Person-centered medicine and chronic disease: the role of interdisciplinary education and treatment adherence

Article Sidebar

Requires Subscription or Fee PDF (USD 25)
Published: Sep 30, 2011
DOI: https://doi.org/10.5750/ijpcm.v1i3.122

Main Article Content

Cathy Boyle
Nurse Educator, Mental Health, The Prince Charles Hospital, Chermside, Queensland, Australia
Gerardus Post
Clinical Lecturer, School of Nursing & Midwifery, Australian Catholic University, Banyo, Queensland, Australia
Philip Masel
Thoracic Physician, The Prince Charles Hospital, Chermside, Queensland, Australia
Paul Fulbrook
Nursing Director, Nursing Research & Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia
Kevin Clark
Assistant Nursing Director- NMCET, Clinical Education and Training, Queensland Health, Brisbane, Australia
Grad Cert
Assistant Nursing Director- NMCET, Clinical Education and Training, Queensland Health, Brisbane, Australia

Abstract

Rationale, aims and objectives: There is some evidence that a brief training program is effective in developing clinicians’ skills, knowledge and attitudes when dealing with non-adherence with medications. The purpose of this study was to implement and evaluate a one-day training program aimed at improving clinicians’ awareness and responsiveness to clients with poor treatment adherence.Method: Forty two participants completed a one-day training program. Using a workshop format, the program was focused on the use of motivational interviewing as a primary strategy which encouraged participants not only to listen but to understand the client’s perspective concerning treatment adherence. Several measures concerning treatment adherence knowledge, beliefs about medicines, therapeutic tasks, therapeutic optimism and satisfaction with training were used to assess the effectiveness of the program. These measures were applied immediately pre- and post-program and on follow-up at four weeks.Results: There was a significant increase in the adherence knowledge and skills of the participating clinicians’ post-program, which although reduced at one-month follow-up, was still above pre-program knowledge. The results also showed an increase in the therapeutic tasks.Conclusion: Promoting treatment adherence is a pivotal part of clinicians’ work in reducing the burden of chronic disease. These results suggest that a one-day program is effective in improving clinicians’ knowledge, attitude and skills regarding treatment adherence. However, further research is needed to measure sustained improvement of clinicians’ knowledge and the outcomes this may have on clients’ adherence.

Article Details

Issue
Vol. 1 No. 3 (2011): September
Section
Regular Articles

References

Australian Institute of Health and Welfare. (2005). Chronic diseases and associated risk factors. Available at:http://www.aihw.gov.au/cdarf/index.cfm

World Health Organization. (2003). Adherence to long-term therapies: evidence for action. Available at: http://www.who.int/chronic_conditions/en/adherence_report.pdf.

World Health Organization. (2003). Failure to take prescribed medicine for chronic disease is a massive, worldwide problem. Available at: http://www.who.int/mediacentre/news/releases/2003/pr54/en/

Haynes, R.B., Yao, X., Degani, A., Kripilani, S., Garg, A. & McDonald, H.P. (2004). Interventions for enhancing client medication adherence (Review). Cochrane Database of Systematic Reviews, 4, CD004371.

Schedlbauer, A., Schroeder, K., Peters, T.J. & Fahey, T. (2004). Interventions to improve adherence to lipid lowering medication (Review). Cochrane Database of Systematic Reviews, 4, CD004371.

Schroeder, K., Fahey, T. & Ebrahim, S. (2004). Interventions for improving adherence to treatment in patients with high blood pressure in ambulatory settings (Review). Cochrane Database of Systematic Reviews, 3, CD004804.

Vermeire, E., Wens, J., Van Royen, P., Biot, Y., Hearnshaw, H. & Lindenmeyer, A. (2005). Interventions for improving adherence to treatment recommendations in people with type 2 diabetes mellitus (Review). Cochrane Database of Systematic Reviews, 2, CD003638.

McIntosh, A.M., Conlon, L., Lawrie, S.M. & Stanfield, A.C. (2006). Compliance therapy for schizophrenia (Review). Cochrane Database of Systematic Reviews, 3, CD003442.

