Open AccessAdherence therapy improves medication adherence and quality of life in people with Parkinson's disease: a randomised controlled trial
Author(s) -
Daley D. J.,
Deane K. H. O.,
Gray R. J.,
Clark A. B,
Pfeil M.,
Sabanathan K.,
Worth P. F.,
Myint P. K.
Publication year - 2014
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.12439
Subject(s) - medicine , spouse , quality of life (healthcare) , physical therapy , psychological intervention , randomized controlled trial , mood , intervention (counseling) , psychiatry , nursing , sociology , anthropology
Summary Background Many factors are associated with medication non‐adherence in Parkinson's disease ( PD ), including complex treatment regimens, mood disorders and impaired cognition. However, interventions to improve adherence which acknowledge such factors are lacking. A phase II randomised controlled trial was conducted investigating whether Adherence Therapy ( AT ) improves medication adherence and quality of life (QoL) compared with routine care ( RC ) in PD . Methods Eligible PD patients and their spouse/carers were randomised to intervention ( RC plus AT ) or control ( RC alone). Primary outcomes were change in adherence (Morisky Medication Adherence Scale) and QoL (Parkinson's Disease Questionnaire‐39) from baseline to week‐12 follow up. Secondary outcomes were MDS ‐ UPDRS (part I, II , IV ), Beliefs about Medication Questionnaire ( BMQ ), EuroQol ( EQ ‐5D) and the Caregiving Distress Scale. Blinded data were analysed using logistic and linear regression models based on the intention‐to‐treat principle. Results Seventy‐six patients and 46 spouse/carers completed the study (intervention: n = 38 patients, n = 24 spouse/carers). At week‐12 AT significantly improved adherence compared with RC ( OR 8.2; 95% CI : 2.8, 24.3). Numbers needed to treat ( NNT ) were 2.2 ( CI : 1.6, 3.9). Compared with RC , AT significantly improved PDQ ‐39 (−9.0 CI : −12.2, −5.8), BMQ general harm (−1.0 CI : −1.9, −0.2) and MDS ‐ UPDRS part II (−4.8 CI : −8.1, −1.4). No significant interaction was observed between the presence of a spouse/carer and the effect of AT . Conclusion Adherence Therapy improved self‐reported adherence and QoL in a PD sample. The small NNT suggests AT may be cost‐effective. A larger pragmatic trial to test the efficacy and cost‐effectiveness of AT by multiple therapists is required.