A theory-based intervention to promote medication adherence in patients with rheumatoid arthritis: a randomized controlled trial

Asgari, S., Abbasi, M., Hamilton, K., Chen, Y.-P., Griffiths, M.D. ORCID: 0000-0001-8880-6524, Lin, C.-Y. and Pakpour, A.H., 2021. A theory-based intervention to promote medication adherence in patients with rheumatoid arthritis: a randomized controlled trial. Clinical Rheumatology, 40 (1), pp. 101-111. ISSN 0770-3198

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Introduction/objectives: Adherence to prescribed medication regimens is fundamental to the improvement and maintenance of the health of patients with rheumatoid arthritis. It is therefore important that interventions are developed to address this important health behavior issue. The aim of the present study was to design and evaluate a theory-based intervention to improve the medication adherence (primary outcome) among rheumatoid arthritis patients.

Methods: The study adopted a pre-registered randomized controlled trial design. Rheumatoid arthritis patients were recruited from two University teaching hospitals in Qazvin, Iran from June 2018 to May 2019 and randomly assigned to either an intervention group (n = 100) or a treatment-as-usual group (n = 100). The intervention group received a theory-based intervention designed based on the theoretical underpinnings of the health action process approach (HAPA). More specifically, action planning (making detailed plans to follow medication regimen), coping planning (constructing plans to overcome potential obstacles that may arise in medication adherence), and self-monitoring (using a calendar to record medication adherence) of the HAPA has been used for the treatment. The treatment-as-usual group received standard care.

Results: Data analysis was conducted based on the principle of intention to treat. Using a linear mixed-effects model (adjusted for age, sex, medication prescribed, and body mass index), the results showed improved medication adherence scores in the intervention group (loss to follow-up = 16) compared to the treatment-as-usual group (loss to follow-up = 12) at the 3-month (coefficient = 3.9; SE = 0.8) and 6-month (coefficient = 4.5; SE = 0.8) follow-up. Intervention effects on medication adherence scores were found to be mediated by some of the theory-based HAPA variables that guided the study.

Conclusion: The results of the present study support the use of a theory-based intervention for improving medication adherence among rheumatoid arthritis patients, a group at-risk of not adhering to medication regimens.

Item Type: Journal article
Publication Title: Clinical Rheumatology
Creators: Asgari, S., Abbasi, M., Hamilton, K., Chen, Y.-P., Griffiths, M.D., Lin, C.-Y. and Pakpour, A.H.
Publisher: Springer Science and Business Media LLC
Date: January 2021
Volume: 40
Number: 1
ISSN: 0770-3198
Rights: © The Author(s) 2020. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Divisions: Schools > School of Social Sciences
Record created by: Linda Sullivan
Date Added: 25 Jun 2020 11:31
Last Modified: 31 May 2021 15:07
URI: https://irep.ntu.ac.uk/id/eprint/40115

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