Diabetes Mellitus, Medication Adherence
Conditions
Brief summary
Medication adherence is especially critical in regions like rural Alabama, where residents have among the worst health outcomes in the US. This project was designed in collaboration with our community member partners and builds on a 5-year partnership of community-engaged research on diabetes peer coaching interventions and our experience with peer storytelling. The investigators will test the hypothesis that an intervention designed within the Corbin and Strauss framework can improve adherence and health outcomes compared to usual care.
Detailed description
Improving medication adherence is one of the greatest challenges in modern medicine. Despite decades of research on the topic, as many as half of patients with chronic diseases are not taking medications as recommended, and costs of nonadherence have been estimated at $290 billion annually. One reason for this persistent finding could be that interventions rarely acknowledge medications within the larger context of the lived experience of illness. Drawing on hundreds of patient interviews, Corbin and Strauss showed that chronic illness is a fundamentally destabilizing influence that forces us to confront the potential limitations of our new, chronically ill self. Accepting our illness may be a crucial step in embracing medication adherence and other self-management behaviors as ways to restore balance following this disruption. The Corbin and Strauss framework is not often used to develop and test interventions to improve medication adherence, and this is the central objective of this proposal. Medication adherence is especially critical in regions like rural Alabama, where residents have among the worst health outcomes in the US. Rates of cardiovascular mortality, diabetes and obesity are very high, but resources are scarce and the area's predominately black residents have deep-seated mistrust of the healthcare system (the region includes Tuskegee, site of the infamous syphilis study). This project was designed in collaboration with our community member partners and builds on a 5-year partnership of community-engaged research on diabetes peer coaching interventions and our experience with peer storytelling. The investigators will test the hypothesis that an intervention designed within the Corbin and Strauss framework can improve adherence and health outcomes compared to usual care. Our Aims are: Aim 1: With our community partners, using qualitative research methods, build on already developed culturally tailored education material to develop the medication adherence intervention. The intervention will consist of educational DVDs with integrated storytelling about how community members accepted their disease and overcame barriers to medication adherence, plus one-on-one telephonic peer coaching. Activities include conducting focus groups with patients; creating the DVDs and the coaching intervention protocol; training peer coaches; and pilot testing. Aim 2: Conduct a randomized controlled trial with 500 individuals with type 2 diabetes and medication nonadherence. The trial will compare the effect of usual care and the intervention on medication adherence and physiologic risk factors including A1c, blood pressure and low density lipoprotein cholesterol (primary outcomes), and quality of life and self-efficacy (secondary outcomes). This innovative approach would be a major shift in how patients are helped in under resourced areas living with chronic diseases commit to taking medications, improving health and eventually reducing health disparities.
Interventions
BEHAVIORALLiving Well with Diabetes Program
The intervention participants will receive the Living Well with Diabetes Program. The program will consist of educational DVDs with integrated storytelling about how community members accepted their disease and overcame barriers to medication adherence, plus one-on-one telephonic peer coaching
Sponsors
Patient-Centered Outcomes Research Institute
University of Alabama at Birmingham
Weill Medical College of Cornell University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
19 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* adults * type 2 diabetes * taking medications for diabetes * medication non adherent
Exclusion criteria
* nursing home residence * plans to move away in the next year * advanced illnesses such as hemodialysis, cancer or dementia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Self Reported Medication Adherence | Baseline, 6 months | Patient-reported adherence to medications as a medication adherence score, from 0-3, where a higher score indicates worse adherence. |
| Change in Blood Pressure | Baseline, 6 months | 2 BP measures were taken 1 minute apart using a LifeSource UA-789 digital blood pressure monitor. |
