Randomized controlled trial of two telemedicine medication reminder systems for older adults with heart failure

Over five million Americans suffer from heart failure (HF), and many poorly manage their disease resulting in high patient burden and costs due to hospitalization. Furthermore, many HF patients suffer from cognitive dysfunction, which could reduce medication adherence. The purpose of this randomized feasibility study was to examine the impact of two medication reminder systems on medication adherence over 28-days of monitoring. It was hypothesized that reminding would increase medication adherence. Sixty adults were recruited from an outpatient cardiology clinic. Participants were randomly assigned to a smartphone or pillbox and active or passive conditions in a 2 X 2 design. Participants’ cognition was tested, and all were taught how to use the assigned device that they used for 28 days. After, participants provided feedback about feasibility and acceptance of the device. A level-2 hierarchical linear model with random effects demonstrated no statistically significant relationship between reminding and adherence. Adherence was not related to cognitive dysfunction. In intent-to-treat analyses, all four groups’ mean adherence rate was 78%, and the mean adherence rates of all groups in completers analyses was 82%. The current sample demonstrated higher adherence rates than estimates from previous literature suggesting this was a well-managed sample prior to the intervention. The effects of measurement reactivity and other contributors to adherence (e.g., motivation, social support, established medication organizer systems) should be considered in future studies.ClinicalTrials.gov Identifier: NCT01463267Funding Sources: ICTR at Kent State University, Case Western Reserve University School of Nursing, and NIH

Name thesis:degree_name

MA

Level thesis:degree_level

masters

Discipline thesis:degree_discipline

College of Arts and Sciences / Department of Psychological Sciences

Grantor dc:publisher

Kent State University

Year dc:date

2013

Author dc:creator

• Goldstein, Carly Michelle

Contributors dc:contributor

• Hughes, Joel

• Psychology
• Health
• medication adherence
• heart failure
• cognitive dysfunction
• telehealth
• mhealth
• telemedicine
• clinical trial

Statement dc:rights

• unrestricted
• This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.

Language dc:language

English

Repository record dc:identifier

http://rave.ohiolink.edu/etdc/view?acc_num=kent1364946106

OAI identifier oai:identifier

oai:etd.ohiolink.edu:kent1364946106