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Multifaceted intervention including motivational interviewing to support medication adherence after stroke/transient
Ulla Hedegaard1, Lene Juel Kjeldsen2, Anton Pottegård3
1Clinical Pharmacology and Pharmacy, Institute of Public Health, University of Southern Denmark, and ; Hospital Pharmacy of Funen, Odense University Hospital, Odense, Denmark.
Cerebrovascular Diseases Extra
|January 20, 2015
Summary
A pharmacist intervention using motivational interviewing did not improve medication adherence for secondary stroke prevention. High adherence rates limited the potential for improvement in this study.
Area of Science:
- Neurology
- Pharmacology
- Public Health
Background:
- Suboptimal medication adherence post-stroke/TIA increases recurrent event risk.
- Motivational interviewing (MI) shows promise in other medical fields.
- Effective strategies are needed to improve secondary stroke prevention adherence.
Purpose of the Study:
- To evaluate a multifaceted pharmacist intervention with MI for medication adherence in stroke/TIA patients.
- To assess the impact on adherence, persistence, and clinical outcomes.
Main Methods:
- Randomized controlled trial comparing pharmacist intervention to usual care.
- Intervention included medication review, MI consultation, and follow-up calls over 6 months.
- Primary outcome: composite medication possession ratio (MPR) for key secondary prevention drugs at 12 months.
Main Results:
- No significant difference in MPR between intervention and control groups at 12 months.
- Adherence rates were high in both groups, with limited room for improvement.
- No significant differences in clinical outcomes or persistence to specific medications.
Conclusions:
- The multifaceted pharmacist intervention with MI did not improve adherence or clinical outcomes.
- High baseline adherence suggests interventions should target high-risk non-adherent patients.
- Future research needs outcomes sensitive to behavioral interventions.
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