Table 4.

Studies with Non-Significant or No Improvement in Medicine Adherence (N=6)

Author, Year, Country	Study Design and Population	Pharmacist Intervention	Comparator, Follow-Up and Outcome Measures	Key Findings
Eussen et al, 201029 (Netherlands)	A multicentre, open-label RCT included 899 patients on statin medications.	Five structured counselling sessions over a year.	Comparator: usual care. Follow-up: 6 and 12 months. Outcomes: Primary (adherence, 1-year discontinuation rate), Secondary (6 months discontinuation rate, ≥90% MPR and LDL-C levels).	The intervention showed a lower discontinuation rate of that was significant only at 6 months but not significant at 1 year. Median MPR was not significantly different between groups (99.5% vs. 99.2%, p=0.14). Adherent patients were more likely to achieve target LDL-c levels at 6 months (74% vs. 50%, p=0.01).
Kooy et al 201319 (Netherlands)	RCT included 299 elderly patients (65 years or above) who had started statins at least one year.	Electronic reminder device (ERD) with or without counselling sessions.	Comparator: control group. Follow-up: 360 days. Outcomes: adherence (refill ≥80%).	Overall, refill adherence was not significantly improved with counselling with ERD (69.25, p=0.55), ERD only (72.4%, p=0.18) compared to control group (64.8%). There was no assessment for clinical outcomes.
Ma et al, 201014 (USA)	RCT involved 689 patients with underlying CHD who had an LLT prescription.	Five Telephone counselling calls.	Comparator: usual care. Follow-up: 12 months. Outcomes: Primary (% patients achieved LDL-C levels), Secondary (adherence, continuous multiple-interval (CMA) from pharmacy records).	The intervention did not show significant improvement in statin adherence (0.88 vs. 0.90, p=0.51). It had no significant impact on clinical outcomes (65% vs. 60%, p=0.29).
Gums et al, 201520 (USA)	Cluster RCT included 593 patients who had at least one AHT.	Physician-pharmacist collaboration management (PPCM)	Comparator: usual care. Follow-up: 9 months. Outcomes: Primary (Adherence, self-reported questionnaire), Secondary (medication changes).	There was no significant difference in the measures of medication adherence between the groups. Patients in the intervention group experienced higher medication changes compared to control group (4.9 vs. 1.1, p=0.003). There was no assessment for clinical outcomes.
Wong et al, 201315 (Hong Kong)	RCT included 274 patients taking at least one long-term AHT and having suboptimal compliance	Counselling sessions with structured patient education and provision of pillboxes and medication knives.	Comparator: usual care (brief drug advice). Follow-up: 3 and 6 months. Outcomes: Primary (BP control), Secondary (adherence, self-reported)	Overall, both percentage of patients with optimal adherence and BP control were improved throughout study period. However, there were no significant differences between the groups in both outcome measures.
Van der Laan et al, 201828 (Netherlands)	RCT included 170 patients who were on AHT.	Two face-to-face consultation (3 months apart).	Comparator: usual care. Follow-up: 9 months. Outcomes: Primary (self-reported adherence), Secondary (BP control).	There were no significant differences between intervention and control groups in both outcome measures.