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Published in: Journal of Translational Medicine 1/2012

Open Access 01-12-2012 | Research

Pharmacist counseling to cardiac patients in Israel prior to discharge from hospital contribute to increasing patient's medication adherence closing gaps and improving outcomes

Authors: Bishara Bisharat, Lubna Hafi, Orna Baron-Epel, Zaher Armaly, Abdalla Bowirrat

Published in: Journal of Translational Medicine | Issue 1/2012

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Abstract

Background

Medication non adherence is a global epidemic perplexing phenomenon that is eminent, but not insurmountable. Our first objective was to explore whether providing pharmacist's counseling to cardiac patients prior to discharge can increase patient's medication adherence, and our second objective was to assess whether better medication adherence leads to reduction of hospital readmissions.

Methods

Observational study was conducted among diagnosed cardiac patients using an intervention strategy at discharge from two hospitals in Israel; The Nazareth and the Haemek hospital. 74 patients were recruited between January 2010 and January 2011. Two separate groups were selected; intervention group: 33 patients who prior to discharge received nurse, pharmacist interventions, and control group: 41 patients who had received the nurse and hospital discharge counseling only.

Results

Regression analysis for examining the first objective reflected significant effect when having a pharmacist interventions, which explains the increasing 11.6% of the variance in medication adherence, [F change (1,73) = 9.43, p < 0.003]. Stepwise regression analysis for examining the second objective demonstrated that the relation between medication adherence and readmissions was insignificant [F (1,73) = 9.43, n.s].

