Creating a synergy effect: A cluster randomized controlled trial testing the effect of a tailored multimedia intervention on patient outcomes

Patient Educ Couns. 2018 Aug;101(8):1419-1426. doi: 10.1016/j.pec.2018.03.017. Epub 2018 Mar 17.

Abstract

Objective: Improving adherence is a challenge and multiple barriers are likely to explain non-adherence. These barriers differ per patient and over course of the regimen. Hence, personalized interventions tailored to the specific barriers are needed. In a theoretical and evidence-based Tailored Multimedia Intervention, technology (online preparatory assessment, text messaging) was used as an add-on to a tailored counseling session (learned during a communication skills training), with the expectation of synergistic effects.

Methods: A cluster randomized controlled trial was conducted in six hospitals, eight nurses and 160 chronic patients. Patient satisfaction with communication, beliefs about medication, self-efficacy and medication adherence were assessed at initiation of the treatment and after six months.

Results: Intervention effects were found for patient satisfaction with nurses' affective communication and self-efficacy at the initiation of treatment. The effect on self-efficacy remained after six months.

Conclusion: By combining tailored counseling with technology, this intervention resulted in positive changes in important prerequisites of medication adherence.

Practical implications: Technology can contribute significantly to health care providers' ability to tailor information to the patients' needs.

Keywords: Cluster randomized controlled trial; Medication adherence; Patient-provider communication; Synergy effect; Tailoring; Technology-mediated intervention.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Counseling
  • Female
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Inflammatory Bowel Diseases / nursing*
  • Inservice Training*
  • Male
  • Medication Adherence
  • Middle Aged
  • Multimedia*
  • Netherlands
  • Nurse-Patient Relations*
  • Nursing Staff, Hospital / education*
  • Patient Education as Topic*
  • Patient Satisfaction
  • Self Efficacy
  • Surveys and Questionnaires
  • Text Messaging
  • Treatment Outcome

Substances

  • Gastrointestinal Agents