ผลลัพธ์ของการเยี่ยมบ้านผู้ป่วยโรคจิตเภทโดยทีมสหสาขาวิชาชีพเครือข่ายบริการสุขภาพ อ.ดอนมดแดง จ.อุบลราชธานี

Ariya Tangmanokun; Surasak Chaiyasong

Authors

Ariya Tangmanokun Master Student, Master of Pharmacy Program in Primary Care Pharmacy, Faculty of Pharmacy, Mahasarakham University
Surasak Chaiyasong Social Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University

Keywords:

home health care, schizophrenia, multi-disciplinary team, primary care

Abstract

Background and Rationale: Treatment discontinuation and medication non-adherence are critical problems in caring patients with schizophrenia; this could cause recurrence and serious consequences of schizophrenia. A multidisciplinary team in Donmoddaeng district, Ubonratchathani province developed a home health care, proactive approach, to promote patient care and treatment continuity. This study aimed to determine outcomes of home health care in patients with schizophrenia provided by a multidisciplinary team in Donmoddaeng district, Ubonratchathani province. Methodology: A randomized controlled trial was conducted in 60 schizophrenia patients (30 in study group and 30 in control group). All patients received usual care at the hospital. The patients in the study group received three visits of home health care by a multidisciplinary team and brief motivation counseling by a pharmacist. This study was a 6-month trial, run during July - December 2019. Clinical outcomes and quality of life were measured together with problem-solving results and patients’ satisfaction pertaining to home health care. Results: Most patients were male (study group 60% vs. control group 63%), aged above 30 years (93% vs. 67%), single (47% vs. 63%), with primary school education (67% vs. 53%), employed (57% vs. 57%), living with family (77% vs. 90%) and had disease longer than 5 years (73% vs. 53%). After brief motivation counseling, the follow up rate with doctor increased from 87% to 100% in month 1 and 2 (p = 0.043), the medication compliance rate also increased from 87% to 100% in month 1 and 2 (p = 0.043). Patients were very satisfied with home health care (4.37±0.49). At month 6, the recurrence rate of schizophrenia in the home health care group was 0% vs. 17% in control group (p = 0.020), and hospitalization due to the recurrence was 0% in the home health care group vs. 13% in the control group (p = 0.038), with average length of stay of 0 day vs. 0.60 ± 1.85 day (p = 0.040). No significant difference in quality of life scores was found (11.00 ± 10.86 vs. 9.50 ± 9.13, p = 0.7). Conclusion: Home health care by multidisciplinary team in patients with schizophrenia was effective. Healthcare facilities should support this proactive approach in order to improve efficiency and effectiveness of schizophrenia patient care.

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