Assessing adherence and comprehension of cardiovascular medicines with pharmacist intervention post-acute myocardial infarction: a pilot study

Background

Due to the addition of multiple new medicines following an acute myocardial infarction (MI), medication non-adherence occurs frequently. Medication education can improve adherence, comprehension, and health-related outcomes. There is currently limited literature about individualised pharmacist-led medication education post-hospital discharge following an MI.

Aim

To assess whether individualised, pharmacist-led education increased patient adherence and comprehension of cardiovascular medicines over a 12-week period following an MI.

Method

All participants completed the Morisky Medication Assessment Scale (MMAS) of self-reported adherence at 1 week and 12 weeks post-hospital discharge. Alongside this, a questionnaire was completed to quantify comprehension of their treatment plan. Participants were randomised to receive individualised pharmacist-led education directed at their medication regimen at 4–6 weeks post-discharge. Data were analysed using paired t-tests and mixed-design analysis of variance (ANOVA). Ethical approval was granted by the Monash Health Human and Research Ethics Committee (Reference no: RES-21-0000234L) and the study conforms to the Australian National Statement on Ethical Conduct in Human Research. Informed consent was obtained from all participants via project information sheets, verbal explanations by recruiting pharmacists with reassurance there would be no difference in standard treatment should patients decline involvement in the project, and written consent forms were completed by all participants.

Results

Of the 29 participants, 15 (51%) received pharmacist-led education. The intervention group's mean MMAS score increased from 6.7 (moderate adherence) at week 1 to 7.6 (moderate adherence) at week 12 post-hospital discharge (p = 0.009). At 12 weeks, the intervention group demonstrated a statistically significant and greater mean MMAS score compared to the control group (7.6 moderate adherence and 6.9 moderate adherence respectively, p = 0.003). The intervention group's mean comprehension level increased from 58% at 1 week to 90% at 12 weeks (p < 0.05). The intervention group demonstrated a greater mean comprehension level at 12 weeks compared to the control group (90% and 48.21% respectively, p < 0.001).

Conclusion

This pilot study demonstrated that individualised, pharmacist-led education may improve self-reported medication adherence and comprehension.