Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Annals of Behavioral Medicine
Published in: Annals of Behavioral Medicine 3/2013

01-12-2013 | Original Article

Improving Adherence to Medication in Stroke Survivors: A Pilot Randomised Controlled Trial

Authors: Ronan E. O’Carroll, Ph.D., Julie A. Chambers, Ph.D., Martin Dennis, M.D., Cathie Sudlow, D.Phil., Marie Johnston, Ph.D.

Published in: Annals of Behavioral Medicine | Issue 3/2013

Login to get access

Abstract

Background

Adherence to preventive medication is often poor, and current interventions have had limited success.

Purpose

This study was conducted to pilot a randomised controlled trial aimed at increasing adherence to preventive medication in stroke survivors using a brief, personalised intervention.

Methods

Sixty-two stroke survivors were randomly allocated to either a two-session intervention aimed at increasing adherence via (a) introducing a plan linked to environmental cues (implementation intentions) to help establish a better medication-taking routine (habit) and (b) eliciting and modifying any mistaken patient beliefs regarding medication/stroke or a control group. Primary outcome was adherence to antihypertensive medication measured objectively over 3 months using an electronic pill bottle.

Results

Fifty-eight people used the pill bottle and were analysed as allocated; 54 completed treatment. The intervention resulted in 10 % more doses taken on schedule (intervention, 97 %; control, 87 %; 95 % CI for difference (0.2, 16.2); p = 0.048).

