Cat.
% yes phys. (n=209) % yes pharm (n=118)
% yes pharm tech (n=366)
%yes pharm team (n=484)
Knowledge
Explain what cholesterol is and why raised cholesterol is undesirable
S
96
54
50
51
Discuss what a statin is and the mechanism of action
S
77
92
80
83
Hand out brochure or written information about statins
S
12
92
95
94
Discuss drug storage recommendations
S
3
35
41
39
Explain what to do if a dose is missed
S
22
34
44
42
Do you ask patients to repeat the received information in their own words regularly, to check whether the information is understood properly? (Refers to items:1;2;3;4;5;12;15;16;26;31;32;33)
S
18
19
21
21
Verbal explanation to the patient
S
94
99
98
98
Use of illustrative materials (pictures/charts/video)
S
14
4
3
3
Hand out written information
S
20
94
97
96
Refer patients to websites
S
38
8
7
7
Do you ask patients to repeat the received information in their own words regularly, to check whether the information is understood properly? (Refers to items:13;17;20;21;22;28;29;30)
S
19
17
19
18
Awareness
Discuss the consequences of non-adherence
S
49
50
48
49
Encourage patients to use a 7-day pillbox
S
47
36
37
37
Giving feedback about the effect of the statin using laboratory findings
F
95
18
10
12
Attitude
Explain that the patient doesn’t notice the effect of the statin but that the effect is evaluated by blood tests to check cholesterol levels
S
87
82
79
80
Discuss the importance of adherence
S
77
84
80
81
Encourage patients to be adherent
S
81
77
78
78
Ask the patient about non-practical problems with taking the medication as prescribed (unwilling to take medication, for example because of misunderstandings about taking medication)
F
56
36
35
35
In case of non-practical problems, propose solutions to solve these problems (for example discussing the necessity or concerns, referral to nurse practitioner)
F
67
70
61
63
Social influence
Involve partner and/or relatives in the treatment
S
30
21
15
16
Self efficacy
Encourage patients to plan ahead (for example for holidays or social activities)
S
19
16
26
23
Discuss potential barriers regarding adherence and possible ways to overcome them
S
41
42
26
30
Ask the patient if he/she is taking the medication as prescribed
F
79
67
69
68
Ask about practical problems with taking medication as prescribed (for example forgetting it or being unable to open the packaging)
F
29
41
34
36
In case of practical problems, discuss solutions with the patient to reduce these practical problems
F
56
84
81
82
Intention formation
Explain how often and how long the medication should be used
S
95
93
96
95
Develop and discuss a written individual dosing schedule
S
21
25
17
19
Write down patients’ dosing schedule (time, name of meds, number of doses)
S
22
41
39
39
Action control
Identify daily routines (like brushing teeth) and encourage patients to align the taking of medicines with their routines
S
36
35
39
38
Encourage patients to use alarm devices as a reminder for taking the medication
S
9
16
10
11
Facilitation
Discuss the common side effects of the drug
S
86
97
99
98
Discuss with the patient how to deal with side-effects
S
75
84
93
90
Monitor and/or discuss possible interactions with other drugs
S
63
98
99
99
Discuss the experienced positive effects of the treatment
F
47
38
38
38
Asking about (perceived) side-effects of the treatment
F
91
82
88
87
If patients experience side-effects, there is an active contribution to reduce these side-effects (sometimes by providing knowledge or adjusting the treatment)
F
93
92
81
84
Suggesting a new medication regimen in case patients feel their present regimen is too complex
F
72
84
59
65
Call the patient after the initiation of the drugs to ask about experiences
G
9
10
14
13
Give the patient a telephone number and tell who to contact in case of side-effects
G
23
25
25
25
Give the patient a telephone number and tell who to contact in case of problems with intake/medication adherence
G
19
15
21
20
Explain patients who to contact in case they would run out of medication
G
74
69
84
80
Metascore
Intensify the number of follow-up visits in case of (possible) treatment non-adherence
G
38
19
12
14
Refer patients to another health care provider for (co-)treatment (e.g., in case of side-effects)
G
35
60
47
50