Apokus, National Centre for Development of Pharmacy Practice, Oslo, Norway.
Norwegian Pharmacy Association, Oslo, Norway.
Int J Pharm Pract. 2020 Aug;28(4):337-345. doi: 10.1111/ijpp.12598. Epub 2019 Dec 29.
To examine whether a pharmacist-led intervention improves medication adherence among patients who have filled a first-time prescription for a cardiovascular medicine.
Design: Unblinded randomized controlled trial.
67 Norwegian pharmacies, October 2014-June 2015.
1480 adults with a first-time prescription for a cardiovascular medicine.
Participants in the intervention group received two consultations with a pharmacist 1-2 and 3-5 weeks after filling the prescription. Participants in the control group received care according to usual practice.
The primary outcome was self-reported adherence as measured by the 8-item Morisky Medication Adherence Scale (MMAS-8), at 7 and 18 weeks after filling the prescription. Adherence from baseline to week 52 was estimated using data from the Norwegian Prescription Database (NPD).
Data from MMAS-8 showed that 91.3% of the patients in the intervention group were adherent after 7 weeks versus 86.8% in the control group (4.5% difference, 95% CI 0.8-8.2, P = 0.017). The corresponding proportions were 88.7% versus 83.7% after 18 weeks (5.0% difference, 95% CI 0.8-9.2, P = 0.021). NPD data (n = 1294) showed no significant difference in adherence after 52 weeks (95% CI -2.0 to 7.8, P = 0.24). However, adherence among statin users (n = 182) was 66.5% in the intervention group versus 57.4% among new statin users in the general population (n = 1500) (difference 9.1%, 95% CI 1.5-16.0, P = 0.019).
The main outcome measure indicates that a short, structured pharmacist-led intervention may increase medication adherence for patients starting on chronic cardiovascular medication. However, these findings could not be confirmed by the NPD data analysis.
考察药剂师主导的干预措施是否能提高首次开具心血管药物处方患者的药物依从性。
设计：非盲随机对照试验。
2014 年 10 月至 2015 年 6 月，挪威 67 家药店。
1480 名首次开具心血管药物处方的成年人。
干预组患者在服药后 1-2 周和 3-5 周时各接受一次与药剂师的咨询。对照组患者接受常规护理。
主要结局是通过 Morisky 药物依从性量表（MMAS-8）在服药后 7 周和 18 周时自我报告的依从性。通过挪威处方数据库（NPD）的数据来估计从基线到第 52 周的依从性。
MMAS-8 数据显示，干预组患者在第 7 周时的依从率为 91.3%，而对照组为 86.8%（差异为 4.5%，95%CI 0.8-8.2，P=0.017）。第 18 周时的相应比例分别为 88.7%和 83.7%（差异为 5.0%，95%CI 0.8-9.2，P=0.021）。NPD 数据（n=1294）显示，第 52 周时的依从性无显著差异（95%CI -2.0 至 7.8，P=0.24）。然而，在接受他汀类药物治疗的患者（n=182）中，干预组的依从率为 66.5%，而在普通人群中（n=1500）新开始使用他汀类药物的患者中为 57.4%（差异 9.1%，95%CI 1.5-16.0，P=0.019）。
主要结局测量表明，短期、结构化的药剂师主导的干预措施可能会提高开始服用慢性心血管药物患者的药物依从性。然而，这些发现无法通过 NPD 数据分析得到证实。
