International Journal of Clinical Pharmacy

, Volume 36, Issue 5, pp 1048–1058 | Cite as

Impact of community pharmacist intervention discussing patients’ beliefs to improve medication adherence

  • Gina GujralEmail author
  • Karl Winckel
  • Lisa M. Nissen
  • W. Neil Cottrell
Research Article


Background Adherence to evidence based medicines in patients who have experienced a myocardial infarction remains low. Individual’s beliefs towards their medicines are a strong predictor of adherence and may influence other factors that impact on adherence. Objective To investigate if community pharmacists discussing patients’ beliefs about their medicines improved medication adherence at 12 months post myocardial infarction. Setting This study included 200 patients discharged from a public teaching hospital in Queensland, Australia, following a myocardial infarction. Patients were randomised into intervention (n = 100) and control groups (n = 100) and followed for 12 months. Method All patients were interviewed between 5 to 6 weeks, at 6 and 12 months post discharge by the researcher using the repertory grid technique. This technique was used to elicit the patient’s individualised beliefs about their medicines for their myocardial infarction. In the intervention group, patients’ beliefs about their medicines were communicated by the researcher to their community pharmacist. The pharmacist used this information to tailor their discussion with the patient about their medication beliefs at designated time points (3 and 6 months post discharge). The control group was provided with usual care. Main outcome measure The difference in non-adherence measured using a medication possession ratio between the intervention and control groups at 12 months post myocardial infarction. Results There were 137 patients remaining in the study (intervention group n = 72, control group n = 65) at 12 months. In the intervention group 29 % (n = 20) of patients were non-adherent compared to 25 % (n = 16) of patients in control group. Conclusion Discussing patients’ beliefs about their medicines for their myocardial infarction did not improve medication adherence. Further research on patients beliefs should focus on targeting non-adherent patients whose reasons for their non-adherence is driven by their medication beliefs.


Adherence Australia Beliefs Community pharmacist intervention Myocardial infarction Repertory grid technique 



We would like to thank all study participants and community pharmacists involved in this research for giving up their time to take part in the study.


This work was supported by the Pharmacy Board of Queensland Research Grants Program 2008, Brisbane, Queensland. The Pharmacy Board had no input in the research design, methodology or results. The ideas expressed in this manuscript are those of the authors and are not intended to represent the position of the Board or members of the Board.

Conflicts of interest

There are no conflicts of interest.


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Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2014

Authors and Affiliations

  • Gina Gujral
    • 1
    Email author
  • Karl Winckel
    • 1
    • 2
  • Lisa M. Nissen
    • 1
    • 3
  • W. Neil Cottrell
    • 1
  1. 1.School of PharmacyThe University of QueenslandBrisbaneAustralia
  2. 2.Department of PharmacyPrincess Alexandra HospitalBrisbaneAustralia
  3. 3.School of Clinical SciencesQueensland University of TechnologyBrisbaneAustralia

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