Effectiveness of a medication adherence service in primary care; an 8-month randomized controlled trial

Abstract

Nonadherence to chronic medication leads to poor disease control with reduced quality of life and a costly impact on health care systems. To warrant persistence, effective interventions during treatment initiation are needed. To address this, we developed an online service to assess a patient’s nonadherence risk and a profile of barriers to adherence, and profile-based recommendations to health care professionals for tailored interventions. This study tests the effect of using this service on the adherence of starters with oral blood glucose lowering drugs or cardiovascular medication (N=1200 distributed across 25 pharmacies) in an 8-month randomized controlled trial. Participants’ nonadherence risks and barriers to adherence are assessed and addressed by pharmacists and GPs. Drug persistence measured with pharmacy refill data will be compared between intervention and control (standard care) pharmacies using multilevel analysis. We expect that using this service will lead to higher adherence scores and better management of adherence risks and barriers. The study is currently in the pilot stage. Its findings contribute to the design and implementation of effective adherence interventions in clinical practice.