Impact of Pharmacists' Intervention in Treatment Outcome after Cataract Surgery

Abstract

Background: Medication knowledge and adherence in post-cataract surgery patients is crucial for optimal recovery. Objectives: To compare the effectiveness of verbal counselling, clinic-based pictogram demonstration and take-home pictogram education on medication knowledge and adherence in post-cataract surgery patients. Materials and Methods: A randomised, parallel-group, controlled trial was conducted in 150 cataract surgery patients. They were equally enrolled in three different experimental groups; EG1 (verbal counselling only), EG2 (verbal+clinic pictograms) and EG3 (verbal+take home pictograms). Knowledge assessment was done by administering 14-item questionnaire at baseline, Day 5 and Day 28. Medication adherence was assessed by bottle weight technique on Day 2 and Day 28. t-test 1 (Day 5), and Post-test 2 (Day 28). Two-way ANOVA with Bonferroni post hoc comparisons was used and effect sizes were reported as partial eta squared (ƞ2) and Cohen’s d. Results: EG3 demonstrated superior knowledge at Post-test 1 (40.36±2.03) and Post-test 2 (39.64±2.03) versus EG1 (32.56±2.93:32.08±2.93) and EG2 (32.78±2.73:32.30±2.73). Two-way ANOVA showed significant main effects of group (F=271.16, p<0.001, ƞ2 =0.23) and time (F=539.52, p<0.001, ƞ2=0.46), with a significant interaction (F=73.44, p<0.001, ƞ2=0.12). EG3 had the lowest bottle weight at Day 28 (6.00 g vs. EG1: 7.74 g and EG2: 7.16 g), with significant pairwise difference which were confirmed by post hoc analysis (EG1 vs. EG3: Cohen’s d= 1.24; EG2 vs. EG3: Cohen’s d=0.86; both <0.05; EG1 vs. EG22: Cohen’s d=0.42; p>0.05). Conclusion: This study suggests that for patients that undergo Cataract surgery, pictogram-based counselling significantly improves the medication knowledge and adherence compared to verbal counselling and clinic-based pictogram demonstration. The outcome suggests the continuous accessibility of pictograms rather than pictogram alone, gives better results. In low literacy population, take-home pictograms serve as a memory aid to adhere to complex medication regimens. These findings support the importance of pharmacist delivered counselling and take-home pictograms as an essential component in healthcare settings.