PSU Knowledge Bank Community:http://kb.psu.ac.th:80/psukb/handle/2553/35842024-03-29T11:17:25Z2024-03-29T11:17:25Zผลของการดูแลผู้ป่วยโดยมีเภสัชกรเป็นผู้จัดการรายกรณี ต่อการชะลอการเสื่อมของไตในผู้ป่วยโรคไตเรื้อรังนพดล พลานุกูลวงศ์http://kb.psu.ac.th:80/psukb/handle/2016/193362024-01-25T07:14:18Z2023-01-01T00:00:00ZTitle: ผลของการดูแลผู้ป่วยโดยมีเภสัชกรเป็นผู้จัดการรายกรณี ต่อการชะลอการเสื่อมของไตในผู้ป่วยโรคไตเรื้อรัง
Authors: นพดล พลานุกูลวงศ์
Abstract: The main objective of this study was to examine the effect of pharmaceutical care program on both clinical and process outcomes in patients with stage 3 or 4 chronic kidney disease. The study was conducted between November 2021 to July 2022. Total 124 patients were enrolled and separated to intervention group (Structure Care, N = 62) and control group (Usual Care, N = 62). The intervention program (case management) consisted of finding drug-related problems, adjusting dosage, conducting patient education, and referring system for multidisciplinary teams. The outcomes were measured as clinical outcomes (blood pressure and renal function test) and process outcomes (identifying and resolving drug-related problems, knowledge score and quality of life). Paired t test, Independent t test and Repeated measure ANOVA was used to compare before/after intervention of each group and compare between group, respectively. Wilcoxon Signed Ranks test and Mann Whitney U test was used in non-normal distribution data.
The study was showed that the average age of patients was 67 years old and 62% were males. Most patients had stage 3a or 3b renal failure. For clinical outcomes, the renal function (eGFR) had been significantly improved in intervention group compared to control group (Control Group: 39.77±12.66, Study Group: 45.88±11.98; p <0.05). There was no difference in SCr between group. However, SCr in intervention group was decreased while significantly increased in control group in the end of intervention (Control Group: 1.67±0.51, Study Group: 1.50±0.45; p<0.05), reflecting lower renal function. Additionally in process outcomes (quality of life, medication and disease knowledge and compliance) were significantly improved in intervention group (EQ-5D-5L: 0.817±0.061, EQ-VAS: 78.47±6.25, knowledge: 7.60 ±1.00, compliance: 66.13; p<0.001) and higher rate in detecting and solving medication problems compared to control group.
This study suggested that pharmaceutical care program by using case management is an effective process to slow the deterioration rate of kidney function in patient with chronic kidney disease and improves patient’s knowledge on kidney disease and decreased drug-related problems, which is likely to slow the deterioration of the kidneys and improved clinical outcomes.
Description: เภสัชศาสตรมหาบัณฑิต (เภสัชศาสตร์สังคมและการบริหาร), 25662023-01-01T00:00:00Zการศึกษางานของกลุ่มงานเภสัชกรรมและคุ้มครองผู้บริโภค: กรณีศึกษาในโรงพยาบาลชุมชนแห่งหนึ่งเอวิกา บุญลิมปนะhttp://kb.psu.ac.th:80/psukb/handle/2016/193322024-01-25T06:55:46Z2023-01-01T00:00:00ZTitle: การศึกษางานของกลุ่มงานเภสัชกรรมและคุ้มครองผู้บริโภค: กรณีศึกษาในโรงพยาบาลชุมชนแห่งหนึ่ง
Authors: เอวิกา บุญลิมปนะ
Abstract: The objective of this study was to analyze the work and the adequacy
of manpower in the department of pharmacy and consumer protection in a
community hospital, and use the obtained information to improve the efficiency of
outpatient pharmacy dispensing services. The researchers studied work categories
and quantities of pharmacists and pharmacy technicians during the weekdays by
reviewing relevant documents, interviewing personnel in the department and
observing work flow. Standard working hours were determined from literature
reviews, stop watch time study and expert opinion for tasks without standard time.
