Justin Presseau1,2, J D Schwalm3, Jeremy M Grimshaw1,4, Holly O Witteman5,6, Madhu K Natarajan3, Stefanie Linklater1, Katrina Sullivan1, Noah M Ivers7,8. 1. a Clinical Epidemiology , Ottawa Hospital Research Institute, University of Ottawa , Ottawa , Canada. 2. b School of Epidemiology, Public Health and Preventive Medicine , University of Ottawa , Ottawa , Canada. 3. c Population Health Research Institute , McMaster University , Hamilton , Canada. 4. d Department of Medicine , University of Ottawa , Ottawa , Canada. 5. e Department of Family and Emergency Medicine , Laval University , Quebec City , Canada. 6. f Research Centre of the Centre Hospitalier Universitaire de Québec , Quebec City , Canada. 7. g Women's College Hospital , Toronto , Canada. 8. h Department of Family and Community Medicine , University of Toronto , Toronto , Canada.
Abstract
BACKGROUND: Despite evidence-based recommendations, adherence with secondary prevention medications post-myocardial infarction (MI) remains low. Taking medication requires behaviour change, and using behavioural theories to identify what factors determine adherence could help to develop novel adherence interventions. OBJECTIVE: Compare the utility of different behaviour theory-based approaches for identifying modifiable determinants of medication adherence post-MI that could be targeted by interventions. METHODS: Two studies were conducted with patients 0-2, 3-12, 13-24 or 25-36 weeks post-MI. Study 1: 24 patients were interviewed about barriers and facilitators to medication adherence. Interviews were conducted and coded using the Theoretical Domains Framework. Study 2: 201 patients answered a telephone questionnaire assessing Health Action Process Approach constructs to predict intention and medication adherence (MMAS-8). RESULTS: Study 1: domains identified: Beliefs about Consequences, Memory/Attention/Decision Processes, Behavioural Regulation, Social Influences and Social Identity. Study 2: 64, 59, 42 and 58% reported high adherence at 0-2, 3-12, 13-24 and 25-36 weeks. Social Support and Action Planning predicted adherence at all time points, though the relationship between Action Planning and adherence decreased over time. CONCLUSIONS: Using two behaviour theory-based approaches provided complimentary findings and identified modifiable factors that could be targeted to help translate Intention into action to improve medication adherence post-MI.
BACKGROUND: Despite evidence-based recommendations, adherence with secondary prevention medications post-myocardial infarction (MI) remains low. Taking medication requires behaviour change, and using behavioural theories to identify what factors determine adherence could help to develop novel adherence interventions. OBJECTIVE: Compare the utility of different behaviour theory-based approaches for identifying modifiable determinants of medication adherence post-MI that could be targeted by interventions. METHODS: Two studies were conducted with patients 0-2, 3-12, 13-24 or 25-36 weeks post-MI. Study 1: 24 patients were interviewed about barriers and facilitators to medication adherence. Interviews were conducted and coded using the Theoretical Domains Framework. Study 2: 201 patients answered a telephone questionnaire assessing Health Action Process Approach constructs to predict intention and medication adherence (MMAS-8). RESULTS: Study 1: domains identified: Beliefs about Consequences, Memory/Attention/Decision Processes, Behavioural Regulation, Social Influences and Social Identity. Study 2: 64, 59, 42 and 58% reported high adherence at 0-2, 3-12, 13-24 and 25-36 weeks. Social Support and Action Planning predicted adherence at all time points, though the relationship between Action Planning and adherence decreased over time. CONCLUSIONS: Using two behaviour theory-based approaches provided complimentary findings and identified modifiable factors that could be targeted to help translate Intention into action to improve medication adherence post-MI.
Entities:
Keywords:
Health Action Process Approach; Theoretical Domains Framework; medication adherence; myocardial infarction
Authors: Holly O Witteman; Justin Presseau; Emily Nicholas Angl; Iffat Jokhio; J D Schwalm; Jeremy M Grimshaw; Beth Bosiak; Madhu K Natarajan; Noah M Ivers Journal: JMIR Hum Factors Date: 2017-03-01
Authors: Jacob Crawshaw; Justin Presseau; Zack van Allen; Livia Pinheiro Carvalho; Kim Jordison; Shane English; Dean A Fergusson; Francois Lauzier; Alexis F Turgeon; Aimee J Sarti; Claudio Martin; Frédérick D'Aragon; Alvin Ho-Ting Li; Greg Knoll; Ian Ball; Jamie Brehaut; Karen E A Burns; Marie-Chantal Fortin; Matthew Weiss; Maureen Meade; Pierre Marsolais; Sam Shemie; Sanabelle Zaabat; Sonny Dhanani; Simon C Kitto; Michaël Chassé Journal: BMJ Open Date: 2019-12-23 Impact factor: 2.692
Authors: Elisabeth Vesnaver; Mindy Goldman; Sheila O'Brien; Paul MacPherson; Terrie Butler-Foster; Don Lapierre; Joanne Otis; Dana V Devine; Marc Germain; Andrew Rosser; Richard MacDonagh; Taylor Randall; William Osbourne-Sorrell; Broderic Clement-Thorne; Taim Bilal Al-Bakri; Kyle A Rubini; Nolan E Hill; Justin Presseau Journal: Health Res Policy Syst Date: 2020-11-02