The Madison Avenue effect: How drug presentation style influences adherence and outcome in patients with asthma - 10/08/11
, Susan J. Bartlett, PhD b, W. Gerald Teague, MD c, John Lima, PharmD d, Charles G. Irvin, PhD e, Rubin Cohen, MD f, Mario Castro, MD, MPH g, Robert A. Wise, MD a, Cynthia S. Rand, PhD a
Reprint requests: Emmanuelle M. Clerisme-Beaty, MD, MHS, Division of Pulmonary Critical Care Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224.Abstract |
Background |
Little is known about how drug presentation influences medication adherence.
Objective |
To examine the effect of an educational program aimed at increasing expectations of treatment benefit on medication adherence.
Methods |
Data are analyzed from 99 participants who underwent electronic drug monitoring during the Trial of Asthma Patient Education, a randomized, placebo-controlled, multicenter trial. Participants with suboptimally controlled asthma were randomized to placebo or montelukast in conjunction with a presentation mode that was either neutral or designed to increase outcome expectancy. Adherence was monitored electronically over 4 weeks and was defined as ≥80% use of prescribed doses. Outcome expectancy, peak expiratory flow, prebronchodilator FEV1, asthma control (Juniper asthma control questionnaire), and asthma-related quality of life were assessed at baseline and at the 4-week follow-up.
Results |
Average electronic medication adherence was 69.9%. There was a significant interaction between presentation mode and drug assignment, with participants in the enhanced/montelukast group having a higher change in outcome expectancy (Δ 2.1 points; P < .001) and better medication adherence (odds ratio, 4.0; 95% CI, 1.1-14.3) compared with those in the neutral/placebo group. There was no difference in asthma symptoms, quality of life, or clinical outcomes on the basis of presentation mode. Rather, increased outcome expectancy was associated with modest improvements in asthma symptoms after adjusting for presentation mode, drug assignment, and medication adherence.
Conclusion |
The use of an enhanced presentation aimed at increasing outcome expectancy may lead to improved medication adherence.
Le texte complet de cet article est disponible en PDF.Key words : Asthma, medication adherence, electronic monitoring, outcome expectancy, behavioral intervention
Abbreviations used : ACQ, OE, PEF, TAPE
Plan
| Supported by grants from the National Institutes of Health (National Heart, Lung, and Blood Institute grant R01HL073494) and the American Lung Association. |
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| Disclosure of potential conflict of interest: S. J. Bartlett is the program chair for the Behavioral Sciences Assembly for the American Thoracic Society. W. G. Teague receives speakers’ honoraria from Merck and Co; receives research support from the NIH/NHLBI, the American Lung Association, and the Centers for Disease Control and Prevention; has provided testimony on behalf of the American Thoracic Society relating to long-acting β-agonists; is a volunteer for Not One More Life; and tithes to Genesis Bible Church, Bible Training Center for Pastors, and Cornerstone Church. C. G. Irvin receives speakers’ fees from Merck and Teva, receives research support from the NIH and the American Lung Association, and is chairman of the American Lung Association Leadership Board in Vermont and the Vermont Department of Health. M. Castro is a consultant for Asthmatx, Schering, Electrocore, and NKTT; is on the advisory board for Genentech; receives speakers’ honoraria from AstraZeneca, Boehringer-Ingelheim, Pfizer, and Merck; receives royalties from Elsevier; and receives research support from the American Lung Association, the NIH, Asthmatx, Amgen, Ception, GlaxoSmithKline, Genentech, MedImmune, Merck, and Novartis. R. A. Wise receives research support from the American Lung Association. C. S. Rand is on the advisory board for the Merck Foundation/MCAN, is on the leadership council for Schering-Plough, and is a consultant for GlaxoSmithKline. The rest of the authors have declared that they have no conflict of interest. |
Vol 127 - N° 2
P. 406-411 - février 2011 Retour au numéro
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