Adherence, Coronary Artery Disease
Conditions
Keywords
Medication Adherence, Reciprocal Peer, Telemonitoring
Brief summary
The purpose of this research study is to improve statin medication adherence among Veterans with coronary artery disease with poor adherence to medications. The investigators are testing if newer technology pill bottle devices linked with individual feedback and/or social incentive strategies can improve medication taking behavior.
Detailed description
Patients with coronary artery disease and previous poor adherence to statin medications will be recruited at Philadelphia VA Medical Center. Enrolled participants will be randomly assigned to one of three arms: 1. Control Group 2. Individual Alarm device and feedback report 3. Individual plus patient-selected Feedback Friend report Patients will be given a medication-monitoring device (Vitality GlowCaps) to monitor the statin medication that is being currently prescribed by their primary care physician. In first group, the control arm (Arm 1), the device reminders will be turned off but the device will continue recording adherence to the medications. In second group, reminder arm (Arm 2), the device will be programmed as an alarm that will be activated if the patient does not take the medication at the time set by the patient. In addition the patient will get a weekly report of his/her adherence. In the third group, patient-selected family/friend/or reciprocal peer feedback arm (Arm 3), in addition to the activation of the alarm function the device will be linked to a weekly report on adherence to medications. This report will be delivered to the patient and to the patient identified family/friend/ or reciprocal peer.
Interventions
BEHAVIORALIndividual Feedback
Patient gets feedback reports on adherence weekly.
BEHAVIORALFeedback Friend
In addition to individual feedback reports this information will be sent to an assigned family/friend or reciprocal peer.
Sponsors
Corporal Michael J. Crescenz VA Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
30 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
* All participants will have a diagnosis of CAD * To be eligible they must be between the ages of 30-75 years of age-to ensure we are targeting those most likely to benefit from improving control to these medications * Patients must have been prescribed a statin by their provider and a documented poor adherence as measured by a 16-month medication adherence rate (Medication Possession Ratio) of \<80%
Exclusion criteria
* Due to the use of the medication adherence reminder device, patients must speak English * Have a home address * Telephone number * Be willing and able to identify a friend or family member * The investigators will exclude atients with active substance abuse, significant hearing loss, or reduced cognitive ability as determined from the patient's problem list
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Adherence | Change in baseline adherence at 3 month and 6 month | Adherence will be measured using the following formula: \[Number of times the pill bottle was opened/(Number of times a day each medication is prescribed to be taken multiplied by the total number of days in study)\]. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient Activation | Change in baseline patient activation at 3 month and 6 month | The investigators will utilize the 13-item Patient Activation Measure (PAM) to measure an individual's activation level.18 This tool has been used in previous studies to predict self-efficacy for health behaviors, such as exercise and medications adherence. Response categories for each item are strongly agree, agree, disagree and strongly disagree. Responses are then scaled and transformed to a score ranging from 0 to 100. These scores are correlated with four stages of activation. |
| Social Support | Change in baseline social support at 3 month and 6 month | The multidimensional scale of perceived social support will be given at baseline, 3-months, and 6-months. This is a 12-item questionnaire is a validated measure of social support. For each item, respondents must choose one answer that reflects their assessment of social support on a 7-point scale.19 The items divide into 3 main factors of support: Family, Friends, and Significant other. |
| LDL levels | Change in baseline LDL level at 6 month | The investigators will obtain baseline LDL levels for each patient prior to the intervention. In addition to monitor impact of adherence to the statin medication the investigators will obtain LDL levels at baseline and 6-month time periods for all patients. |
Countries
United States
Outcome results
None listed