Federal Study of Adherence to Medications in the Elderly (FAME)

NCT ID: NCT00393419

Last Updated: 2006-10-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-06-30

Study Completion Date

2006-08-31

Brief Summary

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The purpose of this study is to determine the effect of a comprehensive pharmacy care program on medication adherence and persistence, blood pressure, and LDL cholesterol.

Detailed Description

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Poor medication adherence is prevalent, difficult to manage, and diminishes the health benefits of pharmacotherapies. Elderly patients with coronary risk factors frequently require treatment with multiple medications which places them at increased risk for medication nonadherence. Effective strategies to improve adherence in the elderly are lacking, and improved health outcomes in this population have not been demonstrated.

Objective: We tested the efficacy of a comprehensive pharmacy care program including patient education and an adherence aid (medications custom-packaged in blister packs) to improve medication adherence and its associated effects on blood pressure and low density lipoprotein cholesterol.

This is a Multi-phase, prospective observational and randomized controlled trial. We enrolled community-based patients aged ≥ 65 years old taking ≥ 4 chronic medications per day.

Intervention: After a 2-month run-in phase during which baseline medication adherence (via pill counts), blood pressure, and low-density lipoprotein cholesterol were measured, participants entered a 6-month intervention phase during which standardized medication education and regular follow-up by a clinical pharmacist was provided and medications were dispensed in daily, time-specific blister packs. Following the intervention phase, participants were randomized to continued pharmacy care/blister packs versus usual care (return to their original method of medication administration) for an additional 6 months.

Main Outcome Measures: The primary endpoint of the observation phase was the change in the proportion of pills taken compared to baseline; secondary endpoints were the associated changes in low-density lipoprotein cholesterol and blood pressure. The primary endpoint of the randomized trial was the between-group comparison of medication persistence analyzed according to intention to treat.

Conditions

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Medication Adherence Hypertension Hyperlipidemia

Keywords

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hypertension hyperlipidemia adherence pharmacist elderly medication

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

ECT

Blinding Strategy

NONE

Interventions

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Comprehensive pharmacy care program

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* 65 years or older taking 4 or more chronic medications independently living

Exclusion Criteria

* assisted living or nursing home residents presence of any serious medical condition for which 1-year survival was expected to be unlikely
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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American Society of Health-System Pharmacists

OTHER

Sponsor Role collaborator

Walter Reed Army Medical Center

FED

Sponsor Role lead

Principal Investigators

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Allen J Taylor, MD

Role: STUDY_DIRECTOR

Walter Reed Army Medical Center

Jeannie K Lee, Pharm.D

Role: PRINCIPAL_INVESTIGATOR

Walter Reed Army Medical Center

Locations

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Walter Reed Army Medical Center

Washington D.C., District of Columbia, United States

Site Status

Countries

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United States

References

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Blackburn DF, Dobson RT, Blackburn JL, Wilson TW. Cardiovascular morbidity associated with nonadherence to statin therapy. Pharmacotherapy. 2005 Aug;25(8):1035-43. doi: 10.1592/phco.2005.25.8.1035.

Reference Type BACKGROUND
PMID: 16207093 (View on PubMed)

Abughosh SM, Kogut SJ, Andrade SE, Larrat P, Gurwitz JH. Persistence with lipid-lowering therapy: influence of the type of lipid-lowering agent and drug benefit plan option in elderly patients. J Manag Care Pharm. 2004 Sep-Oct;10(5):404-11. doi: 10.18553/jmcp.2004.10.5.404.

Reference Type BACKGROUND
PMID: 15369423 (View on PubMed)

Jackevicius CA, Mamdani M, Tu JV. Adherence with statin therapy in elderly patients with and without acute coronary syndromes. JAMA. 2002 Jul 24-31;288(4):462-7. doi: 10.1001/jama.288.4.462.

Reference Type BACKGROUND
PMID: 12132976 (View on PubMed)

Sokol MC, McGuigan KA, Verbrugge RR, Epstein RS. Impact of medication adherence on hospitalization risk and healthcare cost. Med Care. 2005 Jun;43(6):521-30. doi: 10.1097/01.mlr.0000163641.86870.af.

Reference Type BACKGROUND
PMID: 15908846 (View on PubMed)

Lee JK, Grace KA, Taylor AJ. Effect of a pharmacy care program on medication adherence and persistence, blood pressure, and low-density lipoprotein cholesterol: a randomized controlled trial. JAMA. 2006 Dec 6;296(21):2563-71. doi: 10.1001/jama.296.21.joc60162. Epub 2006 Nov 13.

Reference Type DERIVED
PMID: 17101639 (View on PubMed)

Other Identifiers

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04-36002

Identifier Type: -

Identifier Source: org_study_id