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Heart Disease and Stroke Prevention: Tailored Pharmacy-based Interventions to Improve Medication Adherence

CDC

An Evidence-Based Practice

Description

Tailored pharmacy-based interventions aim to help patients who are at risk for cardiovascular disease take their medications as prescribed. Interventions include the following:

Assessment interviews or assessment tools are used to identify adherence barriers (things that get in the way of patients taking their medications as prescribed)

Tailored guidance and services pharmacists use results of the assessment to develop and deliver tailored guidance and services that aim to reduce patients’ barriers
-Guidance includes focused medication counseling or motivational interview sessions
-Services include one or more of the following: patient tools such as pillboxes, medication cards and calendars, medication refill synchronization, enhanced follow-up

Interventions may be set in community or health system pharmacies. They may include additional components such as communication between the pharmacist and the patient’s primary care provider, or patient education materials. Interventions may be used alone, or they may be part of a broader intervention to reduce patients’ cardiovascular disease risk.

Impact

The Community Preventive Services Task Force (CPSTF) recommends tailored pharmacy-based adherence interventions for cardiovascular disease prevention. Evidence shows interventions delivered by pharmacists in community and health system pharmacies increased the proportion of patients who reported taking medications as prescribed. The CPSTF also finds these interventions are cost-effective for cardiovascular disease prevention.

Results / Accomplishments

Medication Adherence
The systematic review team converted outcomes from 27 studies into adherent or non-adherent, based on whether patients possessed, took, or refilled their cardiovascular disease prevention medications at least 80% of the time.
-The proportion of patients considered adherent increased by a median of 6.9 percentage points (an increase of 9.9%)

The remaining 21 studies used various tools to measure adherence (e.g., objective provider counts or records, self-report) and reported generally favorable results.

Cardiovascular Disease Risk Conditions
A subset of 17 studies evaluated intervention effects on blood pressure control and lipid control

-There was a median increase of 13.9 percentage points in the proportion of patients who achieved blood pressure control (13 studies)
-Results were mixed for LDL (3 studies) and cholesterol (1 study).

About this Promising Practice

Primary Contact
The Community Guide
1600 Clifton Rd, NE
MS H21-8
Atlanta, GA 30329
(404) 498-1827
communityguide@cdc.gov
https://www.thecommunityguide.org/
Topics
Health / Heart Disease & Stroke
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