Medication Adherence in Rheumatic Diseases

Study Overview
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Brief Summary
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The investigators will pilot test a clinician-led intervention to improve medication adherence in general rheumatology clinic across a spectrum of rheumatic diseases. The study will assess feasibility, acceptability, and fidelity, and explore signal for improved medication adherence.

Official Title
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Improving Medication Adherence in Chronic Rheumatic Diseases

Conditions
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Chronic Rheumatic Diseases

Intervention / Treatment
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* Behavioral: Clinician-led adherence intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: all providers at Southpoint Rheumatology All patients with a rheumatic disease diagnosis currently prescribed at least one rheumatic medication will be included in the analysis Exclusion Criteria: new patients, those who are not prescribed any rheumatic disease medications, or do not have available pharmacy refill data

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Clinicians in this arm will be trained to conduct the adherence intervention in general rheumatology clinic with all follow up patients with a chronic rheumatic disease. Patients seen by these clinicians will contribute to the outcome data collection. | Behavioral: Clinician-led adherence intervention<br>* The clinician will review real time pharmacy refill data during clinic and use effective communication techniques to discuss adherence with the patient<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intervention Feasibility | Percent of providers agreeing to participate | 4 weeks | 
| Intervention Feasibility | Provider survey based on the Feasibility of Intervention Measure, scores range from 1-5, 5 is most feasible | 4 weeks | 
| Intervention Feasibility | Percent of visits with EMR documentation of providers reviewing refills | 4 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acceptability | Provider survey based on the Acceptability of Intervention Measure, scores range from 1-5, 5 is most acceptable | 4 weeks | 
| Acceptability, as measured by the percentage of patients who report a positive feeling after having an adherence conversation with their providers | Patient survey will be administered after their provider visit | 4 weeks | 
| Fidelity | Provider survey about the frequency of conducting the intervention components of reviewing pharmacy refills and using effective communication strategies | 4 weeks | 
| Fidelity | Frequency of EMR documentation of completing the intervention components of reviewing pharmacy refills and using effective communication strategies | 4 weeks | 
| Change in medication adherence | 90-day medication possession ratio at 3 months after the intervention visit compared to baseline | baseline, 3 months | 
| Change in medication adherence | 90-day medication possession ratio at 6 months after the intervention visit compared to baseline | baseline, 6 months |