PMID- 14583903
OWN - NLM
STAT- MEDLINE
DCOM- 20040414
LR  - 20191210
IS  - 1071-9164 (Print)
IS  - 1071-9164 (Linking)
VI  - 9
IP  - 5
DP  - 2003 Oct
TI  - Effect of a pharmacist-led intervention on diuretic compliance in heart failure 
      patients: a randomized controlled study.
PG  - 404-11
AB  - BACKGROUND: Noncompliance is a major factor in the morbidity and unnecessary 
      hospital readmissions for patients with heart failure. Several studies have aimed 
      to reduce rehospitalizations in heart failure patients through a comprehensive, 
      multidisciplinary approach. Medication compliance was rarely measured in these 
      studies or, when it was measured, the method employed was seldom valid. We aimed 
      at determining the effect of a pharmacist-led intervention on medication 
      compliance in patients with heart failure. METHODS: We conducted a randomized 
      controlled trial into the effect of a pharmacist-led intervention on medication 
      compliance in patients with heart failure (predominantly New York Heart 
      Association [NYHA] II and III) treated with loop diuretics, presenting to a 
      cardiology outpatient clinic or admitted to hospitals in The Netherlands. 
      Patients in the intervention group received monthly consultations from their 
      community pharmacist during a 6-month period. Patients in the control group 
      received usual care. Primary endpoint was medication compliance, assessed with a 
      medication event monitoring system, an electronic pill bottle that registers time 
      of opening. Secondary endpoints were the number of rehospitalizations, death, and 
      quality of life. RESULTS: A total of 152 patients were randomized: 74 patients to 
      the intervention arm and 78 patients to the usual care arm. Over the 6-month 
      study period, patients in the intervention group had 140/7656 days without use of 
      loop diuretics compared with 337/6196 days in the usual care group (relative risk 
      0.33 [confidence interval (CI) 95% 0.24-0.38]). Two consecutive days of nondosing 
      occurred on 18/7656 days in the intervention group compared with 46/6196 days in 
      the usual care group (relative risk 0.32 [CI 95% 0.19-0.55]). There were no 
      significant differences in rehospitalizations, mortality, or disease-specific 
      quality of life between groups. CONCLUSIONS: A pharmacy-led intervention can 
      improve medication compliance in patients with moderate to severe heart failure, 
      even in those with relatively high compliance. Future interventions should also 
      focus at less compliant patients.
FAU - Bouvy, Marcel L
AU  - Bouvy ML
AD  - Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for 
      Pharmaceutical Sciences (UIPS), PO Box 80082, 3508 TB Utrecht, The Netherlands.
FAU - Heerdink, Eibert R
AU  - Heerdink ER
FAU - Urquhart, John
AU  - Urquhart J
FAU - Grobbee, Diederick E
AU  - Grobbee DE
FAU - Hoes, Arno W
AU  - Hoes AW
FAU - Leufkens, Hubert G M
AU  - Leufkens HG
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
RN  - 0 (Diuretics)
SB  - IM
EIN - J Card Fail. 2003 Dec;9(6):481. Hoe Arno W [corrected to Hoes Arno W]
MH  - Aged
MH  - Diuretics/*therapeutic use
MH  - Female
MH  - Heart Failure/*drug therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Netherlands
MH  - Outcome Assessment, Health Care/statistics & numerical data
MH  - Patient Compliance/*statistics & numerical data
MH  - Pharmaceutical Services/*organization & administration
MH  - Pharmacists
MH  - Surveys and Questionnaires
EDAT- 2003/10/30 05:00
MHDA- 2004/04/15 05:00
CRDT- 2003/10/30 05:00
PHST- 2003/10/30 05:00 [pubmed]
PHST- 2004/04/15 05:00 [medline]
PHST- 2003/10/30 05:00 [entrez]
AID - S1071916403001301 [pii]
AID - 10.1054/s1071-9164(03)00130-1 [doi]
PST - ppublish
SO  - J Card Fail. 2003 Oct;9(5):404-11. doi: 10.1054/s1071-9164(03)00130-1.