The Impact of Pharmaceutical Care on Asthmatic Patients with Drug Related Problems (DRPs) after Development of a Computer Application ผลการบริบาลทางเภสัชกรรมในผู้ป่วยโรคหืดที่มีปัญหาการใช้ยาร่วมกับการใช้โปรแกรมคอมพิวเตอร์ในการบันทึกและส่งต่อข้อมูลผู้ป่วย

Abstract

          In the past, pharmacists provided pharmaceutical care along with recorded data in the form of A4 size paper. The most important problem found is the incorrect technique to use metered dose inhaler (MDI). Then, the inhalation technique monitoring card was use instead of A4 size paper. The card improves the proper technique to use MDI but it might lost and could not connected to the electronic medical record. The objectives of this study was to determine DRPs during pharmaceutical care, compare the hospitalization from asthma exacerbation within previous 4 weeks, before and after providing pharmaceutical care using a computer application for patients with asthma. Data were retrospectively collected from electronic medical record from September 2016 to January 2018. Patients with asthma diagnosis who visit the adult asthma clinic and the pharmacy of specialist clinic from October 2016 to December 2017 were included. McNemar’s test was used to compare the hospitalization from asthma exacerbation. Of 152 patients with 201 events, the average age was 56.46±15.07 years. DRPs which was found the most is non-compliance 69.7%. Most of them had the incorrectness of technique to use MDI and no care giver. Then, consult the physician to step-up and step-down 9.5% and 2.5%, respectively. The intervention was accepted 91.3%. Incidence of emergency visit and admission due to asthma exacerbation were significantly decreased from 31.3% to 9.8% and 12.5% to 5.4%, respectively (p<0.001, p=0.021, respectively). Providing pharmaceutical care in patients with DPRs with using the computer application, pharmacist can continuous follow-up patients and the incidence of hospitalization due to asthma exacerbation were decreased. One stop service should be developed as possible and extend to other hospitals with HI program.