Impact of Clinical Pharmacist-Led Discharge Counseling on Health Outcomes and Quality of Life in Chronic Disease Patients

Abstract

Objectives: Patients with chronic disorders like Ischemic Heart Disease (IHD), Acute Coronary Syndrome (ACS), Stroke and associated coexisting disorders such as Chronic Kidney Disease (CKD), Hypertension (HTN), Diabetes Mellitus (DM) and Thyroid diseases have high preventable post-discharge Medication Related Adverse Events (MRAEs). The present study was designed to determine whether disease education and discharge counseling, provided by a clinical pharmacist, have an influence on patients with chronic diseases. A cross sectional study was conducted in Metas of Seventh-day Adventists Hospital, Surat and Shrimad Rajchandra Hospital, Dharampur. Materials and Methods: This was a prospective, randomized, interventional study involving 150 patients (75 in each group). Intervention group was provided with the standard care and a clinical pharmacist based discharge medication counseling consisting of drug review, DRP identification and intervention, an educational leaflets for all identified DRP s moreover followed up at 7th day. The standard care for discharge was provided for the control group. The primary outcome was adhesion to treatment (MMAS-8) and secondary outcomes included Quality-of-Life impact (HRQoL, RAND SF-36), patient satisfaction (12-item Likert Scale), and medication discrepancies assessed at 1 week post-discharge and 1-month post-discharge. Results: Intervention group showed significantly greater improvements than the control group in MMAS scores (mean difference 3.933, p<0.05), HRQoL and patient satisfaction conformers. Improvements were most striking in physical health, emotional well-being and social functioning. Conclusion: Clinical pharmacist led discharge counseling significantly improved medication adherence, HRQoL and patient satisfaction which reiterates potential of pharmacists improving post-discharge patient outcomes.