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. 2014 Jan 13;2(1):1389.
doi: 10.4081/hpr.2014.1389.

Improving Maintenance Medication Adherence in Adult Inflammatory Bowel Disease Patients: A Pilot Study

Michelle L Matteson-Kome  1 , Jessica Winn  2 , Matthew L Bechtold  1 , Jack D Bragg  1 , Cynthia L Russell  3
Affiliations

Improving Maintenance Medication Adherence in Adult Inflammatory Bowel Disease Patients: A Pilot Study

Michelle L Matteson-Kome et al. Health Psychol Res. .

Abstract

Medication nonadherence in inflammatory bowel disease (IBD) may lead to suboptimal control of the disease, decreased quality of life, and poor outcomes. This pilot study evaluated the feasibility, intervention mechanism, and potential effectiveness of a three-month continuous self-improvement (CSI) intervention to enhance medication adherence (MA) in adult nonadherent IBD patients. Adult IBD patients taking a daily or twice-daily dosed maintenance medication were screened electronically for two months to determine baseline MA levels. Nonadherent IBD participants were randomized to the CSI or the attention control (AC) intervention and monitored for three months. The CSI intervention consisted of a data evaluation and system refinement process in which system changes were identified and implemented. The AC group was given educational information regarding IBD disease process, extra-intestinal manifestations of IBD, and medical therapy. Demographic statistics, change scores for within and between-group differences, and effect size estimates were calculated. Nine nonadherent participants (medication adherence score <0.85) were eligible for randomization. The intervention was found feasible and acceptable. Although no statistically significant improvement in MA was found (P=0.14), adherence improved in 3 of 4 of the CSI group and 1 of 2 in the attention control group. The effect size calculation of 1.9 will determine the sample size for future study. The results of this pilot study showed the intervention was feasible and had a positive effect on MA change score and adherence levels. A larger fully powered study is needed to test of the effectiveness of this innovative intervention.

Keywords: adherence; inflammatory bowel disease; intervention.

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Conflict of interest statement

Conflict of interests: the authors declare no potential conflict of interests.

Figures

Figure 1.
Figure 1.
Patient flow diagram.
Figure 2.
Figure 2.
Plan, Do, Check, Act cycle.
Figure 3.
Figure 3.
Medication Event Monitoring System report before continuous self-improvement.
Figure 4.
Figure 4.
Medication Event Monitoring System report after continuous self-improvement.
See this image and copyright information in PMC

References

    1. Sabaté E. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization, 2003.
    1. Roter DL, Hall JA, Merisca R, et al. Effectiveness of interventions to improve patient compliance: a meta-analysis. Med Care 1998;36:1138-61. - PubMed
    1. Peterson AM, Takiya L, Finley R. Metaanalysis of trials of interventions to improve medication adherence. Am J Health Syst Pharm 2003;60:657-65. - PubMed
    1. McDonald HP, Garg A, Haynes RB. Interventions to enhance patient adherence to medication prescriptions: scientific review. JAMA 2002;288:2868-79. - PubMed
    1. Kripalani S, Yao X, Haynes RB. Interventions to enhance medication adherence in chronic medical conditions: a systematic review. Arch Intern Med 2007;167:540-50. - PubMed

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