Effect of Medication Album and Medical Adherence in Patients with Chronic Disease in Primary Care

Abstract

Background: Patients with chronic diseases who fail to achieve target levels of disease control in the service areas of Ban Wat Cai and Bang Muang Primary Care Units, Nakhon Sawan, Thailand, often require medication adjustments to optimize disease management.  However, incorrect medication use following these adjustments has frequently been observed, resulting in suboptimal disease control.  To address this issue, a medication album was introduced to support medication adjustments among patients with chronic diseases.  Nevertheless, evidence regarding the effectiveness of this intervention remains limited. This study aimed to compare the medication adherence of patients with chronic diseases who underwent medication adjustments in a group that used a medication album supported by verbal counseling and a group that received medication adjustments with verbal counseling alone.

Methods:  This study was conducted as a Quasi-experimental study with a non-equivalent control group design.  Patients with chronic diseases receiving services at Bang Muang Primary Care Unit underwent medication adjustments supported by a medication album and verbal counseling, whereas those at Ban Wat Cai Primary Care Unit received medication adjustments with verbal counseling alone.  Medication adherence was evaluated by assessing patients’ ability to explain their medication regimens and through pill counts. Evaluations were performed by pharmacists who were blinded to the intervention groups. Comparative analyses between groups were conducted using multivariable log-risk regression.

Result: A total of 144 patients with chronic diseases were included. After excluding patients according to the exclusion criteria, 106 patients remained. Of these, 42 patients received medication adjustments supported by the medication album, whereas 64 received medication adjustments without the medication album. Multivariable log-risk regression analysis demonstrated that patients who received medication adjustments supported by the medication album were 1.31 times more likely to use their medications correctly than those who did not receive the medication album (95% CI, 1.08–1.59).

Conclusion: Integrating a medication album with verbal explanation during medication adjustment significantly enhances medication adherence among patients with chronic diseases and a history of inappropriate medication use in primary care. This study recommends using a medication album as standard care for patients with chronic disease in primary care.