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      Determinants of exit-knowledge of ambulatory patients on their dispensed medications: The case in the outpatient pharmacy of Mizan-Tepi University Teaching Hospital, Southwest Ethiopia

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          Abstract

          Background

          Patient’s knowledge about dispensed medications is one of the major factors that determine the rational use of medicines.

          Objectives

          This study aimed to assess exit-knowledge of ambulatory patients about their dispensed medications and associated factors at the outpatient pharmacy of Mizan-Tepi University Teaching Hospital, Southwest Ethiopia.

          Methods

          A hospital-based cross-sectional study design was conducted from August to October 2021. Study subjects were selected by random sampling technique and were interviewed using a structured interview questionnaire. Binary logistic regression was used to identify factors associated with exit knowledge. At a 95% confidence interval (CI), p≤0.05 was considered statistically significant.

          Result

          Of the total 400 participants, 116 (29.0%) participants had sufficient exit-knowledge about their dispensed medication. Patients with higher educational level had increased exit knowledge of dispensed medications than those with no formal education (AOR: 5.590; 95% CI 1.019–30.666). Also, the nature of illness as being chronic significantly enlarged the odds (AOR 5.807; 95% CI 2.965–11.372) of having sufficient exit-knowledge. Participants who reported, “I do not know” and “I did not get enough information from the pharmacist” had lower odds (AOR 0.374; 95% CI: 0.142–0.982) and (AOR 0.166; 95% CI 0.062–0.445) of sufficient exit-knowledge in comparison to those who responded “I got enough information from the pharmacist” respectively. Furthermore, the odd of sufficient exit-knowledge was 7.62 times higher in those who claimed prescribing doctor as the source of information.

          Conclusion

          The majority of patients had insufficient exit-knowledge about their dispensed medications. Educational status, nature of the disease, perceived sufficiency of pharmacist knowledge, and source of information were significantly associated with exit knowledge.

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          Most cited references21

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          Interventions to enhance patient adherence to medication prescriptions: scientific review.

          Low adherence with prescribed treatments is ubiquitous and undermines treatment benefits. To systematically review published randomized controlled trials (RCTs) of interventions to assist patients' adherence to prescribed medications. A search of MEDLINE, CINAHL, PSYCHLIT, SOCIOFILE, IPA, EMBASE, The Cochrane Library databases, and bibliographies was performed for records from 1967 through August 2001 to identify relevant articles of all RCTs of interventions intended to improve adherence to self-administered medications. Studies were included if they reported an unconfounded RCT of an intervention to improve adherence with prescribed medications for a medical or psychiatric disorder; both adherence and treatment outcome were measured; follow-up of at least 80% of each study group was reported; and the duration of follow-up for studies with positive initial findings was at least 6 months. Information on study design features, interventions, controls, and findings (adherence rates and patient outcomes) were extracted for each article. Studies were too disparate to warrant meta-analysis. Forty-nine percent of the interventions tested (19 of 39 in 33 studies) were associated with statistically significant increases in medication adherence and only 17 reported statistically significant improvements in treatment outcomes. Almost all the interventions that were effective for long-term care were complex, including combinations of more convenient care, information, counseling, reminders, self-monitoring, reinforcement, family therapy, and other forms of additional supervision or attention. Even the most effective interventions had modest effects. Current methods of improving medication adherence for chronic health problems are mostly complex, labor-intensive, and not predictably effective. The full benefits of medications cannot be realized at currently achievable levels of adherence; therefore, more studies of innovative approaches to assist patients to follow prescriptions for medications are needed.
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            Interventions for improving pharmacist-led patient counselling in the community setting: a systematic review