Conclusions

A simple, brief intervention increased medication adherence in stroke survivors, over and above any effect of increased patient contact or mere measurement. (http://​controlled-trials.​com, number ISRCTN38274953.)
Literature
1.
World Health Organisation. Adherence to long-term therapies: Evidence for action. Geneva: WHO; 2003.
2.
3.
Esposti LD, Saragoni S, Benemei S, et al. Adherence to antihypertensive medications and health outcomes among newly-treated hypertensive patients. Clinicoecon Outcomes Res. 2011;3:47-54.PubMedCrossRef
4.
Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2008;(2):CD000011.
5.
Scottish Intercollegiate Guidelines Network. Management of patients with stroke or TIA: Assessment, investigation, immediate management and secondary prevention—A national guideline. Guideline 108. Edinburgh: SIGN; 2008.
6.
Bushnell CD, Zimmer LO, Pan W, et al. Persistence with stroke prevention medications 3 months after hospitalization. Arch Neurol. 2010;67:1456-1463.PubMedCrossRef
7.
Hayes TL, Larimer N, Adami A, Kaye JA. Medication adherence in healthy elders: Small cognitive changes make a big difference. J Aging Health. 2009;21:567-580.PubMedCrossRef
8.
Fischer B, Lehrl S, Weber E, Gundert-Remy U, Fischer U. Cerebrovascular insufficiency and compliance with drug therapy. Z Gerontol. 1981;14:145-152.PubMed
9.
Webb TL, Sheeran P. Does changing behavioral intentions engender behavior change? A meta-analysis of the experimental evidence. Psychol Bull. 2006;132:249-268.PubMedCrossRef
10.
Brown I, Sheeran P, Reuber M. Randomized controlled trial of an implementation intention intervention to enhance adherence with antiepileptic drug treatment. Epilepsy Behav. 2009;16:634-639.PubMedCrossRef
11.
Leventhal H, Diefenbach M, Leventhal EA. Illness cognition: Using common sense to understand treatment adherence and affect cognition interactions. Cognitive Ther Res. 1992;16:143-163.CrossRef
12.
Clifford S, Barber N, Horne R. Understanding different beliefs held by adherers, unintentional nonadherers, and intentional nonadherers: Application of the Necessity-Concerns Framework. J Psychosom Res. 2008;64:41-46.PubMedCrossRef
13.
O’Carroll RE, Whittaker J, Hamilton B, Johnston M, Sudlow C, Dennis M. Predictors of adherence to secondary prevention medication in stroke patients. Ann Behav Med. 2011;41:383-390.PubMedCrossRef
14.
15.
Stephenson J. Noncompliance may cause half of antihypertensive drug “failures”. JAMA. 1999;282:313-314.PubMedCrossRef
16.
O’Carroll RE, Dennis M, Johnston M, Sudlow C. Improving Adherence to Medication in Stroke Survivors (IAMSS): A randomised controlled trial: Study protocol. BMC Neurol. 2010;10:15.PubMedCrossRef
17.
Wetzels GE, Nelemans PJ, Schouten JS, van Wijk BL, Prins MH. All that glisters is not gold: A comparison of electronic monitoring versus filled prescriptions-an observational study. BMC Health Serv Res. 2006;6:8.PubMedCrossRef
18.
Horne R. Measuring adherence: The case for self-report. Int J Behav Med. 2004;11(suppl):75.
19.
Horne R, Weinman J, Hankins M. The Beliefs about Medicines Questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health. 1999;14:1-24.CrossRef
20.
Trewby PN, Reddy AV, Trewby CS, Ashton VJ, Brennan G, Inglis J. Are preventive drugs preventive enough? A study of patients’ expectation of benefit from preventive drugs. Clin Med. 2002;2:527-533.PubMedCrossRef
21.
Broadbent E, Petrie KJ, Weinman J. The Brief Illness Perception Questionnaire (BIPQ): Validity and reliability. Int J Behav Med. 2004;11:278.
22.
Enderby PM, Wood VA, Wade DT, Hewer RL. The Frenchay Aphasia Screening Test: A short, simple test for aphasia appropriate for non-specialists. Int Rehabil Med. 1987;8:166-170.PubMed
23.
Folstein MF, Folstein SE, McHugh PR. Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189-198.PubMedCrossRef
24.
Sniehotta FF, Scholz U, Schwarzer R. Action plans and coping plans for physical exercise: A longitudinal intervention study in cardiac rehabilitation. Brit J Health Psychol. 2006;11:23-37.CrossRef
25.
Petrie KJ, Cameron LD, Ellis CJ, Buick D, Weinman J. Changing illness perceptions after myocardial infarction: An early intervention randomized controlled trial. Psychosom Med. 2002;64:580-586.PubMed
26.
SIGN: Management of patients with stroke or TIA: assessment, investigation, immediate management and secondary prevention. A national clinical guideline. Edinburgh: Scottish Intercollegiate Guidelines Network; 2008.
27.
Lane P. Handling drop-out in longitudinal clinical trials: A comparison of LOCF and MMRM approaches. Pharm Stat. 2008;7:93-106.PubMedCrossRef
28.
Graham J. Missing data analysis: Making it work in the real world. Ann Rev Psychol. 2009;60:549-576.CrossRef
29.
Rubin DB. Multiple imputation for non-response in surveys. New York: Wiley; 1987.CrossRef
30.
Hughes CM. Medication non-adherence in the elderly. How big is the problem? Drugs Aging. 2004;21:793-811.PubMedCrossRef
31.
Jackson C, Lawton RJ, Raynor DK, et al. Promoting adherence to antibiotics: A test of implementation intentions. Patient Educ Couns. 2006;61:212-218.PubMedCrossRef
32.
Alhalaqia F, Nawafleh AH, Clark A, et al. Adherence therapy for medication non-compliant patients with hypertension: A randomised controlled trial. J Hum Hypertens. 2012;26:117-126.CrossRef
33.
Ellis G, Rodger J, McAlpine C, Langhorne P. The risk of stroke nurse specialist input on risk factor modification: A randomised controlled trial. Age Aging. 2005;34:389-392.CrossRef
34.
Gadkari AS, McHorney CA. Unintentional non-adherence to chronic prescription medications: How unintentional is it really? BMC Health Serv Res. 2012;12:98.PubMedCrossRef
35.
Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral and biomedical sciences. Behav Res Methods. 2007;39:175-191.PubMedCrossRef
Metadata
Title
Improving Adherence to Medication in Stroke Survivors: A Pilot Randomised Controlled Trial
Authors
Ronan E. O’Carroll, Ph.D.
Julie A. Chambers, Ph.D.
Martin Dennis, M.D.
Cathie Sudlow, D.Phil.
Marie Johnston, Ph.D.
Publication date
01-12-2013
Publisher
Springer US
Published in
Annals of Behavioral Medicine / Issue 3/2013
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-013-9515-5

Other articles of this Issue 3/2013

Annals of Behavioral Medicine 3/2013 Go to the issue

Original Article

Using Mental Imagery to Deliver Self-Regulation Techniques to Improve Sleep Behaviors

Letter to the Editor

Sleep Duration, Physical Activity, and Metabolic Syndrome for Adolescents

Invited Commentary

The Harms of Internalized AIDS Stigma: a Comment on Tsai et al.

Brief Report

Cue-Induced Smoking Urges Deplete Cigarette Smokers’ Self-Control Resources

Original Article

Internalized Stigma, Social Distance, and Disclosure of HIV Seropositivity in Rural Uganda

Original Article

Depression and Anxiety Following Myocardial Infarction and Their Inverse Associations with Future Health Behaviors and Quality of Life