The Effects of Clinical Pharmacist Education on Lifestyle Modifications of Postmyocardial Infarction Patients in South India: A Prospective Interventional Study
ABSTRACT: Background: Myocardial infarction (MI) is associated with significant short-term and long-term mortality and morbidity. Secondary prevention and treatment of post-MI patients through medication and lifestyle modification is becoming an important aspect of patient care regimens. Pharmacist...
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2020-01-01
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English |
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Article |
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DOAJ |
author |
Sarumathy Sundararajan, M. Pharm Shanmugarajan Thukani Sathanantham, M. Pharm., PhD Shanmugasundaram Palani, M. Pharm., PhD |
spellingShingle |
Sarumathy Sundararajan, M. Pharm Shanmugarajan Thukani Sathanantham, M. Pharm., PhD Shanmugasundaram Palani, M. Pharm., PhD The Effects of Clinical Pharmacist Education on Lifestyle Modifications of Postmyocardial Infarction Patients in South India: A Prospective Interventional Study Current Therapeutic Research Clinical pharmacist Medication adherence Postmyocardial infarction Secondary lifestyle modifications |
author_facet |
Sarumathy Sundararajan, M. Pharm Shanmugarajan Thukani Sathanantham, M. Pharm., PhD Shanmugasundaram Palani, M. Pharm., PhD |
author_sort |
Sarumathy Sundararajan, M. Pharm |
title |
The Effects of Clinical Pharmacist Education on Lifestyle Modifications of Postmyocardial Infarction Patients in South India: A Prospective Interventional Study |
title_short |
The Effects of Clinical Pharmacist Education on Lifestyle Modifications of Postmyocardial Infarction Patients in South India: A Prospective Interventional Study |
title_full |
The Effects of Clinical Pharmacist Education on Lifestyle Modifications of Postmyocardial Infarction Patients in South India: A Prospective Interventional Study |
title_fullStr |
The Effects of Clinical Pharmacist Education on Lifestyle Modifications of Postmyocardial Infarction Patients in South India: A Prospective Interventional Study |
title_full_unstemmed |
The Effects of Clinical Pharmacist Education on Lifestyle Modifications of Postmyocardial Infarction Patients in South India: A Prospective Interventional Study |
title_sort |
effects of clinical pharmacist education on lifestyle modifications of postmyocardial infarction patients in south india: a prospective interventional study |
publisher |
Elsevier |
series |
Current Therapeutic Research |
issn |
0011-393X |
publishDate |
2020-01-01 |
description |
ABSTRACT: Background: Myocardial infarction (MI) is associated with significant short-term and long-term mortality and morbidity. Secondary prevention and treatment of post-MI patients through medication and lifestyle modification is becoming an important aspect of patient care regimens. Pharmacists have a crucial role in providing these disease-prevention interventions compared with other health care professionals. Objectives: The primary objective included evaluation of clinical pharmacist interventions at discharge and post-MI discharge follow-up to improve the secondary lifestyle modifications and medication adherence among post-MI patients. The secondary objective included the prevention of hospital readmission rates for major adverse cardiovascular events and death among post-MI patients. Methods: In this prospective interventional study comprising 160 screened patients, 154 patients were randomized according to eligibility criteria of whom 77 were enrolled in Group A (the intervention group: clinical care along with pharmacist education) and 77 in Group B (the control group: clinical care with usual counseling) (November 2017–April 2018). Two patients were lost to follow-up in both study groups. Group A patients received clinical care with pharmacist structured intervention at post-MI discharge and through telephone follow-ups, whereas Group B patients received clinical care with usual counseling at baseline. Patients in both groups were analyzed for secondary lifestyle modifications such as fasting blood sugar level; postprandial blood sugar level; blood pressure; and total cholesterol, LDL-C, HDL-C, VLDL-C, and triglyceride level; hospital readmission rates; and medication adherence at the baseline. At the end of 6 months patients in both study groups underwent follow-up. Medication adherence was analyzed using the Medication Adherence Rating Scale. Statistical analysis was carried out by using SPSS software version 17 (SPSS-IBM Inc, Armonk, NY). Results: The mean (SD) age of the study population was 56.38 (11.68) years in Group A and 53.93 (13.26) years in Group B. Ther were more male patients than female patients in the study population. There was a statistically significant reduction in systolic and diastolic BP in Group A (P ˃ 0.0031 and P ˃ 0.0069, respectively) compared with Group B. Reduction in total cholesterol levels were observed in Group A compared with Group B (P ˃ 0.0001) patients, but there were no significant reductions found in lipid profile values, including LDL-C (P ˃ 0.0669), HDL-C (P ˃ 0.595), triglyceride (P ˃ 0.119), and VLDL-C (P ˃ 0.4215) at follow-up. Group A patients were more adherent to the medications with lower hospital readmission rates compared with Group B. Conclusions: Clinical pharmacist counseling improved the medication adherence and lifestyle modifications in post-MI patients with the reduction in blood glucose levels, blood pressure, and total cholesterol levels among the study population. |
