Pharmacist Competences and Impact of Pharmacist Intervention on Medication Adherence: an Observational Study.

Background: The aim of this study is to determine the results of pharmacist interventions on patient's adherence to drugs in community settings.

Subjects And Methods: The study was designed using a standard EQ-SDQ questionnaire and a Culig questionnaire about the adherence to drug. General Level Framework (GLF) was used as a tool for competence assessment among community pharmacists. Participants were pharmacists that issued the medication on repeat prescription in the pharmacy. They interviewed the patient at the first visit to the pharmacy and the next time when the patient came to refill the prescription. The survey was conducted during a two-month period in the Atlantic Pharma pharmacy chain. A total of 152 patients were included at the first visit and 87 patients at the second visit.

Results: About two thirds of patients (65.5%) identified themselves as adherent during the first survey, and this number increased slightly during the second interview (by 3.5%), but not statistically significant (p=0.75). A total number of drugs prescribed during the first and second survey was 252 and 253 respectively. The percentage of the advices given to the patients increased during the second survey, but not statistically significant (p=0.62).

Conclusion: It is definitely important to check that a patient understands current disease and what are doubts and difficulties in taking a therapy. The reasons for possible nonadherence are different: fears, worsening of the clinical state or other negative treatment outcomes. Enough time should always be left to clarify anything that is unclear and to listen. Application of GLF program for improving pharmacist competences resulted in slightly increased patient adherence to medication. For further development of competences, pharmacist intervention should include some other contents, i.e. tailoring the dosage scheme, counselling about drug-drug and drug-food interactions. The pharmacist counseling should be reimbursed by the Croatian Health Insurance Fund.