PURPOSE: Examine the effectiveness of a community-based, multimedia intervention on medication adherence among hypertensive adults. DESIGN: Randomized controlled trial. SETTING:Rural south Alabama. SUBJECTS:Low-income adults (N = 434) receiving medication at no charge from a public health department or a Federally Qualified Health Center. INTERVENTION: Both interventions were home-based and delivered via computer by a community health advisor. The adherence promotion (AP) intervention focused on theoretical variables related to adherence (e.g., barriers, decisional balance, and role models). The cancer control condition received general cancer information. MEASURES: Adherence was assessed by pill count. Other adherence-related variables, including barriers, self-efficacy, depression, and sociodemographic variables, were collected via a telephone survey. ANALYSIS: Chi-square analysis tested the hypothesis that a greater proportion of participants in the AP intervention are ≥80% adherent compared to the control group. General linear modeling examined adherence as a continuous variable. RESULTS: Participants receiving the intervention did not differ from individuals in the control group (51% vs. 49% adherent, respectively; p = .67). Clinic type predicted adherence (p < .0001), as did forgetting to take medications (p = .01) and difficulty getting to the clinic to obtain medications (p < .001). CONCLUSIONS: Multilevel interventions that focus on individual behavior and community-level targets (e.g., how health care is accessed and delivered) may be needed to improve medication adherence among low-income rural residents.
RCT Entities:
PURPOSE: Examine the effectiveness of a community-based, multimedia intervention on medication adherence among hypertensive adults. DESIGN: Randomized controlled trial. SETTING: Rural south Alabama. SUBJECTS: Low-income adults (N = 434) receiving medication at no charge from a public health department or a Federally Qualified Health Center. INTERVENTION: Both interventions were home-based and delivered via computer by a community health advisor. The adherence promotion (AP) intervention focused on theoretical variables related to adherence (e.g., barriers, decisional balance, and role models). The cancer control condition received general cancer information. MEASURES: Adherence was assessed by pill count. Other adherence-related variables, including barriers, self-efficacy, depression, and sociodemographic variables, were collected via a telephone survey. ANALYSIS: Chi-square analysis tested the hypothesis that a greater proportion of participants in the AP intervention are ≥80% adherent compared to the control group. General linear modeling examined adherence as a continuous variable. RESULTS:Participants receiving the intervention did not differ from individuals in the control group (51% vs. 49% adherent, respectively; p = .67). Clinic type predicted adherence (p < .0001), as did forgetting to take medications (p = .01) and difficulty getting to the clinic to obtain medications (p < .001). CONCLUSIONS: Multilevel interventions that focus on individual behavior and community-level targets (e.g., how health care is accessed and delivered) may be needed to improve medication adherence among low-income rural residents.
Authors: Joshua S Benner; Robert J Glynn; Helen Mogun; Peter J Neumann; Milton C Weinstein; Jerry Avorn Journal: JAMA Date: 2002 Jul 24-31 Impact factor: 56.272
Authors: Katherine M Rich; Javier Valencia Huamaní; Sara N Kiani; Robinson Cabello; Paul Elish; Jorge Florez Arce; Lia N Pizzicato; Jaime Soria; Jeffrey A Wickersham; Jorge Sanchez; Frederick L Altice Journal: AIDS Care Date: 2018-05-30
Authors: Jamie Schaffler; Katerina Leung; Sarah Tremblay; Laura Merdsoy; Eric Belzile; Angella Lambrou; Sylvie D Lambert Journal: J Gen Intern Med Date: 2018-02-09 Impact factor: 5.128
Authors: Allison A Lewinski; Hayden B Bosworth; Karen M Goldstein; Jennifer M Gierisch; Shelley Jazowski; Felicia McCant; Courtney White-Clark; Valerie A Smith; Leah L Zullig Journal: Contemp Clin Trials Commun Date: 2021-02-06