Impact of home visit pharmacists on diabetes patient medication adherence and self-care activities: a randomized controlled trial Tunggul Adi Purwonugroho1*, Laksmi Maharani1, Ika Mustikaningtias1, Budi Raharjo2, Vitis Vini Fera Ratna Utami1, Githa Fungi Galistiani3, Hanif Nasiatul Baroroh1, Hening Pratiwi1
1Department of Pharmacy, Faculty of Health Sciences, University of Jenderal Soedirman, Purwokerto, Indonesia
2Indonesian Pharmacist Association, Central Java Region, Indonesia
3Faculty of Pharmacy, University of Muhammadiyah Purwokerto, Purwokerto, Indonesia
Abstract
Background: Pharmacist has a promising role to improve diabetes patient condition by providing an educational intervention.
Purpose: This study aimed to evaluate the impact of home-visit pharmacist on diabetes patient^ medication adherence and self-care activities.
Methods: Twenty four weeks of randomized controlled trial in Banyumas district, Central Java province, Indonesia was performed. Patients in the intervention group received home visit services by participant pharmacists, while the control group obtained usual care. The outcomes were patient medication compliance measured with Morisky Medication Adherence Scales-8 (MMAS-8) and patient lifestyle using The Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. Before other statistical tests were taken, the data were tested for normality, and parametric or non-parametric tests were conducted accordingly. The level of significance used in all tests was 0.05 (two-tailed).
Results: In the final analysis, 41 patients in the control group and 47 patients in the intervention group were included. Adherence score increased 13.11% (95%CI: 7.00% to 19.22%- P < 0.001) and 20.21% (95%CI: 13.56% to 26.86%- P < 0.001) on usual care group and intervention group, respectively. Moreover, there was 5.18% between-group improvement even though the change was not statistically significant (P = 0.210). There were significant improvements on SDSCA scores in intervention group (score increased by 7.32, p<0.0001) and control group (score increased by 5.05, p=0.015). Additionally, there was a between-group difference of 2.27 on SDSCA score, but the statistic was not significant (p=0.4).
Conclusion: Even though statistically significance has not been achieved, home-visit performed by community pharmacist improved the adherence and lifestyles of patients with diabetes.
