A Randomised Pilot Study on the Impact of Pharmacists’ Telephone Follow-Up on Medication Adherence among Patients Receiving Antiretroviral Medication Delivered Through Postal Service (MDPS)

Abstract

Introduction:
Adherence to antiretroviral therapy (ART) remains a great challenge. Close monitoring is required at all times to rapidly identify non-adherent patients, establish the causes, and find suitable solutions. This pilot study investigated the impact of pharmacists’ telephone follow-up — Enhanced Pharmacist-Assisted Service in Antiretroviral Therapy (EPAS-ART), on top of the standard care on ART adherence among patients receiving ART via Medication Delivered through Postal Service (MDPS).
Methods:
Patients who receive ART medication from Hospital Pulau Pinang were randomly assigned to either EPAS-ART in addition to the standard care, or the standard care alone. The EPAS-ART intervention offers monthly telephone follow-up sessions over six months to review patients’ medication adherence, adverse drug reactions, and medication concerns, followed by individualised recommendations to address any identified issues. The primary outcome was self-reported medication adherence by pill counting at 6 months.
Results:
A total of 60 patients on ART medication with a mean age of 41.28 ± 10.17 years, completed the 6-month follow-up. The age, gender, ethnicity, ART regime, and duration of ART were similar between the EPAS-ART group and standard care group. There was slight improvement from baseline to 6 months follow-up in self-reported medication adherence for the EPAS-ART group, and a slight decline in the standard care group. However, there were no significant differences between the groups in mean self-reported medication adherence (P=0.062).
Conclusion:
The study showed no statistically significant difference in self-reported medication adherence between the EPAS-ART and standard care groups. However, the intervention had an impact on maintaining optimum medication adherence among patients in the EPAS-ART group with an early detection of patients’ adverse drug reactions to the ART regimen.