Data were prospectively collected during October 1, 2019 - September 30, 2020 and
retrospectively collected during October 1, 2018 - September 30, 2019.
Subsequently, the obtained information was used to analyze the adequacy of
manpower in various assumptions and to improve work efficiency. Annual workloads
of pharmacists and pharmacy technicians were 15,137.16 and 10,846.12 hours,
equivalent to manpower of 9.01 and 6.46 people, respectively. The actual numbers
of workers operators were 8 and 6, respectively, that were slightly less than the
number that should be. Therefore, work efficiency was purposively improved in
outpatient dispensing services because it needed manpower more than the other
works. Improvement focused on minimizing the waiting time between work
processes. After improvement of outpatient dispensing service, waiting time between
work processes significantly reduced from 27.83±16.75 to 12.59±8.90 minutes, while
working time significantly reduced from 5.40±2.77 to 4.81±2.40 minutes, (P<0.05),
resulting in a significant decrease in patients’ waiting time from 33.23±16.98 to 17.39±9.44 minutes (P<0.05). Work study is an effective method to be taken if an
organization has an inadequate manpower. The method provides information that
suggests the approach to improve work efficiency with existing manpower without
the need to increase manpower.
Description: เภสัชศาสตรมหาบัณฑิต (เภสัชศาสตร์สังคมและการบริหาร), 25662023-01-01T00:00:00Zลักษณะที่พึงประสงค์และประสิทธิผลทางคลินิกของโมบายแอปพลิเคชันต่อความร่วมมือในการรับประทานยาในผู้ป่วยสูงอายุที่มีกลุ่มอาการทางเมตาบอลิกจิรายุ ชาญชัยชูจิตhttp://kb.psu.ac.th:80/psukb/handle/2016/190732023-11-17T03:11:38Z2018-01-01T00:00:00ZTitle: ลักษณะที่พึงประสงค์และประสิทธิผลทางคลินิกของโมบายแอปพลิเคชันต่อความร่วมมือในการรับประทานยาในผู้ป่วยสูงอายุที่มีกลุ่มอาการทางเมตาบอลิก
Authors: จิรายุ ชาญชัยชูจิต
Abstract: This research was a study of desirable characteristics and clinical effectiveness of mobile application on medication adherence in elderly patients with metabolic syndrome such as hypertension, diabetes mellitus and hyperlipidemia as an alternative self-care and improving of quality of life. The research process was a mixed method of qualitative and quantitative research. There was divided into 2 parts. The first part was documentary research and targeted interviews to gather data about desirable characteristics of mobile application for the elderly. The second part was study of clinical effectiveness of mobile application on medication adherence. This part had been selected subjects randomly. The subjects were divided into 2 groups. First group was 32 people in experimental group, while second group was 35 people in control group. The results of research were evaluated into two parts. The first part was the clinical evaluation before and after the research, including blood pressure and plasma glucose level. The second part was measurement of medication adherence included 1) Pill count is measured by counting the tablets, which measured after the installation of the mobile application. 2) Questionnaire for medication adherence was measured before and after the study. The duration of the study was based on a physician appointment of the individual patient.
Research Results: Mobile application suitable for older people should have the same abilities as older people such as vision, hearing, touching and memory. In this study, the mobile application would require basic drug information such as drug name, indications and side effects, as well as a drug reminding system to encourage and enhance patient medication adherence. For clinical results, after the experiment, blood pressure (Systolic) of the experimental group was significantly decrease when compare with control group (P-value <0.001) and blood pressure (Diastolic) was not significantly different from those in the control group (P-value = 0.196). The plasma glucose level of the experimental group was lower but not significantly different from the control group (P-value=0.296). For the result of medication adherence, the experimental group had an average score of pill count increase significantly from 78.43 to 85.45(P-value <0.001). There was a statistically significant difference in the questionnaires score between the experimental group and control group. The mean was 17.97 and 15.14 (F= 16.442, P<0.001)
Conclusion: A mobile application on mobilephone was suitable for using and collaborates to use in elderly patient. As a result, the used of mobile applications can increase medication adherence and include clinical outcomes that are likely to improve.
