Department of Rheumatology and Pharmacy, Sint Maartenskliniek, Nijmegen, The Netherlands.
Patient Educ Couns. 2012 Oct;89(1):143-51. doi: 10.1016/j.pec.2012.07.007. Epub 2012 Aug 9.
To describe the systematic development and content of a short intervention to improve medication adherence to disease-modifying anti-rheumatic drugs in non-adherent patients with rheumatoid arthritis (RA).
The intervention mapping (IM) framework was used to develop the intervention. The following IM steps were conducted: (1) a needs assessment; (2) formulation of specific intervention objectives; (3) inventory of methods and techniques needed to design the intervention and (4) production and piloting of the intervention.
The intervention (consisting of two group sessions led by a pharmacist, a homework assignment, and a follow-up call) aims to improve the balance between necessity and concern beliefs about medication, and to resolve practical barriers in medication taking. The central communication method used is motivational interviewing.
By applying the IM framework, we were able to create a feasible, time-efficient and promising intervention to improve medication adherence in non-adherent RA patients. Intervention effects are currently being assessed in a randomized controlled trial.
This paper could serve as a guideline for other health care professionals when developing similar interventions. If the RCT demonstrates sufficient effectiveness of this intervention in reducing medication non-adherence in RA patients, the intervention could be embedded in clinical practice.
描述一种改善类风湿关节炎（RA）不依从患者疾病修正抗风湿药物用药依从性的简短干预措施的系统开发和内容。
采用干预映射（IM）框架来开发干预措施。进行了以下 IM 步骤：（1）需求评估；（2）制定具体的干预目标；（3）设计干预措施所需的方法和技术清单；（4）干预措施的制定和试点。
干预措施（由一名药剂师主导的两次小组会议、一项家庭作业和一次随访电话组成）旨在改善对药物治疗必要性和关注信念的平衡，并解决药物治疗中的实际障碍。使用的核心沟通方法是动机性访谈。
通过应用 IM 框架，我们能够创建一种可行、高效且有前途的干预措施，以提高不依从 RA 患者的用药依从性。目前正在一项随机对照试验中评估干预效果。
本文可为其他医疗保健专业人员开发类似干预措施提供指导。如果 RCT 证明该干预措施在减少 RA 患者药物不依从性方面具有足够的有效性，那么该干预措施可以嵌入临床实践中。
