Impact of Patient Counseling in improving medication adherence among diabetic patients in Kathmandu Valley

Author(s): Sabyata Gautam

This study aims to find impact of pharmacist’s counselling on medication adherence among diabetic
patients in Kathmandu valley. Data collection was done from Jan 2017 till June 2018. In our descriptive cum
exploratory study, of total 321 patients, the mean age of diabetic patients was 57.5 ± 12.47years. Metformin
500mg was found to be prescribed mostly (n= 107 patients). When calculated in per day cost of OHAs,
minimum was Rs.2 and maximum was Rs. 103.42 with average cost of Rs. 25.10. While undergoing KAP
assessment, the knowledge score wasn’t found to be satisfactory, though results on practice and attitude
were satisfactory. MARS 5 and MARS were used to measure compliance before and after counselling. MARS5 contains likert scale questions with total score of 25. MARS 5 scoring after counseling had mean of 24.06
± 1.54, which was 23.17 ± 2.40 before counselling (P ≤ 0.000). Similarly, the study found the mean values of
8.21 ± 1.24 (before counselling) and 9.03 ±0.89 (after counselling) while using 10 item MARS questionnaire
(P ≤ 0.000). Thus, counselling from pharmacist is effective in improving the compliance among diabetic
patients. Knowledge and attitude scores of the patients were found to be statistically significant with
medication compliance (P< 0.05). Notable improvement in patient’s blood sugar levels (F, R, PP) were also
observed after counselling. Since most of the patients, with reference to the self, admitted that lack of
knowledge regarding disease was major reason for non-adherence, awareness programs are much in nee.