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Objectives:
Studies estimate that > 40% of patients with chronic conditions have low adherence to medications, which might increases morbidity, mortality and higher rate of hospitalization. The results are similar in Hadar-Haifa branch of Maccabi HealthCare Services (MHCS) concerning adherence to statin in Cardio-vascular patients. We assume that low adherence to medications in those patients is accompanied with low control of serum glucose, lipid profile and blood pressure measures. The purpose of this study is to increase adherence to medical treatment.
Hypothesis:
Improving adherence to medical treatment can lead to better control of serum blood tests and blood pressure in patients with chronic conditions.
Methods:
A cardiovascular registry was established 3 years ago in MHCS. The inclusion criteria are based on:
1) Discharge diagnosis from hospitals after acute event.
2) Diagnosis from medical electronic files according to ICD-9 code. The registry can identify the rate of adherence to medication. Adherence rate is the percentage of refilling prescriptions during last 12 months in a computer-based pharmacy system and considered to be high if > 75%. The intervention program consists of: identification of patients suffering DM + CVD with low adherence to statins, LDL-C levels > 130 mg/dl and HBA1C > 8% in Hadar-Haifa branch. Most probably those patients receive > 5 different medications. Patients will be invited to 4 meetings with the clinical pharmacist. The meetings will include explanation about the chronic condition, medications, its necessity and importance in controlling diseases, time of taking and possible side effects. Patients will be provided with a case box for keeping medications as a daily reminder. Patients will be asked to sign informed consent in order to participate in the program. Statistical Comparison will be done for rate of adherence, serum glucose, lipid profile and blood pressure that will be measured before, at 6 months and at end of program. |