Research published in BMJ Quality and Safety has shown that tailored telephone advice from a pharmacist can significantly improve medication adherence in patients with long-term conditions.
The findings are important proof of pharmacists’ expertise in advising patients on the proper use of medicines.
The three-year randomised-controlled trial, co-funded by Pharmacy2U, the UK’s largest online pharmacy, and UCL School of Pharmacy, is the first research of its type to measure the impact of telephone based pharmacy interventions by a mail order pharmacy on patients taking medication for chronic conditions.
Researchers recruited 677 patients taking medication for type 2 diabetes and/or high cholesterol. Approximately half (340) of the patients were offered the intervention: two tailored telephone conversations with a pharmacist, 4-6 weeks apart, a written summary of the discussion and a medicines reminder chart. The control group were offered their existing dispensing service from Pharmacy2U: ordering prescribed medication online or by phone and having prescriptions delivered by post.
The researchers found that the intervention group were significantly more likely than the control group to be adherent to their medication. The results are especially significant as the improved adherence was evident 6 months after the pharmacist intervention was completed. Ninety-two per cent of patients said they were satisfied with the service overall.
It is known that there is a link between adherence to medicines and clinical outcomes and although in this study a subsample of patients who provided blood samples, glycemic and cholesterol control did not differ significantly between the two groups, there were positive trends.
The authors conclude: “A telephone intervention, led by a pharmacist and tailored to the individual’s needs, can significantly improve medication adherence in patients with long-term conditions using a mail order pharmacy.”
The study was headed by Professor Nick Barber, formerly Professor of the Practice of Pharmacy at the University of London. He led the research behind the development of pharmacy’s New Medicines Service and has a special interest in the development and evaluation of services to improve adherence.
He said: “These findings are very exciting for the pharmacy profession, for patients and indeed for everyone treating patients with chronic conditions in the NHS. The research has proved our hypothesis that appropriately designed and timely pharmacy interventions can improve chronic patients’ compliance with their medication. Now further research is needed to confirm that it leads to better clinical outcomes.”
It is vital that patients adhere to their medication. Diabetes and hyperlipidaemia are both signification risk factors for heart disease, the leading contributor to the global disease burden in older people. Pharmacists, as experts in the use of medicines, have a vital role alongside doctors in ensuring that these and patients with other chronic conditions stick to their treatment for optimum outcomes.
Dr Julian Harrison, Director of Pharmacy2U, said: “As an innovative pharmacy provider, we are delighted with the findings of this research, which highlight the expert role of pharmacists in advising patients on their medication regime. Before the study, we had anecdotal evidence of the positive impact of our existing services – such as the repeat prescription reminder service – on compliance. We now have proof of the value of additional phone support from a qualified pharmacist through this robust, independent study.
“Pharmacy2U now offers advice on medication adherence to all our customers, and we will extend this further to ensure more of our customers are actively invited to participate in this valuable service.”
The study was co-supervised by Professor Theo Raynor, Professor of Pharmacy Practice at the University of Leeds and Dr. Li Wei, UCL School of Pharmacy. The PhD researcher was Dr Imogen Lyons, who holds an MSc in Public Health from the University of Edinburgh and a BA in Psychology from University College, Dublin.
Read more about it in the BMJ Quality and Safety.