| Patient-focused intervention to improve long-term adherence to evidence-based medications: A randomized trial. | |
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MedLine Citation:
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PMID: 22520532 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: Nonadherence to cardiovascular medications is a significant public health problem. This randomized study evaluated the effect on medication adherence of linking hospital and community pharmacists. METHODS: Hospitalized patients with coronary artery disease discharged on aspirin, β-blocker, and statin who used a participating pharmacy were randomized to usual care or intervention. The usual care group received discharge counseling and a letter to the community physician; the intervention group received enhanced in-hospital counseling, attention to adherence barriers, communication of discharge medications to community pharmacists and physicians, and ongoing assessment of adherence by community pharmacists. The primary end point was self-reported use of aspirin, β-blocker, and statin at 6 months postdischarge; the secondary end point was a ≥75% proportion of days covered (PDC) for β-blocker and statin through 6 months postdischarge. RESULTS: Of 143 enrolled patients, 108 (76%) completed 6-month follow-up, and 115 (80%) had 6-month refill records. There was no difference between intervention and control groups in self-reported adherence (91% vs 94%, respectively, P = .50). Using the PDC to determine adherence to β-blockers and statins, there was better adherence in the intervention versus control arm, but the difference was not statistically significant (53% vs 38%, respectively, P = .11). Adherence to β-blockers was statistically significantly better in intervention versus control (71% vs 49%, respectively, P = .03). Of 85 patients who self-reported adherence and had refill records, only 42 (49%) were also adherent by PDC. CONCLUSIONS: The trend toward better adherence by refill records with the intervention should encourage further investigation of engaging pharmacists to improve continuity of care. |
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Authors:
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Sara Bristol Calvert; Judith M Kramer; Kevin J Anstrom; Lisa A Kaltenbach; Judith A Stafford; Nancy M Allen Lapointe |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American heart journal Volume: 163 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-04-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 657-665.e1 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2012 Mosby, Inc. All rights reserved. |
Affiliation:
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Duke Clinical Research Institute, Duke University Medical Center, Durham, NC. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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