topic |
Clinical pharmacist Medication adherence Postmyocardial infarction Secondary lifestyle modifications |
url |
http://www.sciencedirect.com/science/article/pii/S0011393X20300035 |
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doaj-6b7d2e02da904ffc9b640da4c27dcfdd2020-11-25T02:35:09ZengElsevierCurrent Therapeutic Research0011-393X2020-01-0192100577The Effects of Clinical Pharmacist Education on Lifestyle Modifications of Postmyocardial Infarction Patients in South India: A Prospective Interventional StudySarumathy Sundararajan, M. Pharm0Shanmugarajan Thukani Sathanantham, M. Pharm., PhD1Shanmugasundaram Palani, M. Pharm., PhD2Department of Pharmacy Practice, School of Pharmaceutical Sciences, Vels Institute of Science, Technology & Advanced Studies, Tamilnadu, IndiaSchool of Pharmaceutical Sciences, Vels Institute of Science, Technology & Advanced Studies, Tamilnadu, India; Address correspondence to: T.S. Shanmugarajan, Department of Pharmacy Practice, School of Pharmaceutical Sciences, Vels Institute of Science, Technology & Advanced Studies, Chennai-600117, Tamilnadu, India.School of Pharmaceutical Sciences, Vels Institute of Science, Technology & Advanced Studies, Tamilnadu, IndiaABSTRACT: Background: Myocardial infarction (MI) is associated with significant short-term and long-term mortality and morbidity. Secondary prevention and treatment of post-MI patients through medication and lifestyle modification is becoming an important aspect of patient care regimens. Pharmacists have a crucial role in providing these disease-prevention interventions compared with other health care professionals. Objectives: The primary objective included evaluation of clinical pharmacist interventions at discharge and post-MI discharge follow-up to improve the secondary lifestyle modifications and medication adherence among post-MI patients. The secondary objective included the prevention of hospital readmission rates for major adverse cardiovascular events and death among post-MI patients. Methods: In this prospective interventional study comprising 160 screened patients, 154 patients were randomized according to eligibility criteria of whom 77 were enrolled in Group A (the intervention group: clinical care along with pharmacist education) and 77 in Group B (the control group: clinical care with usual counseling) (November 2017–April 2018). Two patients were lost to follow-up in both study groups. Group A patients received clinical care with pharmacist structured intervention at post-MI discharge and through telephone follow-ups, whereas Group B patients received clinical care with usual counseling at baseline. Patients in both groups were analyzed for secondary lifestyle modifications such as fasting blood sugar level; postprandial blood sugar level; blood pressure; and total cholesterol, LDL-C, HDL-C, VLDL-C, and triglyceride level; hospital readmission rates; and medication adherence at the baseline. At the end of 6 months patients in both study groups underwent follow-up. Medication adherence was analyzed using the Medication Adherence Rating Scale. Statistical analysis was carried out by using SPSS software version 17 (SPSS-IBM Inc, Armonk, NY). Results: The mean (SD) age of the study population was 56.38 (11.68) years in Group A and 53.93 (13.26) years in Group B. Ther were more male patients than female patients in the study population. There was a statistically significant reduction in systolic and diastolic BP in Group A (P ˃ 0.0031 and P ˃ 0.0069, respectively) compared with Group B. Reduction in total cholesterol levels were observed in Group A compared with Group B (P ˃ 0.0001) patients, but there were no significant reductions found in lipid profile values, including LDL-C (P ˃ 0.0669), HDL-C (P ˃ 0.595), triglyceride (P ˃ 0.119), and VLDL-C (P ˃ 0.4215) at follow-up. Group A patients were more adherent to the medications with lower hospital readmission rates compared with Group B. Conclusions: Clinical pharmacist counseling improved the medication adherence and lifestyle modifications in post-MI patients with the reduction in blood glucose levels, blood pressure, and total cholesterol levels among the study population.http://www.sciencedirect.com/science/article/pii/S0011393X20300035Clinical pharmacistMedication adherencePostmyocardial infarctionSecondary lifestyle modifications |