A Brief Intervention to Improve Medication Knowledge and Adherence Among Family Medicine Patients in South Texas
Condition: Diabetes Mellitus, Type 2; Hyperlipidemia; Hypertension
MeSH terms: Diabetes Mellitus, Type 2; Hyperlipidemias
Study type: Interventional

Summary: 
      This study examines a brief physician counseling intervention to improved medication
      knowledge and compliance in family medicine patients who have diabetes, hypertension or high
      cholesterol.
    

Detailed description: 
      This study examined a brief intervention to improve medication knowledge and compliance in
      family medicine patients. The study was conducted in a network of six family medicine
      residency programs in South Texas, funded by a grant from the Health Research Services
      Administration. Family medicine patients were invited to participate in the study if they
      took medicines for type 2 diabetes, hypertension, or hyperlipidemia and responded "yes" to
      the screening question: "Do you sometimes have trouble taking all your medications as
      prescribed?"

      At enrollment, clinic staff administered a Medication Survey to patients to assess the
      variables: readiness to change, reported medication knowledge; reported compliance, and
      predictors of knowledge and compliance. Self-reports of compliance were validated with a
      social desirability scale, and with physician impressions. Six and twelve weeks
      post-enrollment, interviewers administered followup surveys by telephone to assess change
      over time in medication knowledge and compliance. One year post-enrollment, investigators
      conducted a chart review to examine changes in health outcomes: blood pressure or HbA1c or
      cholesterol levels, and number of hospitalizations.

      Three physicians per clinic site (18 total) conducted medication interventions for the
      purpose of this study. This intervention was brief behavior change counseling done in the
      context of a routine office visit, guided by simple strategies outlined in Rollnick et al
      (1999). First, physicians reviewed subjects= medication regimen and addressed their concerns.
      We selected a simple strategy from Rollnick et al. - a brainstorming session - that built
      patients' confidence to change health behaviors. Afterward, physicians offered pillboxes to
      patients who desired them, and reviewed potential adverse reactions to medicines. One week
      after the intervention, physicians telephoned patients to reinforce behavior change and to
      answer questions about the medications. Prior to training physicians to conduct this
      intervention, we enrolled five subjects per physician into a control group. We attempted to
      blind physicians to these patients= enrollment status; usual care was provided to control
      subjects. After training, enrollees' charts were flagged so that physicians knew to conduct
      the intervention. We sought five patients per physician to receive the intervention.
    

Intervention name(s): Physician counseling for health behavior change
Intervention type(s): Behavioral
Intervention description(s): Physician counseling for health behavior change, compared to a no-counseling comparison group
Allocation: Non-Randomized
Intervention model: Factorial Assignment
Masking: Single (Care Provider)
Primary purpose: Treatment
Keywords: Patient compliance; Hispanics; Health Behavior; Family Physicians; Primary Healthcare