TELEPHONE CONTACTS DO NOT IMPROVE ADHERENCE TO NIACIN OR BILE-ACID SEQUESTRANT THERAPY

OBJECTIVE: Noxious adverse effects frequently limit patient acceptance of niacin and bile acid sequestrants (BAS), first-line agents in the management of hypercholesterolemia. The purpose of this study was to d etermine whether telephone contacts from a healthcare professional cou ld improve drug adherence and tolerance in patients prescribed these m edications. PATIENTS AND METHODS: This was a randomized, single-blind trial of telephone contacts vs. no intervention in patients with hyper lipidemia who were prescribed either niacin or BAS in a large, Veteran s Affairs, lipid clinic. Patients randomized to telephone contact (n-- 8 1) received weekly calls from a trained healthcare professional duri ng the first month of drug therapy. Counseling regarding adverse effec ts, and prescriptions to overcome minor adverse effects, were provided as needed to patients during the telephone contact. RESULTS: Signific ant differences were not observed between groups in the drug discontin uance rate, adherence assessed by two independent methods, or in the f inal dosage of medication ingested. CONCLUSIONS: Telephone contacts do not improve either adherence or tolerance to niacin or BAS. Alternati ve approaches to enhance acceptance of these medications requires furt her evaluation.