| Improving medication adherence through patient education distinguishing between appropriate and inappropriate utilization. Patient Education Study Group. | |
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MedLine Citation:
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PMID: 10451079 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the effectiveness of a computer assisted educational intervention to facilitate appropriate utilization of an antiinflammatory medication (Arthrotec) and investigate the mechanism by which it produces these effects. METHODS: A double blind, multicenter, randomized, controlled trial studied patients over age 50 years with hip or knee osteoarthritis (OA). All patients (n = 252) were treated with the medication (diclofenac + misoprostol). Patients randomized to the experimental group interacted with a computer program delivering information about their disease, the medication, its intended and side effects, appropriate utilization (distinguishing between appropriate versus inappropriate continuation and discontinuation of medication), patient involvement in treatment related decision making, and communication with service providers. In the control condition, another computer program presented generic information about OA. Data were collected at pre-test, post-test, and 8 week followup. RESULTS: Appropriate utilization of the medication occurred more frequently in the experimental than the control group (p<0.029). Compared to controls, the experimental group demonstrated significant improvements in knowledge, realistic expectations of drug benefits, perceived ease of adherence, and self-efficacy (all p<0.05). There was no difference between the groups with regard to illness intrusiveness, pain, or disability, but there was a greater improvement in stiffness in the experimental group (-0.63; 95% CI -0.81 to -0.45) compared to the control group (-0.39; 95% CI -0.53 to -0.25) at a level of p = 0.04. CONCLUSION: In conditions such as OA, where patient involvement in decision making is essential to the effectiveness of care, computer assisted education focussing on appropriate vs inappropriate continuation and discontinuation of medications has the potential to improve knowledge, increase self-efficacy, maintain realistic expectations, and facilitate adherence, resulting in more beneficial clinical outcomes. |
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Authors:
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S M Edworthy; G M Devins |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of rheumatology Volume: 26 ISSN: 0315-162X ISO Abbreviation: J. Rheumatol. Publication Date: 1999 Aug |
Date Detail:
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Created Date: 1999-09-23 Completed Date: 1999-09-23 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7501984 Medline TA: J Rheumatol Country: CANADA |
Other Details:
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Languages: eng Pagination: 1793-801 Citation Subset: IM |
Affiliation:
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Department of Medicine and Community Health Sciences, Faculty of Medicine, University of Calgary, Alberta, Canada. edworthy@mccaig.ucalgary.ca |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anti-Inflammatory Agents, Non-Steroidal / therapeutic use Anti-Ulcer Agents / therapeutic use Computer-Assisted Instruction Decision Making Diclofenac / therapeutic use Double-Blind Method Drug Therapy, Combination Female Humans Male Middle Aged Misoprostol / therapeutic use Osteoarthritis / drug therapy, psychology, therapy* Patient Compliance* Patient Education as Topic* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents, Non-Steroidal; 0/Anti-Ulcer Agents; 15307-86-5/Diclofenac; 59122-46-2/Misoprostol |
| Comments/Corrections | |
Comment In:
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J Rheumatol. 1999 Aug;26(8):1647-9
[PMID:
10451055
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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