title: Proactive pharmaceutical care interventions improve patients' adherence to lipid-lowering medication.
abstract: BACKGROUND
  Lipid-lowering drugs are effective preventive medication for patients at risk of cardiovascular complications. However, medication adherence is suboptimal, thereby decreasing therapy effectiveness. Pharmaceutical care interventions may increase therapy adherence.
  
  
  OBJECTIVE
  To assess the effect of a proactive pharmaceutical care intervention program, Medication Monitoring and Optimization (MeMO), on therapy discontinuation and adherence with lipid-lowering drugs as well as patients' satisfaction with the intervention program.
  
  
  METHODS
  This prospective intervention study included 1002 patients initiating lipid-lowering drug therapy from 9 Dutch community pharmacies. In the intervention group (n = 500), the MeMO program was used, comprising continuous monitoring of patients' adherence to lipid-lowering drugs and personal counseling with nonadherent patients. The intervention group was compared with a historical reference group (n = 502) receiving usual care. Outcomes were therapy discontinuation and adherence.
  
  
  RESULTS
  Discontinuation rates with lipid lowering drugs in the first year after drug initiation were 13.6% for the intervention group and 25.9% in the usual care group; continued but non-adherent use was 3.2% and 7.6% in these groups. Patients in the MeMO program had a decreased risk to discontinue medication of 51% (95% confidence interval: 34%-63%). Results were not affected by potential confounders. Patient satisfaction with MeMO was very high; one quarter of patients mentioned that they only received information about their medication from their pharmacy.
  
  
  CONCLUSIONS
  Improving adherence to lipid lowering drugs can be achieved by a proactive pharmaceutical care program. Pharmacists can contribute to optimal use of chronic medication, which is likely to reduce healthcare costs.
authors.affiliation: West Pharmacy, Emmeloord, Netherlands.
authors.forename: Ada G G
authors.initials: AG
authors.lastname: Stuurman-Bieze
authors.forename: Eric G
authors.initials: EG
authors.lastname: Hiddink
authors.forename: Job F M
authors.initials: JF
authors.lastname: van Boven
authors.forename: Stefan
authors.initials: S
authors.lastname: Vegter
mesh_terms: D003157:Community Pharmacy Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011446:Prospective Studies
chemical_list: D000960:Hypolipidemic Agents
keywords: adherence; discontinuation; lipid-lowering drugs; pharmaceutical care; pharmacist intervention; statins