Improving Post-Discharge Medication Adherence in Patients with CVD: A Pilot Randomized Trial
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Arquivos Brasileiros de Cardiologia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014002400009 |
Resumo: | Background:Effective interventions to improve medication adherence are usually complex and expensive.Objective:To assess the impact of a low-cost intervention designed to improve medication adherence and clinical outcomes in post-discharge patients with CVD.Method:A pilot RCT was conducted at a teaching hospital. Intervention was based on the four-item Morisky Medication Adherence Scale (MMAS-4). The primary outcome measure was medication adherence assessed using the eight-item MMAS at baseline, at 1 month post hospital discharge and re-assessed 1 year after hospital discharge. Other outcomes included readmission and mortality rates.Results:61 patients were randomized to intervention (n = 30) and control (n = 31) groups. The mean age of the patients was 61 years (SD 12.73), 52.5% were males, and 57.4% were married or living with a partner. Mean number of prescribed medications per patient was 4.5 (SD 3.3). Medication adherence was correlated to intervention (p = 0.04) and after 1 month, 48.4% of patients in the control group and 83.3% in the intervention group were considered adherent. However, this difference decreased after 1 year, when adherence was 34.8% and 60.9%, respectively. Readmission and mortality rates were related to low adherence in both groups.Conclusion:The intervention based on a validated patient self-report instrument for assessing adherence is a potentially effective method to improve adherent behavior and can be successfully used as a tool to guide adherence counseling in the clinical visit. However, a larger study is required to assess the real impact of intervention on these outcomes. |
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Arquivos Brasileiros de Cardiologia (Online) |
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Improving Post-Discharge Medication Adherence in Patients with CVD: A Pilot Randomized TrialCardiovascular DiseasesMedication AdherencePatient DischargePatient Discharge SummariesRandomized Controlled TrialBackground:Effective interventions to improve medication adherence are usually complex and expensive.Objective:To assess the impact of a low-cost intervention designed to improve medication adherence and clinical outcomes in post-discharge patients with CVD.Method:A pilot RCT was conducted at a teaching hospital. Intervention was based on the four-item Morisky Medication Adherence Scale (MMAS-4). The primary outcome measure was medication adherence assessed using the eight-item MMAS at baseline, at 1 month post hospital discharge and re-assessed 1 year after hospital discharge. Other outcomes included readmission and mortality rates.Results:61 patients were randomized to intervention (n = 30) and control (n = 31) groups. The mean age of the patients was 61 years (SD 12.73), 52.5% were males, and 57.4% were married or living with a partner. Mean number of prescribed medications per patient was 4.5 (SD 3.3). Medication adherence was correlated to intervention (p = 0.04) and after 1 month, 48.4% of patients in the control group and 83.3% in the intervention group were considered adherent. However, this difference decreased after 1 year, when adherence was 34.8% and 60.9%, respectively. Readmission and mortality rates were related to low adherence in both groups.Conclusion:The intervention based on a validated patient self-report instrument for assessing adherence is a potentially effective method to improve adherent behavior and can be successfully used as a tool to guide adherence counseling in the clinical visit. However, a larger study is required to assess the real impact of intervention on these outcomes.Sociedade Brasileira de Cardiologia - SBC2014-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014002400009Arquivos Brasileiros de Cardiologia v.103 n.6 2014reponame:Arquivos Brasileiros de Cardiologia (Online)instname:Sociedade Brasileira de Cardiologia (SBC)instacron:SBC10.5935/abc.20140151info:eu-repo/semantics/openAccessOliveira-Filho,Alfredo D.Morisky,Donald E.Costa,Francisco A.Pacheco,Sara T.Neves,Sabrina F.Lyra-Jr,Divaldo P.eng2015-09-01T00:00:00Zoai:scielo:S0066-782X2014002400009Revistahttp://www.arquivosonline.com.br/https://old.scielo.br/oai/scielo-oai.php||arquivos@cardiol.br1678-41700066-782Xopendoar:2015-09-01T00:00Arquivos Brasileiros de Cardiologia (Online) - Sociedade Brasileira de Cardiologia (SBC)false |
