Impact of community pharmacist intervention discussing patients' beliefs to improve medication adherence

Abstract

Background: Adherence to evidence based medicines in patients who have experienced a myocardial infarction remains low. Individual's beliefs towards their medicines are a strong predictor of adherence and may influence other factors that impact on adherence.

Objective: To investigate if community pharmacists discussing patients' beliefs about their medicines improved medication adherence at 12 months post myocardial infarction.

Setting: This study included 200 patients discharged from a public teaching hospital in Queensland, Australia, following a myocardial infarction. Patients were randomised into intervention (n = 100) and control groups (n = 100) and followed for 12 months.

Method: All patients were interviewed between 5 to 6 weeks, at 6 and 12 months post discharge by the researcher using the repertory grid technique. This technique was used to elicit the patient's individualised beliefs about their medicines for their myocardial infarction. In the intervention group, patients' beliefs about their medicines were communicated by the researcher to their community pharmacist. The pharmacist used this information to tailor their discussion with the patient about their medication beliefs at designated time points (3 and 6 months post discharge). The control group was provided with usual care.

Main outcome measure: The difference in non-adherence measured using a medication possession ratio between the intervention and control groups at 12 months post myocardial infarction.

Results: There were 137 patients remaining in the study (intervention group n = 72, control group n = 65) at 12 months. In the intervention group 29 % (n = 20) of patients were non-adherent compared to 25 % (n = 16) of patients in control group.

Conclusion: Discussing patients' beliefs about their medicines for their myocardial infarction did not improve medication adherence. Further research on patients beliefs should focus on targeting non-adherent patients whose reasons for their non-adherence is driven by their medication beliefs.