Impact of home medication management review on medication adherence among Jordanian patients

Abstract

Objectives This study was designed to evaluate the impact of Home Medication Management Review (HMMR) on self‐reported adherence, and to explore the effect of different patient factors on their medication adherence. Method Consecutive patients from outpatient clinics who were eligible for the study were recruited and randomly distributed into two groups. Patients in both groups were visited at home by the clinical pharmacist at baseline. For the intervention group only, the pharmacist delivered counselling regarding self‐reported adherence. After identifying treatment‐related problems (TRPs), the pharmacist sent a letter to the patients’ physician with certain recommendations (intervention group only). Both groups were reassessed for adherence after 3 months from baseline to measure the difference between the two groups. Key findings A total of 97 participants were included. Mean ages for the intervention and control groups were 63.13 and 58.39 respectively. The majority of patients were women. The study revealed significant association with the number of TRPs, and level of adherence in the intervention group at follow‐up (R2 = 0.348, P < 0.001). Adherence score for patients diagnosed with hypertension, diabetes and other chronic conditions indicates that more than 70% of the participants have ‘medium adherence score’ in comparison with <10% having ‘high adherence’ at baseline. Three months postbaseline, 33% of patients in the intervention group were found to have high adherence compared to 14% in the control group. Adherence score significantly decreases in ‘low scores of adherence’ and increases in ‘high scores of adherence’ (P < 0.001) at follow‐up in the intervention group. No significate association between adherence and patient factors was found. Conclusion HMMR service has resulted in significant improvements in patients’ adherence when compared to control group patients who did not receive the service. Besides receiving the service, no other patient factors played a role in patients’ improvement in adherence.

Medication Adherence Interventions for Cardiovascular Disease in Low- and Middle-Income Countries: A Systematic Review

“…These interventions were nurse-led, 19 , 21 , 26 , 27 , 32 , 36 , 38 , 41 , 45 , 48 , 53 , 56 community health worker-led, 52 , 55 , 57 and clinical/community pharmacist-led. 23–25 , 31 , 43 , 61 , 62 In Kavita et al 53 a team-based approach was used to deliver a medication adherence intervention; a group of experts from cardiology, nursing, community medicine, and fine arts developed and validated an intervention package that consisted of a booklet for nurses, a patient education booklet and flashcards for patient education. After one year of follow-up, the mean adherence scores were significantly higher in the intervention group ( p <0.001); effect size (Cohen’s d) was 1.1.…”

“…Four studies were conducted in Africa: two in Nigeria, 19,20 one in Ghana, 21 and one in South Africa 22 Eight of the studies were conducted in the Americas: Brazil, [23][24][25][26][27] Argentina, 28 Portugal, 29 and Chile. 30 Thirty-three of the studies were conducted in Asia: Jordan, 31,32 Iran, [33][34][35][36][37][38][39][40][41] Philippines, 42 Malaysia, 43 China, [44][45][46][47][48][49][50] Taiwan, 51 India, [52][53][54][55][56][57] Vietnam, 58 Pakistan, [59][60][61] and Thailand 62,63 (Table 1). Also, 35 of the studies were randomized clinical trials and nine articles were non-randomized studies; one study was a cohort study; others were quasiexperimental and pre-post studies.…”

“…Hypertension was the most common cardiovascular condition addressed across the studies. Interventions that were more effective at improving medication adherence included changing from multi-dose medications to fixed-dose combinations, team-based healthcare, 31 , 33 , 53 and patient education combined with reminders. We also observed that studies that combined multiple medication adherence strategies in the interventions reported significant improvements in medication adherence.…”

Assessing the impact of medication management review service for females diagnosed with depression and anxiety: A randomized control trial

“…The questionnaire was developed, validated, and used previously in similar studies. The questionnaire included eight questions as follows: how many times the patient forgot to take his antipsychiatry medications within the last month, stopped their antipsychiatry medications from time to time, stopped their antipsychiatry medications when feeling better, worse, or due to experiencing side effects. The questionnaire was scored at a scale of 0 (never), 1 (rarely), 2 (sometimes), 3 (often), and 4 (always).…”

Impact of pharmacist‐led interventions on patient care in ambulatory care settings: A systematic review

“…33,49 All the included articles had a control arm that is usual care provided to the patient. Follow up periods varied among included studies, in 21 studies patients were followed for less than 6 months, [29][30][31][32][33][34][35][36][37][38][40][41][42]44,[47][48][49][50][52][53][54][55] 5 studies between 6 months and one year 27,28,43,45,57 and 3 studies for more than one year. 39,46,51 Overall, the majority of the studies (n = 19, 61.29%) evaluated the impact of CMR on different outcomes, followed by AR n = 6 (19.3%), and none studied PR.…”