- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03254745
Evaluation of Pharmacist's Intervention in Improving Treatment Outcomes of Rheumatoid Arthritis: A Randomized Controlled Trial (PACTRA)
Evaluation of Pharmacist's Intervention in Improving Treatment Outcomes of Rheumatoid Arthritis Patients in Karachi, Pakistan: The Pharmacist Assisted Care Trial for Rheumatoid Arthritis Patients (PACTRA)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
One of the major problems in managing RA is adherence to rehabilitation and medication. Studies report low adherence to medication among patients of RA. Certain barriers to rehabilitation also exists which may include exhaustive treatment attendance, time management and direct costs. Patient intentionally make decisions of non adherence to their prescribed rehabilitation schedule and medication regimen. This may be due to suffering from adverse drug reactions (ADRs) of medications, excessive pain arising from physical therapy and/or out-of-pocket costs.
Pharmacists have the potential to improve the patient's clinical, humanistic and economic outcomes in rheumatoid arthritis by providing pharmaceutical care. This can be executed by:
- Resolving drug related problems and managing drug therapy
- Management of modifiable risk factors such as weight
- Recommending dietary and lifestyle changes
- Providing patient counseling, disease education and medication advice
- Reducing the out-of-pocket costs
- Improve overall well being and quality of life
Evidence from the past indicates a varying prevalence of RA in Pakistan. Figures for prevalence of RA varied geographically as literature reported a prevalence of 0.142% to 5.5% in the southern and northern region of Pakistan respectively. Recently, a study conducted in a tertiary care unit in the city of Karachi located in southern region reported a figure of 633 (12.9%) for RA patients out of total 4900 patients who visited rheumatology clinic in the hospital. It highlighted that disease burden in this region has dramatically increased.
Most Pakistani patients lack adequate disease knowledge and awareness regarding RA. Moreover, patients in Pakistan have to pay direct medical cost in most of the cases. In the past, studies have highlighted that Pakistani patients view costs per session and treatment attendance as major barriers to undergo physical therapy sessions for rheumatological disorders.
There is a dearth of literature reported on pharmacist's inclusion to improve treatment outcomes in rheumatoid arthritis.There are no reported figures for adherence to treatment and medications for RA or any musculoskeletal disease. Studies conducted in Pakistan also highlight that pharmacists have the potential to improve economic, clinical and humanistic outcomes by providing pharmaceutical care to patients. However, it is to be seen if pharmacist can actually achieve the milestone i.e. improve patient treatment outcomes of rheumatoid arthritis. A randomized trial is therefore needed employing pharmacist intervention in RA patients. This present an excellent opportunity to identify the areas where a pharmacist has the potential to play his/her role and evaluate its effectiveness.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Sindh
-
Karachi, Sindh, Pakistan, 75600
- Clifton Central Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Out-patients with established diagnosis of rheumatoid arthritis over 3 months.
- Participants who are willing to participate in the study.
Exclusion Criteria:
- Patients with no rheumatoid arthritis.
- Patients currently undergoing surgery or had previous history of surgery.
- Patients with more than 3 comorbidities.
- Patients who are not willing to participate.
- In-patients will not be included.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: HEALTH_SERVICES_RESEARCH
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: DOUBLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Pharmacist intervention
|
The intervention in the study will be a pharmacist's intervention that will be provided to rheumatoid arthritis patients in order to improve their treatment outcomes.
It will be in the form of a single (1) session by pharmacist (face-to-face) followed by written material for use at home.
The pharmacist will look at the patient's baseline data and provide counseling.
The venue for counseling will be the hospitals.
|
NO_INTERVENTION: Usual care
Patients will not be counseled by pharmacist and will be allowed to take usual care.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Disease knowledge
Time Frame: Week 12 from baseline
|
Knowledge about rheumatoid arthritis
|
Week 12 from baseline
|
Medication Adherence
Time Frame: Week 12 from baseline
|
Patients' adherence to their medications
|
Week 12 from baseline
|
Health Related Quality of Life (HR-QOL)
Time Frame: Week 12 from baseline
|
Rheumatoid arthritis patients' health related quality of life
|
Week 12 from baseline
|
Treatment Adherence
Time Frame: Week 12 from baseline
|
Patients' adherence to their rehabilitation
|
Week 12 from baseline
|
Direct Cost of treatment
Time Frame: Week 12 from baseline
|
Direct cost of rheumatoid arthritis treatment on patient's pocket
|
Week 12 from baseline
|
Disease Activity
Time Frame: Week 12 from baseline
|
The disease activity was assessed by disease activity score (DAS) also known as DAS - 28 score.
|
Week 12 from baseline
|
Adverse events
Time Frame: Week 12 from baseline
|
The adverse events were assessed directly through patients' medical history that was available in hospital database.
|
Week 12 from baseline
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Patient satisfaction
Time Frame: At Week 12
|
Patient satisfaction from pharmacists in managing rheumatoid arthritis
|
At Week 12
|
Collaborators and Investigators
Sponsor
Investigators
- Study Director: Azmi A Hassali, PhD, Universiti Sains Malaysia
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- PACT1
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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