Pharmacists Praised for Promoting ACS Medication Adherence

Rehospitalization and mortality associated with acute coronary syndrome (ACS) often boils down to poor cardioprotective medication adherence. For this reason, researchers are considering different ways to improve adherence among ACS patients.

One study conducted by a multidisciplinary team at the US Department of Veterans Affairs (VA) went directly to the source: patients discharged on medications after an acute ACS. As these patients were offering their thoughts on factors that improve medication adherence, they praised pharmacists as exceptional motivators.

All enrolled patients had completed an earlier study called the Multi-Faceted Intervention to Improve Cardiac Medication Adherence and Secondary Prevention Measures — The Medication Study. This previous research involved 253 patients and compared medication adherence at 1 year between usual care and a multimodal intervention that involved pharmacists and other clinicians on medication reconciliation and patient support.

The 64 patients enrolled in the extension study had above-average compliance with their cardiovascular medications and met with clinical interviewers for in-depth discussions about their adherence.

Patients reported that mutually respectful and collaborative provider—patient treatment planning was critical for improved adherence. Feeling “cared for” motivated these patients to actively participate in their health care.

Patients appreciated frequent provider interactions. They also cited medication refill reminder calls as a factor in their improved adherence.

These adherent patients indicated that having social support, adherence routines, and positive attitudes toward an ACS event also helped them remain compliant with their medications.

Two-thirds of patients reported positive expe­riences with clinical staff, especially with study pharmacists who were perceived to be supportive and concerned. One patient specifically indicated that when the pharmacist contacted him regularly, it heightened his awareness of the importance of medication adherence.

The researchers suggested that training health care providers to respect patients’ views about their medications could be the next step toward improving adherence. Directly asking patients what they need to improve adherence could help pharmacists understand nonadherence better.

This extension study was published in the July 2015 issue of Patient Preference and Adherence.