1.KAP Investigation and Influential Factor Study of Medication Risk among Residents
Jiaying ZHANG ; Xirui GUO ; Xingwei WU ; Huan XIONG ; Xiangzun XIONG ; Huan LIU ; Enwu LONG
China Pharmacy 2018;29(11):1445-1448
OBJECTIVE:To investigate the status quo of knowledge-attitude-practice(KAP)of medication in residents,and to explore potential risk factors that may affect medication. METHODS:By approximate random sampling,online(wenjuanxing)and offline method (5 communities of Chengdu city) were used to collect general information (gender, age, monthly income, residence,medical insurance,education level,working condition,occupation)of the residents aged 19 year-old above and conduct KAP investigation during Jul.-Aug. 2017. Multiple linear regression analysis was used to analyze the influence of residents'general information on KAP. RESULTS:A total of 517 online and offline valid questionnaires were obtained, including 200 offline questionnaires were sent out and 184 valid questionnaires were returned with recovery rate of 92%. Average scores of medication knowledge,attitude and practice were (71.4 ± 32.3),(33.7 ± 14.0),(60.7 ± 19.4),which all reached"good"in the evaluation standard of questionnaire results. The results of multiple linear regression showed that elderly and low education level were the significant influential factors of residents'lack of medication knowledge. The male,elderly,low income and low education level were the influential factors of poor drug use behavior. The residents with poor attitudes towards medication were low income and low educated population. CONCLUSIONS:The average risk of residents'medication in China is low,but it is still necessary to strengthen medication education for special people. It is requisite to focus on the elderly,the low education level,the low income population and the male residents.
2.Practice of Medication Therapy Management for A Patient with Obesity Diabetes Mellitus by Clinical Pharmacists
Huan XIONG ; Xingwei WU ; Xirui GUO ; Xiangzun XIONG ; Jiaying ZHANG ; Enwu LONG
China Pharmacy 2019;30(13):1830-1834
OBJECTIVE: To explore the role of clinical pharmacists in medication therapy management (MTM). METHODS: Referring to the practice model of MTM in the United States, taking a noninfectious chronic disease (obesity diabetes mellitus) patient as an example, clinical pharmacists of endocrinology specialty carried out MTM according to five processes, such as patient information collection, medication therapy review, the formulation of medication-related action plan (MRP), interventions related to direct communication with physicians or advising patients to consult relevant medical service personnel, record and follow-up. RESULTS: The information of patients collected by clinical pharmacists included past medical history, family history, allergy history and medication history, etc. It was the top priority MRP for this patient to identify inappropriate hypoglycemic drug therapy, obesity-induced obstructive sleep apnea-hypopnea syndrome and hyperlipidemia. For obesity patients with type 2 diabetes mellitus, clinical pharmacists recommend that patients changed insulin drugs to non-insulin drugs, and liraglutide was recommended. In view of the poor control of blood lipid level, fenofibrate was recommended for patients on the basis of oral administration of simvastatin. The patient’s attending physician agreed with the above suggestion and adjusted the prescription. Clinical pharmacists provided medication education for the patients about the importance of each drug, control of total energy intake, balanced diet and physical exercise. The follow-up results after 6 months showed that blood glucose (fasting blood glucose 5-7 mmol/L, postprandial blood glucose 8-10 mmol/L) and blood lipid (total cholesterol 4.80 mmol/L, triglyceride 1.60 mmol/L, low density lipoprotein 3.05 mmol/L) of the patient were effectively controlled and body weight was reduced by 3 kg, but the improvement of lifestyle was poor, mainly due to the nature of his work. Clinical pharmacists once again communicated with him and emphasized the importance of proper physical exercise. The patients agreed to continue the follow-up. CONCLUSIONS: Clinical pharmacists can provide professional consultation and service for patients with chronic diseases by means of MTM service mode, which has certain value for improving medical quality.