Document Detail


Improving medication adherence through patient education distinguishing between appropriate and inappropriate utilization. Patient Education Study Group.
MedLine Citation:
PMID:  10451079     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
S M Edworthy; G M Devins
Related Documents :
22411019 - A review of the medical treatment of pediatric glaucomas at moorfields eye hospital.
18361259 - In chronic disease, nationwide data show poor adherence by patients to medication and b...
19480229 - Medication adherence and persistence in severe obstructive sleep apnea.
15351159 - Medical predictors for psychopathology in adults with operated congenital heart disease.
17932089 - The use of individually tailored environmental supports to improve medication adherence...
16713529 - Adherence to antihypertensive medication assessed by self-report was associated with el...
22045009 - The value of hazwoper medical surveillance.
3454239 - The law and intensive care. the role of the courts in the ethical decision-making process.
9867889 - Descriptive epidemiology of injury and illness among cruise ship passengers.
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of rheumatology     Volume:  26     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-09-23     Completed Date:  1999-09-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  1793-801     Citation Subset:  IM    
Affiliation:
Department of Medicine and Community Health Sciences, Faculty of Medicine, University of Calgary, Alberta, Canada. edworthy@mccaig.ucalgary.ca
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Anti-Ulcer Agents; 15307-86-5/Diclofenac; 59122-46-2/Misoprostol
Comments/Corrections
Comment In:
J Rheumatol. 1999 Aug;26(8):1647-9   [PMID:  10451055 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Determinants of pain severity in knee osteoarthritis: effect of demographic and psychosocial variabl...
Next Document:  Identification of a new single nucleotide substitution on the hypoxanthine-guanine phosphoribosyltra...