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Improving post-discharge medication adherence in patients with CVD: a pilot randomized trial
Alfredo D Oliveira-Filho1, Donald E Morisky2, Francisco A Costa3
1Universidade Federal de Alagoas, Maceió, AL, Brazil.
Arquivos Brasileiros De Cardiologia
|January 16, 2015
Summary
A low-cost intervention improved medication adherence in post-discharge cardiovascular disease patients. While initial adherence rates were significantly higher in the intervention group, the difference narrowed after one year, indicating a need for sustained support.
Area of Science:
- Cardiology
- Health Services Research
- Behavioral Medicine
Background:
- Effective medication adherence interventions are often complex and costly.
- Post-discharge care for cardiovascular disease (CVD) patients presents challenges in maintaining medication adherence.
- Low adherence rates can negatively impact clinical outcomes and increase healthcare costs.
Purpose of the Study:
- To evaluate the effectiveness of a low-cost intervention to enhance medication adherence in post-discharge CVD patients.
- To assess the impact of this intervention on clinical outcomes, including readmission and mortality rates.
- To determine if a validated self-report adherence scale can guide adherence counseling.
Main Methods:
- A pilot randomized controlled trial (RCT) was conducted at a teaching hospital.
- The intervention utilized the four-item Morisky Medication Adherence Scale (MMAS-4) to guide counseling.
- Medication adherence was measured using the eight-item MMAS at baseline, 1 month, and 1 year post-discharge. Readmission and mortality were also tracked.
Main Results:
- 61 patients were randomized; the intervention group (n=30) showed higher adherence than the control group (n=31) at 1 month (83.3% vs 48.4%).
- This adherence difference diminished by 1 year (60.9% vs 34.8%), though the intervention group remained higher.
- Readmission and mortality rates were linked to lower adherence in both groups.
Conclusions:
- A low-cost intervention, guided by a validated adherence scale, shows potential for improving medication adherence behaviors.
- This approach can be a valuable tool for adherence counseling during clinical visits.
- Further research with larger sample sizes is necessary to confirm the intervention's impact on clinical outcomes.
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