Advertisement

International Journal of Clinical Pharmacy

, Volume 34, Issue 2, pp 295–311 | Cite as

Interventions promoting adherence to cardiovascular medicines

  • Judith van Dalem
  • Ines Krass
  • Parisa Aslani
Review Article

Abstract

Background Cardiovascular diseases (CVDs) are a large burden on the healthcare system. Medicines are the primary treatment for these diseases; however, adherence to therapy is low. To optimise treatment and health outcomes for patients, it is important that adherence to cardiovascular medicines is maintained at an optimal level. Therefore, identifying effective interventions to improve adherence and persistence to cardiovascular therapy is of great significance. Aim of the Review This paper presents a review of the literature on interventions used in the community setting which aim to improve adherence to cardiovascular medicines in patients with hypertension, dyslipidaemia, congestive heart failure or ischaemic heart disease. Methods Several databases (Medline, EMBASE, PsychINFO, IPA, CINAHL, Pubmed, Cochrane) were searched for studies which were published from 1979–2009, evaluated interventions intended to improve adherence to cardiovascular medicines in the community setting, had at least one measure of adherence, and consisted of an intervention and comparison/control group. Results Among 36 eligible studies (consisting of 7 informational, 15 behavioural, 1 social, and 13 combined strategy interventions), 17 (1 informational, 10 behavioural, and 6 combined) reported a significant improvement in adherence and/or persistence. Behavioural interventions were the most successful. Twenty-one studies (4 informational, 9 behavioural, and 8 combined) also demonstrated improvements in clinical outcomes, though, effects were frequently variable, contradictory and not related to changes in adherence. Conclusion Several types of interventions are effective in improving adherence and/or persistence within the CVD area and in the community setting. Behavioural interventions have shown the greatest success (compared to other types of interventions); and adding informational strategies has not resulted in further improvements in adherence. Improving adherence and persistence to cardiovascular medicines is a dynamic process that is influenced by many factors, and one which requires long term multiple interventions to promote medicine taking in patients

Keywords

Adherence Cardiovascular diseases Community healthcare setting Interventions Primary care setting 

Notes

Funding

None.

Conflicts of Interest

None.

