Motivational Interviewing and Medication Review in Coronary Heart Disease
- Conditions
- Coronary Heart Disease
- Interventions
- Behavioral: Standard TreatmentBehavioral: MI and Medication review
- Registration Number
- NCT02102503
- Lead Sponsor
- Göran Petersson
- Brief Summary
Low medication adherence in patients with coronary heart disease increases mortality.
This study investigates if an intervention of medication review and counselling can improve patients' medication adherence and treatment results.
- Detailed Description
The study will investigate the effects of medication review and Motivational Interviewing (MI) on patients with Coronary Heart Disease (CHD). Clinical pharmacists competent in MI and cardiology will conduct medication interviews and medication reviews at the outpatient clinic. The intervention will continue during 9 months, with interviews and reviews as needed.
Follow-up of results will take place 16 months after inclusion (corresponding to 4 months after the end of intervention).
The MI-Component will be quality assured by MITI 4.2-coding (Motivational Interviewing Treatment Integrity). The study will investigate effects on clinical outcomes, medication adherence, patients´ beliefs about medicines and quality of life.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 417
- Admitted for angiography
- Verified Coronary Artery Disease (ICD-10 I20-I21)
- Planned for follow up at the out-patient clinic (standard treatment)
- Swedish speaking
- Cognitive impairment or any othe condition making interview or phone calls impossible.
- Non-participation in the standard follow-up
- Prior participation in this study
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description MI and Medication review Standard Treatment The intervention starts three months post-discharge after the standard treatment at the out-patients clinic. A medication review focused on cardiovascular drugs, and a counselling session with a clinical pharmacist using Motivational Interviewing (MI)-approach, and a follow-up phone call two weeks later. For patients with negative beliefs about medicines, three additional MI-sessions in clinic or by phone are planned together with the patient. Irrespective of beliefs the intervention ends with a second medication review and counselling session, which is coordinated with the 12-months post-discharge follow-up in primary care. Standard treatment Standard Treatment Standard treatment at the cardiology out-patient clinic. Follow-up by nurse after two weeks and by physician after two months. MI and Medication review MI and Medication review The intervention starts three months post-discharge after the standard treatment at the out-patients clinic. A medication review focused on cardiovascular drugs, and a counselling session with a clinical pharmacist using Motivational Interviewing (MI)-approach, and a follow-up phone call two weeks later. For patients with negative beliefs about medicines, three additional MI-sessions in clinic or by phone are planned together with the patient. Irrespective of beliefs the intervention ends with a second medication review and counselling session, which is coordinated with the 12-months post-discharge follow-up in primary care.
- Primary Outcome Measures
Name Time Method Percentage of patients who achieve the treatment goal for Low density lipoprotein cholesterol (LDL-C) 16 months According to Swedish guidelines the goal is \< 1,8mmol/L or at least 50% reduction from baseline.
- Secondary Outcome Measures
Name Time Method Percentage of patients adherent to preventive medication: Angiotensin Converter Enzyme inhibitor (ACEi) or Angiotensin Receptor Blocker (ARB) 16 months Prescription refill according to the Swedish Prescribed Drug Register, 1 refill month 12-16 is set as the cut-off for adherence.
Percentage of patients adherent to preventive medication: P2Y12-antagonist 16 months Prescription refill according to the Swedish Prescribed Drug Register, 1 refill month 12-16 is set as the cut-off for adherence.
Percentage of patients with Systolic Blood Pressure <140 16 months As registered in the Electronic Health Record
Changes in Quality of Life 16 months The Heart QoL instrument
Percentage of patients adherent to preventive medication: Acetylsalicylic acid (ASA) 16 months Prescription refill according to the Swedish Prescribed Drug Register, 1 refill month 12-16 is set as the cut-off for adherence.
Percentage of patients adherent to cholesterol lowering treatment 16 months Prescription refill according to the Swedish Prescribed Drug Register, Percent Day Covered (PDC) during follow-up period, 80% is set as the cut-off for adherence.
Percentage of patients adherent to preventive medication: Beta-blocker 16 months Prescription refill according to the Swedish Prescribed Drug Register, 1 refill month 12-16 is set as the cut-off for adherence.
Number of Cardiovascular Re-admissions and Emergency Department visits 16 months According to the Health Care register of Kalmar County
Trial Locations
- Locations (1)
Kalmar County Hospital
🇸🇪Kalmar, Sweden
Kalmar County Hospital🇸🇪Kalmar, Sweden