Effectiveness of a group-based intervention to change medication beliefs and improve medication adherence in patients with rheumatoid arthritis: A randomized controlled trial

被引:50
作者
Zwikker, Hanneke E. [1 ,2 ]
van den Ende, Cornelia H. [1 ,2 ]
van Lankveld, Wim G. [3 ]
den Broeder, Alfons A. [1 ,2 ]
van den Hoogen, Frank H. [1 ,2 ]
van de Mosselaar, Birgit [1 ,2 ]
van Dulmen, Sandra [4 ,5 ,6 ]
van den Bemt, Bart J. [1 ,2 ,7 ]
机构
[1] Sint Maartensklin, Dept Rheumatol, NL-6500 GM Nijmegen, Netherlands
[2] Sint Maartensklin, Dept Pharm, NL-6500 GM Nijmegen, Netherlands
[3] HAN Univ Appl Sci, Inst Hlth Studies, Nijmegen, Netherlands
[4] NIVEL Netherlands Inst Hlth Serv Res, Utrecht, Netherlands
[5] Radboud Univ Nijmegen Med Ctr, Dept Primary & Community Care, Nijmegen, Netherlands
[6] Buskerud Univ Coll, Dept Hlth Sci, Drammen, Norway
[7] Radboud Univ Nijmegen Med Ctr, Dept Pharm, Nijmegen, Netherlands
关键词
Medication adherence; Beliefs about medication; Rheumatoid arthritis; Randomized controlled trial; Motivational interviewing; DRUG-TREATMENT; SELF-EFFICACY; QUESTIONNAIRE; EDUCATION; HEALTH; NONADHERENCE; PERSISTENCE; VALIDATION; REGIMENS; VALIDITY;
D O I
10.1016/j.pec.2013.12.002
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objective: To assess the effect of a group-based intervention on the balance between necessity beliefs and concern beliefs about medication and on medication non-adherence in patients with rheumatoid arthritis (RA). Methods: Non-adherent RA patients using disease-modifying anti-rheumatic drugs (DMARDs) were randomized to an intervention or control arm. The intervention consisted, aniongst others, of two motivational interviewing-guided group sessions led by the same pharmacist. Control patients received brochures about their DMARDs. Questionnaires were completed up to 12 months follow-up. Results: 123 patients (mean age: 60 years, female: 69%) were randomized. No differences in necessity beliefs and concern beliefs about medication and in medication non-adherence were detected between the intervention and control arm, except at 12 months' follow-up: participants in the intervention arm had less strong necessity beliefs about medication than participants in the control arm (b: -1.0(95% Cl: -2.0, -0.1)). Conclusion: This trial did not demonstrate superiority of our intervention over the control arm in changing beliefs about medication or in improving medication adherence over time. Practice implications: Absent intervention effects might have been due to, amongst others, selection bias and a suboptimal treatment integrity level. Hence, targeting beliefs about medication in clinical practice should not yet be ruled out. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:356 / 361
页数:6
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