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The impact of a pharmacist-led patient management in improving chronic non communicable diseases in rural and urban outpatient settings in Sri Lanka

NRC Grant:  14-038

Dr. S.F. Jayamanne
Dept. of Medicine
Faculty of Medicine
University of Kelaniya
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Area of Research: Medical Science
Status:Ongoing

 

objectives

a) To assess whether the addition of a pharmacist to the standard outpatient care improves disease control of the patients with chronic NCDs. 

b) To identify the opportunities of improving non communicable disease controlling in government hospital outpatient setting in both urban and rural areas. 

c) To evaluate the cost effectiveness of employing pharmacists in the outpatient setting. 

d) To evaluate the health related quality of life of NCD patients. 

e) To understand whether the education of patients regarding the disease condition and drugs contribute in the prevention of short term complications of diabetes. 

f) To evaluate the impact of educating the patients on improved adherence to the given regimes. 

g) To assess the improvement of patient’s knowledge on disease conditions, disease management and drugs with the provision of patient counseling by the pharmacist. 

h) To determine the incidence of adverse drug reactions detected by the pharmacist. 

overview

Non communicable diseases (NCDs) have become a major health issue in the world health today. Sri Lanka as a developing country is bearing a huge burden of NCDs due to frequent morbidities, premature deaths and health cost.  With the increasing number of patients in the outpatient clinics in government hospitals, there is a minimal opportunity for the standard care to provide adequate information to the patients to assist them with the management of NCDs.  There are adherence issues, incorrect practices and beliefs among the patients that need to be addressed.  The proportion of budget allocated on NCDs by the government is high.  If patients become non-adhered to the regimes and poorly manage their conditions, this allocation will not be of maximum use. There will be frequent physician visits and hospital admissions.  Mortality rates from NCDs will be high. The addition of a pharmacist to the standard care in the outpatient setting can address this problem as demonstrated in world literature. T his study will provide evidence on the positive impact a pharmacist can provide to the management of chronic NCDs.  The cost analysis will provide further information on how much of cost can be saved for the government.  The only significant cost will be the salary of the pharmacist.  The cost to be saved will be calculated for the number of hospital admissions prevented.  This information will be of considerable benefit to the government health sector in the country.  Apart from the direct cost that can be saved, the impact on the national productivity due to improved health of the work force cannot be neglected. Employing pharmacists in the outpatient clinic setting will be a simple intervention which can make a significant improvement in the country’s health.  Pharmacy education in the country is now upgraded to a degree program.  Hence there would be abundant human resources.  All that will take for this change to be made real is the policy formulation. Findings of this study can be utilized effectively in improving the cost-effective management of NCDs and thus will provide a national impact on the health and socio-economic development in the country