Low medication adherence in patients with coronary heart disease increases mortality. This study investigates if an intervention of medication review and counselling can improve patients' medication adherence and treatment results.
The study will investigate the effects of medication review and Motivational Interviewing (MI) on patients with Coronary Heart Disease (CHD). Clinical pharmacists competent in MI and cardiology will conduct medication interviews and medication reviews at the outpatient clinic. The intervention will continue during 9 months, with interviews and reviews as needed. Follow-up of results will take place 16 months after inclusion (corresponding to 4 months after the end of intervention). The MI-Component will be quality assured by MITI 4.2-coding (Motivational Interviewing Treatment Integrity). The study will investigate effects on clinical outcomes, medication adherence, patients´ beliefs about medicines and quality of life.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
417
Kalmar County Hospital
Kalmar, Sweden
Percentage of patients who achieve the treatment goal for Low density lipoprotein cholesterol (LDL-C)
According to Swedish guidelines the goal is \< 1,8mmol/L or at least 50% reduction from baseline.
Time frame: 16 months
Percentage of patients adherent to cholesterol lowering treatment
Self-reported adherence according to Morisky-8-Item Adherence Scale
Time frame: 16 months
Percentage of patients adherent to cholesterol lowering treatment
Prescription refill according to the Swedish Prescribed Drug Register, 1 refill month 12-16 is set as the cut-off for adherence.
Time frame: 16 months
Percentage of patients adherent to cholesterol lowering treatment
Prescription refill according to the Swedish Prescribed Drug Register, Percent Day Covered (PDC) during follow-up period, 80% is set as the cut-off for adherence.
Time frame: 16 months
Percentage of patients adherent to preventive medication: Angiotensin Converter Enzyme inhibitor (ACEi) or Angiotensin Receptor Blocker (ARB)
Prescription refill according to the Swedish Prescribed Drug Register, 1 refill month 12-16 is set as the cut-off for adherence.
Time frame: 16 months
Percentage of patients adherent to preventive medication: Acetylsalicylic acid (ASA)
Prescription refill according to the Swedish Prescribed Drug Register, 1 refill month 12-16 is set as the cut-off for adherence.
Time frame: 16 months
Percentage of patients adherent to preventive medication: P2Y12-antagonist
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Prescription refill according to the Swedish Prescribed Drug Register, 1 refill month 12-16 is set as the cut-off for adherence.
Time frame: 16 months
Percentage of patients adherent to preventive medication: Beta-blocker
Prescription refill according to the Swedish Prescribed Drug Register, 1 refill month 12-16 is set as the cut-off for adherence.
Time frame: 16 months
Percentage of patients with Systolic Blood Pressure <140
As registered in the Electronic Health Record
Time frame: 16 months
Changes in Quality of Life
The Heart QoL instrument
Time frame: 16 months
Number of Cardiovascular Re-admissions and Emergency Department visits
According to the Health Care register of Kalmar County
Time frame: 16 months