Mercadante A R, Lee S, Uh K, Chau A, Truong U, Jeong A, Hata M, Law A V
College of Pharmacy, Western University of Health Sciences, 309 E 2nd St, Pomona, CA 91766, USA.
High Point University, Fred Wilson School of Pharmacy, 602 International Ave, High Point, NC 27262, USA.
Explor Res Clin Soc Pharm. 2021 Sep 23;4:100072. doi: 10.1016/j.rcsop.2021.100072. eCollection 2021 Dec.
Interventions to improve medication adherence in chronic conditions have shown limited success or sustainability. Previous data revealed that phone calls to patients regarding adherence goal awareness resulted in significant improvement in proportion of days covered (PDC).
The objective of this study was to explore specific pharmacist adherence interventions via phone in various practice settings.
A prospective, randomized controlled study was conducted with patients who belonged to university-associated health care settings [ambulatory care, chain store, small health plan, and federally qualified health center (FQHC)]. At each site, patients with at least one chronic medication and a calculated PDC < 0.80 were randomized into control (=115) and intervention (=126) groups. Control groups (C) received usual pharmacy communication while intervention groups (X) were specifically called by a pharmacist to be informed of PDC goals and their commitment to adherence. PDC values were calculated 3 to 12 months for both groups the time of intervention, then compared with each patient's respective baseline/pre-PDC.
Data from a total of 241 patients were pooled to examine change in PDC. There was no significant difference between groups in baseline criteria or PDC. Comparing within groups, there were significant correlations between Pre- and Post-PDCs for the intervention group (X = 0.32 < 0.05) alone. There were significant improvements from initial PDC to those calculated at the time of Post-intervention PDC within both groups, (C = 0.18 ± 0.28 p < 0.05) and (X = 0.16 ± 0.24, p < 0.05). Approximately 44% of all sampled patients reached their adherence goals (PDC ≥ 0.80) after 3-9 months.
Results suggested that patient adherence behavior may improve after any call made by pharmacy staff. This communication and attention from the pharmacy may be enough for patients to consider their medication-taking habits without the need for discussing specific goals and importance of adherence.
改善慢性病患者药物依从性的干预措施成效有限或难以持续。既往数据显示，致电患者告知其依从性目标可显著提高药物覆盖天数比例（PDC）。
本研究旨在探索药师在不同实践环境中通过电话进行的特定依从性干预措施。
对来自大学附属医院（门诊护理、连锁药店、小型健康计划机构和联邦合格健康中心）的患者进行了一项前瞻性随机对照研究。在每个地点，至少服用一种慢性疾病药物且计算得出的PDC<0.80的患者被随机分为对照组（n = 115）和干预组（n = 126）。对照组（C）接受常规药房沟通，而干预组（X）由药师专门致电告知其PDC目标及其对依从性的承诺。在干预后3至12个月计算两组的PDC值，然后与每位患者各自的基线/干预前PDC进行比较。
汇总了总共241例患者的数据以检查PDC的变化。两组在基线标准或PDC方面无显著差异。在组内比较时，仅干预组（X）的干预前和干预后PDC之间存在显著相关性（r = 0.32，P<0.05）。两组从初始PDC到干预后PDC计算时均有显著改善，（C组：0.18±0.28，P<0.05）和（X组：0.16±0.24，P<0.05）。在3至9个月后，约44%的所有抽样患者达到了他们的依从性目标（PDC≥0.80）。
结果表明，药房工作人员的任何一次致电后患者的依从行为可能都会改善。药房的这种沟通和关注可能足以让患者考虑其用药习惯，而无需讨论依从性的具体目标和重要性。
