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Randomized Controlled Trial
. 2011 May;43(5):245-53.
doi: 10.1016/j.aprim.2010.05.006. Epub 2011 Jan 5.

[Effect of pharmacist involvement in adherence to medications in patients with high to moderate cardiovascular risk (Study EMDADER-CV-INCUMPLIMIENTO)]

[Article in Spanish]
Miguel Ángel Rodríguez Chamorro  1 , Emilio García-Jiménez, Pedro Amariles, Alfonso Rodríguez Chamorro, Eva María Pérez Merino, Fernando Martínez Martínez, María José Faus Dader
Affiliations
Randomized Controlled Trial

[Effect of pharmacist involvement in adherence to medications in patients with high to moderate cardiovascular risk (Study EMDADER-CV-INCUMPLIMIENTO)]

[Article in Spanish]
Miguel Ángel Rodríguez Chamorro et al. Aten Primaria. 2011 May.

Abstract
in English, Spanish

Objective: To evaluate the effect of pharmacist involvement, by means of Pharmacotherapy Follow-Up (PFU) in the improvement of medication adherence and therapeutic outcomes.

Design: An experimental, controlled, and randomised clinical study comparing a PFU program with the routine process in Spanish community pharmacies improved with health education during 8 months.

Setting: Nine Spanish community pharmacies.

Participants: Patients between 25 and 74 years with a moderate-high cardiovascular risk (CVR), who arrived with a prescription, in their name, for drugs for at least one CVR factor.

Interventions: The patients were randomly assigned to the intervention group (IG), and received PFU and health education, or the control group (CG), who received health education only.

Main measurements: Adherence to treatment, and blood pressure (BP) and total cholesterol (TC) levels at the beginning and end of the study.

Results: Of the 87 patients enrolled, 85 finished the study: 41 from the CG and 44 from the IG. Both groups increased adherence at the end of the [CG: 26.9%; 95% CI: 12.7- 41; IG: 27.3%; 95% CI: 13.6 - 41]. Although the IG showed better results in the variation of BP and TC levels, the differences compared to the CG were not statistically significant.

Conclusions: PFU and health education improves adherence to treatment. To be a patient who completes the study is also associated with improvement in the blood pressure and blood pressure/total cholesterol objectives.

Objetivo: Evaluar el efecto de la actuación del farmacéutico, mediante seguimiento farmacoterapéutico (SFT) en la mejora de la adherencia y de objetivos terapéuticos.

Diseño: Estudio clínico experimental controlado, aleatorizado, comparativo de un programa de SFT con el proceso habitual en farmacias comunitarias españolas mejorado con educación sanitaria, durante 8 meses.

Emplazamiento: Nueve farmacias comunitarias españolas.

Participantes: Pacientes entre 25-74 años con riesgo cardiovascular (RCV) alto-moderado, que acudieron con una receta, a su nombre, de medicamentos para al menos un factor de RCV.

Intervenciones: Los pacientes se asignaron aleatoriamente al grupo intervención (GI), que recibió SFT y educación sanitaria, o al grupo control (GC), que recibió solamente educación sanitaria.

Mediciones principales: Adherencia al tratamiento y cifras de presión arterial (PA) y colesterol total (CT), al inicio y final estudio.

Resultados: De los 87 pacientes reclutados, 85 acabaron el estudio: 41 del GC y 44 del GI. Ambos grupos aumentaron la adherencia al final del estudio [GC: 26,9%; IC95%:12,7 a 41; GI: 27,3%; IC95%:13,6 a 41]. Aunque el GI mostró mejores resultados en la variación de las cifras de PA y CT, las diferencias en relación al GC no fueron estadísticamente significativas.

Conclusiones: El SFT y la educación sanitaria mejoran la adherencia al tratamiento. Además ser paciente cumplidor al final del estudio se relaciona con la mejora de los objetivos de la presión arterial y de presión arterial/colesterol total.

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Figures

None
Esquema general del estudio: Ensayo clínico controlado aleatorio comparativo del seguimiento farmacoterapéutico con educación sanitaria en las farmacias comunitarias.
See this image and copyright information in PMC

References

    1. Adherence to long-therm therapies. Evidence for action. World Health Organization 2004.
    1. Rodríguez Chamorro MA. Efecto de la actuación farmacéutica en la adherencia del tratamiento farmacológico de pacientes ambulatorios con riesgo cardiovascular (EMDADER-CV-INCUMPLIMIENTO). Tesis Doctoral. Universidad de Granada. Marzo 2009. - PMC - PubMed
    1. Borrás Vivés R. Sistemas personalizados de dispensación desde la farmacia comunitaria. Aula de la farmacia. 2005;20:8–22.
    1. FORO de Atención Farmacéutica. Documento de Consenso. Madrid.2008. Disponible en: www.atencionfarmaceutica-ugr.es
    1. Sanz A. Intervención para mejorar la adherencia al tratamiento. Offarm. 2007;5:118–119.

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