Page 44 - รายงานประจำปี ๒๕๕๕ ศูนย์องค์รวมเพื่อการศึกษาและบำบัดโรคมะเร็ง คณะแพทยศาสตร์

รายงานประจ�าปี 2555
ศูนย์องค์รวมเพื่อการศึกษาและบ�าบัดโรคมะเร็ง

Improvement of medical
knowledge and a tendency of longer survival

in oncologicpatients receiving medication reconciliation with
intensive counseling

Atittaya Yeela , Apinya Prisutkul , Maliwan Sukuntapan , Nannapat Pruphetkaew ,
1
2
1
1
Arunee Dechaphunkul , Patrapim Sunpaweravong 1
1
1 Holistic Center for Cancer Study and Care (HOCC-PSU), Division of Medical Oncology, Department of Medicine,

2 Division of Epidemiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
Introduction: Patients with cancer may have chemotherapy and other medications Table 2: Differential blood pressure in control and intervention group in visit 1 and visit 2
to palliate symptoms or co-morbidities. Medication reconciliation, comparing Control group Intervention group
pre-existing medication to the current one, is a notable step to improve quality of Blood pressure (n=36) (n=31) P-value
care. Moreover, adding intensive counseling may increase efficiency of anticancer and Median (max, min) Median (max, min)
co-morbidities therapy. This research aimed primarily to compare medical knowledge - Systolic BP (Visit 1 – Visit 2) -8.5 (-57, 36) -10 (-50, 15) 0.955
pre- and post- medication reconciliation with or without intensive counseling. Other
objectives were to determine incidence and severity of medication error, response, - Diastolic BP (Visit 1 – Visit 2) -4 (-22, 40) -3 (-27, 15) 0.981
and survival of patients.
Figure 1: A tendency of overall survival Figure 2: Effect of response on anticancer
Materials and methods: This study was a randomized-controlled study enrolling improvement in patients receiving treatment to overall survival
cancer patients treating at HOCC-PSU between March-August 2011. Oncologic medication reconciliation at 3-6 months
patients at the medical oncology clinic were randomized to receiving medication
reconciliation with a conservative counseling (control) or an intensive one
(intervention). All patients had pre-test for medication knowledge done on visit 1 and
post-test on visits 1-2 using a verified questionnaire. Records of medication errors,
response to anticancer and co-morbidity therapy, and survival were followed.
Sample size analysis using power analysis ( = 95%) and medication knowledge
scores comparison using Wilcoxon signed rank were applied.

Results: One hundred and twenty-two patients gave their consent and completed
the study process. Sixty-two patients were assigned to the intervention group and
sixty patients to the control. In the control, no differences of pre- and post- test
medication knowledge scores were observed. In the intervention, mean medication
knowledge scores of the post-test were significantly higher than the pre-test (Table 1).
Medication error events regarding dose omission and improper dose, however, were
equal to 50% in the control group whereas 33.33% and 66.67%, respectively, in
the intervention group. Differential blood pressure in same patients between visit 1
and visit 2 (control versus intervention group) were shown in Table 2. A tendency Conclusions: Medication reconciliation with intensive counseling to outpatient
of overall survival improvement was observed in patients receiving medication oncologic patients significantly improved their medication knowledge and revealed
reconciliation (Figure1). Effect of response on anticancer treatment to overall a promising tendency of overall survival improvement. This intervention should be
survival was shown in figure 2. considered to be implemented into a standard oncology care to improve the
treatment outcome and encourage patient safety environment.
Table 1: Medication knowledge scores in control and intervention group in visit 1 and visit 2
Keywords: Medication Reconciliation, Counseling, Medication knowledge,
Mean (+S.D.) Control group Intervention group P-value Survival
(n=60) (n=62)
- pre-test medication References:
knowledge scores (Visit1) 5.73 (+ 1.24) 5.87 (+ 1.19) 0.4482
1. Bayoumi I, Howard M, Holbrook AM, et al. Interventions to improve medication reconciliation in primary
- post- test medication care. The Annals of Pharmacotherapy. 2009;43: 1667-75.
knowledge scores (Visit1) 5.70 (+ 1.24) 7.28 (+ 0.70) < 0.001*
2. Nassaralla CL, Naessens JM, Chaudhry R, et al. Medication reconciliation in ambulatory care: attempts
- post- test medication at improvement. Qual Saf Health Care. 2009;18: 402-7.
knowledge scores (Visit2) 5.71 (+ 1.25) 6.44 (+ 1.35) < 0.001* 3. Varkey P, Cunningham J, Bisping S. National patient safety goals. Improving medication reconciliation
in the outpatient setting. Jt Comm J Qual Patient Saf. 2007;33: 286-92.

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คุณภาพเพื่อสังคมไทย” ระหว่างวันที่ 8-10 สิงหาคม 2555 โดย ภญ. อาทิตยา ยีละ

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