A community pharmacist delivered adherence support service for dyslipidaemia

Abstract

Background: Dyslipidaemia is a major risk factor for coronary heart disease. A key issue in management is adherence to therapy. Pharmacists are ideally situated to provide a service to increase medication adherence and optimize health outcomes. This study aimed to evaluate the impact of a community pharmacist-delivered adherence support service on patients' adherence and total cholesterol levels. Methods: A repeated measures [baseline (t=1), post-intervention at 3-monthly intervals (t=2,3,4)], randomized-controlled study in community pharmacies, with patients on chronic lipid-lowering therapy was conducted. Measures used were Brief Medication Questionnaire, Medication Adherence Report Scale, total cholesterol and pharmacist intervention data sheets. A baseline t-test of cholesterol levels between groups was conducted followed by a repeated-measures analysis of variance. Results: Seventeen pharmacists recruited 142 patients (97 completions: 49 control, 48 intervention). Most patients missed either the third or last visit, thus data at t=3 and 4 were combined. Although the intervention group started with a higher cholesterol level (5.1 vs. 4.8mmol/l), a difference was observed in the drop in cholesterol levels of the intervention group between t=2 and 3 (F 1,95=8.85, P<0.01), and between the two groups over the study period (F2,190=4.89, P<0.05). No changes in medicine adherence scores were observed though there was an improvement in participants' exercise and eating habits. Conclusions: Patients significantly lowered their cholesterol levels probably as a result of the service delivered by their pharmacists within the short study time frame of 9 months. © The Author 2010. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.