Results
Participants
An additional month of recruitment was required to ensure an
adequate number of participants. At the end of seven months,
a total of 20 participants with probable TIA or confirmed
stroke, hypertension, and one or all of the following had been
recruited: cognitive deficit (MMSE < 26), reduced level of selfefficacy
(score < 7), and/or any self- or pharmacist-reported nonadherence
to specific medications. Early in the study process,
pill counts were found by the research teamto be an unreliable
measure of adherence. Based on these concerns, a calculation of
improvement in pill count at six-months frombaseline was not
conducted or included in these results. Thewide range of adherence
calculated frompill count data confirms the difficulty with
this measure (range 50% to 116%) in this participant group.
Most characteristics of study participants were similar to the historical
profile of SPC clients at the study site (Hamilton Health
Sciences, 2009). Participants ranged in age from 32 to 87 years
(M= 67.5 years; SD = 16.077). Themajority of participants were
male (60%). Fifty per cent of participants were diabetic; 60% had
three or more risk factors. MMSE scores at baseline ranged
from 22 to 30 with only two of the 20 participants scoring < 26
(Folstein et al. 1975). Differences in the characteristics of the
participant group when compared to historical SPC client data
included a higher incidence of hypertension (100%versus 71.8%),
diabetes (50% versus 21%) and hyperlipidemia (65% versus
58.1%). Table 1 provides the characteristics of study participants.
All participants (n = 20) self-monitored blood pressure during
the study. Fifty per cent of participants owned blood pressure
monitoring machines at recruitment or were able to attend a
local pharmacy weekly for blood pressure checks. Others
were provided with machines (50%). Thirty per cent were in
the habit of using medication dosettes on recruitment. Only
one participant did not have a family physician (5%).
Primary outcomes
The average amount ofNCMcontact and therapeutic intervention
time for each participant over the six-month follow-up
period was 4.8 hours. This translated into approximately four
hours per week in calls and visits. The qualitative analysis of
NCMcase notes and client responses to open-ended questions
revealed the following themes