Pharmacist-led education improves caregiver’s JIA knowledge

Counselling provided by a pharmacist enhances the caregiver’s knowledge about juvenile idiopathic arthritis (JIA) and may even reduce costs for patients with JIA, according to a Singapore study.

“Paediatric rheumatology centres should consider the inclusion of a clinical pharmacist in their team,” the researchers said.

In the study, newly diagnosed JIA patients and their caregivers were enrolled into the pharmacist-led educational program, which used standardized education materials. The primary outcome was JIA knowledge by caregivers before and after counselling. Other outcomes included caregiver satisfaction, time spent, and cost savings by patients.

Fourteen responses were included in the analysis. JIA knowledge by caregivers significantly improved from a median score of 5 prior to counselling to 10 post-counselling (p=0.006). Caregivers also expressed satisfaction with the service, with a median satisfaction score of 32. [Proc Singap Healthc 2025;doi:10.1177/20101058251400380]

Manpower costs for training and for the pharmacist to deliver the program was 0.5 full-time employee. The pharmacist-led counselling resulted in potential cost savings of SGD 54‒92 for each patient. Furthermore, the pharmacist contributed to education and research on rheumatology topics.

“The inclusion of the clinical pharmacist in the paediatric multidisciplinary rheumatology team had a positive impact in many areas,” the researchers said. “The pharmacist-led education session significantly improved caregivers’ knowledge in the management of JIA and was well-received by caregivers.”

Side effects

A study by Kirchner and colleagues identified medication side effects as the main reason for nonadherence among JIA patients. [Pediatr Rheumatol Online J 2023;21:31]

In another study, the top reported reasons for medication noncompliance were lack of awareness on the importance of medications, side effects, and difficulty in taking medications. [Front Pharmacol 2023;14:1149320]

A study in the US also pointed to medication side effects as one of the main barriers to treatment adherence, while another study identified how the fear of adverse reactions of treatment and knowledge gap in JIA disease mechanisms could negatively impact medication adherence. [Curr Rheumatol Rep 2014;16:410; J Rheumatol 2018;45:690-696]

“These studies highlighted why patient education is of utmost importance and why our materials emphasized disease explanation and medications with specific common side effects and corresponding management tips,” the researchers said.

“This also stresses how clinical pharmacists are in a unique position to educate patients and caregivers to self-manage common self-limited medication side effects and when to seek medical advice for more concerning side effects,” they added.

The clinical pharmacist in the program also improved accessibility to clinical pharmacy services by providing a direct contact number for patients and caregivers so they could ask medication-related questions via calls or text messages.

“It was interesting to note that despite improvement in caregivers’ knowledge, the change in caregivers’ confidence to manage JIA was not statistically significant. However, it was suggestive of a trend towards improved caregiver confidence post-counselling,” the researchers said.

“If more caregivers were recruited, perhaps the improvement in confidence could be demonstrated,” they added.