Improving Proton-Pump Inhibitor Adherence Intervention Between Primary Care and Community Pharmacies: A Pre-Post Intervention Study.

Abstract

Purpose: Proton-pump inhibitor (PPI) therapy stands as the primary treatment for upper gastrointestinal symptoms, yet poor adherence often results in treatment failure. Given that patients experiencing these symptoms frequently seek assistance at community pharmacies, the development of collaborative tools with primary care is becoming imperative. The objective was to assess the effectiveness of a pharmaceutical intervention, as demonstrated by a collaborative model between primary care and community pharmacies, in enhancing adherence to PPI among patients experiencing upper gastrointestinal symptoms.

Patients and methods: A Pre-post intervention study was carried out in Spanish community pharmacies (June-October 2022). During the baseline visit, patients' sociodemographic and clinical variables were evaluated. Patients were categorized as adherent or non-adherent using the Morisky Medication Adherence Scale (MMAS-4). In the follow-up visit (14 days later), the impact of the intervention was measured by changes in the Gastroesophageal Reflux Disease Impact Scale (GIS).

Results: Of the 351 patients with an active PPI prescription, 178 (50.7%) were non-adherent. Nearly 70% of these patients (122, 68.5%) received an intervention to improve adherence. The overall GIS score improved after the intervention (mean 25.34, SD 5.66 vs mean 27.64, SD 5.63, p < 0.001). All GIS score items showed improvement after the intervention except for the item regarding the taking of additional medication different from that prescribed by the clinician (p = 0.200).

Conclusion: The pharmaceutical intervention had a positive impact on patients' symptom relief and overall quality of life, highlighting the significance and efficacy of a collaborative model between primary care and professional pharmaceutical services.

Clinical trials registry: Clinical Trial Registration (NCT05162079).