References

  1. 1.
    World Health Organization. Cardiovascular Diseases (CVDs) Fact Sheet No 317, September 2011. Available from: http://www.who.int/mediacentre/factsheets/fs317/en/index.html. Accessed 26 Sept 2011.
  2. 2.
    World Health Organization. Adherence to long-term therapies: evidence for action. Generva: World Health Organization; 2003.Google Scholar
  3. 3.
    Ho PM, Bryson CL, Rumsfeld JS. Medication adherence: its importance in cardiovascular outcomes. Circulation. 2009;119(23):3028–35.PubMedCrossRefGoogle Scholar
  4. 4.
    Coronary Drug Project Research Group. Influence of adherence to treatment and response of cholesterol on mortality in the Coronary Drug Project. N Engl J Med. 1980;303:1038–41.CrossRefGoogle Scholar
  5. 5.
    Horwitz RI, Viscoli CM, Berkman L, Donaldson RM, Horwitz SM, Murray CJ, Ransohoff DF, Sindelar J. Treatment adherence and risk of death after a myocardial infarction. Lancet. 1990;336:542–5.PubMedCrossRefGoogle Scholar
  6. 6.
    Sabate E, Adherence to long-term therapies. 2003, Geneva: World Health Organization 110.Google Scholar
  7. 7.
    Simpson SH, Eurich DT, Majumdar SR, Padwal RS, Tsuyuki RT, Varney J, Johnson JA. A meta-analysis of the association between adherence to drug therapy and mortality. BMJ. 2006;333(7557):15.PubMedCrossRefGoogle Scholar
  8. 8.
    Beta Blocker Heart Attack Trial Research Group. A randomized trial of propranolol in patients with acute myocardial infarction: mortality results. JAMA. 1982;247:1707–14.CrossRefGoogle Scholar
  9. 9.
    Glynn LG, Murphy AW, Smith SM, Schroeder K, Fahey T. Interventions used to improve control of blood pressure in patients with hypertension. Cochrane Database Syst Rev, 2010; (3) Art No. CD005182; ISSN 1464-780X. doi: 10.1002/14651858.CD005182.pub4.
  10. 10.
    Schedlbauer A, Davies P, Fahey T. Interventions to improve adherence to lipid lowering medication. Cochrane Database Syst Rev, 2010; (3) Art No CD004371; ISSN 1464-780X. doi: 10.1002/14651858.CD004371.pub3.
  11. 11.
    Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence. Cochrane Database Syst Rev, 2008; (2) Art No CD000011; ISSN 1464-780X. doi:  10.1002/14651858.CD000011.pub 3.
  12. 12.
    Kripalani S, Yao X, Haynes RB. Interventions to enhance medication adherence in chronic medical conditions: a systematic review. Arch Intern Med. 2007;167(6):540–50.PubMedCrossRefGoogle Scholar
  13. 13.
    Schroeder K, Fahey T, Hollinghurst S, Peters TJ. Nurse-led adherence support in hypertension: a randomized controlled trial. Fam Pract. 2005;22(2):144–51.PubMedCrossRefGoogle Scholar
  14. 14.
    Holland R, Brooksby I, Lenaghan E, Ashton K, Hay L, Smith R, Shepstone L, Lipp A, Daly C, Howe A, Hall R, Harvey I. Effectiveness of visits from community pharmacists for patients with heart failure: HeartMed randomised controlled trial. BMJ. 2007;334(7603):1098.PubMedCrossRefGoogle Scholar
  15. 15.
    Murray MD, Young J, Hoke S, Tu W, Weiner M, Morrow D, Stroupe KT, Wu J, Clark D, Smith F, Gradus-Pizlo I, Weinberger M, Brater DC. Pharmacist intervention to improve medication adherence in heart failure: a randomized trial. Ann Intern Med. 2007;146(10):714–25.PubMedGoogle Scholar
  16. 16.
    Udelson JE, Pressler SJ, Sackner-Bernstein J, Massaro J, Ordronneau P, Lukas MA, Hauptman PJ. Adherence with once daily versus twice daily carvedilol in patients with heart failure: the compliance and quality of life study comparing once-daily controlled-release carvedilol CR and twice-daily immediate-release carvedilol IR in patients with heart failure (CASPER) trial. J Card Fail, 2009; 15(5): 385–93.Google Scholar
  17. 17.
    Bouvy ML, Heerdink ER, Urquhart J, Grobbee DE, Hoes AW, Leufkens HG. Effect of a pharmacist-led intervention on diuretic compliance in heart failure patients: a randomized controlled study. J Card Fail. 2003;9(5):404–11.PubMedCrossRefGoogle Scholar
  18. 18.
    GESICA investigators. Randomised trial of telephone intervention in chronic heart failure: DIAL trial. BMJ, 2005; 331(7514): 425.Google Scholar
  19. 19.
    Wakefield BJ, Holman JE, Ray A, Scherubel M, Burns TL, Kienzle MG, Rosenthal GE. Outcomes of a home telehealth intervention for patients with heart failure. J Telemed Telecare. 2009;15(1):46–50.PubMedCrossRefGoogle Scholar
