VA Study: Pharmacist Intervention Boosts Patient Compliance
Shapiro, Lynn, Drug Topics
While approximately 40% of patients with schizophrenia have been partly or entirely nonadherent with antipsychotic medications, patient adherence improved dramatically when Veterans Affairs (VA) pharmacy staff coordinated these patients' medications, according to results of a VA study reported in Schizophrenia Bulletin.
Lead author Marcia Valenstein, MD, senior research scientist with the Department of Veterans Affairs Serious Mental Illness Treatment, Research, and Evaluation Center, Health Services Research and Development in Ann Arbor, Mich., and associate professor, Department of Psychiatry at the University of Michagan Medical School, enrolled 118 patients with bipolar disorder, schizoaffective disorder, and schizophrenia at four VA hospitals to see whether the pharmacy-based intervention, known as Meds-Help, would help patients remember to take their medications more regularly.
"Although the inclusion criteria for the study required patients to have a mental health diagnosis, many of the veterans in the study also had co -morbid conditions, such as hypertension or diabetes," said Agnes Jensen, a pharmacy technician who assisted Dr. Valenstein throughout the trial. "So we'd pack medications such as atenolol in blister packs, along with patients' psychotropic medicines," Jensen said. "This made things easier for patients, and they really liked it."
To further boost compliance, Jensen conducted medication and packaging education sessions for all patients in the trial. She also mailed patients refill reminders 2 weeks before scheduled refill dates. If patients didn't fill their antipsychotic prescriptions within 7 to 10 days of a fill date, she alerted patients' clinicians.
Patients' medication adherence soared once they were in the hands of pharmacy staff, Dr. Valenstein said. "Those patients receiving the intervention had medications on hand during 91% of their outpatient days during the first six months in the program, compared with 64% of outpatient days among patients who were not receiving the Meds-Help intervention. …