Background: Diabetes and its associated complications take a toll on the elderly. It is known that medication burden could reduce patients’ adherence, which in turn impacts negatively on the health-related quality of life (HRQOL) of those suffering from chronic diseases. Studies have been conducted on HRQOL and its associated factors among diabetic patients but none has studied pill burden effects on HRQOL. This research evaluated pharmacist’s intervention on pill burden effects on the HRQOL of elderly diabetic patients. Methods: This 8-month randomized controlled study involved 170 elderly type 2 diabetic patients. Socio-demographics, the impact of the number and dosage frequency of drugs on adherence, and the influence of the pill burden on HRQOL scores were evaluated at baseline and at 4 and 8 months. Patients in the intervention group were educated about diabetes and its management and counselled on treatment adherence. Brisk walking was specially demonstrated to them at least 4 times during the study period. The control group received only the usual call reminders for appointment days. Results: At baseline, 58.8 and 64.7%, respectively, in the control and intervention groups responded “yes” (indicating a negative effect on their adherence) to >5 pills per prescription, while the figures were 55.3 and 15.3%, respectively, at 8 months (p = 0.711 and p = 0.000, respectively). Patients on 1–5 pills per prescription in the control group had the following physical functioning scores: baseline (44.2 ± 14.2) versus 4 months (47.2 ± 19.1) and 8 months (47.7 ± 16.1); p = 0.277 and p = 0.160. The physical functioning scores in the intervention group were: baseline (41.7 ± 16.1) versus 4 months (67.6 ± 23.1) and 8 months (92.5 ± 3.5); p ≤ 0.001. The same pattern of results was found for those on >5 pills per prescription. Conclusion: This study demonstrates pharmacists’ ability to improve the HRQOL of patients through continuous counselling, supply of relevant information, and monitoring of drug, exercise, and diet adherence. Intervention such as this could be beneficial to diabetic patients and others with chronic diseases.

中文翻译：

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药剂师干预药物负担对尼日利亚西南部某三级医院老年糖尿病患者健康相关生活质量的影响

背景：糖尿病及其相关并发症对老年人造成伤害。众所周知，药物负担会降低患者的依从性，进而对慢性病患者的健康相关生活质量（HRQOL）产生负面影响。已经对糖尿病患者的 HRQOL 及其相关因素进行了研究，但没有研究过药物负担对 HRQOL 的影响。本研究评估了药剂师干预药物负担对老年糖尿病患者 HRQOL 的影响。方法：这项为期 8 个月的随机对照研究涉及 170 名老年 2 型糖尿病患者。在基线和 4 个月和 8 个月时评估了社会人口统计学、药物数量和给药频率对依从性的影响以及药丸负担对 HRQOL 评分的影响。干预组的患者接受了糖尿病及其管理方面的教育，并就治疗依从性进行了咨询。在研究期间，特别向他们展示了至少 4 次快走。对照组仅在约会日收到通常的电话提醒。结果：在基线时，对照组和干预组分别有 58.8% 和 64.7% 的人对每个处方>5 片药片的回答为“是”（表明对他们的依从性有负面影响），而这些数字分别为 55.3% 和 15.3%，在8 个月（分别为 p = 0.711 和 p = 0.000）。对照组中每次服用 1-5 粒药丸的患者的身体功能评分如下：基线 (44.2 ± 14.2) 对比 4 个月 (47.2 ± 19.1) 和 8 个月 (47.7 ± 16.1)；p = 0.277 和 p = 0.160。干预组的身体功能评分为：基线（41.7±16.1）与4个月（67.6±23.1）和8个月（92.5±3.5）；p≤0.001。对于每张处方服用 5 片以上药丸的患者，也发现了相同的结果模式。结论：本研究证明了药剂师通过持续咨询、提供相关信息以及监测药物、运动和饮食依从性来提高患者 HRQOL 的能力。诸如此类的干预可能对糖尿病患者和其他慢性病患者有益。提供相关信息，并监测药物、运动和饮食依从性。诸如此类的干预可能对糖尿病患者和其他慢性病患者有益。提供相关信息，并监测药物、运动和饮食依从性。诸如此类的干预可能对糖尿病患者和其他慢性病患者有益。