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To the Editor: In their randomized controlled trial, Dr Lee and colleagues¹ found a beneficial effect of a pharmacy care program on patient medication adherence. They attempted to compare broad strategies rather than isolate single processes, which is an appropriate focus.² However, there are 2 points that need to be considered when interpreting their results.

First, while the increases in medication adherence and persistence are likely a result of the pharmacy care program, the same cannot be concluded about the clinical outcomes of blood pressure and lipid levels. This is because some nonpharmacological variables that could act as confounders were either not assessed or not adjusted for in their analyses. These factors include physical activity, diet, obesity, work status, and family history.^3-4 It would be informative if the authors could present a baseline comparison of these variables in the 2 study groups and present an adjusted analysis if there were . . . [Full Text of this Article]

Aldo Mariotto, MD
aldo.mariotto@ulss17.it
Department of Primary Health Care
Padova, Italy

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