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Pharmacist intervention to improve medication adherence in heart failure: a randomized trial
Michael D Murray1, James Young, Shawn Hoke
1Center for Pharmaceutical Outcomes and Policy, University of North Carolina School of Pharmacy, Chapel Hill, North Carolina 27599-7360, USA.
Annals of Internal Medicine
|May 16, 2007
Summary
A pharmacist intervention improved medication adherence for heart failure patients, reducing healthcare use and costs. However, these benefits diminished after the intervention ended, suggesting ongoing support is crucial.
Area of Science:
- Cardiology
- Pharmacology
- Health Services Research
Background:
- Poor medication adherence is common in heart failure patients on multiple prescriptions.
- Few rigorously tested interventions exist to improve adherence.
Purpose of the Study:
- To evaluate if a pharmacist intervention enhances medication adherence and health outcomes in low-income heart failure patients compared to usual care.
Main Methods:
- A randomized controlled trial involving 314 low-income heart failure patients (≥50 years).
- A 9-month multilevel pharmacist intervention targeting medication management for patients with low health literacy.
- Primary outcomes: adherence (electronic monitors) and exacerbations (ED visits/hospital admissions).
Main Results:
- Medication adherence increased by 10.9 percentage points during the intervention but effects dissipated post-intervention.
- Medications were taken on schedule more often in the intervention group, but this effect also faded.
- The intervention group showed a 19.4% reduction in emergency department visits and hospital admissions, with lower direct healthcare costs.
Conclusions:
- Pharmacist interventions can improve adherence and reduce healthcare utilization and costs for heart failure outpatients.
- The positive effects likely require continuous intervention as benefits diminished after the intervention ceased.
- Limitations include exclusion of adherence aids and a single study site serving an indigent population.
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