title: Impact of drugs counselling by an undergraduate pharmacist on cardiac surgical patient's compliance to medicines.
abstract: Open heart surgery is a procedure which warrants patient education about the complexity of drug regimens and lifestyle modifications. Patient nonadherence is likely to have a considerable negative impact on the patients' quality of life post-cardiac surgery.
  
  
  OBJECTIVE
  To evaluate the impact of pharmacist intervention on patients' adherence to medication and lifestyle changes.
  
  
  METHODS
  This case-controlled study was conducted at the Cardiac Surgical Ward and Outpatients Clinic of Mater Dei Hospital, Malta. Eighty consecutive patients who underwent coronary artery bypass or heart valve surgery were interviewed on their day of discharge using the 'Past Medical History Questionnaire'. The patients were then randomized to receive pharmacist intervention or usual care. Those who received intervention (40 patients) were given a chart with pictorial explanation of the time of day together with a colorful photograph of each tablet prescribed. This group of patients was also counselled to comply to oral analgesia and exercise and also on the avoidance of alcohol and smoking during the recovery period. The control patients received usual care without the pharmacist intervention. All patients were re-interviewed eight weeks after discharge using the 'Assessing Patient Compliance Questionnaire'. Any differences between the control and experimental groups were analysed using Chi-square, Three-Way Cross tabulation One-Way ANOVA and Two-Way ANOVA tests using the SPSS software version 17.0.
  
  
  RESULTS
  A statistically significant difference between the two groups in the mean percentage compliance was registered following pharmacist intervention (p<0.05). Patients in the experimental group had a higher mean percentage compliance score (88%) than patients in the control group (66%).
  
  
  CONCLUSIONS
  The statistically significant difference in the mean percentage compliance between the two groups following pharmacist intervention shows conclusive evidence of the advantage patients gain when offered this intervention. The pharmacist intervention provides patients with sufficient information to help them achieve optimal benefit from the medication prescribed.
authors.affiliation: Department of Pharmacy, University of Malta . Msida ( Malta ).
authors.forename: Natalie
authors.initials: N
authors.lastname: Zerafa
authors.affiliation: Department of Pharmacy, University of Malta . Msida ( Malta ).
authors.forename: Maurice
authors.initials: M
authors.lastname: Zarb Adami
authors.affiliation: Department of Surgery, University of Malta ; & Consultant Cardiothoracic Surgeon Mater Dei Hospital. B'Kara ( Malta ).
authors.forename: Joseph
authors.initials: J
authors.lastname: Galea
keywords: Cardiac Surgical Procedures; Malta; Medication Adherence; Pharmacists