Effectiveness of a Program to Promote Medication Adherence Using Tele-pharmacy in Uncontrolled Diabetic Patients, Sukhothai Hospital.

Abstract

This one-group pretest-posttest quasi-experimental study aimed to evaluate the effectiveness of a medication adherence program utilizing tele-pharmacy among patients with uncontrolled type 2 diabetes at Sukhothai Hospital. The sample consisted of 50 patients. The research instruments were divided into two parts: 1) the medication adherence program, and 2) data collection tools, which included a demographic questionnaire, an insulin injection skill assessment form, the Medication Adherence Scale for Thais (MAST®), a health belief questionnaire, a medication knowledge questionnaire, and a drug-related problem record form. The instruments demonstrated a content validity index of 0.90 and a reliability (Cronbach's alpha) of 0.88. The intervention involved sending educational materials via the "Pichit Baowan" LINE application, alternating content every two weeks, alongside continuous tele-pharmacy counseling by pharmacists over a 4-month period.

After participating in the program, patients demonstrated statistically significant improvements in clinical outcomes and health behaviors (p < 0.001). The mean HbA1c decreased from 9.42% to 8.02%, and fasting plasma glucose (FPG) decreased from 178.84 to 129.82 mg/dl. The proportion of patients with adequate medication adherence increased from 38% to 98%. All patients improved their insulin injection skills to a high level, and the majority achieved significantly higher scores in health beliefs and medication knowledge, reaching high levels (p < 0.001). Regarding drug-related problems, the incidence of failure to receive prescribed medications decreased from 100% to 30%, and adverse drug reactions decreased from 32% to no reported cases (p < 0.001). The use of herbs or dietary supplements decreased from 10% to zero occurrences; however, this change was not statistically significant (p = 0.063)

In conclusion, this study demonstrates the effectiveness of integrating tele-pharmacy with the health belief model in developing knowledge, enhancing skills, and increasing medication adherence. This approach enables patients to control their blood sugar levels efficiently and allows pharmacists to proactively monitor and concretely reduce drug-related problems.