Sarah Chapman1,2, Alice Sibelli1,3, Anja St-Clair Jones4, Alastair Forbes5,6, Angel Chater1,7, Rob Horne1. 1. UCL School of Pharmacy, Centre for Behavioural Medicine, London, UK. 2. Department of Pharmacy & Pharmacology, University of Bath, Bath, UK. 3. Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 4. Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Pharmacy Department, Brighton, UK. 5. Institute for Digestive Diseases, University College London, London, UK. 6. Norwich Medical School, University of East Anglia, Norwich, UK. 7. Centre for Health, Wellbeing and Behaviour Change, Faculty of Education and Sport, University of Bedfordshire, Bedford, UK.
Abstract
BACKGROUND AND AIMS: Interventions to improve adherence to medication may be more effective if tailored to the individual, addressing adherence-related beliefs about treatment and overcoming practical barriers to daily use. We evaluated whether an algorithm, tailoring support to address perceptual and practical barriers to adherence, reduced barriers and was acceptable to patients with inflammatory bowel disease [IBD]. METHODS:Participants with IBD, prescribedazathioprine and/or mesalazine, were recruited via patient groups, social media, and hospital clinics and allocated to Intervention or Control Groups. The online intervention comprised messages tailored to address beliefs about IBD and maintenance treatment and to provide advice on overcoming practical difficulties with taking regular medication. The content was personalised to address specific perceptual and practical barriers identified by a pre-screening tool. Validated questionnaires assessed barriers to adherence and related secondary outcomes at baseline and at 1 and 3 months of follow-up. RESULTS: A total of 329 participants were allocated to the Intervention [n = 153] and Control [n = 176] Groups; just under half [46.2%] completed follow-up. At 1 and 3 months, the Intervention Group had significantly fewer concerns about IBD medication [p ≤0.01]; and at three months, fewer doubts about treatment necessity, fewer reported practical barriers, and higher reported adherence [p <0.05]. Relative to controls at follow-up, the Intervention Group were more satisfied with information about IBD medicines, and viewed pharmaceuticals in general more positively. Questionnaires, interviews, and intervention usage indicated that the intervention was acceptable. CONCLUSIONS: Personalised adherence support using a digital algorithm can help patients overcome perceptual barriers [doubts about treatment necessity and medication concerns] and practical barriers to adherence.
RCT Entities:
BACKGROUND AND AIMS: Interventions to improve adherence to medication may be more effective if tailored to the individual, addressing adherence-related beliefs about treatment and overcoming practical barriers to daily use. We evaluated whether an algorithm, tailoring support to address perceptual and practical barriers to adherence, reduced barriers and was acceptable to patients with inflammatory bowel disease [IBD]. METHODS:Participants with IBD, prescribed azathioprine and/or mesalazine, were recruited via patient groups, social media, and hospital clinics and allocated to Intervention or Control Groups. The online intervention comprised messages tailored to address beliefs about IBD and maintenance treatment and to provide advice on overcoming practical difficulties with taking regular medication. The content was personalised to address specific perceptual and practical barriers identified by a pre-screening tool. Validated questionnaires assessed barriers to adherence and related secondary outcomes at baseline and at 1 and 3 months of follow-up. RESULTS: A total of 329 participants were allocated to the Intervention [n = 153] and Control [n = 176] Groups; just under half [46.2%] completed follow-up. At 1 and 3 months, the Intervention Group had significantly fewer concerns about IBD medication [p ≤0.01]; and at three months, fewer doubts about treatment necessity, fewer reported practical barriers, and higher reported adherence [p <0.05]. Relative to controls at follow-up, the Intervention Group were more satisfied with information about IBD medicines, and viewed pharmaceuticals in general more positively. Questionnaires, interviews, and intervention usage indicated that the intervention was acceptable. CONCLUSIONS: Personalised adherence support using a digital algorithm can help patients overcome perceptual barriers [doubts about treatment necessity and medication concerns] and practical barriers to adherence.
Authors: Amy Hai Yan Chan; Rob Horne; Helen Lycett; Eva Raebel; Jordi Guitart; Emilie Wildman; Karen Ang Journal: Front Pharmacol Date: 2021-03-31 Impact factor: 5.810
Authors: Maria G Grammatikopoulou; Dimitrios G Goulis; Konstantinos Gkiouras; Meletios P Nigdelis; Stefanos T Papageorgiou; Theodora Papamitsou; Alastair Forbes; Dimitrios P Bogdanos Journal: Nutrients Date: 2020-11-27 Impact factor: 5.717