Background: Preliminary evidence suggests that providing longer duration prescriptions at discharge may improve long-term adherence to secondary preventative cardiac medications among post-myocardial infarction (MI) patients. We implemented and assessed the effects of two hospital-based interventions-(1) standardized prolonged discharge prescription forms (90-day supply with 3 repeats for recommended cardiac medications) plus education and (2) education only-on long-term cardiac medication adherence among elderly patients post-MI.
Methods: We conducted an interrupted time series study of all post-MI patients aged 65-104 years in Ontario, Canada, discharged from hospital between September 2015 and August 2018 with ≥ 1 dispensation(s) for a statin, beta blocker, angiotensin system inhibitor, and/or secondary antiplatelet within 7 days post-discharge. The standardized prolonged discharge prescription forms plus education and education-only interventions were implemented at 2 (1,414 patients) and 4 (926 patients) non-randomly selected hospitals in September 2017 for 12 months, with all other Ontario hospitals (n = 143; 18,556 patients) comprising an external control group. The primary outcome, long-term cardiac medication adherence, was defined at the patient-level as an average proportion of days covered (over 1-year post-discharge) ≥ 80% across cardiac medication classes dispensed at their index fill. Primary outcome data were aggregated within hospital groups (intervention 1, 2, or control) to monthly proportions and independently analyzed using segmented regression to evaluate intervention effects. A process evaluation was conducted to assess intervention fidelity.
Results: At 12 months post-implementation, there was no statistically significant effect on long-term cardiac medication adherence for either intervention-standardized prolonged discharge prescription forms plus education (5.4%; 95% CI - 6.4%, 17.2%) or education only (1.0%; 95% CI - 28.6%, 30.6%)-over and above the counterfactual trend; similarly, no change was observed in the control group (- 0.3%; 95% CI - 3.6%, 3.1%). During the intervention period, only 10.8% of patients in the intervention groups received ≥ 90 days, on average, for cardiac medications at their index fill.
Conclusions: Recognizing intervention fidelity was low at the pharmacy level, and no statistically significant post-implementation differences in adherence were found, the trends in this study-coupled with other published retrospective analyses of administrative data-support further evaluation of this simple intervention to improve long-term adherence to cardiac medications.
Trial Registration: ClinicalTrials.gov : NCT03257579 , registered June 16, 2017 Protocol available at: https://pubmed.ncbi.nlm.nih.gov/33146624/ .
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9210591 | PMC |
http://dx.doi.org/10.1186/s12916-022-02401-5 | DOI Listing |
JAMA Netw Open
January 2025
Amazon Health Services, Seattle, Washington.
Importance: Medication nonadherence imposes high morbidity, mortality, and costs but is challenging to address given its multiple causes. Subscription models are increasingly used in health care to encourage healthy behaviors; in January 2023, Amazon Pharmacy launched RxPass, a subscription program offering Amazon Prime members (hereafter, company members) in 45 states access to 60 common generic medications for a flat $5 monthly fee.
Objective: To evaluate the associations of program enrollment with medication refills, days' supply, and out-of-pocket costs.
Pak J Med Sci
January 2025
Dr. Ayesha Babar Kawish, MSPH Al-Shifa School of Public Health, Al-Shifa Trust, Rawalpindi, Pakistan.
Background & Objectives: Poor medication adherence is an essential contributor to Pakistan's high prevalence of uncontrolled hypertension. This study will be aimed to assess the efficacy of a one-of-a-kind developed intervention in improving medication adherence and treatment outcomes in hypertension patients.
Methods: Twleve months duration long randomized controlled trial from January to December 2021 will be carried out at Shaikh Zayed Medical Complex (SZMC), Lahore.
Patient Prefer Adherence
January 2025
Department of Pharmacy, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, People's Republic of China.
Purpose: The purpose of this study was to explore the lean management strategies used by an outpatient hospital pharmacy in China to reduce internal errors in prescription dispense and to describe their impact on patient satisfaction.
Methods: The type and number of internal errors in prescription dispense from January 1, 2022, to December 31, 2022, were collected. The causes of these errors were analyzed based on a series of lean management concepts and methods, and Lean Management was implemented from January 1, 2023, to December 31, 2023, in this outpatient hospital pharmacy.
BMC Med
January 2025
Yueyang Centre for Disease Control and Prevention, Yueyang, Hunan Province, China.
Background: A 12-month cluster randomized controlled trial (RCT) demonstrated the effectiveness of an application-based education program in reducing the salt intake and systolic blood pressure (SBP) of schoolchildren's adult family members. This study aimed to assess whether the effect at 12 months persisted at 24 months.
Methods: Fifty-four schools were randomly assigned to either the intervention or control group.
AIDS Behav
January 2025
School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China.
Sexual minority men living with HIV face challenges affecting their quality of life and medication adherence. While self-compassion has shown promise in improving quality of life, targeted interventions for this group remain limited. This pilot study evaluated the efficacy of an online self-compassion group intervention on quality of life and medication adherence among sexual minority men living with HIV.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!