Effect of a pharmacist-led intervention on adherence among patients with a first-time prescription for a cardiovascular medicine: a randomized controlled trial in Norwegian pharmacies†

Abstract

Objective To examine whether a pharmacist‐led intervention improves medication adherence among patients who have filled a first‐time prescription for a cardiovascular medicine. Methods Design: Unblinded randomized controlled trial . Setting: 67 Norwegian pharmacies, October 2014–June 2015. Participants: 1480 adults with a first‐time prescription for a cardiovascular medicine. Intervention: Participants in the intervention group received two consultations with a pharmacist 1–2 and 3–5 weeks after filling the prescription. Participants in the control group received care according to usual practice. Main outcome measure: The primary outcome was self‐reported adherence as measured by the 8‐item Morisky Medication Adherence Scale (MMAS‐8), at 7 and 18 weeks after filling the prescription. Adherence from baseline to week 52 was estimated using data from the Norwegian Prescription Database (NPD). Key Findings Data from MMAS‐8 showed that 91.3% of the patients in the intervention group were adherent after 7 weeks versus 86.8% in the control group (4.5% difference, 95% CI 0.8–8.2, P = 0.017). The corresponding proportions were 88.7% versus 83.7% after 18 weeks (5.0% difference, 95% CI 0.8–9.2, P = 0.021). NPD data ( n = 1294) showed no significant difference in adherence after 52 weeks (95% CI −2.0 to 7.8, P = 0.24). However, adherence among statin users ( n = 182) was 66.5% in the intervention group versus 57.4% among new statin users in the general population ( n = 1500) (difference 9.1%, 95% CI 1.5–16.0, P = 0.019). Conclusion The main outcome measure indicates that a short, structured pharmacist‐led intervention may increase medication adherence for patients starting on chronic cardiovascular medication. However, these findings could not be confirmed by the NPD data analysis.

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