Kooy Marcel J, van Geffen Erica C G, Heerdink Eibert R, van Dijk Liset, Bouvy Marcel L
Department of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, P,O, Box 80082, Utrecht 3508 TB, The Netherlands.
BMC Health Serv Res. 2014 May 15;14:219. doi: 10.1186/1472-6963-14-219.
Adherence to medication is often low. Pharmacists may improve adherence, but a one-size-fits-all approach will not work: different patients have different needs. Goal of the current study is to assess the effectiveness of a patient-tailored, telephone-based intervention by a pharmacist at the start of pharmacotherapy aimed at improving medication adherence, satisfaction with information and counselling and the beliefs about medicines.
METHODS/DESIGN: A cluster randomized controlled intervention trial in 30 Dutch pharmacies, randomly assigned to 1 of 2 intervention groups. Each group consists of an intervention arm and an usual care arm. The intervention arm in the first group is the usual care arm in the second group and vice versa. One intervention arm focuses on patients starting with antidepressants or bisphosphonates and the other on antilipaemic drugs or renin angiotensin system (RAS)-inhibitors. The intervention consists of a telephone call by a pharmacist 2 or 3 weeks after a new prescription. A random sample of pharmacies will send questionnaires 3 months after the first prescription. This contains socio-demographic questions, a measure of beliefs about medicines (BMQ), satisfaction with information received (SIMS, abbreviated) and frequency of pharmacy counselling (Consumer Quality Index, CQI, abbreviated). The primary outcome measure will be medication adherence calculated from dispensing records retrieved 12 months after the intervention. Patients' beliefs on medication, perception of the quality of information received and pharmacy counselling are secondary outcomes.
The TelCIP study will determine the effectiveness of telephone counselling to improve adherence in patients initiating a new treatment. By measuring satisfaction with information and counselling and beliefs about medication the study will also give clues for the reason of a potential increase in adherence. Finally the study will provide information on which patients are most likely to benefit from this intervention.
The trial is registered at http://www.trialregister.nl under the identifier NTR3237.
药物治疗的依从性通常较低。药剂师或许能够提高依从性,但一刀切的方法行不通:不同患者有不同需求。本研究的目的是评估药剂师在药物治疗开始时针对患者量身定制的电话干预措施的有效性,该干预旨在提高药物治疗依从性、对信息及咨询服务的满意度以及对药物的认知。
方法/设计:在30家荷兰药店进行一项整群随机对照干预试验,随机分为2个干预组之一。每组均包括一个干预组和一个常规护理组。第一组的干预组是第二组的常规护理组,反之亦然。一个干预组关注开始使用抗抑郁药或双膦酸盐的患者,另一个干预组关注使用抗血脂药或肾素血管紧张素系统(RAS)抑制剂的患者。干预措施包括在新处方开具2或3周后由药剂师进行电话随访。一个随机抽取的药店样本将在首次处方开具3个月后发送问卷。问卷包含社会人口统计学问题、对药物的认知度测量(BMQ)、对所获信息的满意度(SIMS,缩写)以及药店咨询频率(消费者质量指数,CQI,缩写)。主要结局指标将根据干预12个月后获取的配药记录计算药物治疗依从性。患者对药物的认知、对所获信息质量的感知以及药店咨询服务属于次要结局指标。
TelCIP研究将确定电话咨询对改善开始新治疗患者的依从性的有效性。通过测量对信息及咨询服务的满意度以及对药物的认知,该研究还将为依从性潜在提高的原因提供线索。最后,该研究将提供哪些患者最可能从这种干预中获益的信息。