A Pilot Study of a Feedback Intervention to Improve Medication Adherence in Older Adults with Hypertension

2.50
Hdl Handle:
http://hdl.handle.net/10755/158907
Type:
Presentation
Title:
A Pilot Study of a Feedback Intervention to Improve Medication Adherence in Older Adults with Hypertension
Abstract:
A Pilot Study of a Feedback Intervention to Improve Medication Adherence in Older Adults with Hypertension
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2010
Author:Ruppar, Todd, PhD, RN
P.I. Institution Name:Katholieke Universiteit Leuven
Title:Center for Health Services & Nursing Research
Contact Address:Kapucijnenvoer 35/4, Leuven, 3000, Belgium
Contact Telephone:+32-16-336-976
Co-Authors:T. Ruppar, Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, BELGIUM;
Background & Purpose: Control of hypertension prevents the development of further chronic disease and limits morbidity and mortality. Unfortunately, effective blood pressure (BP) control is frequently not achieved due to poor medication adherence (MA). This exploratory RCT tested an 8-week feedback-based intervention to improve MA and BP control among elders with hypertension. Secondary aims included intervention tolerability and feasibility assessments. Design & Methods: Independently-living older adults being treated for hypertension were recruited, screened for eligibility, and randomized to an 8-week feedback intervention or to a control condition. Medication adherence was measured using electronic monitoring. Intervention group participants received MA and BP feedback, medication and disease education, and a medication instruction card. Control group participants were provided with printed information on arthritis management and were seen only for outcome measurement visits. Data Analysis: Effect sizes (Cohen's d) were calculated for MA, SBP, and DBP at multiple time points using standardized mean differences divided by the pooled standard deviations. Results: Fifteen older adults (mean age: 72.47 plus or minus 8.53) were randomized to intervention (n=10) or control (n=5) groups. MA effect size (Cohen's d) peaked at 2.24 at the end of the intervention (8-weeks). The effect then waned and stabilized, with an effect size of 0.88 at 12 weeks, 0.48 at 16 weeks, and 0.45 at 20 weeks. Both SBP and DBP saw improvement in the intervention group and little change in the control group at 12 weeks (dSBP=0.99; dDBP=1.12) and 20 weeks (dSBP=0.34; (dDBP=0.30). Implications: While this pilot study was not powered for tests of statistical significance, all three primary outcomes had effect sizes suggesting the potential for clinically significant improvement in MA and BP outcomes. Additional research is needed in a larger RCT to further study the intervention's effects and its potential to be translated into clinical practice.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleA Pilot Study of a Feedback Intervention to Improve Medication Adherence in Older Adults with Hypertensionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158907-
dc.description.abstract<table><tr><td colspan="2" class="item-title">A Pilot Study of a Feedback Intervention to Improve Medication Adherence in Older Adults with Hypertension</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Ruppar, Todd, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Katholieke Universiteit Leuven</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Center for Health Services &amp; Nursing Research</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Kapucijnenvoer 35/4, Leuven, 3000, Belgium</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">+32-16-336-976</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">todd.ruppar@med.kuleuven.be</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">T. Ruppar, Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, BELGIUM;</td></tr><tr><td colspan="2" class="item-abstract">Background &amp; Purpose: Control of hypertension prevents the development of further chronic disease and limits morbidity and mortality. Unfortunately, effective blood pressure (BP) control is frequently not achieved due to poor medication adherence (MA). This exploratory RCT tested an 8-week feedback-based intervention to improve MA and BP control among elders with hypertension. Secondary aims included intervention tolerability and feasibility assessments. Design &amp; Methods: Independently-living older adults being treated for hypertension were recruited, screened for eligibility, and randomized to an 8-week feedback intervention or to a control condition. Medication adherence was measured using electronic monitoring. Intervention group participants received MA and BP feedback, medication and disease education, and a medication instruction card. Control group participants were provided with printed information on arthritis management and were seen only for outcome measurement visits. Data Analysis: Effect sizes (Cohen's d) were calculated for MA, SBP, and DBP at multiple time points using standardized mean differences divided by the pooled standard deviations. Results: Fifteen older adults (mean age: 72.47 plus or minus 8.53) were randomized to intervention (n=10) or control (n=5) groups. MA effect size (Cohen's d) peaked at 2.24 at the end of the intervention (8-weeks). The effect then waned and stabilized, with an effect size of 0.88 at 12 weeks, 0.48 at 16 weeks, and 0.45 at 20 weeks. Both SBP and DBP saw improvement in the intervention group and little change in the control group at 12 weeks (dSBP=0.99; dDBP=1.12) and 20 weeks (dSBP=0.34; (dDBP=0.30). Implications: While this pilot study was not powered for tests of statistical significance, all three primary outcomes had effect sizes suggesting the potential for clinically significant improvement in MA and BP outcomes. Additional research is needed in a larger RCT to further study the intervention's effects and its potential to be translated into clinical practice.</td></tr></table>en_GB
dc.date.available2011-10-26T21:30:49Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:30:49Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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