Conclusions

While physicians and nurses can have an impact on improving adherence, pharmacists have demonstrated the ability to inform, problem-solve and provide performance support directly to patients.
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Literature
1.
go back to reference Russell S, Daly J, Hughes E, op't-Hoog C: Nurses and 'difficult' patients: negotiating non-adherence. JAN. 2003, 43: 281-287. 10.1046/j.1365-2648.2003.02711.x.CrossRef Russell S, Daly J, Hughes E, op't-Hoog C: Nurses and 'difficult' patients: negotiating non-adherence. JAN. 2003, 43: 281-287. 10.1046/j.1365-2648.2003.02711.x.CrossRef
2.
go back to reference Amaral P: The special case of compliance in the elderly. Compliance: the dilemma of the chronically ill. Edited by: Gerber K, Nehemkis A. 1986, New York: Springer Amaral P: The special case of compliance in the elderly. Compliance: the dilemma of the chronically ill. Edited by: Gerber K, Nehemkis A. 1986, New York: Springer
5.
go back to reference Cabezas C, Salvador C, Quadrada D, Bartes A, Bore M, Perea N, Peipoch E: Randomized clinical trial of a post-discharge pharmaceutical care program vs. regular follow-up in patients with heart failure. Farm Hosp. 2006, 30: 328-342. 10.1016/S1130-6343(06)74004-1.CrossRef Cabezas C, Salvador C, Quadrada D, Bartes A, Bore M, Perea N, Peipoch E: Randomized clinical trial of a post-discharge pharmaceutical care program vs. regular follow-up in patients with heart failure. Farm Hosp. 2006, 30: 328-342. 10.1016/S1130-6343(06)74004-1.CrossRef
6.
go back to reference Murray MD, Tu W, Wu J, Morrow D, Smith F, Brater DC: Factors associated with exacerbation of heart failure include treatment adherence and health literacy skills. Clin Pharmacol Therapeut. 2009, 85: 651-658. 10.1038/clpt.2009.7.CrossRef Murray MD, Tu W, Wu J, Morrow D, Smith F, Brater DC: Factors associated with exacerbation of heart failure include treatment adherence and health literacy skills. Clin Pharmacol Therapeut. 2009, 85: 651-658. 10.1038/clpt.2009.7.CrossRef
7.
go back to reference Sadik A, Yousif M, McElnay J: Pharmaceutical care of patients with heart failure. Br J Clin Pharmacol. 2005, 60: 183-193. 10.1111/j.1365-2125.2005.02387.x.CrossRefPubMedPubMedCentral Sadik A, Yousif M, McElnay J: Pharmaceutical care of patients with heart failure. Br J Clin Pharmacol. 2005, 60: 183-193. 10.1111/j.1365-2125.2005.02387.x.CrossRefPubMedPubMedCentral
8.
go back to reference Urquhart J: Some economic consequences of nonadherance. Curr Hypertens Rep. 2001, 3: 473-480. 10.1007/s11906-001-0009-7.CrossRefPubMed Urquhart J: Some economic consequences of nonadherance. Curr Hypertens Rep. 2001, 3: 473-480. 10.1007/s11906-001-0009-7.CrossRefPubMed
9.
go back to reference Wu J, Moser D, Chung M, Lennie T: Objectively measured, but not self-reported, medication adherence independently predicts event-free survival in patients with heart failure. J Card Fail. 2008, 14: 203-210. 10.1016/j.cardfail.2007.11.005.CrossRefPubMedPubMedCentral Wu J, Moser D, Chung M, Lennie T: Objectively measured, but not self-reported, medication adherence independently predicts event-free survival in patients with heart failure. J Card Fail. 2008, 14: 203-210. 10.1016/j.cardfail.2007.11.005.CrossRefPubMedPubMedCentral
10.
go back to reference Kerzman H, Baron-Epel O, Toren O: What do discharged patients know about their medication?. Patient Educ Couns. 2004, 2004 (56): 276-282. Kerzman H, Baron-Epel O, Toren O: What do discharged patients know about their medication?. Patient Educ Couns. 2004, 2004 (56): 276-282.
11.
go back to reference Jin J, Sklar GE, Sen-Oh VM, Chuen-Li S: Factors affecting therapeutic adherance: a review from the patient's perspective. The Clin Risk Manag. 2008, 4: 269-286. Jin J, Sklar GE, Sen-Oh VM, Chuen-Li S: Factors affecting therapeutic adherance: a review from the patient's perspective. The Clin Risk Manag. 2008, 4: 269-286.
12.
go back to reference Chesney MA, Ickovics JR, Chambers DB, Gifford AL, Neidig J, Zwickl J, Wu AW: Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG adherence instruments. AIDS Care. 2000, 12: 255-266. 10.1080/09540120050042891.CrossRefPubMed Chesney MA, Ickovics JR, Chambers DB, Gifford AL, Neidig J, Zwickl J, Wu AW: Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG adherence instruments. AIDS Care. 2000, 12: 255-266. 10.1080/09540120050042891.CrossRefPubMed
13.
