- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05645653
Nurse-led Medication Self-management Intervention in the Improvement of Medication Adherence
Nurse-led Medication Self-management Intervention in the Improvement of Medication Adherence in Adult Patients With Multi-morbidity: A Feasibility Randomized Control Trial
Back ground & Aims Adult patients suffering from multimorbidity are at high risk of medication non-adherence. It has been well established that self-management support is an effective strategy to enhance medication adherence for patients with chronic conditions. However, little is known about the effect of the medication self-management intervention in Adult patients with multimorbidity. The aim of this study to evaluate the effectiveness of a nurse-led medication self-management intervention in improving medication adherence and health outcomes in adult patients with multimorbidity.
Methods This study is a single centre, single-blind, two-arm randomised controlled trial. Adult patients with multi-morbidity will be recruited from NCCCR Qatar. A total of 100 participants will be randomly allocated to receive standard care or standard care plus the medication self-management intervention. The intervention will be delivered by clinical nurse specialists. The 6-week intervention includes three face-to-face education sessions (2st week, 4rd week and 6th week) and two weekly (8th week and 10 week) follow-up phone calls. Participants in the control group continue to receive all respects of standard care offered by healthcare providers, including chronic disease management, drug prescription, referral to hospital specialists, health education and consultations regarding patients' diseases and treatments during centre visits.
Outcome The primary outcome is medication adherence as measured by the 8-item Medication Adherence Report Scale. Secondary outcomes include medication self-management capacity (medication knowledge, medication beliefs, and medication self-efficacy), treatment experiences (medication treatment satisfaction and treatment burden). All outcomes will be measured at baseline, immediately post-intervention (7th week), and at 3-month post-intervention.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Kalpana Singh, Ph.D
- Phone Number: 40258218
- Email: nkalpanasingh@gmail.com
Study Contact Backup
- Name: Badriya Lenjawi, Ph.D
- Email: blenjawi@hamad.qa
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- +18 years old or over,
- Patients with at least two of the identified comorbidities (Hypertension, Chronic painful condition, Cancer, Inflammatory connective tissue disorders, Diabetes, Lipid disorder, Dyspepsia and gastroenteritis, Heart disease, Chronic obstructive pulmonary disease, Stroke and cerebrovascular disease , chronic kidney disorder , Asthma Thyroid disorders, Anemia, Chronic liver disease, Depression, Epilepsy, Anxiety & other stress related disorders), (3) having at least one medication prescribed for a chronic condition over at least the 3 months prior to inclusion in the study,
- Non-adherence to medications, as defined by scoring zero on the 8-item Medication Adherence Report Scale (Morisky -8)(29),
- Independently managing their medications (i.e., not rely on a care taker),
- Able to speak or understand English/Arabic,
- Able and willing to receive phone calls, and
- Capable of providing a written informed consent to participate in the study.
Exclusion Criteria:
- Being institutionalized in a long-term care facility,
- Planning to move away from the community in the next 6 months,
- Cognitive impairment (Mini-cog scores < 4), and
- Currently participating in research involving chronic disease management. Patients with cognitive impairment are excluded because they may not be able to provide valid answers to the questionnaires.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Educational treatment
The medication self-management intervention consists of three face-to-face education sessions and two weekly telephone follow-up over 6 weeks.
Intervention components are derived from an extensive review of the literature, including the related theoretical framework and current practice.
Based on the extended IMB model of medication adherence, this intervention is designed to offer information related to medication treatment, motivate patients to adhere, help build medication self-management skills, and develop adherence improvement plans.
The face-to-face meeting will take place in the clinical nurse specialist counselling room in NCCCR.
|
A comprehensive assessment of adherence problems will be firstly conducted to identify the factors that affect adherence, including how and why these factors contribute to poor adherence.
Medication-related knowledge and skills will be provided based on individual treatments and barriers to adherence.
Motivational interviewing techniques will be used for a better understanding of patients' cognitive factors of adherence behavior.
|
No Intervention: Standard Care
Participants in the control group will continue to receive standard care from Physicians, nurses, and clinical pharmacists in the NCCCR.
Physicians are the primary providers and coordinators of care for patients with chronic conditions.
Physicians provide patients consultations and education regarding their diseases and treatments (typically clinician-centred) at each patient visit to the chronic disease clinic.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Medication Adherence
Time Frame: 3 months
|
The Morisky-8 is a self-reporting measure of unintentional and intentional medication non-adherent behaviors with a yes and no response.
