An Intervention Study to ENHANCE MEDICATION COMPLIANCE in Community-Dwelling Elderly Individuals

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Abstract
Objective: To determine whether daily videotelephone or regular telephone reminders would increase the proportion of prescribed cardiac medications taken in a sample of elderly individuals who have congestive heart failure (CHF). Methods: The authors recruited community-dwelling individuals age 65 and older who had the primary or secondary diagnosis of CHF into a randomized controlled trial of reminder calls designed to enhance medication compliance. There were three arms: a control group that received usual care; a group that received regular daily telephone call reminders; and a group that received daily videotelephone call reminders. Compliance was defined as the percent of therapeutic coverage as recorded by Medication Event Monitoring System (MEMS) caps. Subjects were recruited from 2 sources: a large urban home health care agency and a large urban ambulatory clinic of a major teaching hospital. Baseline and post-intervention MOS 36-ltem Short-Form Health Survey (SF-36) scores and Minnesota Living with Heart Failure (MLHF) scores were obtained. Results: There was a significant time effect during the course of the study from baseline to post-intervention (F [2,34] = 4.08, ? < .05). Over the elderly individuals who were called, either by telephone or videotc phone, showed enhanced medication compliance relative to the cot group. There was a trend, but no significant difference between the intervention groups. Both SF-36 and MLHF scores improved from bé line to post-intervention for all groups. There was no significant ch« in the SF-36 scores for the sample, but there was a significant change the MLHF scores (p < .001). The control group had a significant fall in the medication compliance rate during the course of the study, drc ping from 81 % to 57%. Conclusions: Telephone interventions are effective in enhancing medk tion compliance and may prove more cost effective than clinic vis preparation of pre-poured pill boxes in the home. Technologie advi which enable clinicians to monitor and enhance patient medication cc pliance may reduce costly and distressing hospitalization for elderly viduals with CHF.