Community pharmacist-led interventions and their impact on patients’ medication adherence and other health outcomes: a systematic review

Milosavljević, Aleksandra; Aspden, Trudi; Harrison, Jeff

doi:10.1111/ijpp.12462

Cited by 185 publications

(158 citation statements)

References 51 publications

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“…In fact, pharmacists, as the most easily accessible members of the treatment team, can inform patients and their families of the outcomes of pharmacotherapy, thereby convincing them to pursue their prescriptions. For example, a recent study systematically reviewed pharmacists‐led contributions to increasing patients' adherence to pharmacotherapy …”

Section: Discussionsupporting

confidence: 93%

“…This highlights the paramount role of both pharmacists and physicians in helping patients better adapt themselves to the treatment by informing them of the side effects of drugs and strategies to deal with them. For instance, researchers have empirically manifested the strategic role of pharmacists and physicians in increasing patients' adherence to medications . More specifically, a recent study conducted on physicians who were specialized in treating patients with psychiatric disorders showed if prescribers were provided with information on non‐adherence, they would effectively manage pharmacotherapy …”

Section: Discussionmentioning

confidence: 99%

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Medication adherence in patients with psychiatric disorders in Tehran

Mehralian

Sharif

Abbasian

2019

J Pharm Health Serv Res

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Objectives Non-adherence to drugs is an obstacle getting in the way of treatment in all diseases, especially chronic diseases. This study aimed to investigate the adherence level of patients with psychiatric disorders and recognize factors contributing to patients' adherence to treatment. The study was done in Psychiatric clinics in Tehran, the capital city of Iran.Methods A cross-sectional study was carried out using a self-report method through a questionnaire consisting of 26 questions. A total of 429 people, who had referred to three large clinics during June and July 2017, participated in this study. In addition to socio-demographic, health and diagnostic characteristics of the patients, the adherence to psychiatric medication and some factors contributing to their adherence were reported. Key findings In this study, the majority of the patients with schizophrenia, that is 211 (49.2%), had low adherence, 141 (32.9%) had moderate adherence, and only 77 (17.9%) had full adherence to their treatment. According to the results of the questionnaire on Morisky drug adherence scale, most of the patients considered forgetfulness as a major cause of their non-adherence. Conclusion Non-adherence to treatment is a major problem in patients, and the intervention of pharmacists as the most accessible of medical staff as well as physicians can help to persuade patients to adhere and continually take medicines. Some issues such as the side effects of medications, patients' lack of belief in the need for treatment and patients' uncertainty about the effectiveness of medicines were the most important factors contributing to their non-adherent behaviour.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Medication adherence in patients with psychiatric disorders in Tehran

Mehralian

Sharif

Abbasian

2019

J Pharm Health Serv Res

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“…[23] Some other studies also corroborate these findings, such as the metaanalysis conducted by Milosavljevic, in which, of a total of 65 articles reviewed, 22 studies show a 61.5% improvement in adherence, in favor of the educational intervention group (counseling person -person, with detailed knowledge about disease prevention and management) compared to the control group (regular advice provided with the medical prescription), with significant results (p<0.05). [24] Previous systematic reviews have shown that the highest percentage of adherence failure reduction linked to an educational intervention strategy is 45.5% and the lowest is 4,8%. In the following Table 4 a comparison is made between the studies carried out on the measurement of adherence.…”

Section: Discussionmentioning

confidence: 99%

Adherence in elderly patients with NCDs: Which is the best, educational or social support? A comparative study in Ecuador

