Patient-centred advice is effective in improving adherence to medicines

Sarah Clifford, Nick Barber, Rachel Elliott, Elaine Hartley, Rob Horne

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Objective: To assess the effects of pharmacists giving advice to meet patients' needs after starting a new medicine for a chronic condition. Method: A prospective health technology assessment including a randomised controlled trial of a pharmacist-delivered intervention to improve adherence using a centralised telephone service to patients at home in England. Patients were eligible for recruitment if they were receiving the first prescription for a newly prescribed medication for a chronic condition and were 75 or older or suffering from stroke, cardiovascular disease, asthma, diabetes or rheumatoid arthritis. Main outcome measures: Incidence of non-adherence, problems with the new medicine, beliefs about the new medicine, safety and usefulness of the interventions. Results: Five hundred patients consented and were randomised. At 4-week follow-up, non-adherence was significantly lower in the intervention group compared to control (9% vs. 16%, P = 0.032). The number of patients reporting medicine-related problems was significantly lower in the intervention group compared to the control (23% vs. 34%, P = 0.021). Intervention group patients also had more positive beliefs about their new medicine, as shown by their higher score on the "necessity-concerns differential" (5.0 vs. 3.5, P = 0.007). The phone calls took a median of 12 min each. Most advice was judged by experts to be safe and helpful, and patients found it useful. Conclusion: Overall, these findings show benefits from pharmacists meeting patients' needs for information and advice on medicines, soon after starting treatment. While a substantially larger trial would be needed to confirm that the effect is real and sustained, these initial findings suggest the service may be safe and useful to patients. © 2006 Springer Science+Business Media, LLC.
    Original languageEnglish
    Pages (from-to)165-170
    Number of pages5
    JournalPharmacy World and Science
    Volume28
    Issue number3
    DOIs
    Publication statusPublished - Jun 2006

    Keywords

    • Chronic disease
    • England
    • Patient adherence
    • Patient needs
    • Pharmacist
    • Randomized controlled trial
    • Telephone service

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