go back to reference Dilorio C, Yeager K, Shafer PO, Letz R, Henry T, Schomer DL, McCarty F: The epilepsy medication and treatment complexity index: reliability and validity testing. J Neurosci Nurs. 2003, 35: 155-162. 10.1097/01376517-200306000-00005.CrossRef Dilorio C, Yeager K, Shafer PO, Letz R, Henry T, Schomer DL, McCarty F: The epilepsy medication and treatment complexity index: reliability and validity testing. J Neurosci Nurs. 2003, 35: 155-162. 10.1097/01376517-200306000-00005.CrossRef
14.
go back to reference Dilorio C, Faherty B, Manteuffel B: Cognitive-perceptual factors associated with antiepileptic medication compliance. Res Nurs Health. 1991, 14: 329-338. 10.1002/nur.4770140504.CrossRef Dilorio C, Faherty B, Manteuffel B: Cognitive-perceptual factors associated with antiepileptic medication compliance. Res Nurs Health. 1991, 14: 329-338. 10.1002/nur.4770140504.CrossRef
15.
go back to reference Graveley EA, Oseasohn CS: Multiple drug regimens: medication compliance among veterans 65 years and older. Res Nurs Health. 1991, 14: 51-58. 10.1002/nur.4770140108.CrossRefPubMed Graveley EA, Oseasohn CS: Multiple drug regimens: medication compliance among veterans 65 years and older. Res Nurs Health. 1991, 14: 51-58. 10.1002/nur.4770140108.CrossRefPubMed
16.
go back to reference Andrade SE: Discontinuation of antihyperlipidemic drugs. Do rates reported in clinical trials reflect rates in primary care settings?. N Engl J Med. 1995, 332: 1125-1131. 10.1056/NEJM199504273321703.CrossRefPubMed Andrade SE: Discontinuation of antihyperlipidemic drugs. Do rates reported in clinical trials reflect rates in primary care settings?. N Engl J Med. 1995, 332: 1125-1131. 10.1056/NEJM199504273321703.CrossRefPubMed
17.
go back to reference Bloom BS: Continuation of initial antihypertensive medication after 1 year of therapy. Clin Ther. 1998, 20: 671-681. 10.1016/S0149-2918(98)80130-6.CrossRefPubMed Bloom BS: Continuation of initial antihypertensive medication after 1 year of therapy. Clin Ther. 1998, 20: 671-681. 10.1016/S0149-2918(98)80130-6.CrossRefPubMed
18.
go back to reference Sidel J: Shaping the healthcare environment through evidence based medicine: a case study of the ICONS project. Hosp Quart. 1998, 2: 29-33. Sidel J: Shaping the healthcare environment through evidence based medicine: a case study of the ICONS project. Hosp Quart. 1998, 2: 29-33.
19.
go back to reference Sullivan SD, Kreiling DH, Hazlet TK: Nonadherance with medication regimens and subsequent hospitalizations: literature analysis and cost of hospitalization estimate. J Res Pharm Econ. 1990, 2: 19-33. Sullivan SD, Kreiling DH, Hazlet TK: Nonadherance with medication regimens and subsequent hospitalizations: literature analysis and cost of hospitalization estimate. J Res Pharm Econ. 1990, 2: 19-33.
20.
go back to reference Morisky DE, Green LW, Levine DM: Concurrent and predictive validity of a self-reported measure of medication adherence. Medical Care. 1986, 24: 67-74. 10.1097/00005650-198601000-00007.CrossRefPubMed Morisky DE, Green LW, Levine DM: Concurrent and predictive validity of a self-reported measure of medication adherence. Medical Care. 1986, 24: 67-74. 10.1097/00005650-198601000-00007.CrossRefPubMed
21.
go back to reference McLean W: An adherence study of prescription refill data, with and without a periodic patient education program. Car Pharm J. 2007, 140: 104-106. McLean W: An adherence study of prescription refill data, with and without a periodic patient education program. Car Pharm J. 2007, 140: 104-106.
22.
go back to reference Rosenstock IM: Historical origins of the health belief model. Health Educ Monogr. 1974, 2: 328-335.CrossRef Rosenstock IM: Historical origins of the health belief model. Health Educ Monogr. 1974, 2: 328-335.CrossRef
23.
go back to reference Chabot I, Moisan J, Gregoire JP, Milot A: A pharmacist intervention program for control of hypertension. Ann Pharmacother. 2003, 37: 1186-1193. 10.1345/aph.1C267.CrossRefPubMed Chabot I, Moisan J, Gregoire JP, Milot A: A pharmacist intervention program for control of hypertension. Ann Pharmacother. 2003, 37: 1186-1193. 10.1345/aph.1C267.CrossRefPubMed
24.
go back to reference Côte I, Gregoire JP, Moisan JA: A pharmacy-based health promotion program in hypertension: cost-benefit analysis. PharmacoEconomics. 2003, 21: 415-428. 10.2165/00019053-200321060-00005.CrossRefPubMed Côte I, Gregoire JP, Moisan JA: A pharmacy-based health promotion program in hypertension: cost-benefit analysis. PharmacoEconomics. 2003, 21: 415-428. 10.2165/00019053-200321060-00005.CrossRefPubMed
25.
go back to reference Galt KA: Cost avoidance, acceptance and outcomes associated with a pharmacotherapy consult clinic in a veteran's affairs medical center. Pharmacotherapy. 1998, 18: 1103-1111.PubMed Galt KA: Cost avoidance, acceptance and outcomes associated with a pharmacotherapy consult clinic in a veteran's affairs medical center. Pharmacotherapy. 1998, 18: 1103-1111.PubMed
