None listed
Conditions
Brief summary
Home Medication Review (HMR), also known as ‘pharmacist-led medication review’ is defined as ‘systematic assessment of consumer’s medication and management of those medications with the aim of optimising consumer health outcome and identifying potential medication-related issues within framework of the quality use of medicine’. Numerous overseas studies have demonstrated that HMR could benefit patients with multiple chronic conditions, age or social circumstance, complexity of their drug regimen, and lack of knowledge or skill on using medication or medication device. The new extension in the role of community pharmacists in pharmaceutical care is anticipated given the increasing number of community pharmacists recently. HMR conducted by community pharmacists (HMR-CP), a comprehensive clinical review of a patient's medicines at his/her home by an accredited community pharmacists upon referral from the patient's Family Medicine Specialist (FMS) or general practitioner (GP), could have benefit T2DM patients who live independently in the community and this warrants for further investigations. The general objective of the study is to develop and evaluate home medication review by community pharmacists (HMR-CP) programme in optimising diabetes care in Malaysia. While the specific objectives are to determine the clinical impact of HMR-CP among patients with T2DM, to determine the humanistic outcomes of HMR-CP among T2DM patients, to determine the cost-effectiveness of implementing HMR-CP in Malaysia and to explore stake holders’ perception on implementation of HMR-CP. The study is mainly divided into 5 stages: pre-intervention phase, training the community pharmacists, pilot study and intervention phase, economic evaluation, and qualitative review from healthcare professionals and patients. A patients with Type 2 Diabetes Mellitus patients from Bandar Pasir Mas Health Clinic who fulfill the inclusion and exclusion criteria will be randomly assigned into two groups: intervention group who will received HMR-CP and controlled group. The primary outcome of this study is the reduction of HbA1c percentage. Four secondary outcomes will be measured: Clinical parameters (i.e. fasting blood glucose, blood pressure and body mass index), medication / medical related issues, medication adherence and wastage of medication will be measure. Besides that, the cost effectiveness of this HMR-CP programme will be evaluated. After the HMR-CP programme, the researcher will conduct a focus group discussion between the healthcare professional (i.e. FMS and community pharmacists) and one-to-one interview with patients to explore the view of the stakeholders on HMR-CP.
Interventions
This study will adopt a randomized clinical trial (RCT) design. Subjects in the control group will have routine follow up at health clinics without receiving home medication review from the community pharmacists. While in the intervention group, the subjects will received additional process of treatment. They will have home medication review by community pharmacists at 0-month, 3-month and 6-month. The established protocol of HMR by Pharmaceutical Service Division, MOH, Malaysia will be referre
This study will adopt a randomized clinical trial (RCT) design. Subjects in the control group will have routine follow up at health clinics without receiving home medication review from the community pharmacists. While in the intervention group, the subjects will received additional process of treatment. They will have home medication review by community pharmacists at 0-month, 3-month and 6-month. The established protocol of HMR by Pharmaceutical Service Division, MOH, Malaysia will be referred in developing the program. During the HMR session, there will be discussion about medication and information about disease between patients and community pharmacists, reviewing how patients used and storage of medication, doing intervention for any pharmaceutical care issues and lifestyle modification to have better disease management. All community pharmacists who participate in this program have a valid license A to practice as community pharmacists. They will provide the intervention with face-to-face mode in the patients' house.The duration of intervention is approximately 30 minutes .
Sponsors
Faculty of Pharmacy, UiTM
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Adult patients (more than 18 years old) diagnosed with Type 2 Diabetes Mellitus. 2. Patients with current HbA1C more than 6.5% 3. Patients taking five (5) or more medications for long term therapy or taking more than twelve (12) doses of medications daily. 4. Patients stayed in 25 km radius from Bandar Pasir Mas Health Clinic
Exclusion criteria
1. Enduring mental health problems or dependant with caretaker 2. Insufficient understanding of English/ Bahasa Malaysia. 3. Patients who are homeless or do not have a proper place to stay. 4. Foreign workers or non-permanents residents. 5. Patients with blood disorders (i.e. haemolytic anemia, haemoglobinopathy22, chronic lymphocytic leukemia). 6. Patients diagnosed with chronic kidney disease.
Outcome results
None listed