Methods to Improve Cardiovascular Disease Medication Adherence

Pharmacist intervention can improve medication adherence and clinical outcomes for patients with cardiovascular disease.

Current medication adherence estimates vary from 13% to 60%, and as many as one-third of cardiovascular patients discontinue their regimens without consulting their prescriber. Notably, patients who self-discontinue clopidogrel following the placement of a drug-eluting stent are significantly more likely to experience a major cardiovascular event a year after the procedure.

Various health care professionals employ motivational interviewing to address cardiovascular risk factors, such as tobacco smoking. Until now, however, there was limited evidence related to the use of motivational interviewing by community pharmacists in order to improve medication adherence.

An article published ahead-of-print in the European Journal of Hospital Pharmacy indicates that pharmacist-conducted motivational interviewing positively impacts medication adherence among patients with acute coronary syndrome (ACS).

The prospective, interventional, controlled feasibility/pilot study enrolled 71 patients discharged from the London Heart Attack Centre. The study employed 32 pharmacists trained to conduct telephone and face-to-face 15- to 20-minute motivational interviews during a 6-month follow-up period.

A key component of this study was communication between pharmacists at the discharging hospital and within the community. This record sharing was a new and unusual practice.

Medication adherence was 17% higher at the 3- and 6-month follow-up interviews compared with the adherence rate in the patient group that didn’t receive pharmacist motivational interviewing. Patients with better adherence were also more likely to report that their medications were necessary.

A similar study found that telephone-based motivational interviewing improved antiplatelet adherence by 14%.

At the current study’s end, all involved—especially patients—were supportive of routine record sharing between pharmacists in different settings.

These findings encourage further study of medication adherence in ACS patients receiving pharmacist motivational interviewing.