A multi-component, family-focused and literacy-sensitive intervention to improve medication adherence in patients with heart failure–A randomized controlled trial

Jia Rong Wu; Barbara Mark; George J. Knafl; Sandra B. Dunbar; Patricia P. Chang; Darren A. DeWalt

doi:10.1016/j.hrtlng.2019.05.011

A multi-component, family-focused and literacy-sensitive intervention to improve medication adherence in patients with heart failure–A randomized controlled trial

Jia Rong Wu, Barbara Mark, George J. Knafl, Sandra B. Dunbar, Patricia P. Chang, Darren A. DeWalt

Research output: Contribution to journal › Article › peer-review

20 Scopus citations

Abstract

Background: Medication nonadherence is prevalent and links to serious outcomes (e.g., rehospitalization/death) in heart failure (HF) patients; therefore, an urgent need exists for an intervention to improve and sustain adherence after intervention completion. Objectives: To test the efficacy of a multi-component, family-focused, literacy-sensitive (FamLit) intervention on medication adherence in HF patients. Methods: Forty-three HF patients and their care partners were enrolled and randomized to receive FamLit or attention-only intervention, including an in-person session at baseline and bi-weekly phone boosters for 3 months. We measured medication adherence from baseline to 3-month post-intervention using the Medication Event Monitoring System. Results: After 3-month intervention, intervention patients had significantly better medication adherence than control patients. At 6 months (3-months post-intervention), intervention effect on adherence was sustained in the FamLit intervention group, while adherence decreased in the control group. Conclusion: Incorporating care partner support and providing an easy-to-understand intervention to patients-care partners may improve/sustain adherence.

Original language	English
Pages (from-to)	507-514
Number of pages	8
Journal	Heart and Lung
Volume	48
Issue number	6
DOIs	https://doi.org/10.1016/j.hrtlng.2019.05.011
State	Published - Nov 1 2019

Bibliographical note

Publisher Copyright:
© 2019 Elsevier Inc.

Funding

This study was supported by funding from the National Institute of Nursing Research of the National Institutes of Health under Award Number K23NR014489 (Jia-Rong Wu, PI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health. This study was supported by funding from the National Institute of Nursing Research of the National Institutes of Health under Award Number K23NR014489 (Jia-Rong Wu, PI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health. The authors declare that there is no conflict of interest.

Funders	Funder number
National Institutes of Health (NIH)
National Institute of Nursing Research	K23NR014489
Office of Extramural Research, National Institutes of Health

Keywords

Behavior intervention
Family intervention
Health literacy
Medication adherence

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine
Cardiology and Cardiovascular Medicine

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10.1016/j.hrtlng.2019.05.011

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title = "A multi-component, family-focused and literacy-sensitive intervention to improve medication adherence in patients with heart failure–A randomized controlled trial",

abstract = "Background: Medication nonadherence is prevalent and links to serious outcomes (e.g., rehospitalization/death) in heart failure (HF) patients; therefore, an urgent need exists for an intervention to improve and sustain adherence after intervention completion. Objectives: To test the efficacy of a multi-component, family-focused, literacy-sensitive (FamLit) intervention on medication adherence in HF patients. Methods: Forty-three HF patients and their care partners were enrolled and randomized to receive FamLit or attention-only intervention, including an in-person session at baseline and bi-weekly phone boosters for 3 months. We measured medication adherence from baseline to 3-month post-intervention using the Medication Event Monitoring System. Results: After 3-month intervention, intervention patients had significantly better medication adherence than control patients. At 6 months (3-months post-intervention), intervention effect on adherence was sustained in the FamLit intervention group, while adherence decreased in the control group. Conclusion: Incorporating care partner support and providing an easy-to-understand intervention to patients-care partners may improve/sustain adherence.",

keywords = "Behavior intervention, Family intervention, Health literacy, Medication adherence",

author = "Wu, {Jia Rong} and Barbara Mark and Knafl, {George J.} and Dunbar, {Sandra B.} and Chang, {Patricia P.} and DeWalt, {Darren A.}",

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AU - Mark, Barbara

AU - Knafl, George J.

AU - Dunbar, Sandra B.

AU - Chang, Patricia P.

AU - DeWalt, Darren A.

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N2 - Background: Medication nonadherence is prevalent and links to serious outcomes (e.g., rehospitalization/death) in heart failure (HF) patients; therefore, an urgent need exists for an intervention to improve and sustain adherence after intervention completion. Objectives: To test the efficacy of a multi-component, family-focused, literacy-sensitive (FamLit) intervention on medication adherence in HF patients. Methods: Forty-three HF patients and their care partners were enrolled and randomized to receive FamLit or attention-only intervention, including an in-person session at baseline and bi-weekly phone boosters for 3 months. We measured medication adherence from baseline to 3-month post-intervention using the Medication Event Monitoring System. Results: After 3-month intervention, intervention patients had significantly better medication adherence than control patients. At 6 months (3-months post-intervention), intervention effect on adherence was sustained in the FamLit intervention group, while adherence decreased in the control group. Conclusion: Incorporating care partner support and providing an easy-to-understand intervention to patients-care partners may improve/sustain adherence.

AB - Background: Medication nonadherence is prevalent and links to serious outcomes (e.g., rehospitalization/death) in heart failure (HF) patients; therefore, an urgent need exists for an intervention to improve and sustain adherence after intervention completion. Objectives: To test the efficacy of a multi-component, family-focused, literacy-sensitive (FamLit) intervention on medication adherence in HF patients. Methods: Forty-three HF patients and their care partners were enrolled and randomized to receive FamLit or attention-only intervention, including an in-person session at baseline and bi-weekly phone boosters for 3 months. We measured medication adherence from baseline to 3-month post-intervention using the Medication Event Monitoring System. Results: After 3-month intervention, intervention patients had significantly better medication adherence than control patients. At 6 months (3-months post-intervention), intervention effect on adherence was sustained in the FamLit intervention group, while adherence decreased in the control group. Conclusion: Incorporating care partner support and providing an easy-to-understand intervention to patients-care partners may improve/sustain adherence.

KW - Behavior intervention

KW - Family intervention

KW - Health literacy

KW - Medication adherence

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A multi-component, family-focused and literacy-sensitive intervention to improve medication adherence in patients with heart failure–A randomized controlled trial

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

Access to Document

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