3043.0: Monday, November 13, 2000 - 1:30 PM

Abstract #13252

Patient compliance in a structured pharmaceutical (clinical) care approach to the management of ambulatory patients with hyperlipidemia

Pamala J Reed, DrPH, MPH1, Richard Herrier, PharmD2, Greta A Gourley, PhD, PharmD1, Dick R Gourley, PharmD1, David K Solomon, PharmD3, Ed Armstrong2, J. Lyle Bootman, PhD2, James C Holt, PharmD3, George Bass, PhD1, Kenneth Kellick, PharmD4, Kamala McMillan, PharmD, MS1, and Tracy Portner, PhD1. (1) College of Pharmacy, University of Tennessee, 847 Monroe Avenue, Memphis, TN 38163, 901.448.1455, pjreed@utmem.edu, (2) College of Pharmacy, University of Arizona, (3) VA Medical Center, Memphis, (4) VA Buffalo, SUNY Buffalo

The purpose of this study was to assess the impact of pharmaceutical care and treatment guidelines on clinical, economic and humanistic outcomes in hyperlipidemia patients. This study attempted to improve patient compliance in hyperlipidemia patients through patient education and counseling by pharmacists. Non-compliance costs the U.S. approximately $35-$100 billion per year. This data was collected between February 1996 and July 1998 at 15 VA sites across the country. There are 460 VA patients, 307 treatment and 153 control patients. Patients were followed for 12 months. Treatment patients were scheduled for a minimum of 7 visits in the pharmacist managed hyperlipidemia clinics. The Morisky Compliance Scale and Medication Possession Ratio (MPR) were used to measure compliance. There was no significant difference in compliance at visit 0 between the two groups, 24.8% of control patients and 21.8% of treatment patients reported some difficulty with compliance. Both groups showed significant improvement in compliance over the study period, treatment patients (t=171.23, 283; p >.001) control patients (t=119.10, 147; p >.001). Treatment patients demonstrated significant improvement in compliance over control patients at the end of the evaluation period (t=202.24, 243; p >.001). By the final visit only 12.7 % of treatment patients reported problems with compliance, as compared to 20.8% of control patients. The MPR was determined to be a poor measure of compliance in this population. The VA automated refill system corrupts the measure. Treatment patients had a significant improvement in total cholesterol, LDL, weight loss, knowledge and satisfaction over control patients.

Learning Objectives: Recognize the value of Pharmaceutical Care in enhancing patient compliance. Describe the Pharmaceutical Care approach to the management of ambulatory patients

Keywords: Complaint, Ambulatory Care

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: This study was supported by a research grant from Novartis Pharmaceuticals, Inc. to the Universities of Tennessee and Arizona Colleges of Pharmacy

The 128th Annual Meeting of APHA