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Personalized Pharmacist-Led Care Ups Med Adherence in ACS

Findings in year after discharge for patients hospitalized with acute coronary syndrome

THURSDAY, Nov. 21, 2013 (HealthDay News) -- For patients admitted with acute coronary syndrome, a personalized attention and coordinated care intervention involving a pharmacist is associated with improved medication adherence after discharge, according to a study published Nov. 18 in JAMA Internal Medicine.

P. Michael Ho, M.D., Ph.D., from the VA Eastern Colorado Health Care System in Denver, and colleagues randomized patients with acute coronary syndrome from four Department of Veterans Affairs medical centers to a multifaceted intervention (INT; 122 patients) or usual care (UC; 119 patients) prior to discharge. The INT, which lasted for one year after discharge, included pharmacist-led medication reconciliation and tailoring; patient education; collaborative care; and educational and medication refill reminder calls.

The researchers found that significantly more patients were adherent in the INT versus the UC group (89.3 versus 73.9 percent, respectively; P = 0.003). The INT group had a higher mean proportion of days covered (0.94 versus 0.87; P < 0.001). Adherence was significantly greater among INT patients for clopidogrel (86.8 versus 70.7 percent; P = 0.03), statins (93.2 versus 71.3 percent; P < 0.001), and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (93.1 versus 81.7 percent; P = 0.03), but not for β-blockers (88.1 versus 84.8 percent; P = 0.59).

"Understanding the impact of such improvement in adherence on clinical outcomes is needed prior to broader dissemination of the program," the authors write.

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