  20. 20.
    Pearce KA, Love MM, Shelton BJ, Schoenberg NE, Williamson MA, Barron MA, Houlihan JM. Cardiovascular risk education and social support (CaRESS): report of a randomized controlled trial from the Kentucky Ambulatory Network (KAN). J Am Board Fam Med. 2008;21(4):269–81.PubMedCrossRefGoogle Scholar
  21. 21.
    Schectman G, Hiatt J, Hartz A. Telephone contacts do not improve adherence to niacin or bile acid sequestrant therapy. Ann Pharmacother. 1994;28(1):29–35.PubMedGoogle Scholar
  22. 22.
    Faulkner MA, Wadibia EC, Lucas BD, Hilleman DE. Impact of pharmacy counselling on compliance and effectiveness of combination lipid-lowering therapy in patients undergoing coronary artery revascularization: a randomized, controlled trial. Pharmacotherapy. 2000;20(4):410–6.PubMedCrossRefGoogle Scholar
  23. 23.
    Coull AJ, Taylor VH, Elton R, Murdoch PS, Hargreaves AD. A randomised controlled trial of senior Lay Health Mentoring in older people with ischaemic heart disease: the Braveheart Project. Age Ageing. 2004;33(4):348–54.PubMedCrossRefGoogle Scholar
  24. 24.
    Saito I, Saruta T. Effect of education through a periodic newsletter on persistence with antihypertensive therapy. Hypertens Res. 2003;26(2):159–62.PubMedCrossRefGoogle Scholar
  25. 25.
    Planas LG, Crosby KM, Mitchell KD, Farmer KC. Evaluation of a hypertension medication therapy management program in patients with diabetes. J Am Pharm Assoc. 2009;49(2):164–70.CrossRefGoogle Scholar
  26. 26.
    De Castro SM, Fuchs FD, Santos MC, Maximiliano P, Gus M, Moreira LB, Ferreira MBC. Pharmaceutical care program for patients with uncontrolled hypertension. AJH. 2006;19(5):528–33.PubMedGoogle Scholar
  27. 27.
    Schneider PJ, Murphy JE, Pedersen CA. Impact of medication packaging on adherence and treatment outcomes in older ambulatory patients. J Am Pharm Assoc (2003). 2008;48(1):58–63.CrossRefGoogle Scholar
  28. 28.
    Hunt JS, Siemienczuk J, Touchette D, Payne N. Impact of educational mailing on the blood pressure of primary care patients with mild hypertension. J Gen Intern Med. 2004;19(9):925–30.PubMedCrossRefGoogle Scholar
  29. 29.
    Hunt JS, Siemienczuk J, Pape G, Rozenfeld Y, MacKay J, LeBlanc BH, Touchette D. A randomized controlled trial of team-based care: impact of physician-pharmacist collaboration on uncontrolled hypertension. J Gen Intern Med. 2008;23(12):1966–72.PubMedCrossRefGoogle Scholar
  30. 30.
    Friedman RH, Kazis LE, Jette A, Smith MB, Stollerman J, Torgerson J, Carey K. A telecommunications system for monitoring and counseling patients with hypertension. Impact on medication adherence and blood pressure control. Am J Hypertens. 1996;9(4 Pt 1):285–92.PubMedCrossRefGoogle Scholar
  31. 31.
    Ogedegbe G, Chaplin W, Schoenthaler A, Statman D, Berger D, Richardson T, Phillips E, Spencer J, Allegrante JP. A practice-based trial of motivational interviewing and adherence in hypertensive African Americans. Am J Hypertens. 2008;21(10):1137–43.PubMedCrossRefGoogle Scholar
  32. 32.
    Mohammadi E, Abedi HA, Jalali F, Gofranipour F, Kazemnejad A. Evaluation of ‘partnership care model’ in the control of hypertension. Int J Nurs Pract. 2006;12(3):153–9.PubMedCrossRefGoogle Scholar
  33. 33.
    Mehos BM, Saseen JJ, MacLaughlin EJ. Effect of pharmacist intervention and initiation of home blood pressure monitoring in patients with uncontrolled hypertension. Pharmacotherapy. 2000;20(11):1384–9.PubMedCrossRefGoogle Scholar
  34. 34.
    Stromberg A, Dahlstrom U, Fridlund B. Computer-based education for patients with chronic heart failure. A randomised, controlled, multicentre trial of the effects on knowledge, compliance and quality of life. Patient Educ Couns. 2006;64(1–3):128–35.PubMedCrossRefGoogle Scholar
  35. 35.
    Guthrie RM. The effects of postal and telephone reminders on compliance with pravastatin therapy in a national registry: results of the first myocardial infarction risk reduction program. Clin Ther. 2001;23(6):970–80.PubMedCrossRefGoogle Scholar
  36. 36.
    Powell KM, Edgren B. Failure of educational videotapes to improve medication compliance in a health maintenance organization. Am J Health Syst Pharm. 1995;52(20):2196–9.PubMedGoogle Scholar
