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Pharmacist-Implemented Self-Management Module in Multiple Sclerosis Patients: A Randomized Controlled Trial
Published online by Cambridge University Press: 13 November 2024
Abstract
Background:
Self-management practices can contribute to the lives of patients with multiple sclerosis. The aim of this study is to improve patients’ self-management abilities through a multidisciplinary developed module.
Methods:
This prospective, randomized controlled trial was conducted between January 2020 and November 2021 at a university hospital in Ankara, Turkiye. The self-management module was implemented by a clinical pharmacist with the aim of enhancing self-management capabilities through an educational approach, with a focus on medication adherence, management of drug-related problems, follow-ups and self-directed activities. The intervention group completed the self-management module, while the control group received usual outpatient care. To evaluate the impact of the module, the Multiple Sclerosis Self-Management Revised scale was administered to the patients. Interviews were conducted at 4-month intervals.
Results:
Study (n = 102) and control group (n = 98) patients were followed up for 8 months, and the median duration of intervention was 11 minutes. The mean (± SD) self-management scores of the study group increased from 68.9 (± 9.3) to 79.0 (± 9.4) at the end of the interviews, and this increase was found to be significant compared to the control group (p < 0.001). The self-management module has been shown to improve self-management, medication adherence, perception of care and patient engagement in treatment (p < 0.001).
Conclusions:
This single-center randomized controlled trial suggests that a pharmacist-implemented self-management module increased patient engagement and medication adherence. The self-management interventions could be tailored to groups that tend to have lower self-management abilities, such as older individuals, and those who have lower educational attainment, health engagement or medication adherence.
Résumé
Les pratiques de prise en charge personnelle peuvent faciliter la vie des personnes atteintes de sclérose en plaques (SP). L’étude visait à améliorer les capacités de prise en charge personnelle de la maladie par les patientes et les patients eux-mêmes à l’aide d’un module pluridisciplinaire.
Il s’agit d’un essai comparatif, prospectif, à répartition aléatoire, qui a été réalisé entre janvier 2020 et novembre 2021, dans un hôpital universitaire, à Ankara, en Türkiye. Le module de prise en charge personnelle a été mis en œuvre par un pharmacien clinicien dans le but d’améliorer les capacités des patients à s’occuper de leur maladie par une approche éducative, notamment en ce qui concerne l’observance médicamenteuse, la prise en charge des effets indésirables des médicaments, le suivi et les initiatives personnelles. Le groupe expérimental a franchi toutes les étapes du module de prise en charge personnelle, tandis que le groupe témoin a reçu les soins usuels en consultation externe. L’équipe de recherche a demandé aux participants et aux participantes de répondre aux questions de l’échelle Multiple Sclerosis Self-Management Revised scale afin d’évaluer l’incidence du module sur leur vie. Les entretiens de suivi ont été effectués tous les quatre mois.
Le groupe expérimental (n = 102) et le groupe témoin (n = 98) ont fait l’objet de suivi durant une période de 8 mois et la durée médiane des interventions était de 11 minutes. La moyenne des résultats (± écart-type) relatifs à la prise en charge personnelle dans le groupe expérimental est passée de 68,9 (± 9,3) à 79,0 (± 9,4) à la fin des entretiens, écart considéré comme une augmentation significative comparativement au groupe témoin (p < 0,001). Le module a permis d’améliorer la prise en charge personnelle, l’observance médicamenteuse, la perception des soins et le rôle actif des malades dans leur traitement (p < 0,001).
Les résultats de cet essai comparatif, unicentrique et à répartition aléatoire donnent à penser que le module de prise en charge personnelle mis en œuvre par un pharmacien a eu pour effet d’améliorer la participation des malades et l’observance médicamenteuse. Il serait possible d’adapter les interventions de prise en charge personnelle aux difficultés que rencontrent certains groupes, par exemple les personnes âgées, celles qui ont un niveau moindre de scolarité, qui sont peu motivées à jouer un rôle actif dans leur santé ou qui ont des manquements à l’observance médicamenteuse.
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- © The Author(s), 2024. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation
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