The impact of pharmacist face-to-face counseling to improve medication adherence among patients initiating statin therapy
Michael Taitel1, Jenny Jiang1, Kristi Rudkin2, Susan Ewing2, Ian Duncan
1Clinical Outcomes and Analytics, Walgreens, 2Corporate Innovation Team, Walgreens, Deerfield, Illinois, USA
Purpose: To evaluate the impact of a community-based pharmacist-led face-to-face counseling program on medication adherence for patients who were new to therapy (NTT) for statin medications.
Patients and methods: This retrospective cohort study evaluated a program that was implemented in 76 national community pharmacies located in the midwest USA. It consisted of two face-to-face patient counseling sessions with a pharmacist that addressed patient barriers to adherence. A group of 2056 NTT statin patients was identified between September 1, 2010 and October 31, 2010, and was followed for 12 months. The intervention group consisted of 586 patients, and the comparison group comprised 516 patients. Outcomes were measured using the continuous medication possession ratio (MPR), categorical MPR, and medication persistency.
Results: After adjusting for covariates, the intervention group had statistically greater MPR than the comparison group at every month measured. For example, at 12 months the intervention group had a MPR of 61.8% (CI, 54.5%–69.2%) and the comparison group had a MPR of 56.9% (CI, 49.5%–64.3%); this 4.9% difference is significant (P < 0.01). The 12 month categorical MPR also showed significant differences between groups (χ2 = 6.12, P < 0.05); 40.9% of the intervention group and 33.7% of comparison group had a MPR greater than or equal to 80%. Finally, the intervention group had significantly greater persistency with their medication therapy than the comparison group at 60, 90, 120, and 365 days.
Conclusion: Patients who participated in brief face-to-face counseling sessions with a community pharmacist at the beginning of statin therapy demonstrated greater medication adherence and persistency than a comparison group. This brief targeted intervention at the initiation of maintenance drug therapy moderates the high risk of nonadherence and discontinuation; it helps patients establish a routine of daily self-medication and potentially improves their long-term clinical outcomes.
Keywords: community pharmacy, adherence, counseling, motivational interviewing, statins
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