Treatment related problems for outpatients with chronic diseases in Jordan: The value of home medication reviews

Iman A. Basheti, Eyad A. Qunaibi, Nailya R. Bulatova, Sundos Samara, Salah Aburuz

Research output: Contribution to journalReview articlepeer-review

38 Citations (Scopus)

Abstract

Background Research conducted in Jordan has shown that suboptimal use of medications by outpatients along with the suboptimal role played by community pharmacists is currently a big dilemma highlighting the need for the Home Medication Review (HMR) service in the country. Objectives To evaluate the prevalence and types of treatment related problems (TRPs) for outpatients with chronic diseases. Setting Patient interview was conducted at the patients' community pharmacy initially, then at their home to collect required data. Methods 167 patients with chronic conditions (mean age 58.9 ± 13.54, 53 % males) were recruited. Data collected by the graduate pharmacists to conduct a HMR included patient's demographics, income, laboratory data, medical history, medication record, and adherence. A HMR was conducted for each patient by the researchers (experienced clinical pharmacists) to identify the patients' TRPs based on published literature. A focus group interview was conducted to elicit information regarding the feasibility of the HMR process and acceptability of the patient to the service. Main outcome measure Prevalence and nature of identified TRPs, associated diseases and drugs, and patients' acceptability to the HMR service. Results The mean number of disease conditions per patient was 4.1 ± 1.7, and the mean number of medications taken by each patient was 8.1 ± 2.7. HMR results showed a mean number of TRPs per patient of 7.4 ± 2.8. TRPs prevalence: 34.7 % of patients were found to have unnecessary drug therapy; 68.3 % had untreated conditions, and 74.9 % had ineffective/incomplete drug therapy; 50.3 % had inappropriate dosage regimen; 10.2 % were found to have actual adverse drug effects. A significant correlation between the number of TRPs and the number of disease states the patient had (r = 0.311, p = 0.003; Pearson correlation) and the number of drugs the patient was taking (r = 0.443, p < 0.001) was found. Patients accepted the HMR service well including the home visiting part. Conclusion TRPs in Jordanian outpatients with chronic diseases visiting community pharmacies are of concern and this signifies the integral role of pharmacists to identify these TRPs and hence provide the HMR service in the country.

Original languageEnglish
Pages (from-to)92-100
Number of pages9
JournalInternational Journal of Clinical Pharmacy
Volume35
Issue number1
DOIs
Publication statusPublished - Feb 2013
Externally publishedYes

Keywords

  • Chronic conditions
  • Community pharmacy
  • Jordan
  • Medication management review
  • Treatment related problems

ASJC Scopus subject areas

  • Pharmacy
  • Toxicology
  • Pharmacology
  • Pharmaceutical Science
  • Pharmacology (medical)

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