dc.title.none.fl_str_mv |
Improving Post-Discharge Medication Adherence in Patients with CVD: A Pilot Randomized Trial |
title |
Improving Post-Discharge Medication Adherence in Patients with CVD: A Pilot Randomized Trial |
spellingShingle |
Improving Post-Discharge Medication Adherence in Patients with CVD: A Pilot Randomized Trial Oliveira-Filho,Alfredo D. Cardiovascular Diseases Medication Adherence Patient Discharge Patient Discharge Summaries Randomized Controlled Trial |
title_short |
Improving Post-Discharge Medication Adherence in Patients with CVD: A Pilot Randomized Trial |
title_full |
Improving Post-Discharge Medication Adherence in Patients with CVD: A Pilot Randomized Trial |
title_fullStr |
Improving Post-Discharge Medication Adherence in Patients with CVD: A Pilot Randomized Trial |
title_full_unstemmed |
Improving Post-Discharge Medication Adherence in Patients with CVD: A Pilot Randomized Trial |
title_sort |
Improving Post-Discharge Medication Adherence in Patients with CVD: A Pilot Randomized Trial |
author |
Oliveira-Filho,Alfredo D. |
author_facet |
Oliveira-Filho,Alfredo D. Morisky,Donald E. Costa,Francisco A. Pacheco,Sara T. Neves,Sabrina F. Lyra-Jr,Divaldo P. |
author_role |
author |
author2 |
Morisky,Donald E. Costa,Francisco A. Pacheco,Sara T. Neves,Sabrina F. Lyra-Jr,Divaldo P. |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Oliveira-Filho,Alfredo D. Morisky,Donald E. Costa,Francisco A. Pacheco,Sara T. Neves,Sabrina F. Lyra-Jr,Divaldo P. |
dc.subject.por.fl_str_mv |
Cardiovascular Diseases Medication Adherence Patient Discharge Patient Discharge Summaries Randomized Controlled Trial |
topic |
Cardiovascular Diseases Medication Adherence Patient Discharge Patient Discharge Summaries Randomized Controlled Trial |
description |
Background:Effective interventions to improve medication adherence are usually complex and expensive.Objective:To assess the impact of a low-cost intervention designed to improve medication adherence and clinical outcomes in post-discharge patients with CVD.Method:A pilot RCT was conducted at a teaching hospital. Intervention was based on the four-item Morisky Medication Adherence Scale (MMAS-4). The primary outcome measure was medication adherence assessed using the eight-item MMAS at baseline, at 1 month post hospital discharge and re-assessed 1 year after hospital discharge. Other outcomes included readmission and mortality rates.Results:61 patients were randomized to intervention (n = 30) and control (n = 31) groups. The mean age of the patients was 61 years (SD 12.73), 52.5% were males, and 57.4% were married or living with a partner. Mean number of prescribed medications per patient was 4.5 (SD 3.3). Medication adherence was correlated to intervention (p = 0.04) and after 1 month, 48.4% of patients in the control group and 83.3% in the intervention group were considered adherent. However, this difference decreased after 1 year, when adherence was 34.8% and 60.9%, respectively. Readmission and mortality rates were related to low adherence in both groups.Conclusion:The intervention based on a validated patient self-report instrument for assessing adherence is a potentially effective method to improve adherent behavior and can be successfully used as a tool to guide adherence counseling in the clinical visit. However, a larger study is required to assess the real impact of intervention on these outcomes. |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014002400009 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014002400009 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.5935/abc.20140151 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia - SBC |
publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia - SBC |
dc.source.none.fl_str_mv |
Arquivos Brasileiros de Cardiologia v.103 n.6 2014 reponame:Arquivos Brasileiros de Cardiologia (Online) instname:Sociedade Brasileira de Cardiologia (SBC) instacron:SBC |
instname_str |
Sociedade Brasileira de Cardiologia (SBC) |
instacron_str |
SBC |
institution |
SBC |
reponame_str |
Arquivos Brasileiros de Cardiologia (Online) |
collection |
Arquivos Brasileiros de Cardiologia (Online) |
repository.name.fl_str_mv |
Arquivos Brasileiros de Cardiologia (Online) - Sociedade Brasileira de Cardiologia (SBC) |
repository.mail.fl_str_mv |
||arquivos@cardiol.br |
_version_ |
1752126564321984512 |