The General Pharmaceutical Council of Spain has published the results of the ADHIÉRETE Programme, part of the Community Pharmacy Research Network (RIFAC, in the Spanish acronym), and which involved the Pharmacy Chambers of Badajoz, Barcelona, Cáceres and Bizkaia, in cooperation with ESTEVE Laboratories. The purpose of this study was to evaluate adherence to pharmacotherapy. It was conducted at 51 community pharmacies in these four provinces with 114 elderly, chronic, polymedicated patients who did not adhere to their treatments. This programme is endorsed by the Ministry of Health, Social Services and Equality, the Vodafone Spain Foundation and Anota.
The final results of this study show a general improvement in adherence rates from 35% to 75.7% in patients after their third visit, based on the results of the Morisky-Green Test. The study relied on the use of adherence support systems, personalized dosage systems (PDS) and mobile applications. An increase in adherence was noted in those patients in the PDS group, which reached 82.9% after the final visit, versus the 57.1% increase in the group using mobile applications. These data and the high dropout rate show that the new technologies used in the study still pose difficulties to patients in this group. We should note that the study did not reveal differences based on gender. The results were equivalent across age groups.
The most common reasons for non-adherence given by the patients were (from highest to lowest) forgetting to take the medication, thinking it was not important to take the medication every day, discomfort, not picking up the medication on time, dosage higher or lower than prescribed, and difficulties using the medication.
The study also detected 257 drug-related problems (DRP), the most frequent being those associated with proton-pump inhibitors (8.7%), followed by angiotensin converting enzyme inhibitors (6.52%) and HMG-CoA reductase inhibitors (6.52%). In addition to non-adherence, the highest rates of DRP involved interactions (11.3%), inappropriate dosage, treatment and/or duration (10%), incorrect administration of the medicine (8%) and the probability of adverse effects (4.3%). The pharmacists' intervention led to a 33.4% drop in drug-related problems. There were also 257 detected cases of negative outcomes associated to medicines (NOM), mainly due to ineffectiveness (51%), need for the medicine (27%) and safety risks (18%).
The data collected during the six-month study also reveal that patients experienced a significant improvement in the perceived quality of life, with an average 5.5-point increase (using the EuroQoL-5D Questionnaire).
European and international repercussions of the ADHIÉRETE Programme
The ADHIÉRETE Programme is part of the European Innovation Partnership on Active and Healthy Aging (EC-EIP-AHA), a European Commission initiative that aims to increase the life expectancy of European citizens by 2020. This Partnership is a priority of the European Union's policy agenda and is intended to improve the prevention of chronic age-related diseases, enhance the quality of life of patients and ensure the viability of public healthcare systems.
Among the Partnership's initiatives, the European Commission included the ADHIÉRETE Programme in a brochure on good practices for "better prescription and adherence to medical plans". Also, in November 2014, the World Health Organization published a report on the role of pharmacist in encouraging the prudent use of antibiotics that referenced the ADHIÉRETE Programme as an example of good practices.
Lastly, on the international stage, the preliminary results of the ADHIÉRETE Programme were recognized as the best oral communication in the category of Pharmaceutical Research at the 74th Congress of the International Pharmaceutical Federation (FIP).
ADHIÉRETE PROGRAMME
This Programme is endorsed by the Ministry of Health, Social Services and Equality and promoted by the General Pharmaceutical Council of Spain and by the Pharmacy Chambers of Badajoz, Barcelona, Cáceres and Bizkaia, and by the Pharmaceutical Group of the European Union, in partnership with Esteve Laboratories and with the support of the Vodafone Spain Foundation and Anota.
The programme seeks to promote professional pharmacy services and is committed to encouraging research in community pharmacy, as specified in the Córdoba Declaration.