| Change in Percentage of HbA1c | Baseline, 6 months | Hemoglobin A1c test to identify the average amount of glucose (sugar) present in a patient's blood. |
| Change in Low-Density Lipoprotein (LDL) Cholesterol | Baseline, 6 months | Finger stick, spectrophotometer to measure cholesterol level. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Diabetes-Specific Quality of Life | Baseline, 6 months | Diabetes specific quality of life will be assessed using the validated Diabetes Distress Scale.The DDS is a 17-item instrument that measures diabetes-related emotional distress. Participants rate the degree to which each item is problematic for them on a 6-point Likert scale, from 1 (no problem) to 6 (serious problem). A score of 3 or greater = moderate distress. |
| Number of Hospital Stays at 6 Months | 6 months | — |
| Number of Emergency Visits at 6 Months | 6 months | — |
| Change in Diabetes Medication Counts | Baseline, 6 months | Change in number of diabetes medications. |
| Number of Physician Office Visits 6 Months | 6 months | — |
| Change in Quality of Life as Assessed With the Short Form 12- Mental Component | Baseline, 6 months | Short Form-12 Mental Component and Physical Component Summary scores range from 0-100; higher scores indicate greater quality of life. |
| Change in Quality of Life as Assessed With the Short Form-12- Physical Component | Baseline, 6 months | Short Form-12 Mental Component and Physical Component Summary scores range from 0-100; higher scores indicate greater quality of life. |
| Change in Medication Use Self-efficacy Score as Measured by SEAMS Scale and the Perceived Diabetes Self-Management Scale, Which is Associated With A1c | Baseline, 6 months | Medication use self-efficacy scores for range from 13-39; higher scores indicate higher levels of self-efficacy for medication adherence. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Change in Medication Beliefs- Harm (Beliefs That Medications Are Harmful) | Baseline, 6 months | Beliefs about medications questionnaire scores range from 5-25; higher scores indicate stronger beliefs. |
| Change in Medication Beliefs- Concerns (Concerns About the Negative Effects of Medications) | Baseline, 6 months | Beliefs about medications questionnaire scores range from 5-25; higher scores indicate stronger beliefs. |
| Change in Medication Beliefs-Necessity (Beliefs About the Necessity of Medications) | Baseline, 6 months | Beliefs about medications questionnaire scores range from 5-25; higher scores indicate stronger beliefs. |
| Change in Medication Beliefs- Overuse (Concerns About the Way Doctors Use Medications) | Baseline, 6 months | Beliefs about medications questionnaire scores range from 5-25; higher scores indicate stronger beliefs. |
Countries
United States
Participant flow
Recruitment details
Recruitment efforts in this area focused on attending health fairs, posting flyers at community locations such as libraries and churches. The main focus of recruitment was in the county's safety net clinic.
Participants by arm
| Arm | Count |
|---|---|
| Peer Coaching The intervention participants will receive the Living Well with Diabetes Program. The program will consist of educational DVDs with integrated storytelling about how community members accepted their disease and overcame barriers to medication adherence, plus one-on-one telephonic peer coaching.
Living Well with Diabetes Program: The intervention participants will receive the Living Well with Diabetes Program. The program will consist of educational DVDs with integrated storytelling about how community members accepted their disease and overcame barriers to medication adherence, plus one-on-one telephonic peer coaching | 203 |
| Usual Care At enrollment, the investigators will provide an educational DVD on general health and wellness topics including vaccination, cancer screening, osteoporosis and other topics not related to diabetes care. There will be no peer storytelling on these DVDs. | 270 |
| Total | 473 |
Baseline characteristics
| Characteristic | Peer Coaching | Total | Usual Care |
|---|---|---|---|
| Age, Continuous | 57.7 years STANDARD_DEVIATION 10.6 | 57.1 years STANDARD_DEVIATION 11.5 | 56.7 years STANDARD_DEVIATION 12.1 |
| Annual Income <$20,000 | 133 Participants | 318 Participants | 185 Participants |
| Annual Income >=$20,000 | 60 Participants | 134 Participants | 74 Participants |
| Body Mass Index | 36.4 kg/m2 STANDARD_DEVIATION 8.8 | 36.5 kg/m2 STANDARD_DEVIATION 8.4 | 36.5 kg/m2 STANDARD_DEVIATION 8 |
| Education 12th grade, GED, HS diploma | 69 Participants | 168 Participants | 99 Participants |
| Education < High School | 46 Participants | 97 Participants | 51 Participants |
