Medication Adherence Improvement By Using Administration Timing Simplification Protocol (ATSP) in Cardiovascular Disease Patients

Abstract

Aims: In chronic diseases, keeping adherence to medication is very difficult. The objective of this study was to evaluate the impact of administration timing simplification protocol (ATSP) on medication adherence and clinical parameters of cardiovascular diseases. Methods: 210 out-patients with cardiovascular disease, who were taking two or more pills of any type of medication per day for more than one year, were enrolled and randomized. The intervention group followed the simplified administration schedule of ATSP with two main strategies: 1) moving medication from "pc" (30 minute after meal) to "stat. pc" (immediately after meal); and 2) moving medication time from "at evening" to "at morning." In contrast, the control group maintained the same medication schedule. Both patient groups were equally educated about the names and effects of the medication. Results: The intervention group had more pills than the control group with marginal statistical significance (5.1 +/- 2.3 vs 4.6 +/- 1.8, p = 0.05). The total frequency of administration was significantly higher in the intervention group than that of the control group (2.9 +/- 1.0 vs 2.6 +/- 0.9, p = 0.03) at the baseline. In the intervention group, the frequency was significantly decreased to 1.5 +/- 0.6 times per day after following ATSP application (p < 0.01). In both patient groups, knowledge about the medication was significantly improved by education. However, medication adherence was only improved in the intervention group. Interestingly, total cholesterol was significantly decreased in the intervention group (p < 0.01). The decrease in serum cholesterol concentration was significantly correlated with the improvement in medication adherence evaluated with Morisky Medication Adherence Scale (MMAS)-8 items (r = 0.507, p < 0.01). Conclusion: ATSP was shown to be an effective strategy to improve medication adherence in chronic cardiovascular disease patients.