  37. 37.
    Marquez Contreras E, Vegazo Garcia O, Claros NM, Gil Guillen V, de la Figuera von Wichmann M, Casado Martinez JJ, Fernandez R. Efficacy of telephone and mail intervention in patient compliance with antihypertensive drugs in hypertension. ETECUM-HTA study. Blood Press, 2005; 14(3): 151–8.Google Scholar
  38. 38.
    Marquez-Contreras E, Martell-Claros N, Gil-Guillen V, de la Figuera-Von Wichmann M, Casado-Martinez JJ, Martin-de Pablos JL, Figueras M, Galera J, Serra A. Efficacy of a home blood pressure monitoring programme on therapeutic compliance in hypertension: the EAPACUM-HTA study. J Hypertens, 2006; 24(1): 169–75.Google Scholar
  39. 39.
    Thomas PD, Miceli R. Evaluation of the “Know Your Health” program for type 2 diabetes mellitus and hypertension in a large employer group. Am J Manag Care, 2006; 12:SP33–9.Google Scholar
  40. 40.
    Johnson SS, Driskell MM, Johnson JL, Prochaska JM, Zwick W, Prochaska JO. Efficacy of a transtheoretical model-based expert system for antihypertensive adherence. Dis Manag. 2006;9(5):291–301.PubMedCrossRefGoogle Scholar
  41. 41.
    Barrios V, Escobar C, Navarro A, Calderón A, Ruilope LM. Antihypertensive effectiveness of lercanidipine administered using an electronic pillbox compared with usual care in a cohort of mild-to-moderately hypertensive patients: the ELECTRA study. Therapy. 2007;4(4):433–40.CrossRefGoogle Scholar
  42. 42.
    Dusing R, Handrock R, Klebs S, Tousset E, Vrijens B. Impact of supportive measures on drug adherence in patients with essential hypertension treated with valsartan: the randomized, open-label, parallel group study VALIDATE. J Hypertens. 2009;27(4):894–901.PubMedCrossRefGoogle Scholar
  43. 43.
    Schmidt S, Sheikzadeh S, Beil B, Patten M, Stettin J. Acceptance of telemonitoring to enhance medication compliance in patients with chronic heart failure. Telemed J E Health. 2008;14(5):426–33.PubMedCrossRefGoogle Scholar
  44. 44.
    Patel BV, Leslie RS, Thiebaud P, Nichol MB, Tang SS, Solomon H, Honda D, Foody JM. Adherence with single-pill amlodipine/atorvastatin vs. a two-pill regimen. Vasc Health Risk Manag. 2008;4(3):673–81.PubMedGoogle Scholar
  45. 45.
    Brown BG, Bardsley J, Poulin D, Hillger LA, Dowdy A, Maher VM, Zhao XQ, Albers JJ, Knopp RH. Moderate dose, three-drug therapy with niacin, lovastatin, and colestipol to reduce low-density lipoprotein cholesterol <100 mg/dl in patients with hyperlipidemia and coronary artery disease. Am J Cardiol. 1997;80(2):111–5.PubMedCrossRefGoogle Scholar
  46. 46.
    Chabot I, Moisan J, Gregoire JP, Milot A. Pharmacist intervention program for control of hypertension. Ann Pharmacother. 2003;37(9):1186–93.PubMedCrossRefGoogle Scholar
  47. 47.
    Sclar DA, Chin A, Skaer TL, Okamoto MP, Nakahiro RK, Gill MA. Effect of health education in promoting prescription refill compliance among patients with hypertension. Clin Ther. 1991;13(4):489–95.PubMedGoogle Scholar
  48. 48.
    Lee JK, Grace KA, Taylor AJ. Effect of a pharmacy care program on medication adherence and persistence, blood pressure, and low-density lipoprotein cholesterol. JAMA. 2006;296(21):2563–71.PubMedCrossRefGoogle Scholar
  49. 49.
    Hansen RA, Kim MM, Song L, Tu W, Wu J, Murray MD. Comparison of methods to assess medication adherence and classify nonadherence. Ann Pharmacother. 2009;43(3):413–22.PubMedCrossRefGoogle Scholar
  50. 50.
    Cook CL, Wade WE, Martin BC, Perri M 3rd. Concordance among three self-reported measures of medication adherence and pharmacy refill records. J Am Pharm Assoc. 2005;45(2):151–9.CrossRefGoogle Scholar
  51. 51.
    Garber MC, Nau DP, Erickson SR, Aikens JE, Lawrence JB. The concordance of self-report with other measures of medication adherence: a summary of the literature. Med Care. 2004;42(7):649–52.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Judith van Dalem
    • 1
  • Ines Krass
    • 2
  • Parisa Aslani
    • 2
  1. 1.Department of Pharmaceutical Sciences, Utrecht Institute for Pharmaceutical Sciences, Faculty of ScienceUtrecht UniversityUtrechtThe Netherlands
  2. 2.Faculty of PharmacyThe University of SydneySydneyAustralia

Personalised recommendations