| Education >High School | 87 Participants | 207 Participants | 120 Participants |
| Employment Employed for wages or self-employed | 53 Participants | 125 Participants | 72 Participants |
| Employment Not worked(ret, out of wrk, homemker, unable work) | 149 Participants | 345 Participants | 196 Participants |
| Hba1c 7.0 or greater | 130 Participants | 286 Participants | 156 Participants |
| Hba1c Less than 7.0 | 73 Participants | 187 Participants | 114 Participants |
| HbA1c | 8.6 % STANDARD_DEVIATION 2.2 | 8.4 % STANDARD_DEVIATION 2.1 | 8.3 % STANDARD_DEVIATION 2 |
| Marital Status Married or living with partner | 75 Participants | 169 Participants | 94 Participants |
| Marital Status Never married, divorced, widowed, separated | 128 Participants | 303 Participants | 175 Participants |
| Medication Adherence Score as measured by the Morisky Medication Adherence Scale Missing | 0 Participants | 1 Participants | 1 Participants |
| Medication Adherence Score as measured by the Morisky Medication Adherence Scale Yes to 0 questions | 67 Participants | 171 Participants | 104 Participants |
| Medication Adherence Score as measured by the Morisky Medication Adherence Scale Yes to 1 questions | 84 Participants | 182 Participants | 98 Participants |
| Medication Adherence Score as measured by the Morisky Medication Adherence Scale Yes to 2 questions | 34 Participants | 74 Participants | 40 Participants |
| Medication Adherence Score as measured by the Morisky Medication Adherence Scale Yes to 3 questions | 12 Participants | 32 Participants | 20 Participants |
| Medication Adherence Score as measured by the Morisky Medication Adherence Scale Yes to 4 questions | 6 Participants | 13 Participants | 7 Participants |
| Number of Subjects Taking Insulin | 96 Participants | 207 Participants | 111 Participants |
| Race/Ethnicity, Customized African American | 178 Participants | 428 Participants | 250 Participants |
| Race/Ethnicity, Customized All Others | 25 Participants | 45 Participants | 20 Participants |
| Sex: Female, Male Female | 159 Participants | 371 Participants | 212 Participants |
| Sex: Female, Male Male | 44 Participants | 102 Participants | 58 Participants |
| Systolic Blood Pressure | 127.8 mmHg STANDARD_DEVIATION 19.4 | 128.6 mmHg STANDARD_DEVIATION 19.7 | 129.1 mmHg STANDARD_DEVIATION 19.9 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 203 | 0 / 270 |
| other Total, other adverse events | 0 / 203 | 0 / 270 |
| serious Total, serious adverse events | 0 / 203 | 0 / 270 |
Outcome results
Primary
Change in Blood Pressure
2 BP measures were taken 1 minute apart using a LifeSource UA-789 digital blood pressure monitor.
Time frame: Baseline, 6 months
Population: 39 participants in the peer coaching arm and 31 participants in the usual care arm were not analyzed because the participants were unable to be contacted, had health reasons, or did not have time.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Peer Coaching | Change in Blood Pressure | Baseline | 128.5 mmHg | Standard Deviation 19.6 |
| Peer Coaching | Change in Blood Pressure | 6 months | 130.6 mmHg | Standard Deviation 20.7 |
| Peer Coaching | Change in Blood Pressure | Change at 6 months | 2.5 mmHg | Standard Deviation 19.5 |
| Usual Care | Change in Blood Pressure | Baseline | 129.3 mmHg | Standard Deviation 19.5 |
| Usual Care | Change in Blood Pressure | 6 months | 133.6 mmHg | Standard Deviation 18.4 |
| Usual Care | Change in Blood Pressure | Change at 6 months | 4.1 mmHg | Standard Deviation 20.5 |
Primary
Change in Low-Density Lipoprotein (LDL) Cholesterol
Finger stick, spectrophotometer to measure cholesterol level.
Time frame: Baseline, 6 months
Population: 39 participants in the peer coaching arm and 31 participants in the usual care arm were not analyzed because the participants were unable to be contacted, had health reasons, or did not have time.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Peer Coaching | Change in Low-Density Lipoprotein (LDL) Cholesterol | Baseline | 84.6 mg/dL | Standard Deviation 38.4 |
| Peer Coaching | Change in Low-Density Lipoprotein (LDL) Cholesterol | 6 months | 80.1 mg/dL | Standard Deviation 33.1 |
| Peer Coaching | Change in Low-Density Lipoprotein (LDL) Cholesterol | Change at 6 months | -4.5 mg/dL | Standard Deviation 38.6 |
| Usual Care | Change in Low-Density Lipoprotein (LDL) Cholesterol | Baseline | 80.7 mg/dL | Standard Deviation 36.3 |
| Usual Care | Change in Low-Density Lipoprotein (LDL) Cholesterol | 6 months | 82.2 mg/dL | Standard Deviation 31 |
| Usual Care | Change in Low-Density Lipoprotein (LDL) Cholesterol | Change at 6 months | 1.5 mg/dL | Standard Deviation 38.2 |
Primary
Change in Percentage of HbA1c
Hemoglobin A1c test to identify the average amount of glucose (sugar) present in a patient's blood.
