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      Pharmacist’s Intervention on Pill Burden Effects on the Health-Related Quality of Life of Elderly Diabetic Patients in a Tertiary Hospital in Southwestern Nigeria

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          Background: Diabetes and its associated complications take a toll on the elderly. It is known that medication burden could reduce patients’ adherence, which in turn impacts negatively on the health-related quality of life (HRQOL) of those suffering from chronic diseases. Studies have been conducted on HRQOL and its associated factors among diabetic patients but none has studied pill burden effects on HRQOL. This research evaluated pharmacist’s intervention on pill burden effects on the HRQOL of elderly diabetic patients. Methods: This 8-month randomized controlled study involved 170 elderly type 2 diabetic patients. Socio-demographics, the impact of the number and dosage frequency of drugs on adherence, and the influence of the pill burden on HRQOL scores were evaluated at baseline and at 4 and 8 months. Patients in the intervention group were educated about diabetes and its management and counselled on treatment adherence. Brisk walking was specially demonstrated to them at least 4 times during the study period. The control group received only the usual call reminders for appointment days. Results: At baseline, 58.8 and 64.7%, respectively, in the control and intervention groups responded “yes” (indicating a negative effect on their adherence) to >5 pills per prescription, while the figures were 55.3 and 15.3%, respectively, at 8 months ( p = 0.711 and p = 0.000, respectively). Patients on 1–5 pills per prescription in the control group had the following physical functioning scores: baseline (44.2 ± 14.2) versus 4 months (47.2 ± 19.1) and 8 months (47.7 ± 16.1); p = 0.277 and p = 0.160. The physical functioning scores in the intervention group were: baseline (41.7 ± 16.1) versus 4 months (67.6 ± 23.1) and 8 months (92.5 ± 3.5); p ≤ 0.001. The same pattern of results was found for those on >5 pills per prescription. Conclusion: This study demonstrates pharmacists’ ability to improve the HRQOL of patients through continuous counselling, supply of relevant information, and monitoring of drug, exercise, and diet adherence. Intervention such as this could be beneficial to diabetic patients and others with chronic diseases.

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          Most cited references 21

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          Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association.

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                Author and article information

                International Journal of Diabetes and Metabolism
                S. Karger AG
                October 2020
                17 September 2019
                : 25
                : 3-4
                : 148-154
                Department of Clinical Pharmacy and Biopharmacy, Olabisi Onabanjo University, Sagamu Campus, Ogun State, Nigeria
                Author notes
                *Dr. Winifred Aitalegbe Ojieabu, Department of Clinical Pharmacy and Biopharmacy, Olabisi Onabanjo University, Sagamu Campus, PO Box 1389, Sagamu, Ogun State (Nigeria), E-Mail natbelpharmacy@yahoo.com
                503174 Int J Diabetes Metab 2019;25:148–154
                © 2019 The Author(s) Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Tables: 4, Pages: 7
                Case Challenge and Education – Research Article


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