Effects of Pharmacy Care Program on medication adherence in outpatients with stable coronary artery disease: a randomized controlled study

Abstract

Aim. To assess the effects of the Pharmacy Care Program on medication adherence in outpatients with stable coronary artery disease (SCAD).Material and methods. An open randomized controlled study was conducted in primary care clinic over the period of 2019-2020. All subjects (n=126) were randomized at visit 1 into the multifaceted intervention group (n=63) or control group (n=63) and invited 12 months after to visit 2. Patients of intervention group were included into the Pharmacy Care Program, which consisted of the following components: pharmacist-led counseling, provision of education materials and 7-day pillbox, weekly SMS-reminders. Medication adherence was measured initially and at the end of the study period by means of eight-item Morisky Medication Adherence Scale (MMAS-8) and Self-Efficacy for Appropriate Medication Use Scale (SEAMS).Results. The implementation of the Pharmacy Care Program improved medication adherence in SCAD outpatients with MMAS-8 median score of 7,0-8,0 (p<0,001) and SEAMS median score of 35,0-36,0 (p=0,017). In the control group, no changes (p=0,123) in MMAS-8 score were revealed, while SEAMS score decreased from 35,0 down to 34,5 (p=0,003). The reduction in systolic blood pressure (p=0,049) and risk of urgent hospital admission (OR=0,28; 95% CI, 0,08-0,99; p=0,041) was registered in the intervention group in contrast to the control group over the 12-month period.Conclusion. The multicomponent intervention within the Pharmacy Care Program contributed to an increase in the adherence to pharmacotherapy of outpatients with stable CAD.