Improving Adherence to Pharmacological Treatment

University of Massachusetts, Worcester689 enrolled

Overview

The overall goal of this study was to implement and evaluate the effects of a systems-based and pharmacist-mediated program designed to improve adherence for patients with known coronary heart disease (CHD) to lipid-lowering pharmacologic therapy and of their physicians/nurse practitioners to the National Cholesterol Education Program Guidelines.

Patients were randomly assigned to a usual care condition which consisted of patients provided with usual care only, or to the Special Intervention (SI) condition. The intervention was implemented and coordinated by pharmacists, who utilized for tracking and communication the Lotus Notes®-based system that was developed for the project.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

689

Conditions

Medication Adherence

Interventions

systems-based and pharmacist-mediated programBEHAVIORAL

Patients in the SI were seen by a study pharmacists prior to discharge to establish a relationship with the patient, explain the pharmacist's role in the study, provide education about all discharge medications and a medication card listing all medications and their manner of use, and set the framework for the follow-up telephone calls. Patients received pharmacist-delivered adherence counseling telephone contacts that took place at two weeks following discharge, and at months 1, 3, 6, and 9 oriented towards assisting patients to remain adherent to prescribed lipid-lowering and other medications, and also towards ensuring that all patients were either documented to be at the LDL-C goal, or were assisted to reach the goal by facilitating the scheduling of repeat lipid measurement as needed and providing information, guidelines and prompts to the patient's physician or nurse practitioner.

Eligibility

Sex: ALLMin age: 30 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria: * was between 30 and 85 years of age; * had known CHD, defined as the presence of at least one coronary lesion at coronary angiography of \>50%. Exclusion Criteria: * was unable or unwilling to give informed consent; * had a history of intolerance to two or more statin drugs; * planned to move out of the area within one year of recruitment; * had a poor prognosis such that life expectancy was thought to be \<5 years; * had a psychiatric illness which limited ability to participate; or * had no telephone.

Locations (1)

UMass Memorial Medical Center

Worcester, Massachusetts, United States

Outcomes

Primary Outcomes

The primary outcome evaluated is the percentage of patients with a serum low-density lipoprotein cholesterol (LDL-C) level <70 mg/dl.

Time frame: One year

Secondary Outcomes

Proportion of prescribed lipid-lowering medication taken by patients as measured by a continuous multiple-interval (CMA) measure of medication availability based on pharmacy records.

Time frame: One year

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.