BackgroundPatient satisfaction is the ultimate goal of healthcare system which can be achieved from good patient-healthcare professional relationship and quality of healthcare services provided.Study was conducted to determine the baseline satisfaction level of newly diagnosed diabetics and to explore the impact of pharmaceutical care intervention on patients’ satisfaction during their follow-ups in a tertiary care teaching hospital in Nepal.MethodsAn interventional, pre-post non-clinical randomised controlled study was designed among randomly distributed 162 [control group (n = 54), test 1 group (n = 54) and test 2 group (n = 54)] newly diagnosed diabetes mellitus patients by consecutive sampling method for 18 months. Diabetes Patient Satisfaction Questionnaire was used to evaluate patient’s satisfaction scores at baseline, three, six, nine and, twelve months’ follow-ups. Test groups patients were provided pharmaceutical care whereas control group patients only received their usual care from physician/nurses. The responses were entered in SPSS version 16. Data distribution was not normal on Kolmogorov-Smirnov test. Non-parametric tests i.e. Friedman test, Mann-Whitney U test and Wilcoxon signed rank test were used to find the differences among the groups before and after the intervention (p ≤0.05).ResultsThere were significant (p < 0.001) improvements in patients’ satisfaction scores in the test groups on Friedman test. Mann-Whitney U test identified the significant differences in satisfaction scores between test 1 and test 2 groups, control and test 1 groups and, control and test 2 groups at 3-months (p = 0.008), (p < 0.001) and (p < 0.001), 6-months (p = 0.010), (p < 0.001) and (p < 0.001), 9-months (p < 0.001), (p < 0.001) and (p < 0.001) and, 12-months (p < 0.001), (p < 0.001) and (p < 0.001) follow-ups respectively.ConclusionPharmaceutical care intervention significantly improved the satisfaction level of diabetics in the test groups compare to the control group. Diabetic kit demonstration strengthened the satisfaction level among the test 2 group patients. Therefore, pharmacist can act as a counsellor through pharmaceutical care program and assist the patients in managing their disease. This will not only modify the patients’ related outcomes and their level of satisfaction but also improve the healthcare system.

Background: Cost is a vital component for people with chronic diseases as treatment is expected to be long or even lifelong in some diseases. Pharmacist contributions in decreasing the healthcare cost burden of chronic patients are not well described due to lack of sufficient evidences worldwide. In developing countries like Nepal, the estimation of direct healthcare cost burden among newly diagnosed diabetics is still a challenge for healthcare professionals, and pharmacist role in patient care is still theoretical and practically non-existent. This study reports the impact of pharmacist-supervised intervention through pharmaceutical care program on direct healthcare costs burden of newly diagnosed diabetics in Nepal through a non-clinical randomised controlled trial approach.

Background and aims: The Helicobacter pylori (H. pylori) prevalence in Asian countries is highly variable, with higher seroprevalence shown in the previous studies of developing Asian countries. We aimed to determine the current H. pylori prevalence, correlate with gastroduodenal diseases and study gastric cancer incidence in Nepal. Methods: Among 3357 patients referred for endoscopy, 2820 eligible patients underwent upper gastrointestinal endoscopy with biopsy; H. pylori was considered positive when either of Rapid Urease Test (RUT) or histopathology showed positive result. Results: The H. pylori prevalence was 29.4% in overall distribution, 41.1% in gastritis and or duodenitis, 69.5% in gastric ulcer, 84.7% in duodenal ulcer, 20.8% in gastric polyp and 11.5% in gastric cancer. The H. pylori infection was significantly associated with gastritis and or duodenitis [P<0.001; Odds Ratio (OR) 1.53, 95% Confidence Interval (CI) 1.47-1.59], gastric ulcer (P<0.001; OR 18.62, 95% CI 12.40-27.81), duodenal ulcer (P<0.001; OR 48.89, 95% CI 25.23- 94.75), gastric polyp (P=0.001; OR 7.66, 95% CI 3.18-18.44) and gastric cancer (P=0.005; OR 3.78, 95% CI 1.82-7.86). The age-standardized (world) annual rate of gastric cancer in Kaski district of Nepal was 3.3 per 100,000. Conclusions: The H. pylori prevalence in Nepal was lower than that shown in the previous studies of developing Asian countries, but was significantly high in gastritis and or duodenitis, and peptic ulcers. Similarly, the gastric cancer incidence was also low in Nepal and was significantly associated with H. pylori. Further study is needed to establish the association of H. pylori with gastric cancer in Nepal. DOI: http://dx.doi.org/10.3126/jaim.v2i2.8777   Journal of Advances in Internal Medicine 2013;02(02):52-60