Time frame: Baseline, 6 months
Population: 39 participants in the peer coaching arm and 31 participants in the usual care arm were not analyzed because the participants were unable to be contacted, had health reasons, or did not have time.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Peer Coaching | Change in Percentage of HbA1c | Baseline | 8.4 percentage of HbA1c | Standard Deviation 2.11 |
| Peer Coaching | Change in Percentage of HbA1c | 6 months | 8.1 percentage of HbA1c | Standard Deviation 1.9 |
| Peer Coaching | Change in Percentage of HbA1c | Change at 6 months | -0.37 percentage of HbA1c | Standard Deviation 1.71 |
| Usual Care | Change in Percentage of HbA1c | Baseline | 8.3 percentage of HbA1c | Standard Deviation 1.99 |
| Usual Care | Change in Percentage of HbA1c | 6 months | 8.1 percentage of HbA1c | Standard Deviation 1.8 |
| Usual Care | Change in Percentage of HbA1c | Change at 6 months | -0.24 percentage of HbA1c | Standard Deviation 1.55 |
Primary
Change in Self Reported Medication Adherence
Patient-reported adherence to medications as a medication adherence score, from 0-3, where a higher score indicates worse adherence.
Time frame: Baseline, 6 months
Population: 39 participants in the peer coaching arm and 31 participants in the usual care arm were not analyzed because the participants were unable to be contacted, had health reasons, or did not have time.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Peer Coaching | Change in Self Reported Medication Adherence | Baseline | 0.78 Scores on a scale | Standard Deviation 0.8 |
| Peer Coaching | Change in Self Reported Medication Adherence | 6 months | 0.53 Scores on a scale | Standard Deviation 0.66 |
| Peer Coaching | Change in Self Reported Medication Adherence | Change at 6 months | -0.25 Scores on a scale | Standard Deviation 0.7 |
| Usual Care | Change in Self Reported Medication Adherence | Baseline | 0.74 Scores on a scale | Standard Deviation 0.79 |
| Usual Care | Change in Self Reported Medication Adherence | 6 months | 0.62 Scores on a scale | Standard Deviation 0.76 |
| Usual Care | Change in Self Reported Medication Adherence | Change at 6 months | -0.12 Scores on a scale | Standard Deviation 0.71 |
Comparison: The study was powered to detect clinically meaningful differences in physiologic risk factors; it had four primary outcomes.Power estimates accounted for clustering of patients within towns, using a variance inflation factor, conservatively estimating power for ICC=0.01-0.05. Process measures were selected to understand which aspects of the intervention were particularly effective, assessing both program satisfaction and peer coach effectiveness.p-value: 0.2295% CI: [-0.23, 0.05]ANCOVA
Secondary
Change in Diabetes Medication Counts
Change in number of diabetes medications.
Time frame: Baseline, 6 months
Population: 44 participants in the peer coaching arm and 38 participants in the usual care arm were not analyzed because the participants were unable to be contacted, had health reasons, or did not have time.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Peer Coaching | Change in Diabetes Medication Counts | Baseline | 1.4 Medications | Standard Deviation 0.7 |
| Peer Coaching | Change in Diabetes Medication Counts | 6 months | 1.3 Medications | Standard Deviation 0.6 |
| Peer Coaching | Change in Diabetes Medication Counts | Change at 6 months | -0.04 Medications | Standard Deviation 0.5 |
| Usual Care | Change in Diabetes Medication Counts | Baseline | 1.3 Medications | Standard Deviation 0.6 |
| Usual Care | Change in Diabetes Medication Counts | 6 months | 1.3 Medications | Standard Deviation 0.6 |
| Usual Care | Change in Diabetes Medication Counts | Change at 6 months | 0.004 Medications | Standard Deviation 0.6 |
Secondary
Change in Diabetes-Specific Quality of Life
Diabetes specific quality of life will be assessed using the validated Diabetes Distress Scale.The DDS is a 17-item instrument that measures diabetes-related emotional distress. Participants rate the degree to which each item is problematic for them on a 6-point Likert scale, from 1 (no problem) to 6 (serious problem). A score of 3 or greater = moderate distress.
