Clinical pharmacists effectively identified and managed drug-related problems and reduced patient concerns about medications, which explains improved medication adherence in coronary patients, though the intervention did not impact prescription quality or LDL-C target achievement.
Medication reviews were conducted for the majority of intervention patients, with a high mean number of drug-related problems identified per patient.
Pharmacists managed the majority of identified drug-related problems, either independently with patients or in collaboration with physicians.
The pharmacist intervention did not result in differences in prescribing quality between intervention and control groups at six months post-discharge.
Patients in the intervention group showed greater reduction in concern scores about their medications compared to control patients.
The MIMeRiC parent trial had previously demonstrated that the pharmacist-led intervention increased adherence to cholesterol-lowering medications and aspirin and improved overall beliefs about medicines.
This study examined how and why a pharmacist-led program helped heart disease patients take their medications more consistently. The program, called MIMeRiC, involved pharmacists conducting detailed medication reviews and using motivational interviewing techniques with patients who had been treated at a cardiology clinic. This paper looks 'under the hood' of the program to understand what pharmacists actually did and what changed for patients as a result. The researchers found that pharmacists identified an average of more than four medication-related problems per patient, and that the vast majority of problems where the outcome was known were resolved or improved — either by the pharmacist working directly with the patient or by consulting with the patient's physician. Importantly, patients who received the intervention became less worried about their medications over time compared to patients who did not receive it, and more than half of intervention patients shifted from an uncertain or ambivalent attitude about their medications to an accepting one, compared to about a third of control patients. This reduction in concern about medications appears to explain why intervention patients were more likely to take their medications as prescribed. This research suggests that pharmacists can play a meaningful role in identifying and fixing medication problems and in helping patients feel more comfortable with their treatment regimens. However, the program did not change how doctors prescribed medications overall, and it did not result in more patients reaching their cholesterol targets — indicating that improving adherence alone may not be sufficient to achieve all desired health outcomes. These findings highlight both the promise and the limitations of pharmacist-led adherence interventions in heart disease care.
Östbring M, Al Musawi A, Eriksson T, Hellström L. (2026). Impact of a pharmacist adherence intervention on medication beliefs and drug-related problems in coronary patients - a process evaluation of the MIMeRiC trial.. BMC health services research. https://doi.org/10.1186/s12913-026-15037-5