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A nurse-based intervention for improving medication adherence in cardiovascular patients: an evaluation of a randomized controlled trial

机译：以护士为基础的干预措施可改善心血管疾病患者的药物依从性：一项随机对照试验的评估

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>Background: Poor medication adherence is a limitation in the secondary prevention of cardiovascular diseases (CVDs) and leads to increased morbidity, mortality, and costs.>Purpose: To examine the process and effect of a nurse-led, web-based intervention based on behavioral change strategies to improve medication adherence in patients with CVD.>Patients and methods: In this single-center, prospective, controlled clinical trial, cardiovascular patients were assigned to usual care, usual care plus a personalized website, or usual care plus a personalized website and personal consultations. Primary outcome was the level of adherence to cardiovascular medication. Data collection occurred between October 2011 and January 2015.>Results: In total, 419 patients were randomized. Just 77 patients logged on the website and half of the invited patients attended the group consultation. Due to the limited use of the website, we combined the results of usual care and the usual care plus website group in one group (usual care) and compared these with the results of the group which received the nurse intervention (intervention group). No significant difference in adherence between the usual care group and the intervention group was observed. The adherence level in the usual care group was 93%, compared to 89% in the intervention group (p=0.08). 29% (usual care) and 31% (intervention group) of the patients showed a low adherence according to the Modified Morisky Scale® (p-value=0.94). The mean necessity concern differential was 3.8 with no differences between the two studied groups (mean 3.8 vs mean 3.9, p-value =0.86).>Conclusion: Our intervention program did not show an effect. This could indicate that structured usual care provided to all cardiovascular patients already results in high medication adherence or that shortly after a cardiovascular event adherence is high. It could also indicate that the program did not have enough impact because there was not enough compliance with the intervention protocol.>Trial registration: ID number , approved May 2011.
机译：>背景：药物依从性差是心血管疾病（CVD）二级预防的局限性，会导致发病率，死亡率和成本增加。>目的：检查过程和行为改变策略的护士主导的基于网络的干预对改善CVD患者药物依从性的效果。>患者和方法：在此单中心，前瞻性，对照临床试验中，心血管疾病患者被分配到常规护理，常规护理加个性化网站，或常规护理加个性化网站和个人咨询。主要结果是坚持心血管药物治疗的水平。数据收集发生在2011年10月至2015年1月之间。>结果：总共有419名患者被随机分组​​。只有77位患者登录了网站，一半的受邀患者参加了团体咨询。由于网站的使用受限，我们将常规护理和常规护理加网站组的结果（一组）合为一组，并将其与接受护士干预的组（干预组）的结果进行比较。在常规护理组和干预组之间，依从性没有显着差异。常规护理组的依从性水平为93％，而干预组为89％（p = 0.08）。根据改良的MoriskyScale®（p值= 0.94），有29％（常规护理）和31％（干预组）的患者依从性较低。两个研究组之间的平均必要性关注差异为3.8，差异无统计学意义（平均3.8 vs平均值3.9，p值= 0.86）。>结论：我们的干预计划未显示出效果。这可能表明，为所有心血管患者提供结构化的常规护理已经导致较高的药物依从性，或者在心血管事件依从性高后不久。它还可能表明该程序没有产生足够的影响，因为没有充分遵守干预协议。>试用注册： ID号，2011年5月批准。

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