            Background Pharmacist counselling is an important service that has been associated with improved outcomes. The primary aim of this review was to identify, describe, and determine the effectiveness of interventions for improving the counselling practice of community pharmacists. Methods We searched PubMed (from January 1990 to June 2017) and the Cochrane Library (June 2017). To supplement our database searches, we searched Google Scholar for papers that cited the identified studies. We included only studies that reported the impact of the intervention on pharmacists’ behaviour during counselling. We searched for data from studies with randomised trials, non-randomised trials, controlled before-after studies, or interrupted time series study designs. Parameters including selection bias, performance bias, detection bias, and attrition bias were assessed. The data were narratively synthesised. Results We screened 2335 abstracts and 59 full-text articles and included 17 RCTs. Overall, three studies were determined to have a high risk of bias, and 14 studies were determined to have an unclear risk of bias. Fifteen studies investigated multifaceted interventions that included two or more components. The most commonly used interventions were educational meetings (n = 14), educational materials (n = 9), educational outreach visits (n = 5), feedback (n = 5), guidelines (n = 5), and local opinion leaders (n = 2). Outcomes were measured using simulated patient visits (n = 10), and the self-reported outcomes of patient or pharmacists (n = 6). Most of the included studies (n = 11) reported some degree of improvement in counselling practices. Conclusions The included studies showed that educational meetings combined with educational materials, outreach visits, and feedback can improve pharmacist counselling in community settings. However, the unclear risk of bias and poor quality of reporting intervention components necessitate caution in interpreting the findings. Recommendations for future studies based on the evidence gap identified in this review are presented. Electronic supplementary material The online version of this article (10.1186/s13643-018-0727-4) contains supplementary material, which is available to authorized users.
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              Which providers should communicate which critical information about a new medication? Patient, pharmacist, and physician perspectives.

              To investigate older patient, pharmacist, and physician perspectives about what information is essential to impart to patients receiving new medication prescriptions and who should provide the information. Qualitative focus group discussions. Senior centers, retail pharmacies, and primary care physician offices. Forty-two patients aged 65 and older, 13 pharmacists, and 17 physicians participated in eight focus groups. Qualitative analysis of transcribed focus group interviews and consensus through iterative review by multidisciplinary auditors. Patient, pharmacist, and physician groups all affirmed the importance of discussing medication directions and side effects and said that physicians should educate about side effects and that pharmacists could adequately counsel about certain important issues. However, there was substantial disagreement between groups about which provider could communicate which critical elements of medication-related information. Some pharmacists felt that they were best equipped to discuss medication-related issues but acknowledged that many patients want physicians to do this. Physicians tended to believe that they should provide most new-medication education for patients. Patients had mixed preferences. Patients aged 80 and older listed fewer critical topics of discussion than younger patients. Patients, pharmacists, and physicians have incongruent beliefs about who should provide essential medication-related information. Differing expectations could lead to overlapping, inefficient efforts that result in communication deficiencies when patients receive a new medication. Collaborative efforts to ensure that patients receive complete information about new medications could be explored.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                24 May 2022
                2022
                : 17
                : 5
                : e0268971
                Affiliations
                [1 ] Department of Pharmaceutical Chemistry, School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
                [2 ] School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
                University of Brasilia: Universidade de Brasilia, BRAZIL
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-7694-4978
                Article
                PONE-D-21-37588
                10.1371/journal.pone.0268971
                9129053
                35609061
                f358d6df-a53e-4faf-a818-a79b4e45900c
                © 2022 Welday Kahssay, Mulugeta

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 26 November 2021
                : 11 May 2022
                Page count
                Figures: 1, Tables: 4, Pages: 12
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                People and Places
                Population Groupings
                Professions
                Medical Personnel
                Pharmacists
                Medicine and Health Sciences
                Pharmacology
                Drugs
                Medicine and Health Sciences
                Health Care
                Patients
                Outpatients
                Medicine and Health Sciences
                Health Care
                Patients
                Medicine and Health Sciences
                Pharmacology
                Drug Interactions
                People and Places
                Population Groupings
                Educational Status
                Medicine and Health Sciences
                Pharmacology
                Adverse Reactions
                Social Sciences
                Sociology
                Education
                Educational Attainment
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.

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