Can medication education improve the drug compliance of the elderly? Evaluation of an in hospital program

Abstract

We report the evaluation of a pharmacist-led medication education program for the elderly. The program consisted of a single group-based education session followed by individual pre-discharge counseling. Patients also received an individual medication record card. The study design was a nonrandomised trial. Patients in the control group received a "dummy" intervention conducted on alternate months to the medication program. Drug compliance was assessed by interviewer-administered questionnaire in the patients' homes at 1 and 3 months post-discharge. The main outcome factor of interest was severe noncompliance with essential medications. This meant taking 80% or less or conversely 120% or more of those medications prescribed for the control of the patient's medical condition. At 1 and 3 months post-discharge, no effect of the program was detected. However, among the sub-group of patients taking four drugs or more the effect of the program was evident at 3 months post-discharge. Among this group at 3 months post-discharge, 55% of control group patients were severely noncompliant with essential medications as compared to 32% of the education group (a difference of 23%, 95% confidence interval 4-42%). This effect was not accounted for by possible confounding factors such as age, sex, number of medications and the patient's living arrangements.