Effects telephone counselling intervention by pharmacist on beliefs about medicines for patients starting treatment: Results of an interim analysis of a cluster randomized controlled trial

Abstract

Background and objective: Adherence to medication is often low. Goal of this study is to assess the effects of Telephone Counselling Intervention by Pharmacist (TelCIP) at the start of therapy on patient beliefs, satisfaction with information about medicines and refill adherence. Setting and method: A Cluster Randomized Controlled Trial with 26 Dutch pharmacies that were randomly assigned to 1 of the 2 intervention groups. Each group consisted of an intervention (TelCIP) arm and an usual care arm. The TelCIP arm in the first group was the usual care arm in the second group and vice versa. One group focuses on patients starting with antidepressants or bisphosponates and the other on antilipaemic drugs or renin angiotensin system (RAS)-inhibiters. TelCIP is a telephone call initiated by a pharmacist 2 or 3 weeks after the first prescription. A selection of pharmacies sent questionnaires 3 months after the first prescription which contained sociodemographic questions, a measure of beliefs about medicines (BMQ), satisfaction with information received (SIMS) and frequency of pharmacy counselling (Consumer Quality Index, CQI). Main outcome measures: Beliefs about medicines is expressed as the necessity-concerns differential. The SIMS and CQI result in a dichotomous outcome. Results: In this interim analysis, 69 patients in the TelCIP arm responded (Intention to treat, ITT) of which 52 actual received the telephone call (Per protocol, PP). In the usual care arm 306 patients responded. There were no differences at baseline in gender, age or firstrefill medication. In the ITT-analysis the necessity-concerns differential was 1.1 [95 %CI-0.2 to 2.4] higher in the TelCIP arm, compared to usual care in the PP analysis the differential was 1.5 [95 %CI 0.0 to 2.9] points higher. Of the patients in the TelCIP arm 50 % (ITT) and 51 % (PP) were satisfied about the information given about side-effects compared to 39 % in the usual care arm but this difference was not significant (p = 0.13 respectively 0.13). The difference on the other SIMS items was less than 10 %. In the TelCIP arm, patients were more frequently asked about their experiences and about the occurrence of side-effects and whether they manage to use medicine as prescribed (