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. 2024 May 21;19(5):e0300499.
doi: 10.1371/journal.pone.0300499. eCollection 2024.

Enhancing medication management in hemodialysis patients: Exploring the impact of patient-centered pharmacist care and motivational interviewing

Ganesh Sritheran Paneerselvam  1 , Lee Kwing Chin Kenneth  1 , Raja Ahsan Aftab  2 , Roland Gamini Sirisinghe  1 , Pauline Siew Mei Lai  3 , Soo Kun Lim  4
Affiliations

Enhancing medication management in hemodialysis patients: Exploring the impact of patient-centered pharmacist care and motivational interviewing

Ganesh Sritheran Paneerselvam et al. PLoS One. .

Abstract

Background: Patients on hemodialysis (HD) often uses several medications, making them highly susceptible to medication-related problems (MRP) thereby leading to medication nonadherence. Therefore, an innovative pharmaceutical care strategy incorporating drug therapy optimization (DTO) and motivational interviewing (MI) can mitigate medication-related problems and optimize patient care.

Aims and objective: The objective of this study is to assess the efficacy of pharmacist led interventions in utilizing DTO and MI techniques in managing medication related problems among patients undergoing hemodialysis.

Method and design: A12-months, cross sectional prospective study was conducted among 63 End Stage Renal Disease (ESRD) patients on HD. DTO was conducted by the pharmacist to identify the MRP by reviewing complete medication list gathered from patient interview and medical records. All MRPs was classified using the PCNE classification version 9.00 and medication issues, that require patient involvement were categorized as patient-related, while those that necessitate physician intervention were classified as physician-related. The DTO was performed at the baseline, 6-month and at the final month of the study. Identified medication issues were communicated to the site nephrologist and was tracked during next follow up. Whereas MI was conducted physically at Month-3 and via telephone on month-6 and month-9 to address patient related medication issues.

Results: Mean age of the study population was 48.5±14 years. While the mean number of prescribed medications was 8.1±2 with 57% of the patients taking more than 5 types of medication. After 12 months of pharmacist intervention using DTO and MI, a mean reduction in MRP was observed for both patient-related and physician-related MRPs across three time series. However, further analysis using repeated measure ANOVA revealed that the reduction in patient-related MRPs was statistically significant [F(1.491, 92.412) = 60.921, p < 0.05], while no statistically significant difference was detected in physician-related MRPs [F(2, 124) = 2.216, P = 0.113].

Conclusion: Pharmaceutical care service through DTO and MI can effectively reduce and prevent drug-related issues to optimize medication therapy among HD patients.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Workflow pharmacist-led pharmaceutical care.
Fig 2
Fig 2. Flow chart summary of study procedure.
See this image and copyright information in PMC

References

    1. Fukuhara S., Lopes A. A., Bragg-Gresham J. L., Kurokawa K., Mapes D. L., Akizawa T., et al. Healthrelated quality of life among dialysis patients on three continents: the Dialysis Outcomes and Practice Patterns Study. Kidney international.2003; 64(5), 1903–1910. doi: 10.1046/j.1523-1755.2003.00289.x - DOI - PubMed
    1. Msaad R., Essadik R., Mohtadi K., Meftah H., Lebrazi H., Taki, et al. Predictors of mortality in hemodialysis patients. The Pan African medical journal. 2019; 33, 61. doi: 10.11604/pamj.2019.33.61.18083 . - DOI - PMC - PubMed
    1. Ferreira E. S., Moreira T. R., da Silva R. G., da Costa G. D., da Silva L. S., Cavalier S. B. O., et al. (2020). Survival and analysis of predictors of mortality in patients undergoing replacement renal therapy: a 20-year cohort. BMC nephrology, 21(1), 502. doi: 10.1186/s12882-020-02135-7 - DOI - PMC - PubMed
    1. Pai A. B., Boyd A., Depczynski J., Chavez I. M., Khan N., & Manley H. Reduced drug use and hospitalization rates in patients undergoing hemodialysis who received pharmaceutical care: a 2-year, randomized, controlled study. Pharmacotherapy.2009; 29(12), 1433–1440. doi: 10.1592/phco.29.12.1433 - DOI - PubMed
    1. Lim D, Schoo A, Lawn S, Litt J. Embedding and sustaining motivational interviewing in clinical environments: a concurrent iterative mixed methods study. BMC Med Educ. 2019;19(1):164. Published 2019 May 22. doi: 10.1186/s12909-019-1606-y - DOI - PMC - PubMed