, ejection fraction, duration of the disease on the questionnaire were studied. Compliance was assessed by pill countmethod. Subsequently the patients were counseled and followed for a period of time. A significant difference in QoL score and compliance wasachieved compared to that of the baseline. By the end of the study more patients were found to be compliant. In conclusion, Patient counselingaided the patients in better understanding of the disease and its control which ultimately improved their health related Quality of life.Keywords: Congestive cardiac failure, pharmacist impact, QoL, K.C.C.QINTRODUCTIONThe concept of quality of life is not yet defined in a uniformway, lacks clarity and even creates confusion. It seems that inmedicine, the term has become a bandwagon concept for allthose human needs which are often neglected in a health carefield increasingly dominated by technology. It is justifiable tosay that it is a term describing a field of interest rather than a[1]single variable . HRQL measures the illness experience asopposed to the disease; it defines the patient reality, his or herpoint of view as opposed to the reality defined by professional[2]medical knowledge . According to WHO, QoL is defined as“an individual perception of their position in life in thecontext of the culture and value systems in which they live andin relation to their goals, expectations, standards and[3]concerns” . QoL assessment could be a useful tool formonitoring the progress of patients receiving drug therapy.Improvement in QoL may be the main goal of treatment inpatients with some diseases like Rheumatoid Arthritis, CCFetc. In these diseases, the therapeutic goal is to avoidimpairment in QoL caused by the adverse effects of the drugs[4]and distress which results in Non-Compliance .Congestive Cardiac Failure (CCF) is a condition progressingto early death and affecting Quality of Life in the form ofAddress for Correspondence:Anoop P, Apt# A4, Jawahar Apts, OP Main Road, Chidambaram - 608002Tamilnadu.E-mail: anoopparchuri@yahoo.co.in[5, 6, 7, 8]fatigue, breathlessness and oedema . Congestive heartfailure is a global burden disease, commonly more prevalentin developed and developing countries and the prevalenceranging from 0.3% to 2% in the population at large, 3-5% inthe population are 65 years old, between 8% and 16% of thoseaged over 75 years. The prevalence of CCF in India was 18.8million per year (1.76%) of the total population and the[9]incidence was 1.57 million per year (0.15%).[10, 11]Measuring of the Quality of LifeOne goal of the measurement of quality of life is to haveobjective evaluations of how and how much the diseaseinfluences patient's life and how patients cope with it. Theseevaluations may be useful as a baseline outcome measuresand should provide framework to determine the impact of any[12, 13, 14, 15]change on patient's quality of life .Some examples of specific instruments to measure quality oflife in heart failure patients are: 1. The Chronic Heart FailureQuestionnaire; 2. The Minnesota Living with Heart FailureQuestionnaire; 3. The Yale Scale; 4. The Quality of LifeQuestionnaire in Severe Heart Failure and 5. The Kansas CityCardiomyopathy Questionnaire.[16, 17, 18]Limitations of Quality of LifeQuality-of-life instruments have always been seen as long,time consuming and unresponsive assessment tools; but,since the introduction and availability of shorter, easiermethods to understand and administer tools, there has been anIndian Journal of Pharmacy Practice Volume 4 Issue 4 Oct - Dec, 2011 66