David J T Campbell1,2,3, Terry Saunders-Smith2, Braden J Manns1,2, Marcello Tonelli1,2, Noah Ivers4,5, Brenda R Hemmelgarn6, Ross T Tsuyuki6,7, Raj Pannu8, Kathryn King-Shier1,9. 1. Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. 2. Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. 3. Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. 4. Department of Family & Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. 5. Department of Family & Community Medicine, Women's College Hospital, Toronto, ON, Canada. 6. Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada. 7. Department of Pharmacology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada. 8. Emergence Creative, New York, NY, USA. 9. Faculty of Nursing, University of Calgary, Calgary, AB, Canada.
Abstract
BACKGROUND: The Assessing outcomes of enhanced Chronic disease Care through patient Education and a value-baSed formulary Study (ACCESS) is a randomized controlled trial evaluating two interventions targeting barriers to care among those at high risk of cardiovascular disease: copayment elimination for cardioprotective medications, and a tailored self-management support programme. We designed a process evaluation to better understand participant perspectives on the interventions. DESIGN: We used a qualitative descriptive study design, collecting patient and pharmacist feedback via individual semi-structured telephone interviews and in-person focus groups. Data were analysed inductively using thematic analysis. RESULTS:Fifty-three patients (39 interviews and 14 in two focus groups) and 20 pharmacists participated. Copayment elimination provided quality of life benefits: minimizing the need to 'cut-back', allowing 'peace of mind' and providing emotional support. Health-related benefits included: improving adherence to covered medications, and helping to afford non-covered goods. The only criticism was that not all medications and testing supplies were covered. Patients reported that the educational materials provided helpful information, acted as a reminder, improved confidence, improved adherence to medication, and helped initiate conversations with providers about indicated medication. Some participants felt that the educational materials were repetitive, overly medication-focused and not tailored enough. Pharmacists felt that their patients benefitted from both interventions, which improved patient adherence and communication with their patients. CONCLUSION: The success of interventions intended to change behaviour is largely dependent upon participant's feelings that the intervention is helpful. This process evaluation provided insights into participants' perceptions on these interventions. Reception of both was largely positive with a few criticisms noted.
RCT Entities:
BACKGROUND: The Assessing outcomes of enhanced Chronic disease Care through patient Education and a value-baSed formulary Study (ACCESS) is a randomized controlled trial evaluating two interventions targeting barriers to care among those at high risk of cardiovascular disease: copayment elimination for cardioprotective medications, and a tailored self-management support programme. We designed a process evaluation to better understand participant perspectives on the interventions. DESIGN: We used a qualitative descriptive study design, collecting patient and pharmacist feedback via individual semi-structured telephone interviews and in-person focus groups. Data were analysed inductively using thematic analysis. RESULTS: Fifty-three patients (39 interviews and 14 in two focus groups) and 20 pharmacists participated. Copayment elimination provided quality of life benefits: minimizing the need to 'cut-back', allowing 'peace of mind' and providing emotional support. Health-related benefits included: improving adherence to covered medications, and helping to afford non-covered goods. The only criticism was that not all medications and testing supplies were covered. Patients reported that the educational materials provided helpful information, acted as a reminder, improved confidence, improved adherence to medication, and helped initiate conversations with providers about indicated medication. Some participants felt that the educational materials were repetitive, overly medication-focused and not tailored enough. Pharmacists felt that their patients benefitted from both interventions, which improved patient adherence and communication with their patients. CONCLUSION: The success of interventions intended to change behaviour is largely dependent upon participant's feelings that the intervention is helpful. This process evaluation provided insights into participants' perceptions on these interventions. Reception of both was largely positive with a few criticisms noted.
Authors: Susan Barnason; Connie White-Williams; Laura P Rossi; Mae Centeno; Deborah L Crabbe; Kyoung Suk Lee; Nancy McCabe; Julie Nauser; Paula Schulz; Kelly Stamp; Kathryn Wood Journal: Circ Cardiovasc Qual Outcomes Date: 2017-06
Authors: Sravya Kakumanu; Braden J Manns; Sophia Tran; Terry Saunders-Smith; Brenda R Hemmelgarn; Marcello Tonelli; Ross Tsuyuki; Noah Ivers; Danielle Southern; Jeff Bakal; David J T Campbell Journal: Trials Date: 2019-10-07 Impact factor: 2.279
Authors: David J T Campbell; Braden J Manns; Pamela Leblanc; Brenda R Hemmelgarn; Claudia Sanmartin; Kathryn King-Shier Journal: Medicine (Baltimore) Date: 2016-12 Impact factor: 1.817
Authors: David J T Campbell; Terry Saunders-Smith; Braden J Manns; Marcello Tonelli; Noah Ivers; Brenda R Hemmelgarn; Ross T Tsuyuki; Raj Pannu; Kathryn King-Shier Journal: Health Expect Date: 2020-10-13 Impact factor: 3.377