EDUCATION (COUNSELLING AND DIGITAL UPDATE) BY CLINICAL PHARMACIST IN PATIENTS WITH POLYPHARMACY IN CHRONIC DISEASES IN THE DEPARTMENT OF GENERAL MEDICINE

Background: As chronic diseases require treatment with an expanding number of medications, the issue of polypharmacy is getting more significant. Polypharmacy can lead to the danger of adverse events, drug interactions and medication non adherence. Objective: To improve patient medication compliance, check whether all the drugs prescribed are safe and appropriate to use, improve the knowledge about their medical state and poly-pharmacy and to check whether there is any drug-drug interaction. Materials And Methods: A prospective observational study was carried in 200 patients. The collected data was investigated for poly-pharmacy and analyzed for factors and consequences associated with poly-pharmacy. Patient information and relevant data is collected in data collection form directly by clinical pharmacist by interviewing the patient and the patient follow-up is done by digital counseling provided to the patient using various sources such as chats, calls, videos. Result: This study was designed to educate patients in poly-pharmacy for chronic diseases through digital counselling means. During the six months study period, a total of 200 patients among which Patients suffering from several diseases have been consumed multiple medicines (8.52±3.58) compared to patients with two types (8.15±4.05) or single type of disease (7.29±3.10), p 0.08. Knowledge assessment score was improved after education (counseling and digital update) by clinical pharmacist (2.75±1.21 7.15±0.94, p value 0.02). Morrisky medication Adherence scale (MMAS-8) score was significantly increased after education (counseling and digital update) by clinical pharmacist (2.83±1.79 7.60±0.66, p value 0.001). Quality of lifeED-5D-5L score was improved after education (counseling and digital update) by clinical pharmacist (1.01±0.78 2.94±1.25, p vale 0.003). We performed Pearson correlation coefficient test to analyze the correlation between poly-pharmacy and quality of life (QOL), We observed that, individuals who consumed poly pharmacy were found with decreased quality of life (r = -0.72 p value = 0.003). This might be due to adverse side effects caused by multiple medications. Among the 200 patients digital counselling by WHATSAPP along with Call and E-mail was done to 16% of patients, WHATASPP and Call was done to 44% of patients, WHATSAPP and E-mail was done to 2% of patients, WHATSAPP was done to 17% of patients, Call was done to 21% of the patients. Patient satisfaction score with clinical pharmacist by Direct counseling 42% (9.02±3.90) and Digital counseling58% (12.29±3.83). Conclusion: The utilization of digital counselling has become an inexorably well-known mode for giving counselling. Nonetheless, little is thought about its effectiveness.This study is an initial effectiveness study on digital counselling. Participants who had gotten digital counselling from a phone evaluated the viability of digital counselling and the quality of their counselling relationship. Generally, respondents showed that digital counselling was useful and that the participants were happy with the counselling they got. There was an improvement found in the quality of life of participants and their knowledge with respect to chronic condition and polypharmacy. The participants understood the significance of medication adherence for polypharmacy in chronic diseases. Participants were made mindful of the suspected adverse drug reactions, drug-to-drug interaction, medication errors, medication redundancy, and so on.