26.
go back to reference Munroe WP, Kunz K, Dalmady-Israel C: Economic evaluation of pharmacist involvement in disease management in a community pharmacy setting. Clin Ther. 1997, 19: 113-123. 10.1016/S0149-2918(97)80078-1.CrossRefPubMed Munroe WP, Kunz K, Dalmady-Israel C: Economic evaluation of pharmacist involvement in disease management in a community pharmacy setting. Clin Ther. 1997, 19: 113-123. 10.1016/S0149-2918(97)80078-1.CrossRefPubMed
27.
go back to reference Poston J: The medication use study: a large-scale controlled evaluation of the effects of the vital interests program on adherence to medication regimens. Can Pharm J. 1999, 123: 31-38. Poston J: The medication use study: a large-scale controlled evaluation of the effects of the vital interests program on adherence to medication regimens. Can Pharm J. 1999, 123: 31-38.
28.
go back to reference George J, Phun YT, Bailey MJ, Kong DC, Stewart K: Development and validation of the medication regimen complexity index. Ann Pharmacother. 2004, 38: 1369-1376. 10.1345/aph.1D479.CrossRefPubMed George J, Phun YT, Bailey MJ, Kong DC, Stewart K: Development and validation of the medication regimen complexity index. Ann Pharmacother. 2004, 38: 1369-1376. 10.1345/aph.1D479.CrossRefPubMed
29.
go back to reference Berk M, Berk L: Mood stabilizers and treatment adherence in bipolar disorder: addressing adverse events. Ann Clin Psychiatry. 2003, 15: 217-224.CrossRefPubMed Berk M, Berk L: Mood stabilizers and treatment adherence in bipolar disorder: addressing adverse events. Ann Clin Psychiatry. 2003, 15: 217-224.CrossRefPubMed
30.
go back to reference Adherance: The Merck Manual of Diagnosis and Therapy, section 19, Chapter 258, Drug Treatment in Newborns, Infants, and Children. Available at www.merck.com Adherance: The Merck Manual of Diagnosis and Therapy, section 19, Chapter 258, Drug Treatment in Newborns, Infants, and Children. Available at www.​merck.​com
32.
go back to reference Morris LS, Schulz RM: Patient adherence--an overview. J Clin Pharm Ther. 1992, 17: 283-295. 10.1111/j.1365-2710.1992.tb01306.x.CrossRefPubMed Morris LS, Schulz RM: Patient adherence--an overview. J Clin Pharm Ther. 1992, 17: 283-295. 10.1111/j.1365-2710.1992.tb01306.x.CrossRefPubMed
33.
go back to reference McDonald HP, Garg AX, Haynes RB: Interventions to enhance patient adherence to medication prescriptions. JAMA. 2002, 288: 2868-2879. 10.1001/jama.288.22.2868.CrossRefPubMed McDonald HP, Garg AX, Haynes RB: Interventions to enhance patient adherence to medication prescriptions. JAMA. 2002, 288: 2868-2879. 10.1001/jama.288.22.2868.CrossRefPubMed
34.
go back to reference World Health Organization: Adherence to Long-Term Therapies: evidence for Action. 2003, Geneva: World Health Organization World Health Organization: Adherence to Long-Term Therapies: evidence for Action. 2003, Geneva: World Health Organization
35.
go back to reference Calabrese A, Cholka K, Lenhart S, McCarty B, Zewe G, Sunseri D, Roberts M, Kapoor W: Pharmacist involvement in a multidisciplinary inpatient medication education program. Am J Health-Syst Pharm. 2003, 60: 1012-1018.PubMed Calabrese A, Cholka K, Lenhart S, McCarty B, Zewe G, Sunseri D, Roberts M, Kapoor W: Pharmacist involvement in a multidisciplinary inpatient medication education program. Am J Health-Syst Pharm. 2003, 60: 1012-1018.PubMed
36.
go back to reference Berg JS, Dischler J, Wagner DJ, Raia JJ, Palmer-Shelvin M: Medication adherance: a healthcare problem. Ann Pharmacother. 1993, 27: 5-19. Berg JS, Dischler J, Wagner DJ, Raia JJ, Palmer-Shelvin M: Medication adherance: a healthcare problem. Ann Pharmacother. 1993, 27: 5-19.
37.
go back to reference Greenburg RN: Overview of patient adherence with medication dosing: a literature review. Clin Ther. 1984, 6: 591-599. Greenburg RN: Overview of patient adherence with medication dosing: a literature review. Clin Ther. 1984, 6: 591-599.
38.
go back to reference Sipkoff M: The newsletter of quality issues in health care. Quality Indicator. 2001 Sipkoff M: The newsletter of quality issues in health care. Quality Indicator. 2001
39.
go back to reference Dunbar-Jacob J, Mortimer-Stephens MK: Treatment adherence in chronic disease. J Clin Epidemiol. 2001, 54: 57-60. 10.1016/S0895-4356(01)00457-7.CrossRef Dunbar-Jacob J, Mortimer-Stephens MK: Treatment adherence in chronic disease. J Clin Epidemiol. 2001, 54: 57-60. 10.1016/S0895-4356(01)00457-7.CrossRef
