Pharmacy-based interventions to reduce primary medication nonadherence to cardiovascular medications

Area of Science:

• Pharmacy Practice
• Public Health
• Medication Adherence Research

Background:

• Primary medication nonadherence (PMN) is a significant issue where patients fail to fill new prescriptions.
• Effective interventions to mitigate PMN require further investigation and description.

Purpose of the Study:

• To evaluate the efficacy of two distinct pharmacy-based interventions in reducing primary medication nonadherence.
• To compare the impact of automated versus live calls on prescription fulfillment rates.

Main Methods:

• A sequential intervention design was employed, comparing automated calls (starting 2007) and live pharmacist calls (starting 2009) against control groups.
• The study included patients prescribed new cardiovascular medications at CVS pharmacies, with randomly selected patients serving as controls.
• Primary medication nonadherence was defined as the failure to pick up a prescription within 30 days of initial processing.

Main Results:

• The automated intervention, involving over 850,000 patients, showed no significant difference in PMN rates compared to its control group (4.2% vs. 4.5%).
• The live intervention, targeting patients with unfulfilled prescriptions after 8 days, demonstrated a significant reduction in PMN (36.9% vs. 41.7%, P<0.0001).
• Specifically, live calls led to a 6.9% decrease in antihypertensive abandonment but only a 1.4% decrease for antihyperlipidemics.

Conclusions:

• Automated reminder calls are ineffective in reducing primary medication nonadherence.
• Live interventions by pharmacists can significantly decrease nonadherence for specific medication classes, such as antihypertensives.
• Despite reductions, a substantial proportion of patients continue to abandon prescriptions even after targeted interventions.