title: Medication Adherence Improvement By Using Administration Timing Simplification Protocol (ATSP) in Cardiovascular Disease Patients.
abstract: OBJECTIVE
  In chronic diseases, keeping adherence to medication is very difficult. The objective of this study was to evaluate the impact of administration timing simplification protocol (ATSP) on medication adherence and clinical parameters of cardiovascular diseases.
  
  
  METHODS
  210 out-patients with cardiovascular disease, who were taking two or more pills of any type of medication per day for more than one year, were enrolled and randomized. The intervention group followed the simplified administration schedule of ATSP with two main strategies: 1) moving medication from "pc" (30 minute after meal) to "stat. pc" (immediately after meal); and 2) moving medication time from "at evening" to "at morning." In contrast, the control group maintained the same medication schedule. Both patient groups were equally educated about the names and effects of the medication.
  
  
  RESULTS
  The intervention group had more pills than the control group with marginal statistical significance (5.1±2.3 vs 4.6±1.8, p=0.05). The total frequency of administration was significantly higher in the intervention group than that of the control group (2.9±1.0 vs 2.6±0.9, p=0.03) at the baseline. In the intervention group, the frequency was significantly decreased to 1.5±0.6 times per day after following ATSP application (p＜0.01). In both patient groups, knowledge about the medication was significantly improved by education. However, medication adherence was only improved in the intervention group. Interestingly, total cholesterol was significantly decreased in the intervention group (p＜0.01). The decrease in serum cholesterol concentration was significantly correlated with the improvement in medication adherence evaluated with Morisky Medication Adherence Scale (MMAS)-8 items (r=0.507, p＜0.01).
  
  
  CONCLUSIONS
  ATSP was shown to be an effective strategy to improve medication adherence in chronic cardiovascular disease patients.
authors.affiliation: Department of Pharmacy, Seoul National University Hospital.|College of Pharmacy, Dongguk University Biomedi Campus.
authors.forename: Sun Hoi
authors.initials: SH
authors.lastname: Jung
authors.affiliation: Department of Pharmacy, Seoul National University Hospital.
authors.forename: Ok Sang
authors.initials: OS
authors.lastname: Lee
authors.affiliation: College of Pharmacy, Dongguk University Biomedi Campus.
authors.forename: Hyang Sook
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital.
authors.forename: Chan Soon
authors.initials: CS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital.
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: College of Pharmacy, Dongguk University Biomedi Campus.
authors.forename: Kyeng Hee
authors.initials: KH
authors.lastname: Kwon
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital.
authors.forename: Hae Young
authors.initials: HY
authors.lastname: Lee
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010045:Outpatients / Q000523:psychology*; D010353:Patient Education as Topic; D011379:Prognosis; D011788:Quality of Life; D016903:Drug Monitoring
keywords: Cardiovascular patients; Compliance; Medication adherence