Main Article Content
Arthritis, Community Pharmacy Services, Patient Education as Topic, Bulgaria
There are different kinds of arthritis, widely spread among the population, that make them a clinical problem with social, psychological and economic burden. Different education programs have been developed in order to improve patients’ disease management, medication compliance and from there patients’ quality of life.
Objective: To develop and implement a community pharmacy-based educational program for patients with arthritis. Improvements in pain, medication compliance, decrease in general practitioner’s visits and hospitalizations are expected.
Methods: Prospective, randomized, controlled trial. The sample consisted of 43 individuals, with different stages of arthritis (aged 15 - 71), attending pharmacies – intervention group; and 43 individuals – control group. A 4-month education was conducted on the following topics: what causes arthritis and what are the factors that can intensify it; pain management and physical activities; self-management and prevention; pharmacotherapy and possible adverse drug reactions. Patient's health-related quality of life was assessed in the beginning and at the end of the survey.
Results: Parameters assessed during the four stages of the program were: frequency of severe pain, frequency of general practitioner’s visits, frequency of urgent medical aid calls, compliance with therapy, satisfaction with pharmacy services. Improvement in patients’ health-related quality of life was observed and also: decrease in the severity of patients’ pain, decrease in the physician’s visits, and increase in satisfaction overall care.
Conclusions: Positive results from the educational approach in pharmacy conditions were demonstrated. These consequences have a potential to increase arthritis patient’s quality of life.
2. MacLean C. Quality Indicators for the Management of Osteoarthritis in Vulnerable Elders, Ann Intern Med. 2001;135:711-721.
3. Hughes SL, Dunlop D. The prevalence and impact of arthritis in older persons. Arthritis Care Res. 1995;8:257-264.
4. Hughes SL, Edelman P, Chang RW, Singer RH, Schuette P. The GERIAIMS. Reliability and validity of the arthritis impact measurement scales adapted for elderly respondents. Arthritis Rheum. 1991;34:856-865.
5. Chakraborty PP, Achar A. Spontaneous bleeding in a patient of rheumatoid arthritis: a complication after accidental overdose of methotrexate. J Assoc Physicians India. 2007;55:501.
6. Whittle S, Hughes R. Folate supplementation and methotrexate treatment in rheumatoid arthritis: a review, Rheumatology 2004;43:267-271.
7. Hoffmeister R. Methotrexate in rheumatoid arthritis. Arthritis Rheum. 1972;15:114.
8. Felson DT, Anderson JJ, Meenan RF. Use of short-term efficacy/toxicity tradeoffs to select second-line drugs in rheumatoid arthritis. A methaanalysis of published clinical trials. Arthritis Rheum. 1992;35:1117-25
9. Hirano P, Lauren D, Lorig K. Arthritis patient-education studies 1987-1991:a review of the literature. Patient Educ Couns 1994;24:9-54.
10. Daltroy L, Liang M. Arthritis Education: Opportunities and State of the Art, Health Educ Behav. 1993;20(1):3-16.
11. Branch VK, Lipsky K, Neiman T, Lipsky PE. Positive impact of an intervention by arthritis patient educators on knowledge and satisfaction of patients in a rheumatology practice. Arthritis Care and Research, 1999;12(6):370-375.
12. Gall EP, Meredith KE, Stillman PL, Rutala PJ, Gooden MA, Boyer JT, Riggs GE. The use of trained patient instructors for teaching and assessing rheumatologic care. Arthritis Rheum. 1984;27:557-563.
13. Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47:533-543.
14. Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS, Medsger TA Jr, Mitchell DM, Neustadt DH, Pinals RS, Schaller JG, Sharp, JT, Wilder, RL, Hunder GG. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988;31(3):315-324.
15. Lorig K, Lubeck D, Kraines RG, Seleznick M, Holman HR. Outcomes of self-help education for patients with arthritis. Arthritis and Rheumatism, 1985;28(6):680-685.
16. Lorig KR, Sobel DS, Ritter PL, Laurent D, Hobbs M. Effect of a Self-Management Program on Patients with Chronic Disease. Effective Clinical Practice, 2001;4(6):256-262.