The total score of the moresky-8 ranges from 0 to 8, with a higher score representing higher adherence to medication.
Approx 50% percentage change in medication adherence after intervention from baseline to 3 months as compared to control
|
3 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Medication Knowledge
Time Frame: 3 months
|
Change medication knowledge using The Patients' Perceived Knowledge in Medication Use Questionnaire (PKMUQ).
The response scale ranges from 1 = strongly disagree to 5 = strongly agree, and the response scores of all 5 items will be summed.
Higher scores indicate a higher level of medication knowledge.
the score will vary from 5 to 25.
|
3 months
|
Medication beliefs
Time Frame: 3 months
|
using the Beliefs about Medication Questionnaire (BMQ 18-item)self-reported questionnaire we will assess the medication beliefs from baseline to 3 months. A 5-point Likert scale ranging from 1 = strongly disagree to 5 = strongly agree is used. A higher score indicates stronger beliefs about the corresponding concepts in each subscale. the score range would be 5 to 90. |
3 months
|
Medication self-efficacy
Time Frame: 3 months
|
Change in Self efficacy will be assess using the SEAMS 13 items of questionnaire.
Each item has a 3-point scale ranging from 1 = not confident to 3 = very confident.
The score of scale ranges from 13 to 39, with a higher medication self-efficacy by a higher score.
|
3 months
|
Treatment burden
Time Frame: 3 months
|
The change in behavior and emotional burden using MTBQ questionnaire.
Each item is scored on 6-point Likert scale, ranging from 0 = does not apply to 5 = most difficult.
Scores are summed to derive a total score ranging from 0 to 50 with a higher score indicating a higher level of treatment burden.
|
3 months
|
Collaborators and Investigators
Sponsor
Collaborators
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 296
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Research data will be stored on a password-protected computer and backed up on a password-protected hard drive Research Department 322A 3rd floor 302.
PI and Senior Biostatistician will have the access of full data
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Heart Diseases
-
Baker Heart and Diabetes InstitutePrincess Alexandra Hospital, Brisbane, Australia; Royal Perth Hospital; Alice... and other collaboratorsRecruitingHeart Failure | Valve Heart DiseaseAustralia
-
Medical University of ViennaUnknownHeart Diseases | Heart Failure | Valvular Heart DiseaseAustria
-
Centre Chirurgical Marie LannelongueActive, not recruitingValvular Heart Disease | Valve Disease, Heart
-
Aristotle University Of ThessalonikiRecruitingCardiovascular Diseases | Heart Failure | Valvular Heart Disease | Biochemical DysfunctionGreece
-
Abiomed Inc.RecruitingHeart Diseases | Acute Decompensated Heart Failure | Congestive Heart Failure | Acute Heart FailureUnited States
-
Kathirvel SubramaniamUniversity of Maryland, Baltimore; CSL BehringRecruitingHeart Failure,Congestive | Heart Disease End StageUnited States
-
Wuerzburg University HospitalRecruitingHeart Failure | Chronic Heart Failure | Chronic Heart DiseaseGermany
-
University of MichiganTerminatedDiastolic Heart Failure | Hypertensive Heart DiseaseUnited States
-
Wake Forest UniversityNational Institute on Aging (NIA)CompletedHeart Failure, Congestive | Diastolic Heart FailureUnited States
-
National Taiwan University HospitalRecruitingValve Heart DiseaseTaiwan
Clinical Trials on Motivational tteaching
-
Veterans Medical Research FoundationThe Tug McGraw FoundationCompleted
-
University of Massachusetts, WorcesterNational Institute of Mental Health (NIMH); Polaris Health DirectionsCompletedCancer | DistressUnited States
-
Massachusetts General HospitalRecruitingDiabetes Mellitus, Type 2United States
-
University of Maryland, BaltimoreMaryland Department of Health and Mental HygieneCompletedFractures, Bone | Smoking, TobaccoUnited States
-
Washington University School of MedicineNational Institute of Mental Health (NIMH)Completed
-
Emory UniversityCompleted
-
Qazvin University Of Medical SciencesCompletedObesity, AdolescentIran, Islamic Republic of
-
Massachusetts General HospitalCompletedACS - Acute Coronary SyndromeUnited States
-
VA Connecticut Healthcare SystemUnknown
-
San Diego State UniversityCompletedDrug AbuseUnited States