Medication Adherence
Conditions
Keywords
coronary heart disease, lipid lowering medication, NCEP guidelines
Brief summary
The overall goal of this study was to implement and evaluate the effects of a systems-based and pharmacist-mediated program designed to improve adherence for patients with known coronary heart disease (CHD) to lipid-lowering pharmacologic therapy and of their physicians/nurse practitioners to the National Cholesterol Education Program Guidelines.
Detailed description
Patients were randomly assigned to a usual care condition which consisted of patients provided with usual care only, or to the Special Intervention (SI) condition. The intervention was implemented and coordinated by pharmacists, who utilized for tracking and communication the Lotus Notes®-based system that was developed for the project.
Interventions
BEHAVIORALsystems-based and pharmacist-mediated program
Patients in the SI were seen by a study pharmacists prior to discharge to establish a relationship with the patient, explain the pharmacist's role in the study, provide education about all discharge medications and a medication card listing all medications and their manner of use, and set the framework for the follow-up telephone calls. Patients received pharmacist-delivered adherence counseling telephone contacts that took place at two weeks following discharge, and at months 1, 3, 6, and 9 oriented towards assisting patients to remain adherent to prescribed lipid-lowering and other medications, and also towards ensuring that all patients were either documented to be at the LDL-C goal, or were assisted to reach the goal by facilitating the scheduling of repeat lipid measurement as needed and providing information, guidelines and prompts to the patient's physician or nurse practitioner.
Sponsors
National Institutes of Health (NIH)
University of Massachusetts, Worcester
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
30 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* was between 30 and 85 years of age; * had known CHD, defined as the presence of at least one coronary lesion at coronary angiography of \>50%.
Exclusion criteria
* was unable or unwilling to give informed consent; * had a history of intolerance to two or more statin drugs; * planned to move out of the area within one year of recruitment; * had a poor prognosis such that life expectancy was thought to be \<5 years; * had a psychiatric illness which limited ability to participate; or * had no telephone.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome evaluated is the percentage of patients with a serum low-density lipoprotein cholesterol (LDL-C) level <70 mg/dl. | One year |
Secondary
| Measure | Time frame |
|---|---|
| Proportion of prescribed lipid-lowering medication taken by patients as measured by a continuous multiple-interval (CMA) measure of medication availability based on pharmacy records. | One year |
Countries
United States
Outcome results
None listed