Time frame: Baseline, 6 months
Population: 39 participants in the peer coaching arm and 34 participants in the usual care arm were not analyzed because the participants were unable to be contacted, had health reasons, or did not have time.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Peer Coaching | Change in Diabetes-Specific Quality of Life | Baseline | 2.6 Scores on a scale | Standard Deviation 1.3 |
| Peer Coaching | Change in Diabetes-Specific Quality of Life | 6 months | 1.9 Scores on a scale | Standard Deviation 1.1 |
| Peer Coaching | Change in Diabetes-Specific Quality of Life | Change at 6 months | -0.6 Scores on a scale | Standard Deviation 1.3 |
| Usual Care | Change in Diabetes-Specific Quality of Life | Baseline | 2.3 Scores on a scale | Standard Deviation 1.3 |
| Usual Care | Change in Diabetes-Specific Quality of Life | 6 months | 2.0 Scores on a scale | Standard Deviation 1.2 |
| Usual Care | Change in Diabetes-Specific Quality of Life | Change at 6 months | -0.3 Scores on a scale | Standard Deviation 1.3 |
Secondary
Change in Medication Use Self-efficacy Score as Measured by SEAMS Scale and the Perceived Diabetes Self-Management Scale, Which is Associated With A1c
Medication use self-efficacy scores for range from 13-39; higher scores indicate higher levels of self-efficacy for medication adherence.
Time frame: Baseline, 6 months
Population: 39 participants in the peer coaching arm and 31 participants in the usual care arm were not analyzed because the participants were unable to be contacted, had health reasons, or did not have time.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Peer Coaching | Change in Medication Use Self-efficacy Score as Measured by SEAMS Scale and the Perceived Diabetes Self-Management Scale, Which is Associated With A1c | Baseline | 31.9 Scores on a scale | Standard Deviation 5.6 |
| Peer Coaching | Change in Medication Use Self-efficacy Score as Measured by SEAMS Scale and the Perceived Diabetes Self-Management Scale, Which is Associated With A1c | 6 months | 33.9 Scores on a scale | Standard Deviation 5.1 |
| Peer Coaching | Change in Medication Use Self-efficacy Score as Measured by SEAMS Scale and the Perceived Diabetes Self-Management Scale, Which is Associated With A1c | Change at 6 months | 2.0 Scores on a scale | Standard Deviation 5.6 |
| Usual Care | Change in Medication Use Self-efficacy Score as Measured by SEAMS Scale and the Perceived Diabetes Self-Management Scale, Which is Associated With A1c | Baseline | 32.2 Scores on a scale | Standard Deviation 6 |
| Usual Care | Change in Medication Use Self-efficacy Score as Measured by SEAMS Scale and the Perceived Diabetes Self-Management Scale, Which is Associated With A1c | 6 months | 33.1 Scores on a scale | Standard Deviation 5.5 |
| Usual Care | Change in Medication Use Self-efficacy Score as Measured by SEAMS Scale and the Perceived Diabetes Self-Management Scale, Which is Associated With A1c | Change at 6 months | 0.9 Scores on a scale | Standard Deviation 5 |
Secondary
Change in Quality of Life as Assessed With the Short Form 12- Mental Component
Short Form-12 Mental Component and Physical Component Summary scores range from 0-100; higher scores indicate greater quality of life.
