Improving Medication Adherence Among Adult Patients with Coronary Heart Disease: A Pilot Study
Abstract
**Please note that the full text is embargoed** ABSTRACT: Background: Medication adherence reduces morbidity, premature mortality, and healthcare costs
related to CHD treatment. Therefore, a patient-centered intervention for both staff and patients was
conducted to improve medication adherence in an outpatient setting.
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Methodology: A pilot study was conducted utilizing a quasi-experimental, pre-post, one group design.
Study participants completed an eight-item modified Medication Adherence Scale (MMAS-8)
questionnaire to measure self-reported medication adherence before and after the intervention, which
consisted of an interview and six weekly follow-up counseling sessions. The study compared the
difference in MMAS-8 scores before and after the intervention. The Statistical Package for the Social
Science (SPSS) software was used to conduct a correlation analysis and a Wilcoxon signed-rank test
to explore whether the mean scores achieved on the MMAS-8 scale had significantly changed after
the intervention.
Results: A total of 50 patients was initially assessed, and 22 participants with low medication
adherence were recruited and completed the intervention. Among the 22 participants, Spearman's
correlation found no significant relationship between demographics and pretest and posttest scores.
The correlation between the number of telephone counseling sessions and the postintervention
MMAS-8 score was also evaluated using Spearman's correlation coefficient. The correlation was not
statistically significant at the 95% confidence interval but was statistically significant at the 90%
confidence interval (p = .094). Spearman's correlation analysis used to evaluate the correlation
between the spoken language (English or Spanish) and the preintervention or postintervention
MMAS-8 score indicated no statistical significance. A Wilcoxon signed-rank test indicated an
average 3.12 point increase in pre-intervention scores from M = 3.37 to post-intervention scores M =
6.59, which was statistically significant (p < .0001). In addition, 95% of participants (21) reported
that participating in the telephone sessions positively affected their compliance with taking
medications.
Conclusions: This study examined the effectiveness of a patient-centered strategy inclusive of an
individualized interview and follow-up telephone counseling to increase medication adherence. The
findings suggest that this form of intervention has a positive and measureable impact on medication
compliance among patients with CHD and carries implications particularly for those who have
limited physical access to healthcare facilities. However, these pilot test results only measured
short-term outcomes. Further study is warranted to assess the long-term impact of this form of
intervention on medication adherence and patient outcomes.