West Pharmacy, Emmeloord, Netherlands.
Ann Pharmacother. 2013 Nov;47(11):1448-56. doi: 10.1177/1060028013501146. Epub 2013 Nov 18.
Lipid-lowering drugs are effective preventive medication for patients at risk of cardiovascular complications. However, medication adherence is suboptimal, thereby decreasing therapy effectiveness. Pharmaceutical care interventions may increase therapy adherence.
To assess the effect of a proactive pharmaceutical care intervention program, Medication Monitoring and Optimization (MeMO), on therapy discontinuation and adherence with lipid-lowering drugs as well as patients' satisfaction with the intervention program.
This prospective intervention study included 1002 patients initiating lipid-lowering drug therapy from 9 Dutch community pharmacies. In the intervention group (n = 500), the MeMO program was used, comprising continuous monitoring of patients' adherence to lipid-lowering drugs and personal counseling with nonadherent patients. The intervention group was compared with a historical reference group (n = 502) receiving usual care. Outcomes were therapy discontinuation and adherence.
Discontinuation rates with lipid lowering drugs in the first year after drug initiation were 13.6% for the intervention group and 25.9% in the usual care group; continued but non-adherent use was 3.2% and 7.6% in these groups. Patients in the MeMO program had a decreased risk to discontinue medication of 51% (95% confidence interval: 34%-63%). Results were not affected by potential confounders. Patient satisfaction with MeMO was very high; one quarter of patients mentioned that they only received information about their medication from their pharmacy.
Improving adherence to lipid lowering drugs can be achieved by a proactive pharmaceutical care program. Pharmacists can contribute to optimal use of chronic medication, which is likely to reduce healthcare costs.
降脂药物是心血管并发症高危患者的有效预防药物。然而，药物的依从性并不理想，从而降低了治疗效果。药学服务干预措施可能会提高治疗的依从性。
评估主动药物治疗管理项目（即药物监测和优化项目，简称 MeMO）对降脂药物治疗停药和依从性的影响，以及患者对干预方案的满意度。
这项前瞻性干预研究纳入了 9 家荷兰社区药店中开始降脂药物治疗的 1002 名患者。在干预组（n=500）中，使用了 MeMO 方案，包括连续监测患者降脂药物的依从性和对不依从的患者进行个人咨询。干预组与接受常规护理的历史参考组（n=502）进行比较。主要结局为治疗停药和依从性。
在药物起始后的第一年，干预组和常规护理组的降脂药物停药率分别为 13.6%和 25.9%；继续但不依从使用的比例分别为 3.2%和 7.6%。接受 MeMO 方案的患者停药风险降低了 51%（95%置信区间：34%-63%）。结果不受潜在混杂因素的影响。患者对 MeMO 的满意度非常高；四分之一的患者表示他们仅从药店获得关于其药物的信息。
通过主动的药物治疗管理项目，可以提高降脂药物的依从性。药剂师可以为优化慢性药物的使用做出贡献，这可能会降低医疗保健成本。