Description: วิทยานิพนธ์ (ภ.ม. (เภสัชศาสตร์สังคมและการบริหาร))--มหาวิทยาลัยสงขลานครินทร์, 25612018-01-01T00:00:00Zการพัฒนาแบบประเมินความแตกฉานด้านสุขภาพสำหรับชาวไทยชนิดรายการคำที่มีคำถามทดสอบความเข้าใจ (THLA-W+) การทดสอบชุมชนฮุซนา หะยีบือราเฮ็งhttp://kb.psu.ac.th:80/psukb/handle/2016/190682023-11-17T02:17:36Z2018-01-01T00:00:00ZTitle: การพัฒนาแบบประเมินความแตกฉานด้านสุขภาพสำหรับชาวไทยชนิดรายการคำที่มีคำถามทดสอบความเข้าใจ (THLA-W+) การทดสอบชุมชน
Authors: ฮุซนา หะยีบือราเฮ็ง
Abstract: This study aimed to test the validity and reliability of the Thai Health Literacy Assessment Questionnaire Using Word List with Extended Questions to Test Comprehension (THLA-W+) in the public and to determine the cut-off value of the scale to interpret the level of health literacy (HL). The researcher tested the THLA-W+ developed by Padong Chanchuto (2017) in 522 people living in Kor-en community within Phuket. There were 3 methods to calculate the scores for THLA-W +, 1. from the number of words with correct pronunciation from reading test, 2. from the number of words with correct choice from comprehension test, and 3. from the number of words with correct pronunciation and choices.
The THLA-W+ test took an average of 6.69 +1.188 minutes. Reliabilities of the scores calculated from reading test, comprehension test and both tests were 0.801, 0.869 and 0.869, respectively, which was satisfactory. Average scores of the THLA-W+ were 45.57 ± 3.24, 31.58 ± 7.65 and 30.59 ± 7.82, respectively Addition of extended questions lowered average score and increased standard deviation. Subjects with a higher level of education got a higher score on the THLA-W+. Correlation coefficients between THLA-W+ score with different HL indicators (eg, understanding of health documents) were positive and statistically significant (r=0.129-0.369). However, the HL indicators measuring various dimensions of the construct beyond reading skill (eg, understanding of health documents) exhibited a lower correlation with THLA-W+ score calculated from reading test compared to that from the selection of correct choice. Correlation coefficient of THLA-W+ calculated from choice selection and that from reading test together with choice selection were as high as 0.98. THLA-W+ score based on the selection of correct choices and that on
reading test together with choice selection showed the same result from the analysis of the Receiver Operating Characteristics (ROC) curve in terms of sensitivity, specificity, areas under the ROC curve, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR +) and negative likelihood ration (LR-). However, their profiles from analysis were better than THLA-W+ based on reading test.
THLA-W+ based on selection of correct choice had a cut-off value at 37 indicating that those with the score 37 having inadequate HL. The score on THLA-W+ could well discriminate those with different levels of HL when using reading ability and understanding of health documents as gold standard. The scale showed sensitivity at 77-82%, specificity at 81-83%, areas under the ROC curve at 0.86-0.87, and PPV at 99%, but low NPV at 7%. LR + was 4.24-4.64, while LR- was 0.27-0.28, implying that the scale could provide important information for decision making in practice. The scale was appropriate for HL surveys in public.
It is therefore concluded that use of the THLA-W+ for public survey of HL should calculate the score from choice selection because of its better psychometric properties compared to those calculated from reading test. Moreover, it simplifies testing process by not requiring to have the staff for testing reading skill of subjects.
Description: วิทยานิพนธ์ (ภ.ม. (เภสัชศาสตร์สังคมและการบริหาร))--มหาวิทยาลัยสงขลานครินทร์, 25612018-01-01T00:00:00Z