Time frame: Baseline, 6 months
Population: 39 participants in the peer coaching arm and 31 participants in the usual care arm were not analyzed because the participants were unable to be contacted, had health reasons, or did not have time.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Peer Coaching | Change in Quality of Life as Assessed With the Short Form 12- Mental Component | Baseline | 42.7 Scores on a scale | Standard Deviation 7.5 |
| Peer Coaching | Change in Quality of Life as Assessed With the Short Form 12- Mental Component | 6 months | 42.0 Scores on a scale | Standard Deviation 6.9 |
| Peer Coaching | Change in Quality of Life as Assessed With the Short Form 12- Mental Component | Change at 6 months | -0.7 Scores on a scale | Standard Deviation 8.6 |
| Usual Care | Change in Quality of Life as Assessed With the Short Form 12- Mental Component | Baseline | 42.3 Scores on a scale | Standard Deviation 7 |
| Usual Care | Change in Quality of Life as Assessed With the Short Form 12- Mental Component | 6 months | 42.1 Scores on a scale | Standard Deviation 7.2 |
| Usual Care | Change in Quality of Life as Assessed With the Short Form 12- Mental Component | Change at 6 months | -0.2 Scores on a scale | Standard Deviation 8.5 |
Secondary
Change in Quality of Life as Assessed With the Short Form-12- Physical Component
Short Form-12 Mental Component and Physical Component Summary scores range from 0-100; higher scores indicate greater quality of life.
Time frame: Baseline, 6 months
Population: 39 participants in the peer coaching arm and 31 participants in the usual care arm were not analyzed because the participants were unable to be contacted, had health reasons, or did not have time.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Peer Coaching | Change in Quality of Life as Assessed With the Short Form-12- Physical Component | Baseline | 39.0 Scores on a scale | Standard Deviation 8.2 |
| Peer Coaching | Change in Quality of Life as Assessed With the Short Form-12- Physical Component | 6 months | 40.4 Scores on a scale | Standard Deviation 8.3 |
| Peer Coaching | Change in Quality of Life as Assessed With the Short Form-12- Physical Component | Change at 6 months | 1.4 Scores on a scale | Standard Deviation 7.7 |
| Usual Care | Change in Quality of Life as Assessed With the Short Form-12- Physical Component | Baseline | 40.1 Scores on a scale | Standard Deviation 7.7 |
| Usual Care | Change in Quality of Life as Assessed With the Short Form-12- Physical Component | 6 months | 40.4 Scores on a scale | Standard Deviation 7.9 |
| Usual Care | Change in Quality of Life as Assessed With the Short Form-12- Physical Component | Change at 6 months | 0.3 Scores on a scale | Standard Deviation 8.1 |
Secondary
Number of Emergency Visits at 6 Months
Time frame: 6 months
Population: This data was not collected.
Secondary
Number of Hospital Stays at 6 Months
Time frame: 6 months
Population: This data was not collected.
Secondary
Number of Physician Office Visits 6 Months
Time frame: 6 months
Population: This data was not collected.
Other Pre-specified
Change in Medication Beliefs- Concerns (Concerns About the Negative Effects of Medications)
Beliefs about medications questionnaire scores range from 5-25; higher scores indicate stronger beliefs.
Time frame: Baseline, 6 months
Population: 39 participants in the peer coaching arm and 31 participants in the usual care arm were not analyzed because the participants were unable to be contacted, had health reasons, or did not have time.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Peer Coaching | Change in Medication Beliefs- Concerns (Concerns About the Negative Effects of Medications) | Follow-up | 14.0 Scores on a scale | Standard Deviation 3.8 |
| Peer Coaching | Change in Medication Beliefs- Concerns (Concerns About the Negative Effects of Medications) | Baseline | 15.4 Scores on a scale | Standard Deviation 3.9 |
| Peer Coaching | Change in Medication Beliefs- Concerns (Concerns About the Negative Effects of Medications) | Change | -1.5 Scores on a scale | Standard Deviation 4 |
| Usual Care | Change in Medication Beliefs- Concerns (Concerns About the Negative Effects of Medications) | Follow-up | 14.7 Scores on a scale | Standard Deviation 8.9 |
| Usual Care | Change in Medication Beliefs- Concerns (Concerns About the Negative Effects of Medications) | Baseline | 14.9 Scores on a scale | Standard Deviation 4.2 |
| Usual Care | Change in Medication Beliefs- Concerns (Concerns About the Negative Effects of Medications) | Change | -0.2 Scores on a scale | Standard Deviation 3.9 |
Other Pre-specified
Change in Medication Beliefs- Harm (Beliefs That Medications Are Harmful)
Beliefs about medications questionnaire scores range from 5-25; higher scores indicate stronger beliefs.
