• David H Thom, Rachel Willard-Grace, Danielle Hessler, Denise DeVore, Camille Prado, Thomas Bodenheimer, and Ellen Chen.
• From the Department of Family and Community Medicine, University of California, San Francisco, School of Medicine; San Francisco (DHT, RW-G, DH, DD, CP, TB, EC); and the Silver Avenue Health Center, San Francisco, CA (EC). dthom@fcm.ucsdf.edu.
• J Am Board Fam Med. 2015 Jan 1; 28 (1): 38-45.

BackgroundLack of concordance between medications listed in the medical record and taken by the patient contributes to poor outcomes. We sought to determine whether patients who received health coaching by medical assistants improved their medication concordance and adherence.MethodsThis was a nonblinded, randomized, controlled, pragmatic intervention trial. English- or Spanish-speaking patients, age 18 to 75 years, with poorly controlled type 2 diabetes, hypertension, and/or hyperlipidemia were enrolled from 2 urban safety net clinics and randomized to receive 12 months of health coaching versus usual care.ResultsOutcomes included concordance between medications documented in the medical record and those reported by the patient and adherence based on the patient-reported number of days (of the last 7) on which patient took all prescribed medications. The proportion of medications completely concordant increased in the coached group versus the usual care group (difference in change, 10%; P = .05). The proportion of medications listed in the chart but not taken significantly decreased in the coached group compared with the usual care group (difference in change, 17%; P = .013). The mean number of adherent days increased in the coached but not in the usual care group (difference in change, 1.08; P < .001).ConclusionsHealth coaching by medical assistants significantly increases medication concordance and adherence.© Copyright 2015 by the American Board of Family Medicine.

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