Abstract
Introduction and Purpose
Previous research suggests that approximately a third of patients do not adhere to medications following acute coronary syndrome (ACS). We recently undertook two systematic reviews with meta-analysis to identify: i) the psychosocial predictors of medication adherence following ACS; ii) the effectiveness of healthcare provider-led interventions to support adherence post-ACS. A qualitative study was also conducted to provide insight into the experiences of patients hospitalised with ACS. We used data from these preliminary studies to develop an intervention to support medication adherence following ACS. We report the findings from a feasibility and acceptability intervention study.
Methods
We conducted a single-arm intervention study with ACS patients recruited from an NHS hospital in London, UK. The intervention consisted of two face-to-face sessions delivered pre-discharge to target both intentional (Session 1) and unintentional barriers (Session 2) to adherence. Patients’ beliefs about medications were measured using the BMQ-specific (necessity, concerns, necessity-concerns differential). Pre-post intervention comparisons were made. Study acceptability (setting, timing, content, delivery) was measured quantitatively and qualitatively.
Results
A total of 15 patients completed the intervention (39% recruitment) (14 male, 1 female). There was a significant difference in pre-intervention (M = 20.50, SD = 3.67) and post-intervention (M = 22.36, SD = 2.24) necessity scores, t(13) = -3.36 (95% CI -3.05 – -0.66), p = .005. There was also a significant difference in pre-intervention (median = 5) and post-intervention (median = 7) necessity-concerns differential scores, Z = -2.94, p = .003. Study acceptability was rated highly (mean = 9.5, SD = 1.0).
Conclusions
Patients elicited stronger beliefs about treatment necessity after receiving the intervention. The intervention was deemed acceptable by patients. Relatively low recruitment rate suggests some feasibility issues. Since this study was completed, we have been undertaking a non-randomised pilot study to determine whether our intervention can be successfully delivered by hospital pharmacists. Treatment beliefs and self-reported medication adherence are the main outcomes of this pilot study.
Previous research suggests that approximately a third of patients do not adhere to medications following acute coronary syndrome (ACS). We recently undertook two systematic reviews with meta-analysis to identify: i) the psychosocial predictors of medication adherence following ACS; ii) the effectiveness of healthcare provider-led interventions to support adherence post-ACS. A qualitative study was also conducted to provide insight into the experiences of patients hospitalised with ACS. We used data from these preliminary studies to develop an intervention to support medication adherence following ACS. We report the findings from a feasibility and acceptability intervention study.
Methods
We conducted a single-arm intervention study with ACS patients recruited from an NHS hospital in London, UK. The intervention consisted of two face-to-face sessions delivered pre-discharge to target both intentional (Session 1) and unintentional barriers (Session 2) to adherence. Patients’ beliefs about medications were measured using the BMQ-specific (necessity, concerns, necessity-concerns differential). Pre-post intervention comparisons were made. Study acceptability (setting, timing, content, delivery) was measured quantitatively and qualitatively.
Results
A total of 15 patients completed the intervention (39% recruitment) (14 male, 1 female). There was a significant difference in pre-intervention (M = 20.50, SD = 3.67) and post-intervention (M = 22.36, SD = 2.24) necessity scores, t(13) = -3.36 (95% CI -3.05 – -0.66), p = .005. There was also a significant difference in pre-intervention (median = 5) and post-intervention (median = 7) necessity-concerns differential scores, Z = -2.94, p = .003. Study acceptability was rated highly (mean = 9.5, SD = 1.0).
Conclusions
Patients elicited stronger beliefs about treatment necessity after receiving the intervention. The intervention was deemed acceptable by patients. Relatively low recruitment rate suggests some feasibility issues. Since this study was completed, we have been undertaking a non-randomised pilot study to determine whether our intervention can be successfully delivered by hospital pharmacists. Treatment beliefs and self-reported medication adherence are the main outcomes of this pilot study.
| Original language | English |
|---|---|
| Title of host publication | INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE |
| Place of Publication | New York |
| Publisher | Springer |
| Pages | S191 - S191 |
| Number of pages | 1 |
| Volume | 25 |
| Publication status | Published - Oct 2018 |