Creating a synergy effect: A cluster randomized controlled trial testing the effect of a tailored multimedia intervention on patient outcomes

PATIENT EDUCATION AND COUNSELING

卷:101

Article

Linn, Annemiek J.¹  van Dijk, Liset²  van Weert, Julia C. M.¹  Gebeyehu, Beniam G.¹  van Bodegraven, Ad. A.^3,4  Smit, Edith G.¹ 

[1] Univ Amsterdam, Amsterdam Sch Commun Res ASCoR, Nieuwe Achtergracht 166,POB 15793, NL-1001 NG Amsterdam, Netherlands

[2] Netherlands Inst Hlth Serv Res NIVEL, Dept Pharmaceut Care, Utrecht, Netherlands

[3] Vrije Univ Amsterdam, Med Ctr, Celiac Ctr Amsterdam, Dept Gastroenterol, Amsterdam, Netherlands

[4] Zuyderland Med Ctr, Dept Internal Med Gastroenterol & Geriatr, Heerlen Sittard Geleen, Netherlands

关键词: Patient-provider communication;    Technology-mediated intervention;    Tailoring;    Medication adherence;    Cluster randomized controlled trial;    Synergy effect;   

DOI  :  10.1016/j.pec.2018.03.017

来源: Elsevier

【 摘 要 】

Objective: Improving adherence is a challenge and multiple barriers are likely to explain non-adherence. These barriers differ per patient and over course of the regimen. Hence, personalized interventions tailored to the specific barriers are needed. In a theoretical and evidence-based Tailored Multimedia Intervention, technology (online preparatory assessment, text messaging) was used as an add-on to a tailored counseling session (learned during a communication skills training), with the expectation of synergistic effects. Methods: A cluster randomized controlled trial was conducted in six hospitals, eight nurses and 160 chronic patients. Patient satisfaction with communication, beliefs about medication, self-efficacy and medication adherence were assessed at initiation of the treatment and after six months. Results: Intervention effects were found for patient satisfaction with nurses' affective communication and self-efficacy at the initiation of treatment. The effect on self-efficacy remained after six months. Conclusion: By combining tailored counseling with technology, this intervention resulted in positive changes in important prerequisites of medication adherence. Practical implications: Technology can contribute significantly to health care providers' ability to tailor information to the patients' needs. (c) 2018 Published by Elsevier B.V.

【 授权许可】

Free