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AMBULATORY CARE

Pharmacist Intervention Enhances Adherence to Orlistat Therapy

Professor, Department of Pharmacy Practice, Albany College of Pharmacy, Albany, NY

Sharon A Alger-Mayer, MD

Associate Professor, Division of Clinical Nutrition, Albany Medical College, Albany

Reprints: Margaret Malone PhD FCCP, Department of Pharmacy Practice, Albany College of Pharmacy, 106 New Scotland Ave., Albany, NY 12208-3492, FAX 518/445-7302, malonem{at}acp.edu

BACKGROUND: Pharmacists, especially those in community practice, should increase their level of intervention in dealing with the nationwide epidemic of obesity since they interact with large numbers of the public on a regular basis. We hypothesized that patients who receive medication for weight loss may have an improved therapeutic outcome if they received additional support from their community pharmacist.

OBJECTIVE: To evaluate the impact of pharmacist support on patient persistence with orlistat.

METHODS: Pharmacists were trained in basic obesity management skills. Patients who were prescribed orlistat and attending an outpatient nutrition program were invited to participate in the study. All patients agreed to receive pharmaceutical care. Those who lived where the service was available were assigned to the intervention (I) group and those who did not were assigned to the control (C) group. All patients received usual care provided by the outpatient clinic.

RESULTS: Thirty patients, 15 in the I group and 15 in the C group, were recruited. Both groups were predominantly women (87%) with a mean ± SD age of 43.8 ± 9.7 years. Patients in the I group had significantly greater persistence with orlistat therapy as assessed by duration of therapy (p = 0.006) and number of patients completing the 26-week study (7 I, 2 C; p = 0.046). There was no significant difference in percent of weight loss between groups (p > 0.05).

CONCLUSIONS: In this pilot study, patients receiving pharmaceutical care took orlistat longer than the controls and had improved outcome with orlistat therapy.

Key Words: adherence, orlistat, persistence, pharmaceutical care

Published Online, September 5, 2003. www.theannals.com, DOI 10.1345/aph.1D183

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