Development and acceptance of a new adherence monitoring package to identify non-adherent patients with polypharmacy in primary care: a feasibility study

BMJ Open Quality

article

Fine Dietrich¹  Andreas Zeller²  Samuel Allemann¹  Isabelle Arnet¹ 

[1]Pharmaceutical Care Research Group, Pharmaceutical Sciences , University of Basel

[2]Centre for Primary Health Care , University Hospital Basel

关键词: Polypharmacy;    Compliance;    Chronic disease management;    General practice;    Pharmacists;   

DOI  :  10.1136/bmjoq-2022-002155

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

Background Adherence to pharmacotherapy is crucial to prevent symptom deterioration in chronic diseases. However, non-adherence to chronic treatments is prevalent, especially in polypharmacy. Practical tools to assess adherence to polypharmacy in primary care are missing.Aims We aimed to develop an Adherence Monitoring Package (AMoPac) for general practitioners (GPs) to identify patient non-adherence. We tested the feasibility and acceptance of AMoPac in the primary healthcare setting.Methods AMoPac was developed based on peer-reviewed literature. It consists in (1) electronic monitoring of patients’ medication intakes for 4 weeks, (2) receiving feedback on intake behaviour by the pharmacist and (3) generating an adherence report to communicate to the GPs. A feasibility study was conducted with heart failure patients. GPs’ acceptance of AMoPac was explored with semistructured interviews. Electronic transmission of the reports into the GP’s electronic health record along with laboratory reports stating N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels was analysed.Results1000 pg/mL).Conclusion AMoPac is feasible in the primary healthcare setting, excluding the integrated transmission of adherence reports to GPs. The procedure was highly accepted by GPs and patients. AMoPac fills a gap by combining clinical values with adherence data, and therefore, delivers a multifaceted picture of the patient’s behaviour. In case of unmet adherence, our tool might facilitate the selection of patient-centred approaches to optimise pharmacological therapies in chronic heart failure patients.Trial registration number NCT04326101.

【 授权许可】

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