title: The Medicines Advice Service Evaluation (MASE): a randomised controlled trial of a pharmacist-led telephone based intervention designed to improve medication adherence.
abstract: To test the effectiveness of a tailored, pharmacist-led centralised advice service to improve adherence to patients on established medications.
  
  
  
  A parallel group randomised controlled trial was conducted. Patients prescribed at least one oral medication for type 2 diabetes and/or lipid regulation were eligible to participate. 677 patients of a mail-order pharmacy were recruited and randomised (340 intervention, 337 control). The intervention comprised two tailored telephone consultations with a pharmacist, 4-6 weeks apart, plus a written summary of the discussion and a medicines reminder chart. The primary outcome was self-reported adherence to medication at 6-month follow-up, collected via a postal questionnaire, analysed using generalised estimating equations. Secondary outcomes included prescription refill adherence, lipid and glycaemic control and patient satisfaction.
  
  
  
  In intention-to-treat analysis 36/340 (10.6%) of the intervention group were non-adherent (<90% of medication taken in the past 7 days) at 6 months compared with 66/337 (19.6%) in the control group, yielding an unadjusted OR of 1.54 (95% CI 1.11 to 2.15, p=0.01). Analyses of dispensing data also showed that the odds of being classified as adherent (≥90%) were 60% greater for the intervention group compared with the control group (OR 1.60, 95% CI 1.14 to 2.24, p<0.01). In a subsample of patients who provided blood samples, glycaemic and lipid control did not differ significantly between groups (p=0.06 and p=0.24, respectively) but positive trends were observed. Ninety-two per cent of intervention group patients reported that they were satisfied with the service overall.
  
  
  
  A telephone intervention, led by a pharmacist and tailored to the individuals' needs, can significantly improve medication adherence in patients with long-term conditions, using a mail-order pharmacy. Further work is needed to confirm a trend towards improved clinical outcome.
  
  
  
  NCT01864239.
authors.affiliation: UCL Interaction Centre, University College London, London, UK.
authors.forename: Imogen
authors.initials: I
authors.lastname: Lyons
authors.affiliation: Health Foundation, London, UK.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Barber
authors.affiliation: School of Healthcare, University of Leeds, Leeds, UK.
authors.forename: David K
authors.initials: DK
authors.lastname: Raynor
authors.affiliation: Research Department of Practice and Policy, UCL School of Pharmacy, University College London, London, UK.
authors.forename: Li
authors.initials: L
authors.lastname: Wei
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D003157:Community Pharmacy Services / Q000458:organization & administration*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010595:Pharmacists; D016037:Single-Blind Method; D013689:Telephone; D016903:Drug Monitoring
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D008055:Lipids
keywords: Compliance; Patient-centred care; Pharmacists; Randomised controlled trial; Reminders