A program of time-specific ‘blister’ packaging, individualized patient education by a pharmacist and bimonthly pharmacist followup increases medication adherence from 61.2 percent to 96.9 percent in elderly patients at risk for heart disease.
The clinical value of the program used in the randomized, controlled FAME study (Federal Study of Adherence to Medications in the Elderly) was clear ? besides improving medication adherence among the patients, blood pressure dropped from 133.2 to 129.9 mm Hg, and LDL cholesterol from 91.7 to 86.8 mg/dL during the study?s first phase.
Sustained medication adherence during the second, randomized phase was 95.5 percent among patients who stayed on trial, versus 69.1 percent among patients who were randomly selected to be withdrawn after phase 1.
FAME was described during a Monday news conference highlighting Late-Breaking Clinical Trials.
Moderator Timothy Gardner, M.D., chair of the 2006 Scientific Sessions program, said he was excited about the report.
?It showed a medication adherence program could have a substantial impact on control of lipids and blood pressure in the elderly,? said Dr. Gardner, medical director of the Center for Heart and Vascular Health at Christiana Care Health Services, Wilmington, Del.
Senior author Allen J. Taylor, M.D., professor of medicine, chief of the Cardiology Service and director of Cardiovascular Research at the Uniformed Services University of the Health Sciences, showed a sample of the blister pack, in this case a morning pack. It has 31 blisters, each holding the pills or capsules required for a patient at that time. Patients would receive similar packs for midday and evening medications.
FAME enrolled 200 patients 65 years or older taking four or more medicines daily. Dr. Taylor said convenient packaging, patient education and followup are all critical to the program?s success.
Given the importance of adherence in staying healthy, Dr. Taylor said the program is cost effective.
?If we can pay for medicines, we can pay for people to take their medicines,? he said.