Abstract
Background Poor adherence to medication can lead to suboptimal outcomes, and is reported to occur frequently. Pharmacists in some countries are funded to support the appropriate use of medications in patients and enhance medication adherence, by providing services such as Medicines Use Review (MUR). Objective To describe and investigate factors that may influence patients' knowledge and perceptions of and adherence to medications as determined during MUR. Setting Community pharmacies in a locality in New Zealand. Method Following consent from five MUR service providers, records of patients' MUR consultations conducted between November 2007 and December 2011 were retrospectively reviewed for information on patients, services, and outcomes. Using multilevel mixed-effects logistic regression, factors that predicted the providers' score of the patients' medication knowledge, and the patients' score of their adherence to and perceptions of medications, were investigated. Main outcome measure patients' knowledge, perceptions and adherence scores. Results A total of 353 MUR patients' records were evaluated. The median (IQR) age of patients was 73 (63-81) years. About 41.1 % of patients were MAori. A total of 204 (57.8 %) patients had two MUR consultations and only 53 (15 %) had four. The mean score of patients' knowledge, perceptions of, and adherence to medications were found to increase in each visit which suggests that adherence support by pharmacists might improve patients' outcomes. Females had higher medication knowledge scores than males (OR 3.09, 95 % CI 1.29-7.44). There was some evidence to suggest MAori had lower scores for knowledge of medications than non-MAori (OR 0.092, 95 % CI 0.02-0.36). In addition, longer duration in the program predicted better scores for medication knowledge, adherence and perceptions of medications. Conclusions MUR was found to have the potential to improve the scores of patients' knowledge and perceptions of and adherence to medicines, and factors such as gender, ethnicity and longer duration in the services were found to predict these outcomes.