%0 Journal Article
%T Impact of Pharmaceutical Care on Self-Administration of Outpatient Low-Molecular-Weight Heparin Therapy
%A Seraina Mengiardi
%A Dimitrios A. Tsakiris
%A Viviane Molnar
%A Urs Kohlhaas-Styk
%A Michael Mittag
%A Stephan Kraehenbuehl
%A Kurt E. Hersberger
%J Pharmacology & Pharmacy
%P 372-385
%@ 2157-9431
%D 2014
%I Scientific Research Publishing
%R 10.4236/pp.2014.54045
%X <p style=\"text-align:justify;\">
	<span style=\"font-size:10.0pt;line-height:97%;font-family:;\" \"=\"\"><span style=\"line-height:1.5;font-family:Verdana;\">Outpatient
subcutaneous (s.c.) therapies are becoming more and more common in the
treatment of different diseases. The effectiveness of community-pharmacy-based
interventions in preventing problems that arise during s.c. self-injections of
low-molecular-weight heparins (LMWH) is unknown. Our objective was to provide a
standard operating procedure (SOP) for community pharmacists and to compare
pharmaceutical vs. standard care in both clinical and daily life settings. We
hypothesized that: pharmaceutical care results in improved adherence, safety,
and satisfaction, and in fewer complications; the interventions used are
feasible in daily life; and the results achieved in clinical and daily life
settings are comparable. In the clinical setting (randomized controlled trial),
patients were recruited sequentially in hospital wards; in the daily life
setting (quasi-experimental design with a comparison group), recruitment took
place in community pharmacies by pharmacists and trained master students during
their internship. Interventions were offered according to patient needs. Data
were collected by means of a monitored self-injection at home and structured
questionnaire-based telephone interviews at the beginning and the end of the
LMWH treatment. The main outcome measures were: scores to assess patient¡¯s
skills; syringe count to assess adherence; and frequency, effectiveness, and
patient¡¯s assessment of received interventions. The results show a median age
of the 139 patients of 54 years. Interventions resulted in improved application
quality (</span><i><span style=\"line-height:1.5;font-family:Verdana;\">p </span></i><span style=\"line-height:1.5;font-family:Verdana;\">&lt; 0.01) and knowledge (</span><i><span style=\"line-height:1.5;font-family:Verdana;\">p </span></i><span style=\"line-height:1.5;font-family:Verdana;\">= 0.03). Oral instructions were
pivotal for improving patients¡¯ application quality. We found no significant
score differences between the intervention groups in the clinical and daily life
settings. Patients¡¯ baseline skills were high, with the lowest score being 0.86
(score range ?2.00 to +2.00). Adherence rate was high (95.8%). In conclusion,
our SOP for pharmacist interventions was of good quality, adequate, appreciated,
and feasible in daily life. Patients are capable of managing s.c. injection
therapies if adequate assistance is provided.</span></span> 
</p>
%K Low-Molecular-Weight Heparin
%K Outpatients
%K Subcutaneous Injections
%K Self Administration
%K Pharmaceutical Care
%K Community Pharmacy
%K Switzerland
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=44676