The impact of pharmacist face-to-face counseling to improve medication adherence among patients initiating statin therapy

Abstract

PurposeTo evaluate the impact of a community-based pharmacist-led face-to-face counseling program on medication adherence for patients who were new to therapy (NTT) for statin medications.Patients and methodsThis retrospective cohort study evaluated a program that was implemented in 76 national community pharmacies located in the midwest USA. It consisted of two face-to-face patient counseling sessions with a pharmacist that addressed patient barriers to adherence. A group of 2056 NTT statin patients was identified between September 1, 2010 and October 31, 2010, and was followed for 12 months. The intervention group consisted of 586 patients, and the comparison group comprised 516 patients. Outcomes were measured using the continuous medication possession ratio (MPR), categorical MPR, and medication persistency.ResultsAfter adjusting for covariates, the intervention group had statistically greater MPR than the comparison group at every month measured. For example, at 12 months the intervention group had a MPR of 61.8% (CI, 54.5%–69.2%) and the comparison group had a MPR of 56.9% (CI, 49.5%–64.3%); this 4.9% difference is significant (P < 0.01). The 12 month categorical MPR also showed significant differences between groups (χ 2 = 6.12, P < 0.05); 40.9% of the intervention group and 33.7% of comparison group had a MPR greater than or equal to 80%. Finally, the intervention group had significantly greater persistency with their medication therapy than the comparison group at 60, 90, 120, and 365 days.ConclusionPatients who participated in brief face-to-face counseling sessions with a community pharmacist at the beginning of statin therapy demonstrated greater medication adherence and persistency than a comparison group. This brief targeted intervention at the initiation of maintenance drug therapy moderates the high risk of nonadherence and discontinuation; it helps patients establish a routine of daily self-medication and potentially improves their long-term clinical outcomes.

Evaluation of the Effect of Education Provided by Pharmacists on Hyperlipidemic Patient’s Adherence to Medications and Blood Level of Lipids

“…This study's finding with regard to the effectiveness of good pharmacist-patient relationship and counseling in increasing medication adherence is consistent with the result of a cross-sectional study conducted by Amal et al In this study authors have pointed out that predictors of high adherence are good physician-patient relationship and counseling, a high level of health-related quality of life and perceived health, and predictors of low adherence included a reducing memory, anxiety/depression, low knowledge about drug, and delay in appointments with physician (Amal et al, 2015). Taitel et al in a research came to this conclusion that patients who profited by consultation of pharmacist before they started to use the statins have significantly better adherence than the control group which is in line with the result of this study (Taitel et al, 2012). Cohen also in a survey suggests that further helpful conversation between health professional and patients may enhance the adherence to drug, especially when the client has concerns about adverse reactions to drug and the medication costs (Cohen et al, 2012).…”

“…These activities do not always lead to fully satisfactory results, especially with regard to medication side effects (Blom and Krass, 2011). Several studies demonstrate that patient counseling with regard to statin benefits, side effects, and the importance of adherence by community pharmacists or physicians can improve adherence and help patients to overcome barriers on the way of adherence (Taitel et al, 2012;Wei et al, 2013). Also involving the patient in the process of treatment and educating them are effective ways for improving drug adherence.…”

An education-behavioural intervention improves adherence to statins

“…Intervention composed of inhospital counselling, attention to adherence barriers, communication of discharge medications to community pharmacists and physicians, and ongoing assessment of adherence by community pharmacists had a positive effect on adherence to statins in secondary prevention patients [22]. The pharmaceutical care programs resulted in lower rates of discontinuation within initial period of statin therapy [23,24]. Patient support and reminders were also found to be the most effective out of 4 categories of intervention (simplification of treatment regimen, patient education, patient support and reminders, and complex behavioural approach) in a recently published systematic review [25].…”

Evaluating the Potential Impact of Pharmacist Counseling on Medication Adherence Using a Simulation Activity

“…6 Counseling by pharmacists in both the inpatient and outpatient settings can improve medication adherence and persistence. 7,8 Various organizations, such as the National Council on Patient Information and Education, the Pharmacy Quality Alliance, and the American Association of Colleges of Pharmacy have partnered with the National Consumer League to create a campaign that increases patient awareness and encourages provider discussion with patients regarding adherence. 9,10 The Center for the Advancement of Pharmacy Education specifically delineates pharmacist-provided education as an objective for students.…”