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Patient Educ Couns. 2012 Oct;89(1):143-51. doi: 10.1016/j.pec.2012.07.007. Epub 2012 Aug 9.

Development and content of a group-based intervention to improve medication adherence in non-adherent patients with rheumatoid arthritis.

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  • 1Department of Rheumatology and Pharmacy, Sint Maartenskliniek, Nijmegen, The Netherlands.



To describe the systematic development and content of a short intervention to improve medication adherence to disease-modifying anti-rheumatic drugs in non-adherent patients with rheumatoid arthritis (RA).


The intervention mapping (IM) framework was used to develop the intervention. The following IM steps were conducted: (1) a needs assessment; (2) formulation of specific intervention objectives; (3) inventory of methods and techniques needed to design the intervention and (4) production and piloting of the intervention.


The intervention (consisting of two group sessions led by a pharmacist, a homework assignment, and a follow-up call) aims to improve the balance between necessity and concern beliefs about medication, and to resolve practical barriers in medication taking. The central communication method used is motivational interviewing.


By applying the IM framework, we were able to create a feasible, time-efficient and promising intervention to improve medication adherence in non-adherent RA patients. Intervention effects are currently being assessed in a randomized controlled trial.


This paper could serve as a guideline for other health care professionals when developing similar interventions. If the RCT demonstrates sufficient effectiveness of this intervention in reducing medication non-adherence in RA patients, the intervention could be embedded in clinical practice.

Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

[PubMed - indexed for MEDLINE]
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