Céspedes¹,

Florido²,

Segovia³

et al. 2019

Preprint

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Background: Adherence to treatment is one of the mainstays of non-communicable diseases adequate control. Non – adherence can affect several aspects to both the patient and the health system. For this reason, it is important to have intervention strategies available to prevent detachment and improve adherence to treatment. The objective of this study is to evaluate the effectiveness of the educational strategy compared with the social and family support for the improvement of adherence in patients with chronic noncommunicable diseases. Methods: A quasi-experimental study was conducted in 159 participants with diagnosis of arterial hypertension or/and diabetes mellitus type 2 plus polypharmacy. Participants were divided in two groups and strategies: Group A: educational (n = 79) and Group B social/family support (n = 80), follow up three months for each group. For group "A", informative group workshops were assigned; while for group "B" therapeutic agreements were established. Adherence to treatment pre- and post-intervention were evaluated using the four item Morisky Green Levine scale of public domain. At the end of the intervention period, an intra and intergroup analysis were performed and a Z test for difference in proportions was applied; the RR was used as a measure of association, and Chi2 as a measure of significance. Results: A total of 152 patients complete the intervention. In group A, pre-intervention non-adherence was 58.2%, post-intervention of 45.3% and final reduction of the failure was 12.9% (p<0,001). In group B, pre-intervention non-adherence was 55%, post-intervention 46.8%, and final reduction of adherence failure of 8.2%, (p> 0.05). Statistically significant difference was obtained between the decrease in the failure reached after the application of the educational strategy compared to social / family support strategy (p = 0.001). Conclusions: Educational strategy is more effective than social/family support strategy, to reduce the failure of therapeutic adherence. There was not association of sociodemographic factors and adherence to treatment.

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“…Pharmacists are accessible health care professionals with extensive medication and disease state training. Pharmacists routinely engage with patients in a variety of settings which provides opportunities to identify and counsel patients with poor medication adherence 18 . Evidence suggests pharmacist‐led interventions can have a positive impact on medication adherence, chronic disease management, and patient outcomes 18,19 .…”

mentioning

confidence: 99%

“…Pharmacists routinely engage with patients in a variety of settings which provides opportunities to identify and counsel patients with poor medication adherence 18 . Evidence suggests pharmacist‐led interventions can have a positive impact on medication adherence, chronic disease management, and patient outcomes 18,19 . A comprehensive systematic review with focused meta‐analyses found significant results in favor of pharmacists' direct patient care interventions and services in medication adherence ( P = .001).…”

mentioning

confidence: 99%

The impact of a pharmacist‐designed mobile application on blood pressure control and medication adherence in patients with hypertension

Manigault

McKinley

Patel

et al. 2020

J Am Coll Clin Pharm

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Introduction Mobile applications (apps) may improve adherence and disease state‐related outcomes in patients with uncontrolled chronic diseases, including hypertension. Objective The purpose of this study was to determine the effectiveness of using a pharmacist‐designed app to improve blood pressure (BP) and promote adherence to antihypertensive medications. Methods This study was a prospective, multicenter, randomized controlled trial. Patients were randomized to an intervention or control group for 3 months. The intervention was a pharmacist‐designed mobile app. Antihypertensive medication refill history was assessed 3 months before, during study, and 3 months after study completion. Continuous outcome measures investigated were systolic/diastolic BP and medication refill history using the cumulative medication gap (CMG). Statistical analysis comparing median difference in BPs and CMGs between groups was conducted using Theil‐Sen Siegel regression. Results The propensity score adjusted population consisted of 78 patients (n = 39 for both groups). No significant difference was observed in the conditional median difference in CMG between groups at the 3‐month follow‐up visit (−0.06 [P = .70]). No significant difference was observed in the conditional median difference in systolic and diastolic BP between groups at the 3‐month follow‐up visit (−2.00 [P = .07] and −1.00 mmHg [P = .39] systolic and diastolic, respectively). Upon subgroup analysis, those nonadherent at baseline in the intention to treat population experienced a significant improvement in outcomes (−0.06 P = .03] and −12.00 mmHg [P = .002] CMG and systolic BP, respectively). Conclusion A pharmacist‐designed mobile app did not result in improved medication adherence or BP control, but may be beneficial in patients with hypertension who struggle with medication adherence.

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Community pharmacist-led interventions and their impact on patients’ medication adherence and other health outcomes: a systematic review

Cited by 185 publications

References 51 publications

Medication adherence in patients with psychiatric disorders in Tehran

Medication adherence in patients with psychiatric disorders in Tehran

Adherence in elderly patients with NCDs: Which is the best, educational or social support? A comparative study in Ecuador

The impact of a pharmacist‐designed mobile application on blood pressure control and medication adherence in patients with hypertension

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