Support of medication adherence by community pharmacists in Czech and Slovak Republics: a questionnaire survey study

M. Molitorisová 1 , J. Kotlářová 2 , M. Snopková 3  and I. Waczulíková 4
  • 1 Slovak Medical University in Bratislava, Faculty of Public Health, Bratislava
  • 2 Charles University, Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy, Hradec Králové
  • 3 Comenius University in Bratislava, Faculty of Pharmacy, Department of Organisation and Management of Pharmacy, Bratislava
  • 4 Comenius University in Bratislava, Faculty of Mathematics, Physics and Informatics, Department of Nuclear Physics and Biophysics, Bratislava


Introduction: Intervention of pharmacists in medication adherence can meaningfully contribute to achieving therapeutic outcomes. Exploring the real-life readiness and opportunities of pharmacists may result in the adoption of measures, which could be seen through improvement of patients’ adherence to pharmacotherapy.

Aim: The aim of the paper was to make a survey on community pharmacists’ potential in medication adherence support in its connectivity to technical and personnel factors, which underline the capacities of pharmacies in dealing with medication adherence.

Methods: The questionnaire survey was conducted from October to December 2014 and involved 158 pharmacists from 117 Czech (CZ) and 41 Slovak (SK) community pharmacies. The structured questionnaire surveyed both technical and personnel factors, including provision of consultancy services related to medication adherence. Non-adherence risk reduction was evaluated by adopting Morisky Scale modified from the pharmacist’s perspective. Questionnaires outcomes were summarised in contingency tables and analyzed for associations between respective categorical variables using χ2 or exact tests and association coefficients. All results are reported as significant at P≤0.05.

Results: The average score of adherence support (CZ/SK 1.95/1.93) was significantly higher as compared to that of persistence or concordance (P<0.001). Reduction of non-adherence risk reached the score of a medium degree (P=0.73, average 2.29 in CZ and 2.22 in SK). These findings were significantly associated with personnel capacities (provision of consultancy, preference for the use of recommended procedures in CZ (P<0.001), number of years of practice in SK (P=0.029)), while significant association with technical equipment (consultancy room) in the SK (P=0.037).

Conclusion: The pharmaceutical care is developing towards the improvement of medication adherence in both countries - assuming a medium degree of adherence support. Further progress may be observed in strengthening the pharmacists’ personnel capacities, and accelerated mainly using information technologies, i.e. through technical capacities.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • [1] Czech Chamber of Pharmacists: Counselling in Pharmacies. (; (in Czech). Revised September 7, 2010. Accessed March 2016.

  • [2] Czech Chamber of Pharmacists: Pharmacies in Smartphones. (; (in Czech). Revised November 15, 2013. Accessed March 2016.

  • [3] Decree No 92/2012 Coll. on the requirements for the minimum technical and material equipment of health facilities and home care contact centers. Ministry of Health. (; (in Czech). Revised March 15, 2012. Effective April 1, 2012. Accessed March 4, 2016.

  • [4] Decree No 129/2012 Coll. on the requirements for good pharmacy practice. Ministry of Health of the Slovak Republic. (; (in Slovak).Revised April 12, 2012. Effective May 15, 2012. Accessed March 4, 2016.

  • [5] FIP. International Pharmaceutical Federation:FIP/WHO Joint Guidelines on Good Pharmacy Practice - Standards for Quality Services. 2011. ( Accessed March 4, 2016.

  • [6] Kriška M, Gajdošík J, Dukát A, Bernadič M. Zlyhanie farmakoterapie – možnosti prevencie. Bratislava: Slovak Academic Press; 2015; (in Slovak).

  • [7] Lau R, Stewart K, McNamara KP et al. Evaluation of a community pharmacy-based intervention for improving patient adherence to antihypertensives: a randomised controlled trial. BMC Health Services Research. 2010; doi: 10.1186/1472-6963-10-34. PubMed

  • [8] Leporini C, De Sarro G, Russo E. Adherence to therapy and adverse drug reactions: is there a link? Expert Opinion on Drug Safety. 2014; doi: 10.1517/14740338.2014.947260. PubMed

  • [9] Masaryková L, Fulmeková M, Lehocká Ľ, Fazekaš T. Identifying and solving drug-related problems in terms of the community pharmacists. Čes slov farm. 2014;63:32-39; (in Slovak).

  • [10] Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24(1):67-74.

  • [11] Pape GA, Hunt JS, Butler KL et al. Team-based care approach to cholesterol management in diabetes mellitus: two-year cluster randomized controlled trial. Arch Intern Med. 2011;171(16):1480-6. PubMed

  • [12] PCNE - Pharmaceutical Care Network Europe Foundation: The PCNE Classification V5.01. 2006. ( Published 2006. Accessed March 4, 2016.

  • [13] Rojas-Fernandez CH, Patel T, Lee L. An Interdisciplinary Memory Clinic: A Novel Practice Setting for Pharmacists in Primary Care. Ann Pharmacother. 2014 Jun;48(6):785-95. PubMed

  • [14] Salvo MC, Cannon-Breland ML. Motivation interviewing for medication adherence. J Am Pharm Assoc. 2015 Jul-Aug;55(4):e354-61. PubMed

  • [15] Santschi V, Chiolero A, Paradis G, Colosimo AL, Burnand B. Pharmacist interventions to improve cardiovascular disease risk factors in diabetes: a systematic review and meta-analysis of randomized controlled trials. Diabetes Care. 2012;35(12):2706-17. Pub Med

  • [16] Spinewine A, Fialová D, Byrne S. The Role of the Pharmacist in Optimizing Pharmacotherapy in Older People. Drugs Aging. 2012;29(6):495-510. PubMed

  • [17] Středa L, Hána K. (eHealth and telemedicine). Praha: Grada Publishing; 2016; (in Czech).

  • [18] Sun AP, Kirby B, Black C, Helms PJ, Bennie M, McLay JS. Unplanned medication discontinuation as a potential pharmacovigilance signal: a nested young person cohort study. BMC Pharmacology and Toxicology. 2014; doi:10.1186/2050-6511-15-11. PubMed

  • [19] Vlček J, Malý J, Dosedel M. (Pharmaceutical care of patients with diabetes mellitus and its relationship to clinical pharmacy). Vnitr Lek. 2009;Apr; 55(4):384-8; (in Czech). PubMed

  • [20] World Health Organization (WHO): Chronic diseases and health promotion: Adherence to long-term therapies: evidence for action. ( Published 2003. Accessed March 4, 2016.

  • [21] Vrijens B, De Geest S, Hughes DA et al. A new taxonomy for describing and defining adherence to medications. Br J Clin Pharmacol. 2012 May;73(5):691–705. PubMed

  • [22] Taitel M, Jiang J, Rudkin K, Ewing S, Duncan I. The impact of pharmacist face-to-face counseling to improve medication adherence among patients initiating statin therapy. Patient Preference and Adherence. 2012;6:323-329. PubMed


Journal + Issues