EFFECTS OF A PROGRAM TO PROMOTE MEDICATION ADHERENCE USING TELEPHARMACY IN PATIENTS WITH HYPERTENSION
DOI:
https://doi.org/10.14456/tbps.2022.3Keywords:
medication adherence, telepharmacy, hypertension, health belief modelAbstract
This randomized controlled study aimed to assess the results of a program intended to promote the medication adherence of patients with hypertension, through providing a telepharmacy service. 65 patients with hypertension from Nakhon Pathom Hospital were included in the study. The patients were randomly assigned to one of two groups - an intervention group or a control group. 35 patients were assigned to the intervention group and 30 patients were assigned to the control group. Patients in the intervention group received messages to remind them to take their medicine. They also received information relating to the risks and severity of hypertension, advice on positive behavioural changes, diet and exercise, in text, infographic, or video form every day for 3 months. In addition, the patients were able to respond and communicate with a pharmacist anytime through the LINE application. In the control group, the patients received the standard care and information normally provided. Outcomes were evaluated through the Morisky Medication Adherence Scale 8-item (MMAS-8) and Health Belief Model evaluation form. Data were analysed by descriptive and inferential statistics including percentage, mean, standard deviation, Man-Whitney U Test, Wilcoxon Signed Ranks Test and Binary Logistic Regression. The results revealed that the medication adherence promoting program was related to moderate to good medication adherence, with statistical significance (p-value < 0.001). The mean adherence score for the intervention group (mean±SD=6.02±0.75) was higher than that for the control group (mean±SD=4.47±0.85) with statistical significance (p-value < 0.001). With respect to the Health Belief Model, the results showed that the intervention group returned higher scores in perceived susceptibility, perceived severity and perceived benefit, and a lower score in perceived barriers than the control group, at a level that was statistically significant (p-value<0.001). Therefore, the medication adherence promoting program using telehealth can assist patients to adhere to their medication program. This program can encourage patients to take their medication, and help disease control on an ongoing basis.
References
World Health Organization. A global brief on hypertension, silent killer, global public health crisis. Geneva: World Health Organization; 2013.
Department of Disease Control. Report of disease situation, NCDs, diabetes, hypertension and related factors, Bangkok: Aksorn Graphic and Design Publishing Limited Partnership, 2019.
Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16(4):223-37.
Vrijens B, Antoniou S, Burnier M, de la Sierra A, Volpe M. Current situation of medication adherence in hypertension. Front Pharmacol. 2017;8: doi:10.3389/fphar.2017.00100
Peacock E, Krousel-Wood M. Adherence to antihypertensive therapy. Med Clin North Am. 2017;101(1):229-45.
The Pharmacy Council of Thailand [Internet]. Annoucement of the Pharmacy Council of Thailand No.56/2020. Standardization and process of telepharmacy (in Thai).
Baldoni S, Amenta F, Ricci G. Telepharmacy services: present status and future perspectives: a review. Medicina 2019;55(7):p.327
Bingham JM, Black M, Anderson EJ, Li Y, Toselli N, Fox S, et al. Impact of telehealth interventions on medication adherence for patients with type 2 diabetes, hypertension, and/or dyslipidemia: A systematic review. Ann Pharmacother. 2020;55:1-13. doi:10.1177/106002802095072.
Jami Pour M, Jafari Seyed M. Toward a maturity model for the application of social media in healthcare: The health 2.0 roadmap. Online Inf. Rev. 2019;43(3):404-25.
Sartori AC, Rodrigues Lucena TF, Takáo Lopes C, Picinin Bernuci M, Yamaguchi MU. Educational intervention using whatsapp on medication adherence in hypertension and diabetes patients: A randomized clinical trial. Telemed J E Health. 2020;26(12):1526-32.
Linecorp [Internet]. Bangkok: LINE Corporation Thailand; 2020 [cited 2021 May 15]. Available from: https://linecorp.com/th/pr/news/th/2020/3592 (in Thai).
Wipaporn W. NS, Kanokporn M. Factors predicting to medication adherence among patients with essential hypertension. J R Thai Army Nurs. 2017;18(1):131-9 (in Thai).
Puengdokmai P, Charoenkitkarn V, Pinyopasakul W, Sriprasong S, Dumavibhat C, Factors influencing medication adherence in hypertensive patients without complications. Princess Naradhiwas Univ J. 2019;8(1):16-26.
Kamran A, Sadeghieh Ahari S, Biria M, Malepour A, Heydari H. Determinants of patient's adherence to hypertension medications: application of health belief model among rural patients. Ann Med Health Sci Res. 2014;4(6):922-7.
Noordzij M, Tripepi G, Dekker FW, Zoccali C, Tanck MW, Jager KJ. Sample size calculations: basic principles and common pitfalls. Nephrol Dial Transplant. 2010;25(5):1388-93.
Sheilini M, Hande HM, Prabhu MM, Pai MS, George A. Impact of multimodal interventions on medication nonadherence among elderly hypertensives: a randomized controlled study. Patient Prefer Adherence. 2019;13:549-59.
Morisky DE, Ang A, Krousel-Wood M, Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich), 2008;10(5):348-54.
Berlowitz DR, Foy CG, Kazis LE, Bolin L, Conroy LB, Fitzpatrick P, et al.Effect of intensive blood-pressure treatment on patient-reported outcomes. N Engl J Med. 2017;377:733-44.
Bress AP, Bellows BK, King J, Hess R, Beddhu S, Zhang Z, et al. Cost-effectiveness of intensive versus standard blood pressure control. N Engl J Med. 2017; 377:745-55.
Kumpiriyapong N. The effect of health belief program on medicine used behavior in older persons with hypertension [Dissertation]. Bangkok: Chulalongkorn University; 2016
Vargas G, Cajita MI, Whitehouse E, Han HR. Use of short messaging service for hypertension management:
a systematic review. J Cardiovasc Nurs. 2017;32(3):260-70.
Morrissey EC, Casey M, Glynn LG, Walsh JC, Molloy GJ. Smartphone apps for improving medication adherence in hypertension: patients' perspectives. Patient Prefer Adherence. 2018;12:813-22.
Andre N, Wibawanti R, Siswanto BB. Mobile phone-based intervention in hypertension management. Int J Hypertens. 2019:1-7.
Promjame S., Kespichayawattana J., The effect of health belief program on medicine used behavior in older persons with hypertention. R Thai Nav Med J. 2018; 45(3):561-77 (in Thai).
Thuy LT, Monkong, S., Pookboonmee, R., Leelacharas, S. and Viwatwongkasem, C. Factors explaining medication adherence of older adults with hypertension: A cross-sectional study. Pacific Rim Int J of Nurs Res. 2020;24(3):306-20.
He C, Wu S, Zhao Y, Li Z, Zhang Y, Le J, et al. Social media-promoted weight loss among an occupational population: Cohort study using a wechat mobile phone app-based campaign. J Med Internet Res. 2017;19(10e357.
Sadun RE, Schanberg LE. Using social media to promote medication adherence. Nat Rev Rheumatol. 2018;14(8):445-6.
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