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Creating a synergy effect: A cluster randomized controlled trial testing the effect of a tailored multimedia intervention on patient outcomes
Authors:Annemiek J. Linn  Liset van Dijk  Julia C.M. van Weert  Beniam G. Gebeyehu  Ad. A. van Bodegraven  Edith G. Smit
Affiliation:1. Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, The Netherlands;2. Department Pharmaceutical Care, Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands;3. Department of Gastroenterology, Celiac Centre Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands;4. Department of Internal Medicine, Gastroenterology and Geriatrics, Zuyderland Medical Centre, Heerlen-Sittard-Geleen, The Netherlands
Abstract:

Objective

Improving adherence is a challenge and multiple barriers are likely to explain non-adherence. These barriers differ per patient and over course of the regimen. Hence, personalized interventions tailored to the specific barriers are needed. In a theoretical and evidence-based Tailored Multimedia Intervention, technology (online preparatory assessment, text messaging) was used as an add-on to a tailored counseling session (learned during a communication skills training), with the expectation of synergistic effects.

Methods

A cluster randomized controlled trial was conducted in six hospitals, eight nurses and 160 chronic patients. Patient satisfaction with communication, beliefs about medication, self-efficacy and medication adherence were assessed at initiation of the treatment and after six months.

Results

Intervention effects were found for patient satisfaction with nurses’ affective communication and self-efficacy at the initiation of treatment. The effect on self-efficacy remained after six months.

Conclusion

By combining tailored counseling with technology, this intervention resulted in positive changes in important prerequisites of medication adherence.

Practical implications

Technology can contribute significantly to health care providers’ ability to tailor information to the patients’ needs.
Keywords:Patient-provider communication  Technology-mediated intervention  Tailoring  Medication adherence  Cluster randomized controlled trial  Synergy effect
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