Impact of a motivational interviewing intervention targeting statins on adherence to concurrent hypertension or diabetes medications

Anjana Mohan, University of Houston College of Pharmacy, Department of Pharmaceutical Health Outcomes and Policy, United States. Electronic address: anjanamohan1611@gmail.com.
Aisha Vadhariya, Duquesne University School of Pharmacy Graduate School of Pharmaceutical Sciences, 418A Mellon Hall, United States. Electronic address: aishavadhariya@gmail.com.
Zahra Majd, University of Houston College of Pharmacy, Department of Pharmaceutical Health Outcomes and Policy, United States. Electronic address: majd.zahra@gmail.com.
Tara W. Esse, CareAllies, Houston, Texas, United States. Electronic address: tara.esse@careallies.com.
Omar Serna, CareAllies, Houston, Texas, United States. Electronic address: oserna@careallies.com.
Susan M. Abughosh, University of Houston College of Pharmacy, Department of Pharmaceutical Health Outcomes and Policy, United States. Electronic address: smabugho@central.uh.edu.

Abstract

OBJECTIVE: This study explored if a motivational interviewing intervention customized for statins impacted adherence to concomitantly used antidiabetic/antihypertensive medications. METHODS: The intervention was conducted among patients with a history of suboptimal adherence to statins and included 152 patients in intervention and 304 controls. This retrospective study design identified patients with claims for statins and either antidiabetic/antihypertensive medications. The outcome variable was adherence, measured as proportion of days covered ≥ 0.80, to antidiabetic/antihypertensive medications. Multivariable linear and logistic regression evaluated the effect of intervention on adherence to antidiabetic/antihypertensive medications during the 6 months post-intervention. RESULTS: The antidiabetic group had 53 intervention patients and 102 controls. The antihypertensive group had 80 intervention patients and 159 controls. There was no significant improvement in adherence for antidiabetic/antihypertensive medications following the intervention. Adherence at baseline was a significant predictor of adherence post-intervention in the antidiabetic (OR = 6.5;P < 0.0001) and antihypertensive (OR = 4.1; P = 0.0001 & β = 0.09; P = 0.008) users. Physician specialty (OR = 3.902; P = 0.01& β = 0.09; P = 0.015) among antidiabetic users and age >70 years (OR = 2.148; P = 0.025) among antihypertensive users were predictors of adherence. CONCLUSION: The intervention targeting statin did not significantly improve antihypertensive/antidiabetic adherence. PRACTICE IMPLICATIONS: Targeted interventions tailored to patient past adherence and specific medications should be explored.