A randomized controlled trial of the impact of pharmacist-led patient-centered pharmaceutical care on patients' medicine therapy-related quality of life

Abstract

Background: Due to a lack of pharmaceutical care (PC)-specific measures for health-related quality of life, a novel generic questionnaire "Patient-Reported Outcomes Measure of Pharmaceutical Therapy for Quality of Life (PROMPT-QoL) was developed. Little was also known about an impact of pharmaceutical care on medicine therapy-related quality of life.

Objective: First, evaluate the impact of PC on medicine therapy-related QoL using the PROMPT-QoL in Thai patients. Second, compare the outcomes of drug-related problems (DRPs) between usual care (UC) and PC groups. Third, assess the responsiveness of the PROMPT-QoL.

Methods: A randomized controlled trial was conducted at a tertiary public hospital in Bangkok, Thailand from March to October 2016. A total of 514 patients were randomly allocated into the UC (N = 255) and pharmacist-led patient-centered PC (N = 259) groups. The follow-up period was three months.

Results: A split-plot ANOVA showed that the PC group significantly improved four domain scores and total score of the PROMPT-QoL than the UC group (all p < 0.01). For improved patients in the PC group (N = 164), the responsiveness of these four domains and the total score was moderate-to-high with standardized effect sizes between 0.23 and 3.01. The PC group also significantly yielded higher proportion of patients with better DRP outcomes than the UC group (p < 0.01).

Conclusions: Pharmacist-led patient-centered PC could improve patients' medicine therapy-related QoL and DRP outcomes. Four out of eight domains and the total score of the PROMPT-QoL were responsive to assess a humanistic impact of PC. More research can be conducted in longer follow-up periods.

Keywords: Drug/medicine/pharmaceutical therapy; Patient-centered; Pharmaceutical care; Pharmacist; Quality of life; Responsiveness.