(B-089) Optimizing Healthcare Outcomes in Ambulatory Patients through Clinical Pharmacist-Led Services

Background: : In India, low health literacy, medication non-compliance, and restricted access to reliable drug information place considerable strain on outpatient care and have a negative impact on the quality of care. Ambulatory pharmacists could potentially able to address these issues through their interventions.

Objectives: To evaluate the impact of ambulatory pharmacist-led interventions on the adherence and quality of life of chronic ambulatory patients.

Methods: A prospective interventional study was carried out in the ambulatory setting of tertiary care Hospital in collaboration with the general medicine department for a period of 9 months. Patients above 18 years of age, suffering from any chronic condition & visiting the study site were included. Ambulatory pharmacist interventions were implemented following the principles of the implementation research framework. The intervention included services like on-site medication device review and training, preventive care activities, medication adherence support, patient counseling, and drug information services. These interventions were delivered to patients according to their needs. Health-related quality of life was measured at baseline, end of 3rd, 6th, and 9th month by using EQ-5D-3L and medication adherence was measured with MARS-5 instrument. The data obtained was analysed using descriptive statistics.

Results: A total of 142 patients enrolled, in which 61% (n=87) were females, 57% (n=81) were above 50 years of age, 54% (n=77) were from rural background, and 68% (n=97) had preliminary education or less.57% of study participants (n=81) were diagnosed with NCDs in last 5 years. Majority of them were suffering from hypertension (63, 44.3%) &diabetes (42, 29.57%). 19.7% (n=28) were using OTC medications & 39.4% (n=5) were on polypharmacy.14% of subjects received medication device usage training and 20% of subjects utilized drug information services. The average baseline HRQoL was 64.3 & follow-up HRQoL measures were 67.87, 71.41 and 75.14 respectively. Non-adherence rate dropped from (n=46) 33% to (n=15)10.5%.

Conclusions: Ambulatory pharmacist's services such as drug information and medication device training with counseling sessions in outpatient care considerably improve the quality of care by enhancing adherence and health-related quality-of-life outcomes.