EFFECT OF A MULTIDISCIPLINARY INTERVENTION ON MEDICATION COMPLIANCE IN ELDERLY PATIENTS WITH CONGESTIVE-HEART-FAILURE

PURPOSE: The objectives of this investigation were to prospectively as sess medication compliance rates in elderly patients with congestive h eart failure, to identify factors associated with reduced compliance, and to evaluate the effect of a multidisciplinary treatment approach o n medication adherence. PATIENTS AND METHODS: A total of 156 patients greater than or equal to 70 years of age (mean, 79.4 +/- 6.0; 67% fema le, 65% nonwhite) hospitalized with congestive heart failure were eval uated prospectively. Prior to discharge, patients were randomized to t he study intervention (n = 80) or conventional care (n = 76). The inte rvention consisted of comprehensive patient education, dietary and soc ial service consultations, medication review, and intensive postdischa rge follow-up. Detailed data were collected on all prescribed medicati ons at the time of discharge, and compliance was assessed by pill coun ts 30 +/- 2 days later. RESULTS: The overall compliance rate during th e first 30 days after discharge was 84.6 +/- 15.1% (range, 23.1-100%). Compliance was 87.9 +/- 12.0% in patients randomized to the study int ervention, compared with 81.1 +/- 17.2% in the control group (P = 0.00 3). A compliance rate of greater than or equal to 80% was achieved by 85.0% of the treatment group versus 69.7% of the control group (P = 0. 036). By multivariate analysis, assignment to the treatment group was the strongest independent predictor of compliance (P = 0.008). Other v ariables included in the model were Caucasian race (P = 0.044) and not living alone (P = 0.09). CONCLUSIONS: A multidisciplinary treatment s trategy is associated with improved medication compliance during the f irst 30 days following hospital discharge in elderly patients with con gestive heart failure, Improved compliance may contribute to improved outcomes in these patients.