40.
go back to reference Haynes RB, Montague P, Oliver T, McKibbon KA, Brouwers MC, Kanani R: Interventions for helping patients to follow prescriptions for medications. Cochrane Database Syst Rev. 2000, 2: CD000011-PubMed Haynes RB, Montague P, Oliver T, McKibbon KA, Brouwers MC, Kanani R: Interventions for helping patients to follow prescriptions for medications. Cochrane Database Syst Rev. 2000, 2: CD000011-PubMed
41.
go back to reference Roter DL, Hall JA, Merisca B, Nordstrom D, Cretin B: Effectiveness of interventions to improve patient adherence: a meta-analysis. Med Care. 1998, 36: 1138-1161. 10.1097/00005650-199808000-00004.CrossRefPubMed Roter DL, Hall JA, Merisca B, Nordstrom D, Cretin B: Effectiveness of interventions to improve patient adherence: a meta-analysis. Med Care. 1998, 36: 1138-1161. 10.1097/00005650-199808000-00004.CrossRefPubMed
42.
go back to reference Ellis S, Shumaker S, Sieber W, Rand C: Adherence to pharmacological interventions: current trends and future directions. Control Clin Trials. 2000, 21: 218-225. 10.1016/S0197-2456(00)00082-9.CrossRef Ellis S, Shumaker S, Sieber W, Rand C: Adherence to pharmacological interventions: current trends and future directions. Control Clin Trials. 2000, 21: 218-225. 10.1016/S0197-2456(00)00082-9.CrossRef
43.
go back to reference Jackevicius CA, Mamdani M, Tu JV: Adherence with statin therapy in elderly patients with and without acute coronary syndromes. JAMA. 2002, 288: 462-467. 10.1001/jama.288.4.462.CrossRefPubMed Jackevicius CA, Mamdani M, Tu JV: Adherence with statin therapy in elderly patients with and without acute coronary syndromes. JAMA. 2002, 288: 462-467. 10.1001/jama.288.4.462.CrossRefPubMed
44.
go back to reference Benner JS, Glynn RJ, Neumann PJ, Mogun H, Weinsten MC, Avorn J: Long-term persistence in use of statin therapy in elderly patients. JAMA. 2002, 288: 455-461. 10.1001/jama.288.4.455.CrossRefPubMed Benner JS, Glynn RJ, Neumann PJ, Mogun H, Weinsten MC, Avorn J: Long-term persistence in use of statin therapy in elderly patients. JAMA. 2002, 288: 455-461. 10.1001/jama.288.4.455.CrossRefPubMed
45.
go back to reference Haynes RB: Improving patient adherence. State of the art, with a special focus on medication taking for cardiovascular diseases. Edited by: Burke LE, Ockene IS. 2001, Armonk: Adherance in Healthcare and Research. Futura Publishing Haynes RB: Improving patient adherence. State of the art, with a special focus on medication taking for cardiovascular diseases. Edited by: Burke LE, Ockene IS. 2001, Armonk: Adherance in Healthcare and Research. Futura Publishing
46.
go back to reference Volmink J, Garner P: Systematic review of randomized controlled trials of strategies to promote adherence to tuberculosis treatment. BMJ. 1997, 315: 1403-1406. 10.1136/bmj.315.7120.1403.CrossRefPubMedPubMedCentral Volmink J, Garner P: Systematic review of randomized controlled trials of strategies to promote adherence to tuberculosis treatment. BMJ. 1997, 315: 1403-1406. 10.1136/bmj.315.7120.1403.CrossRefPubMedPubMedCentral
47.
go back to reference Farmer KC: Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practice. Clin Ther. 1999, 21: 1074-1090. 10.1016/S0149-2918(99)80026-5.CrossRefPubMed Farmer KC: Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practice. Clin Ther. 1999, 21: 1074-1090. 10.1016/S0149-2918(99)80026-5.CrossRefPubMed
48.
go back to reference Turner BJ, Hecht FM: Improving on a coin toss to predict patient adherence to medications. Ann Intern Med. 2001, 134: 1004-1006.CrossRefPubMed Turner BJ, Hecht FM: Improving on a coin toss to predict patient adherence to medications. Ann Intern Med. 2001, 134: 1004-1006.CrossRefPubMed
49.
go back to reference Vitolins MZ, Rand CS, Rapp SR, Ribisi PM, Sevick MA: Measuring adherence to behavioral and medical interventions. Control Clin Trials. 2000, 21: 188-194. 10.1016/S0197-2456(00)00077-5.CrossRef Vitolins MZ, Rand CS, Rapp SR, Ribisi PM, Sevick MA: Measuring adherence to behavioral and medical interventions. Control Clin Trials. 2000, 21: 188-194. 10.1016/S0197-2456(00)00077-5.CrossRef
Metadata
Title
Pharmacist counseling to cardiac patients in Israel prior to discharge from hospital contribute to increasing patient's medication adherence closing gaps and improving outcomes
Authors
Bishara Bisharat
Lubna Hafi
Orna Baron-Epel
Zaher Armaly
Abdalla Bowirrat
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Journal of Translational Medicine / Issue 1/2012
Electronic ISSN: 1479-5876
DOI
https://doi.org/10.1186/1479-5876-10-34

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