Dunbar-Jacob, J. & Mortimer-Stephens, M.K. (2001). Treatment adherence in chronic disease. Journal of Clinical Epidemiology 54, s57-s60.

Schaffer, S.D. & Yoon, S.L. (2001). Evidence-based methods to enhance medication adherence. Nurse Practitioner 26, 44-54.

Winnick, S., Lucas, D.O., Hartman, A.L. & Toll, D. (2005). How do you improve compliance? Pediatrics 115, e718-e724.

Sokol, M.C., McGuigan, K.A., Verbrugge, R.R. & Epstein, R.S. (2005). Impact of medication adherence on hospitalization risk and healthcare cost. Medical Care 43, 521-530.

Kravitz, R.L. & Melnikow, J. (2004). Medical adherence research: time for a change in direction? Medical Care 42, 197-199.

Happell, B., Manias, E. & Pinikahana, J. (2002). The role of the inpatient mental health nurse in facilitating patient adherence to medication regimes. International Journal ofMental Health Nursing 11, 251-259.

Byrne, M.K., Willis, A., Deane, F.P., Hawkins, B. & Quinn, R. (2010). Training inpatient mental health staff how to enhance patient engagement with medications: Medication Alliance training and dissemination outcomes in a large US mental health hospital. Journal of Evaluation in Clinical Practice 16, 114 – 120.

Lehane, E. & McCarthy, G. (2007). An examination of the intentional and unintentional aspects of medication non-adherence in patients diagnosed with hypertension. Journal of Clinical Nursing 16, 698-706.

Gray, R., Wykes, T. & Gornay, K. (2003). The effect of medication management training on community mental health nurse’s clinical skills. International Journal of Nursing Studies 40, 163-169.

Broers, S., Smets, E., Bindels, P., Evertsz, F.P., Calff, M. & de Haes, H. (2005). Training general practitioners in behavior change counseling to improve asthma medication adherence. Patient Education and Counseling 58, 279-287.

Krousel-Wood, M., Hyre, A., Munter, P. & Morisky, D. (2005). Methods to improve medication adherence in patients with hypertension: current status and future directions. Current Opinion in Cardiology 20, 296-300.

Britt, E., Hudson, S.M. & Blampied, N.M. (2004). Motivational interviewing in health settings; a review. Patient Education and Counseling 53, 147-155.

Gray, A. & Robson, D. (2004). Concordance skills: collaboration, involvement: choice. A manual for mental health workers. Prepared as a Service to Medicine by Janssen-Cilag Pty. Ltd. Sydney.

Balkrishnan, R. (2005). The importance of medication adherence in improving chronic-disease related outcomes: what we know and what we need to further know. Medical Care 43, 517-520.

Byrne, M.K., Deane, F.P., Lambert, G. & Coombs, T. (2004). Enhancing medication adherence: clinician outcomes from the Medication Alliance training program. Australian and New Zealand Journal of Psychiatry 38, 246-253.

Byrne, M.K., Deane, F.P. & Caputi, P. (2008). Mental health clinicians’ beliefs about medicines, attitudes and expectations of improved medication adherence in patients. Evaluation & the Health Professions 31 (4), 390-403.

Horne, R., Weinman, J.& Hankins, M. (1999). The beliefs about Medicines Questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychology and Health 14, 1-24.

Elsom, S. (2002) The Therapeutic Optimism Scale. Melbourne: Monash University.

Education and Research Centre. (2008). Satisfaction with Training Questionnaire, Brisbane: The Prince Charles Hospital.

Borelli, B., Riekert, K.A. & Weinstein, A. (2007). Brief motivational interviewing as a clinical strategy to promote asthma medication adherence. Journal of Allergy and Clinical Immunology 120 (5), 1023-1030.

Levensky, E.R., Forcehimes, A., O’Donohue, W.T. & Beitz, K. (2007). Motivational Interviewing: An evidence-based approach to counselling helps patients follow treatment recommendations. American Journal of Nursing 107 (10), 50-58.

Welch, G., Rose, G. & Ernst, D. (2006). Motivational Interviewing and Diabetes: What Is It, How Is It used, and Does It Work? Diabetes Spectrum 19 (1), 5-11.