Objective
To assess the effects of pharmacists giving advice to meet patients’ needs after starting a new medicine for a chronic condition.
Method
A prospective health technology assessment including a randomised controlled trial of a pharmacist-delivered intervention
to improve adherence using a centralised telephone service to patients at home in England. Patients were eligible for recruitment
if they were receiving the first prescription for a newly prescribed medication for a chronic condition and were 75 or older
or suffering from stroke, cardiovascular disease, asthma, diabetes or rheumatoid arthritis.
Main outcome measures
Incidence of non-adherence, problems with the new medicine, beliefs about the new medicine, safety and usefulness of the interventions.
Results
Five hundred patients consented and were randomised. At 4-week follow-up, non-adherence was significantly lower in the intervention
group compared to control (9% vs. 16%, P = 0.032). The number of patients reporting medicine-related problems was significantly lower in the intervention group compared
to the control (23% vs. 34%, P = 0.021). Intervention group patients also had more positive beliefs about their new medicine, as shown by their higher score
on the “necessity-concerns differential” (5.0 vs. 3.5, P = 0.007). The phone calls took a median of 12 min each. Most advice was judged by experts to be safe and helpful, and patients
found it useful.
Conclusion
Overall, these findings show benefits from pharmacists meeting patients’ needs for information and advice on medicines, soon
after starting treatment. While a substantially larger trial would be needed to confirm that the effect is real and sustained,
these initial findings suggest the service may be safe and useful to patients.
Keywords Chronic disease - England - Patient adherence - Patient needs - Pharmacist - Randomized controlled trial - Telephone service