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Trials
Published in: Trials 1/2022

Open Access 01-12-2022 | Telemedicine | Study protocol

A randomized controlled trial of customized adherence enhancement (CAE-E): study protocol for a hybrid effectiveness-implementation project

Authors: Jennifer B. Levin, Farren Briggs, Carol Blixen, Mark Bauer, Douglas Einstadter, Jeffrey M. Albert, Celeste Weise, Nicole Woods, Edna Fuentes-Casiano, Kristin A. Cassidy, Julie Rentsch, Kaylee Sarna, Martha Sajatovic

Published in: Trials | Issue 1/2022

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Abstract

Background

Mood-stabilizing medications are a cornerstone of treatment for people with bipolar disorder, though approximately half of these individuals are poorly adherent with their medication, leading to negative and even severe health consequences. While a variety of approaches can lead to some improvement in medication adherence, there is no single approach that has superior adherence enhancement and limited data on how these approaches can be implemented in clinical settings. Existing data have shown an increasing need for virtual delivery of care and interactive telemedicine interventions may be effective in improving adherence to long-term medication.

Methods

Customized adherence enhancement (CAE) is a brief, practical bipolar-specific approach that identifies and targets individual patient adherence barriers for intervention using a flexibly administered modular format that can be delivered via telehealth communications. CAE is comprised of up to four standard treatment modules including Psychoeducation, Communication with Providers, Medication Routines, and Modified Motivational Interviewing. Participants will attend assigned module sessions with an interventionist based on their reasons for non-adherence and will be assessed for adherence, functioning, bipolar symptoms, and health resource use across a 12-month period. Qualitative and quantitative data will also be collected to assess barriers and facilitators to CAE implementation and reach and adoption of CAE among clinicians in the community.

Discussion

The proposed study addresses the need for practical adherence interventions that are effective, flexible, and designed to adapt to different settings and patients. By focusing on a high-risk, vulnerable group of people with bipolar disorder, and refining an evidence-based approach that will integrate into workflow of public-sector care and community mental health clinics, there is substantial potential for improving bipolar medication adherence and overall health outcomes on a broad level.

Trial registration

The study was registered on ClinicalTrials.gov NCT04622150 on November 9, 2020.
Appendix
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Metadata
Title
A randomized controlled trial of customized adherence enhancement (CAE-E): study protocol for a hybrid effectiveness-implementation project
Authors
Jennifer B. Levin
Farren Briggs
Carol Blixen
Mark Bauer
Douglas Einstadter
Jeffrey M. Albert
Celeste Weise
Nicole Woods
Edna Fuentes-Casiano
Kristin A. Cassidy
Julie Rentsch
Kaylee Sarna
Martha Sajatovic
Publication date
01-12-2022
Publisher
BioMed Central
Keyword
Telemedicine
Published in
Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-022-06517-0

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