Related Experiment Video
Updated: Feb 14, 2026
In Silico Clinical Trials for Cardiovascular Disease
Published on: May 27, 2022
Motivational Interviewing and Medication Review in Coronary Heart Disease (MIMeRiC): Protocol for a Randomized
Malin Johansson Östbring1,2, Tommy Eriksson3,4, Göran Petersson2
1Pharmaceutical Department, Kalmar County Council, Kalmar, Sweden.
Insights
This study evaluated an intervention to improve medication adherence in coronary heart disease patients. The approach, using motivational interviewing and medication review, aims to help patients reach treatment goals.
Area of Science:
- Cardiology
- Pharmacology
- Behavioral Science
Background:
- Many coronary patients do not meet blood pressure and cholesterol goals.
- Effective treatment relies on appropriate medication and patient adherence.
- There's a need for interventions that improve adherence and clinical outcomes.
Purpose of the Study:
- To assess an intervention's effect on treatment goals in secondary coronary heart disease prevention.
- The intervention focuses on improving patient adherence and treatment quality.
- A protocol for process evaluation is published separately.
Main Methods:
- Prospective, randomized, outcomes-blinded trial (MIMeRiC).
- Compares clinical pharmacist-led motivational interviewing (MI) and medication review with standard care.
- Patients stratified by beliefs about medicines; intervention group receives 2-5 individualized sessions over 7 months.
Main Results:
- Enrollment: 417 patients (Oct 2013 - Dec 2016).
- Primary outcome: proportion achieving low-density lipoprotein cholesterol goal at 12 months.
- Secondary outcomes: adherence, blood pressure, quality of life, healthcare use.
Conclusions:
- The MIMeRiC trial assesses an intervention for medication adherence and individualized support.
- Results will guide further development of support for preventive medicine users.
- Intervention design is theoretically based and uses beliefs about medicines for individualization.
Background:
Preventive treatment goals for blood pressure and cholesterol levels continue to be unmet for many coronary patients. The effect of drug treatment depends on both its appropriateness and the patients' adherence to the treatment regimen. There is a need for adherence interventions that have a measurable effect on clinical outcomes.
Objective:
This study aims to evaluate the effects on treatment goals of an intervention designed to improve patient adherence and treatment quality in secondary prevention of coronary heart disease. A protocol for the prespecified process evaluation of the trial is published separately.
Methods:
The Motivational Interviewing and Medication Review in Coronary heart disease (MIMeRiC) trial is a prospective, randomized, outcomes-blinded trial designed to compare individualized follow-up by a clinical pharmacist using motivational interviewing (MI) and medication review with standard follow-up. Patients were randomized to 2 groups after stratification according to their beliefs about medicines. After standard follow-up at the cardiology clinic, patients in the intervention group are seen individually by a clinical pharmacist 2 to 5 times as required over 7 months, at the clinic. The pharmacist reviews each patient's medication and uses MI to manage any problems with prescribing and adherence. The primary study outcome is the proportion of patients who have reached the treatment goal for low-density lipoprotein cholesterol by 12 months after discharge. Secondary outcomes are the effects on patient adherence, systolic blood pressure, disease-specific quality of life, and health care use.
Results:
The protocol for this study was approved by the Regional Ethics Committee, Linköping, in 2013. Enrollment started in October 2013 and ended in December 2016 when 417 patients had been included. Follow-up data collection will conclude in March 2018. Publication of the primary and secondary outcome results from the MIMeRiC trial is anticipated in 2019.
Conclusions:
The MIMeRiC trial will assess the effectiveness of an intervention involving medication reviews and individualized support. The results will inform the continued development of support for this large group of patients who use preventive medicines for lifelong treatment. The design of this adherence intervention is based on a theoretical framework and is the first trial of an intervention that uses beliefs about medicines to individualize the intervention protocol.
Trial Registration:
ClinicalTrials.gov NCT02102503; https://clinicaltrials.gov/ct2/show/NCT02102503 (Archived by WebCite at http://www.webcitation.org/6x7iUDohy).
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