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Patient Educ Couns. 2014 Mar;94(3):356-61. doi: 10.1016/j.pec.2013.12.002. Epub 2013 Dec 11.

Effectiveness of a group-based intervention to change medication beliefs and improve medication adherence in patients with rheumatoid arthritis: a randomized controlled trial.

Author information

1
Departments of Rheumatology and Pharmacy, Sint Maartenskliniek, P.O. Box 9011, 6500 GM Nijmegen, The Netherlands. Electronic address: h.zwikker@maartenskliniek.nl.
2
Departments of Rheumatology and Pharmacy, Sint Maartenskliniek, P.O. Box 9011, 6500 GM Nijmegen, The Netherlands.
3
HAN University of Applied Sciences, Institute of Health Studies, The Netherlands.
4
NIVEL (Netherlands Institute for Health Services Research), The Netherlands; Department of Primary and Community Care, Radboud University Medical Centre, The Netherlands; Department of Health Science, Buskerud University College, Drammen, Norway.
5
Departments of Rheumatology and Pharmacy, Sint Maartenskliniek, P.O. Box 9011, 6500 GM Nijmegen, The Netherlands; Department of Pharmacy, Radboud University Medical Centre, The Netherlands. Electronic address: b.vandenbemt@maartenskliniek.nl.

Abstract

OBJECTIVE:

To assess the effect of a group-based intervention on the balance between necessity beliefs and concern beliefs about medication and on medication non-adherence in patients with rheumatoid arthritis (RA).

METHODS:

Non-adherent RA patients using disease-modifying anti-rheumatic drugs (DMARDs) were randomized to an intervention or control arm. The intervention consisted, amongst others, of two motivational interviewing-guided group sessions led by the same pharmacist. Control patients received brochures about their DMARDs. Questionnaires were completed up to 12 months follow-up.

RESULTS:

123 patients (mean age: 60 years, female: 69%) were randomized. No differences in necessity beliefs and concern beliefs about medication and in medication non-adherence were detected between the intervention and control arm, except at 12 months' follow-up: participants in the intervention arm had less strong necessity beliefs about medication than participants in the control arm (b: -1.0 (95% CI: -2.0, -0.1)).

CONCLUSION:

This trial did not demonstrate superiority of our intervention over the control arm in changing beliefs about medication or in improving medication adherence over time.

PRACTICE IMPLICATIONS:

Absent intervention effects might have been due to, amongst others, selection bias and a suboptimal treatment integrity level. Hence, targeting beliefs about medication in clinical practice should not yet be ruled out.

KEYWORDS:

Beliefs about medication; Medication adherence; Motivational interviewing; Randomized controlled trial; Rheumatoid arthritis

PMID:
24388126
DOI:
10.1016/j.pec.2013.12.002
[Indexed for MEDLINE]

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