Time frame: Baseline, 6 months
Population: 39 participants in the peer coaching arm and 31 participants in the usual care arm were not analyzed because the participants were unable to be contacted, had health reasons, or did not have time.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Peer Coaching | Change in Medication Beliefs- Harm (Beliefs That Medications Are Harmful) | Baseline | 10.6 Scores on a scale | Standard Deviation 2.7 |
| Peer Coaching | Change in Medication Beliefs- Harm (Beliefs That Medications Are Harmful) | Follow-up | 9.8 Scores on a scale | Standard Deviation 2.7 |
| Peer Coaching | Change in Medication Beliefs- Harm (Beliefs That Medications Are Harmful) | Change | -0.8 Scores on a scale | Standard Deviation 2.5 |
| Usual Care | Change in Medication Beliefs- Harm (Beliefs That Medications Are Harmful) | Baseline | 9.8 Scores on a scale | Standard Deviation 2.8 |
| Usual Care | Change in Medication Beliefs- Harm (Beliefs That Medications Are Harmful) | Follow-up | 9.7 Scores on a scale | Standard Deviation 2.8 |
| Usual Care | Change in Medication Beliefs- Harm (Beliefs That Medications Are Harmful) | Change | -0.1 Scores on a scale | Standard Deviation 2.8 |
Other Pre-specified
Change in Medication Beliefs-Necessity (Beliefs About the Necessity of Medications)
Beliefs about medications questionnaire scores range from 5-25; higher scores indicate stronger beliefs.
Time frame: Baseline, 6 months
Population: 39 participants in the peer coaching arm and 31 participants in the usual care arm were not analyzed because the participants were unable to be contacted, had health reasons, or did not have time.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Peer Coaching | Change in Medication Beliefs-Necessity (Beliefs About the Necessity of Medications) | Baseline | 19.1 Scores on a scale | Standard Deviation 3.6 |
| Peer Coaching | Change in Medication Beliefs-Necessity (Beliefs About the Necessity of Medications) | Follow-up | 20.0 Scores on a scale | Standard Deviation 3.9 |
| Peer Coaching | Change in Medication Beliefs-Necessity (Beliefs About the Necessity of Medications) | Change | 0.9 Scores on a scale | Standard Deviation 3.5 |
| Usual Care | Change in Medication Beliefs-Necessity (Beliefs About the Necessity of Medications) | Baseline | 19.6 Scores on a scale | Standard Deviation 3.9 |
| Usual Care | Change in Medication Beliefs-Necessity (Beliefs About the Necessity of Medications) | Follow-up | 19.4 Scores on a scale | Standard Deviation 4.2 |
| Usual Care | Change in Medication Beliefs-Necessity (Beliefs About the Necessity of Medications) | Change | -0.2 Scores on a scale | Standard Deviation 3.7 |
Other Pre-specified
Change in Medication Beliefs- Overuse (Concerns About the Way Doctors Use Medications)
Beliefs about medications questionnaire scores range from 5-25; higher scores indicate stronger beliefs.
Time frame: Baseline, 6 months
Population: 39 participants in the peer coaching arm and 31 participants in the usual care arm were not analyzed because the participants were unable to be contacted, had health reasons, or did not have time.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Peer Coaching | Change in Medication Beliefs- Overuse (Concerns About the Way Doctors Use Medications) | Baseline | 13.3 Scores on a scale | Standard Deviation 3.2 |
| Peer Coaching | Change in Medication Beliefs- Overuse (Concerns About the Way Doctors Use Medications) | Follow-up | 12.6 Scores on a scale | Standard Deviation 3.4 |
| Peer Coaching | Change in Medication Beliefs- Overuse (Concerns About the Way Doctors Use Medications) | Change | -0.6 Scores on a scale | Standard Deviation 3.3 |
| Usual Care | Change in Medication Beliefs- Overuse (Concerns About the Way Doctors Use Medications) | Baseline | 12.7 Scores on a scale | Standard Deviation 3.4 |
| Usual Care | Change in Medication Beliefs- Overuse (Concerns About the Way Doctors Use Medications) | Follow-up | 12.6 Scores on a scale | Standard Deviation 3.4 |
| Usual Care | Change in Medication Beliefs- Overuse (Concerns About the Way Doctors Use Medications) | Change | -0.1 Scores on a scale | Standard Deviation 3.3 |