Self-efficacy, Beliefs and Adherence- Pilot and Feasibility Trial of a Pharmacist-led Intervention
| Status: | Recruiting |
|---|---|
| Conditions: | Diabetes |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 18 - 80 |
| Updated: | 12/8/2018 |
| Start Date: | December 4, 2018 |
| End Date: | December 31, 2020 |
| Contact: | Olayinka O Shiyanbola, PhD, BPharm |
| Email: | Olayinka.Shiyanbola@wisc.edu |
| Phone: | 6088902091 |
This study uses an intervention mixed methods design. The overall purpose is to improve
medication adherence and assess the clinical impact on diabetes outcomes among patients with
uncontrolled diabetes. We will examine if usual care combined with a clinic-based health
literacy/psychosocial support intervention improves medication adherence compared to usual
care alone. A randomized controlled trial will be conducted at William S. Middleton Memorial
Veterans Hospital in Madison, targeting individuals with uncontrolled diabetes. The
patient-centered health literacy intervention will focus on enhancing patients' self-efficacy
and addressing patients' negative beliefs in medicine and illness.
medication adherence and assess the clinical impact on diabetes outcomes among patients with
uncontrolled diabetes. We will examine if usual care combined with a clinic-based health
literacy/psychosocial support intervention improves medication adherence compared to usual
care alone. A randomized controlled trial will be conducted at William S. Middleton Memorial
Veterans Hospital in Madison, targeting individuals with uncontrolled diabetes. The
patient-centered health literacy intervention will focus on enhancing patients' self-efficacy
and addressing patients' negative beliefs in medicine and illness.
The study will improve medication adherence for patients with diabetes using two strategies:
1) addressing health literacy by reducing the complexity of diabetes content disseminated to
patients during medication counseling and 2) addressing health literacy by enhancing
patient-pharmacist communication. The second strategy aims to improve the psychosocial
support offered to patients by building self-efficacy and addressing negative beliefs about
medicines and diabetes. Together, the patient and the pharmacist can work together towards
goal setting, problem solving, and negotiation of competing priorities.
Currently, with usual care, the pharmacist confirms if patients understand how to take
medications correctly, adjusts diabetes medications, and monitor patients' hemoglobin A1C
levels periodically to make sure that patients are capable of managing their diabetes
appropriately. With the proposed intervention, the pharmacist will identify patients'
concerns and barriers to medication taking and self-care with diabetes with an emphasis on
self-efficacy, negative beliefs in medicine and illness. Then the pharmacist will provide
individualized plans and set specific goals with each patient by strengthening their
confidence in medication use and health literacy skills in navigating health information for
diabetes self-care. The methods described for the intervention are in line with the current
clinic workflow and will not require a substantial change to the current system for
counseling diabetes patients. Knowledge change often does not lead to behavior change. Hence,
the intervention will innovatively focus on moving knowledge towards action as the clinical
pharmacist works with patients in assessing health literacy, identifying their barriers to
medication use, including lack of self-efficacy, addressing negative beliefs about diabetes
and diabetes medications; towards problem solving, and developing goals and action plans that
will improve medication adherence and glycemic control.
1) addressing health literacy by reducing the complexity of diabetes content disseminated to
patients during medication counseling and 2) addressing health literacy by enhancing
patient-pharmacist communication. The second strategy aims to improve the psychosocial
support offered to patients by building self-efficacy and addressing negative beliefs about
medicines and diabetes. Together, the patient and the pharmacist can work together towards
goal setting, problem solving, and negotiation of competing priorities.
Currently, with usual care, the pharmacist confirms if patients understand how to take
medications correctly, adjusts diabetes medications, and monitor patients' hemoglobin A1C
levels periodically to make sure that patients are capable of managing their diabetes
appropriately. With the proposed intervention, the pharmacist will identify patients'
concerns and barriers to medication taking and self-care with diabetes with an emphasis on
self-efficacy, negative beliefs in medicine and illness. Then the pharmacist will provide
individualized plans and set specific goals with each patient by strengthening their
confidence in medication use and health literacy skills in navigating health information for
diabetes self-care. The methods described for the intervention are in line with the current
clinic workflow and will not require a substantial change to the current system for
counseling diabetes patients. Knowledge change often does not lead to behavior change. Hence,
the intervention will innovatively focus on moving knowledge towards action as the clinical
pharmacist works with patients in assessing health literacy, identifying their barriers to
medication use, including lack of self-efficacy, addressing negative beliefs about diabetes
and diabetes medications; towards problem solving, and developing goals and action plans that
will improve medication adherence and glycemic control.
Inclusion Criteria:
- English-speaking men and women 18-80 years old with diabetes
- Taking oral diabetes medications and/or insulin
- One hemoglobin A1C measure of 8% or greater in the last 18 months
- A score less than 25 on the Medication Adherence Rating Scale (MARS-5)
Exclusion Criteria:
- Unable to provide informed consent
- Younger than 18 years old or older than 80 years old
- Unable to understand English
- Do not take oral diabetes medications and/or insulin
- A score equal to 25 on the Medication Adherence Rating Scale (MARS-5)
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