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. 2016 Sep 13;5(3):e187.
doi: 10.2196/resprot.5750.

A Multifaceted Nurse- and Web-Based Intervention for Improving Adherence to Treatment in Patients With Cardiovascular Disease: Rationale and Design of the MIRROR Trial

Angelien Sieben  1 , Hein Aw van Onzenoort, Kees J van Laarhoven, Sebastian Jh Bredie
Affiliations

A Multifaceted Nurse- and Web-Based Intervention for Improving Adherence to Treatment in Patients With Cardiovascular Disease: Rationale and Design of the MIRROR Trial

Angelien Sieben et al. JMIR Res Protoc. .

Abstract

Background: Poor adherence to medication is one of the limitations in the treatment of cardiovascular diseases, thereby increasing the risk of premature death, hospital admissions, and related costs. There is a need for simple and easy-to-implement interventions that are based on patients' perspectives, beliefs, and perceptions of their illness and medication.

Objective: The objective is to test the effectivity of this intervention to improve medication adherence in patients with established cardiovascular disease, that is, in secondary prevention.

Methods: In this study the effect of a personalized visualization of cardiovascular risk levels through a website aiming at supporting self management in combination with a group consultation and communication intervention by a nurse on adherence to treatment in 600 patients with manifest cardiovascular diseases will be assessed. The health belief model was chosen as main theoretical model for the intervention.

Results: Primary outcome is adherence to treatment calculated by refill data. Secondary outcomes include the Beliefs about Medication Questionnaire and the Modified Morisky Scale. Patients are followed for one year. Results are expected by 2015.

Conclusions: This study assesses adherence to treatment in a high-risk cardiovascular population by applying an intervention that addresses patients' capacity and practical barriers as well as patients' beliefs and perceptions of their illness and medication.

Clinicaltrial: ClinicalTrials.gov NCT01449695; https://clinicaltrials.gov/ct2/show/NCT01449695 (Archived by WebCite at http://www.webcitation.org/6kCzkIKH3).

Keywords: cardiovascular; eHealth; medication adherence; nursing.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Techniques and applications influence perceived susceptibility in the current trial. The main determinant behind perceived susceptibility is a lack of knowledge regarding prescribed medications and the influence on risk reduction.
Figure 2
Figure 2
Techniques and applications influence perceived severity in the current trial. The main determinant behind perceived severity is patients’ beliefs, perception and management of their illness (awareness, outcome expectations).
Figure 3
Figure 3
Techniques and applications influence perceived benefits in the current trial. The main determinant behind perceived benefits is patients' beliefs, perceptions, and management of their illness (awareness).
Figure 4
Figure 4
Techniques and applications influence perceived barriers, cue to action, and self-efficacy in the current trial. The main determinant behind perceived barriers is skills and self-efficacy.
Figure 5
Figure 5
Patient flow chart.
See this image and copyright information in PMC

References

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