BACKGROUND: Medication nonadherence contributes to hospitalization and mortality, yet there have been few interventions tested that improve adherence and reduce hospitalization and mortality in heart failure (HF). Our objective was to determine whether an education intervention improved medication adherence and cardiac event-free survival. METHODS AND RESULTS: A randomized controlled trial was conducted on 82 HF patients. The intervention was based on the theory of planned behavior (TPB) and included feedback of medication-taking behavior using the Medication Event Monitoring System (MEMS). Patients were assigned to one of three groups: 1) theory-based education plus MEMS feedback; 2) theory-based education only; or 3) usual care (control). Cardiac events were collected for 9 months. Patients in both intervention groups were more adherent over follow-up compared with the control group. In Cox regression, patients in either intervention group had a longer event-free survival compared with those in the control group before and after controlling age, marital status, financial status, ejection fraction, New York Heart Association functional class, angiotensin-converting enzyme inhibitor use, and presence or absence of a significant other during the intervention (P < .05). CONCLUSIONS: Use of an intervention based on the TPB improves medication adherence and outcomes in patients with HF and therefore offers promise as a clinically applicable intervention to help patients with HF to adhere to their prescribed regimen.
RCT Entities:
BACKGROUND: Medication nonadherence contributes to hospitalization and mortality, yet there have been few interventions tested that improve adherence and reduce hospitalization and mortality in heart failure (HF). Our objective was to determine whether an education intervention improved medication adherence and cardiac event-free survival. METHODS AND RESULTS: A randomized controlled trial was conducted on 82 HF patients. The intervention was based on the theory of planned behavior (TPB) and included feedback of medication-taking behavior using the Medication Event Monitoring System (MEMS). Patients were assigned to one of three groups: 1) theory-based education plus MEMS feedback; 2) theory-based education only; or 3) usual care (control). Cardiac events were collected for 9 months. Patients in both intervention groups were more adherent over follow-up compared with the control group. In Cox regression, patients in either intervention group had a longer event-free survival compared with those in the control group before and after controlling age, marital status, financial status, ejection fraction, New York Heart Association functional class, angiotensin-converting enzyme inhibitor use, and presence or absence of a significant other during the intervention (P < .05). CONCLUSIONS: Use of an intervention based on the TPB improves medication adherence and outcomes in patients with HF and therefore offers promise as a clinically applicable intervention to help patients with HF to adhere to their prescribed regimen.
Authors: Cornelia H M van Jaarsveld; Adelita V Ranchor; Gertrudis I J M Kempen; James C Coyne; Dirk J van Veldhuisen; Robbert Sanderman Journal: Eur J Heart Fail Date: 2005-10-04 Impact factor: 15.534
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Authors: Fabienne Dobbels; Sabina De Geest; Johan van Cleemput; Walter Droogne; Johan Vanhaecke Journal: J Heart Lung Transplant Date: 2004-11 Impact factor: 10.247
Authors: Jennifer L Kuntz; Monika M Safford; Jasvinder A Singh; Shobha Phansalkar; Sarah P Slight; Qoua Liang Her; Nancy Allen Lapointe; Robin Mathews; Emily O'Brien; William B Brinkman; Kevin Hommel; Kevin C Farmer; Elissa Klinger; Nivethietha Maniam; Heather J Sobko; Stacy C Bailey; Insook Cho; Maureen H Rumptz; Meredith L Vandermeer; Mark C Hornbrook Journal: Patient Educ Couns Date: 2014-09-16
Authors: Jia-Rong Wu; Susan K Frazier; Mary Kay Rayens; Terry A Lennie; Misook L Chung; Debra K Moser Journal: Health Psychol Date: 2012-07-02 Impact factor: 4.267