Impact of home medication management review on medication adherence among Jordanian patients

ObjectivesThis study was designed to evaluate the impact of Home Medication Management Review (HMMR) on self-reported adherence, and to explore the effect of different patient factors on their medication adherence. MethodConsecutive patients from outpatient clinics who were eligible for the study were recruited and randomly distributed into two groups. Patients in both groups were visited at home by the clinical pharmacist at baseline. For the intervention group only, the pharmacist delivered counselling regarding self-reported adherence. After identifying treatment-related problems (TRPs), the pharmacist sent a letter to the patients' physician with certain recommendations (intervention group only). Both groups were reassessed for adherence after 3months from baseline to measure the difference between the two groups. Key findingsA total of 97 participants were included. Mean ages for the intervention and control groups were 63.13 and 58.39 respectively. The majority of patients were women. The study revealed significant association with the number of TRPs, and level of adherence in the intervention group at follow-up (R-2=0.348, P<0.001). Adherence score for patients diagnosed with hypertension, diabetes and other chronic conditions indicates that more than 70% of the participants have medium adherence score' in comparison with <10% having high adherence' at baseline. Three months postbaseline, 33% of patients in the intervention group were found to have high adherence compared to 14% in the control group. Adherence score significantly decreases in low scores of adherence' and increases in high scores of adherence' (P<0.001) at follow-up in the intervention group. No significate association between adherence and patient factors was found. ConclusionHMMR service has resulted in significant improvements in patients' adherence when compared to control group patients who did not receive the service. Besides receiving the service, no other patient factors played a role in patients' improvement in adherence.