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Clinical pharmacy and clinical trials (including case series)
CPC-007 Adherence Problems Identified by Motivational Interviewing and medicines Review in Stroke Patients
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  1. U Hedegaard1,
  2. LJ Kjeldsen2,
  3. J Hallas3
  1. 1University of Southern Denmark, Institute of Public Health Clinical Pharmacolgy, Odense, Denmark
  2. 2Amgros I/S, The Danish Research Unit for Hospital Pharmacy, Copenhagen, Denmark
  3. 3University of Southern Denmark, Institute of Public Health Clinical Pharmacology, Odense, Denmark

Abstract

Background Poor adherence to secondary prevention medicines occurs frequently in patients suffering a stroke or Transient Ischemic Attack (TIA). To improve the adherence of these patients, a complex individualised pharmacist intervention was designed and is being used in an ongoing study investigating the effect on medicines adherence and new stroke events. The present work is a sub-analysis of this study.

Purpose To examine adherence-related issues in stroke/TIA patients identified by use of a complex pharmacist intervention including medicines review and motivational interviewing.

Materials and Methods The study is being performed at the Neurology Ward and the Emergency Ward, Odense University Hospital, where patients treated for TIA or acute ischemic stroke are randomised to a complex individualised pharmacist intervention or a control group. The pharmacist intervention consists of 3 components: 1) A medicines review focused on potential adherence-related problems followed by recommendations to the ward physicians 2) A motivational interviewing consultation where the content is based on issues raised by the patient 3) A follow-up telephone call one week after discharge with standardised adherence questions to uncover potential non-adherence.

Results Twenty-four patients received the pharmacist intervention. Among the topics covered, 7 potential adherence-related problems were identified. Four of the recommendations were accepted by the physicians, 2 were refused and there was no response to one. The issues most commonly addressed in the consultations were change of lifestyle (79%), medicines management (67%) and adverse reactions (58%). Other issues included effectiveness of the medicines (50%), adherence aids (42%) and information about the disease (8%). According to the standardised questions, one patient had adherence problems at the one-week follow-up phone call.

Conclusions A complex pharmacist intervention can be used to identify potential adherence-related problems in stroke patients.

No conflict of interest.

https://doi.org/10.1136/ejhpharm-2013-000276.464

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