Packaging helps elderly adhere to medication

By Martha Kerr

CHICAGO (Reuters Health) - Blister packs of appropriately grouped medications, along with guidance from a pharmacist, can greatly improve treatment adherence rates of elderly patients, researchers announced here at the American Heart Association's Scientific Sessions 2006.

The results of the Federal Study of Adherence to Medications in the Elderly (FAME) were presented by Dr. Allen J. Taylor of Walter Reed Army Medical Center in Washington, DC, in a late-breaking clinical trials session. The study involved 200 patients who took four or more medications a day. The average number of daily medications was nine.

At the beginning of the study, data were collected for 2 months. During this time, adherence rates were 61 percent, Taylor reported.

The patients then received individually prepared blister packs of their medications and participated in a comprehensive pharmacy care program.

Medication compliance rates jumped to 97.5 percent, Taylor announced.

As a result, blood pressure was significantly better controlled and low-density lipoprotein (LDL) cholesterol ("the bad cholesterol") levels were lower than they were at the start of the study.

For the next six months, patients were randomly assigned to continue the pharmacy care program or to return to their usual habits of taking medication.

In the usual-care group, "compliance rates rapidly fell" to near pre-study levels and blood pressure levels did return to where they were before. The compliance rates were 69 percent (vs. the original 61 percent), so there was some "carry-over" effect.

In contrast, patients in the comprehensive care group maintained their high compliance rates. Blood pressure rates continued to fall, as did LDL cholesterol.

Taylor noted that "physicians don't have time to follow-up" at this level of intensity. "We don't think of the pharmacist as an important part of patient care," but they are trained and knowledgeable, and in a unique position to interact closely with patients. "We should take advantage of that."

"Multiple medications are difficult for patients to manage," he said. Despite great expenditure on drug safety and efficacy, "if patients don't take them, they don't work."