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Randomized Controlled Trial
. 2014 Dec;103(6):503-12.
doi: 10.5935/abc.20140151. Epub 2014 Oct 14.

Improving post-discharge medication adherence in patients with CVD: a pilot randomized trial

[Article in English, Portuguese]
Alfredo D Oliveira-Filho  1 , Donald E Morisky  2 , Francisco A Costa  3 , Sara T Pacheco  1 , Sabrina F Neves  1 , Divaldo P Lyra Jr  4
Affiliations
Randomized Controlled Trial

Improving post-discharge medication adherence in patients with CVD: a pilot randomized trial

[Article in English, Portuguese]
Alfredo D Oliveira-Filho et al. Arq Bras Cardiol. 2014 Dec.

Abstract

Background: Effective interventions to improve medication adherence are usually complex and expensive.

Objective: To assess the impact of a low-cost intervention designed to improve medication adherence and clinical outcomes in post-discharge patients with CVD.

Method: A pilot RCT was conducted at a teaching hospital. Intervention was based on the four-item Morisky Medication Adherence Scale (MMAS-4). The primary outcome measure was medication adherence assessed using the eight-item MMAS at baseline, at 1 month post hospital discharge and re-assessed 1 year after hospital discharge. Other outcomes included readmission and mortality rates.

Results: 61 patients were randomized to intervention (n = 30) and control (n = 31) groups. The mean age of the patients was 61 years (SD 12.73), 52.5% were males, and 57.4% were married or living with a partner. Mean number of prescribed medications per patient was 4.5 (SD 3.3). Medication adherence was correlated to intervention (p = 0.04) and after 1 month, 48.4% of patients in the control group and 83.3% in the intervention group were considered adherent. However, this difference decreased after 1 year, when adherence was 34.8% and 60.9%, respectively. Readmission and mortality rates were related to low adherence in both groups.

Conclusion: The intervention based on a validated patient self-report instrument for assessing adherence is a potentially effective method to improve adherent behavior and can be successfully used as a tool to guide adherence counseling in the clinical visit. However, a larger study is required to assess the real impact of intervention on these outcomes.

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Conflict of interest statement

Potential Conflict of Interest

No potential conflict of interest relevant to this article was reported.

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