Renal failure is one of the major health problems in the world. Any gaps in the patient care may affect the patient adherence and quality of life. As part of a multi-disciplinary patient care strategy, clinical pharmacy service has led to improvement in patient care. The purpose of the study is to evaluate the role of medication reconciliation in renal failure patients and to observe the effect of medication alert card and patient counseling in medication reconciliation. In control, Drug Related Problems (DRPs) were identified only by chart review. In test group, one arm containing patients with DRPs were identified using medication reconciliation alone and in second arm, patient counseling and medication alert card was used in addition to reconciliation. Patient data were recorded on a standard template obtained from The Manitoba Renal Program (Canada). DRPs were recorded. Knowledge was assessed with a questionnaire before and after counseling and it was quantified. More number of DRPs was identified by means of medication reconciliation. Patient counseling and medication alert card had a significant role in medication reconciliation. The study was statistically significant with P<0.05. Medication reconciliation in renal failure helps to identify more number of drug related problems. Patient counseling and medication alert card have effectively improved the effect of reconciliation in renal failure patients and thus could improve clinical outcomes and quality of life.
Diabetic foot ulcer usually develops due to lack of knowledge and awareness regarding the consequences of the disease progression and poor foot care among diabetics. The objective of the study is to enhance knowledge, attitude and clinical practice among diabetic foot ulcer patients through pharmacist counseling, and to assist physician in the selection of cost effective antibiotics. Data on the disease condition such as duration of illness, type of diabetes, category of infections, classification of foot ulcer, risk factors, comorbidities and antibiotics used were collected and analyzed. Additionally, the details of culture sensitivity report for sensitive and resistant microorganisms with respect to antibiotics were recorded. Appropriate patient education on diabetic foot ulcer helps to improve their knowledge, attitude, and practice significantly. The commonest microbial isolates identified in diabetic foot ulcer patients were Klebsiella pneumonia, Pseudomonas aeruginosa and Staphylococcus aureus. Culture sensitive drugs found were meropenem, amoxicillin with clavulanic acid, clindamycin and the resistant drugs were cefepime, levofloxacin and penicillin.
The burden of Non Communicable Diseases (NCDs) is one of the vital factors that is currently affecting most of the developing countries. NCDs accounted for 68% of worldwide deaths in 2012 and nearly three fourth of these deaths occurred in low and middle-income countries. The efforts of developing countries towards eradication of poverty and achievement of sustainable development is currently hindered due to significant loss in productivity caused by NCDs related premature deaths and treatment. South Africa and India are confronted with various health and developmental issues. Being a highly populated country, India faces a great challenge from NCDs as it mainly affects the most productive age group, which results in a heavy absolute economic burden. South Africa is faced with the problem of quadruple burden of diseases along with the problem of high incidence of poverty and inequality. Being resource-scarce economies, increasing expenses on health sector will adversely affect the availability of resources for other sectors in these countries. Both South Africa and India have initiated steps to combat the burden of NCDs in line with Global targets set by WHO. If appropriate actions are not initiated to prevent NCDs, it will further increase poverty and widen inequality. In view of this a holistic approach involving all the sectors of the economy, including community to work together, is essential to address the challenges of NCDs.
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