Improving Medication Compliance by Counseling and Special Prescription Container

Abstract

The effects of patient counseling and the use of special medication containers on compliance among 100 hypertensive patients were Studied. Patients who were attending a hypertension clinic, who were prescribed two or more medications per day, and who routinely obtained prescription refills at the clinic's pharmacy, were assigned randomly to one of four groups—control; received disease and medication counseling; used a special medication container; and received counseling plus used the container. The container had a separate compartment for each dose, labeled with the day and time the dose was to be taken. Measures of compliance over a three-month period included attendance (for scheduled appointments at either the clinic or pharmacy for a refill), dosage-unit count, and arterial blood pressure readings. The two groups receiving counseling kept more appointments than either the control group (p <0.05) or the container-alone group (p <0.05), and attendance was better for clinic appointments than pharmacy appointments (p <0.002). Each intervention had an additive effect in increasing compliance. Highest levels of medication compliance were found in the containerplus-counseling and container-alone groups (p <0.01), indicating that the special container had a positive effect. The latter group also experienced a significant decrease (p <0.02) in diastolic blood pressure. The study showed that special treatment of any kind tended to improve medication compliance. Counseling increased patient knowledge and interest, and the medication container helped patients to follow prescribed regimens more closely.