A non-clinical randomised controlled trial to assess the impact of pharmaceutical care intervention on satisfaction level of newly diagnosed diabetes mellitus patients in a tertiary care teaching hospital in Nepal

Abstract

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.

Do randomised controlled trials relevant to pharmacy meet best practice standards for quality conduct and reporting? A systematic review

“…The median Cochrane risk of bias score by individual paper was 50.0% (IQR 33.3–66.7). Only one paper met all criteria of the Cochrane tool and two papers did not meet any. The median CONSORT score was 59.5% (IQR 52.0–70.3%) with three papers meeting 83.8% of the criteria and one meeting only 29.7% .…”

Perception of patients towards the role of pharmacist: a cross-sectional study from selected three hospitals in Central Nepal

“…This might be due to the fact that Nepalese pharmacy professionals working in some hospital pharmacies are known to include various patient-focused services such as counselling and education, prescription auditing, medicine information, training on special devices and telepharmacy. [15][16][17]27,28] Similarly, community pharmacy professionals have also been engaged in several services such as patient counselling, blood pressure monitoring, medication record keeping, first-aid treatment and vaccination. [9,26,46] Initiation of such services might change patients' perception of pharmacist as a businessman to healthcare service provider in future.…”

“…Moreover, this study does not differentiate the opinion of patients with varying medical conditions and medications, but a study on Nepalese patients with diabetes mellitus provided neutral response on satisfaction towards pharmacists (contribution and support, ability to answer queries and time spent). [17] Additionally, the presence of confounders in this study could have been overcome using other study designs if not through multivariate analysis.…”

“…[14] Few teaching hospitals have pharmacy with drug information centre, medication counselling centre and pharmacovigilance centre, but running them continues to be challenging. [13] There are evidences in literature that hospital pharmacies in Nepal provide counselling on medications and/or devices of chronic diseases [15][16][17][18] and also run continuing pharmacy education (CPE). [19] Although there are software for controlling inventory and billing of medications and devices, hospitals still lack software that can assist dispensing process.…”

Satisfaction and expressed needs of pharmaceutical care services and challenges recognized by patients in South Korea

“… 4 – 10 There are many studies that measure the outcomes of PCSs globally; however, the results are not consistent. 5 , 11 , 12 They may vary depending on the target patient population, the service setting, and even the questionnaires’ content. As pharmacists look for opportunities to develop and expand the scope of practice for PCSs, patients’ views on these issues must be understood.…”