Multifaceted medication adherence intervention for patients with hypertension in secondary care

Ulla Hedegaard, Jesper Hallas, Lene Ravn-Vestergaard Nielsen, Lene Juel Kjeldsen

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    Background and Objectives
    Medication adherence is often suboptimal among patients with hypertension. Non-adherence is a multi-dimensional problem and a successful adherence intervention requires multiple components to address the underlying reason for non-adherence. The objective of the present study was to describe the content and process outcomes of an adherence program developed for hypertensive patients in a hospital setting.
    The intervention development was based on adherence and behavioral theories, and evidence of effective interventions. The intervention was pharmacist-led and included three components: a focused medication review, a patient interview and follow-up telephone calls. Two tools were used to identify and address non-adherence: The DRAW©-tool and an adherence questionnaire. A study carried out at, three out clinics at Odense University Hospital, Denmark was used to evaluate process outcomes.
    In total, 240 patients with hypertension were invited to participate in the study. Among these, 156 patients (65%) accepted participation and received the intervention.
    The focused medication review revealed 91 drug-related problems categorized into eight types. According to the questionnaire, 44.2% of the patients had at least one item indicated an adherence problem. The DRAW©-tool used at the interview, identified 416 problems, 60% medication-related and 40% life style-related. In total 528 actions were taken divided into 8 categories. Motivational interviewing was the most frequent action (60%) and was exercised in 94% of the patients.
    All participants gave informed consent and the study was approved by The Regional Scientific Ethical Committee for Southern Denmark and the Danish Registry Board
    A pharmacist-led multifaceted tailored adherence intervention has been developed to be used in patients with hypertension. The intervention was feasible for identifying and addressing a large range of potential medication- adherence and life style problems. Motivational interviewing was the most frequent action taken and used in nearly all patients.
    Implications to practice
    This study could serve as a guide for development of similar interventions.
    Original languageDanish
    Publication date2015
    Publication statusPublished - 2015
    EventNordic Social Pharmacy and Health Services Researh Conference & The Nordic Networking Group of Clinical Pharmacy - Tartu, Estonia
    Duration: 3. Jun 20155. Jun 2015


    ConferenceNordic Social Pharmacy and Health Services Researh Conference & The Nordic Networking Group of Clinical Pharmacy

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