(P-058) Process Evaluation of Implementing a Pharmacist-led Intervention to Improve Adherence to Antihypertensive Drugs Among Patients with Type 2 Diabetes in Indonesian Community Health Centers

Location: Poster Gallery-Drug Utilization Research

Co-Author(s)

Sofa Alfian

Groningen Research Institute of Pharmacy, University of Groningen, Netherlands
Jv

Job F. van Boven

Assistant Professor
University of Groningen, University Medical Center Groningen, Dept of Clinical Pharmacy & Pharmacology, Netherlands
AI

Aulia Iskandarsyah

University of Padjadjaran, Indonesia
RA

Rizky Abdulah

University of Padjadjaran, Indonesia
EH

Eelko Hak

University of Groningen, Netherlands

Presenting Author(s)

Petra Denig, PharmD, PhD, FISPE

PhD, FISPE
University Medical Center Groningen
Groningen, Netherlands

Background: A pharmacist-led intervention targeted at non-adherent patients with type 2 diabetes in Community Health Centers (CHCs) in Indonesia resulted in a significant improvement in adherence to antihypertensive drugs.

Objectives: The aim of this study was to evaluate the process of implementation from both the pharmacist and the patient perspective.

Methods: Using the RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework, we conducted a focus group among pharmacists (N=5) and a survey among patients (N=44) participating in the intervention group.

Results: Of 111 patients screened for eligibility, 49 (86%) completed both intervention visits. All pharmacists adopted the provided training and found support tools useful. The pharmacists implemented the intervention as intended (adequate intervention fidelity >69%). Factors relevant for implementation included having sufficient time and confidence, home visits for specific patients, multidisciplinary collaboration, and availability of a personal counseling room. To maintain the intervention, the need for practical guidance and support from health care authorities was mentioned. Most patients (96%) were satisfied with the information provided by the pharmacists and they believed the tailored counselling was helpful. Most patients (84%) reported that the duration of counselling was sufficient. The large majority of patients would like to receive the counselling regularly.

Conclusions: Positive effects of the pharmacist-led intervention can be explained by adequate levels of reach, adoption and implementation in the participating CHCs. For successful implementation and maintenance in Indonesia or other low- and middle-income countries, sufficient training, resources, multidisciplinary collaboration, guidance and support from health care authorities are expected to be important.