Preliminary Feasibility of a Peer-supported Diabetes Medication Adherence Intervention for African Americans

2019 ◽  
Vol 6 (6) ◽  
pp. 558-569 ◽  
Author(s):  
Olayinka O. Shiyanbola ◽  
Adati Tarfa ◽  
Ariana Song ◽  
Lisa K. Sharp ◽  
Earlise Ward
Keyword(s):  
Medication Adherence ◽  
African Americans ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Management Strategies ◽  
Phone Call ◽  
Diabetes Medication ◽  
Support Mechanism ◽  
Culturally Informed

Objectives: African Americans (AAs) have higher rates of medication nonadherence compared to non-Hispanic whites. In this study, we determined the preliminary feasibility of an 8-week intervention focused on improving culturally-informed illness and medication beliefs, self-efficacy, and medication adherence. Methods: We used purposeful sampling to recruit 8 peer ambassadors (PAs), individuals constituting the advisory board of AAs adherent to their medicines, and 7 peer buddies (PBs), assessed as non-adherent to their diabetes medicines. PAs and PBs were paired. They completed 2 group educational sessions together and one follow-up phone call to PBs by PAs. Results: PAs were mostly female (N = 5, 63%), mean age of 55 years (± 8.3). Similarly, PBs were mostly female (N = 6, 86%), mean age of 56 years (± 6.3). Follow-up interviews with PBs revealed that they liked discussing medication management strategies and diabetes management resources, sharing their diabetes experiences with their PA and connecting with them over the phone. All PBs reported a positive, trusting relationship between them and their PAs. Conclusions: This study demonstrates AAs with diabetes medication adherence challenges are receptive to a peer support mechanism to address culturally informed beliefs and enhance patient-provider communication and self-efficacy.

scholarly journals Feasibility of a Texting Intervention to Improve Medication Adherence Among Older HIV+ African Americans: A Mixed-Method Pilot Study

2019 ◽  
Vol 5 ◽  
pp. 233372141985566 ◽  
Author(s):  
Marta E. Pagan-Ortiz ◽  
Paul Goulet ◽  
Laura Kogelman ◽  
Sue E. Levkoff ◽  
Patricia Flynn Weitzman
Keyword(s):  
Medication Adherence ◽  
Pilot Study ◽  
African Americans ◽  
Mixed Method ◽  
Self Efficacy ◽  
Text Messaging ◽  
The United States ◽  
Self Report ◽  
Art Adherence ◽  
Older African Americans

Antiretroviral therapy (ART) is the primary treatment for HIV, and adherence to it is crucial to addressing health disparities. Approximately half of individuals in the United States living with HIV are African Americans, and those over 45 years of age are more likely to die early from HIV/AIDS than their White counterparts. This mixed-method pilot study evaluated the feasibility of a text-based mobile phone intervention designed to improve ART adherence among older African Americans with HIV. Feasibility was assessed via implementation, participant adherence, acceptability, and satisfaction, as well as short-term impact on medication adherence, adherence-related self-efficacy, and positive affect. The intervention utilized pill reminder, motivational, and health educational texts. Participants ( N = 21) ranged in age from 50 to 68 years. Outcomes were evaluated via quantitative results from self-report measures and qualitative data from four focus groups. There was no attrition in participation. After 8 weeks, participants reported statistically significant improvements in medication adherence, but not in self-efficacy or affect scores. Qualitative findings highlight the psychologically supportive potential of the intervention, challenges to adherence, as well as suggestions for improvement. The study demonstrates that a text messaging intervention may be feasible for older African Americans with HIV, and helpful in supporting ART adherence.

scholarly journals A Feasibility Pilot Trial of a Peer-support Educational Behavioral Intervention to Improve Diabetes Medication Adherence in African Americans

2021 ◽  
Author(s):  
Olayinka Shiyanbola ◽  
Martha Maurer ◽  
Mattigan Mott ◽  
Luke Schwerer ◽  
Nassim Sarkarati ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Medication Adherence ◽  
African Americans ◽  
Effect Size ◽  
Self Efficacy ◽  
Hemoglobin A1c ◽  
The United States ◽  
Post Intervention ◽  
Phone Calls

Abstract BackgroundAfrican Americans are twice as likely to die from diabetes, compared to other racial and ethnic groups in the United States. Poor adherence to diabetes medications is common among African Americans and contributes to these disproportionally worse outcomes. A pilot study was conducted to determine the feasibility and acceptability of a peer-supported intervention targeting diabetes and medication beliefs, communication, and self-efficacy skills to enhance medication adherence among African Americans with type 2 diabetes. MethodsBased on the extended self-regulatory model and information-motivation-behavioral skills model, this intervention was piloted using a single group pre/post-intervention study design at two sites. Seventeen African Americans who self-reported as adherent to diabetes medicines (ambassadors), were paired with 22 African Americans with self-reported poor medication adherence (buddies). Measures assessed at baseline and one-month post-intervention included glycemic control (hemoglobin A1c), self-reported medication adherence, diabetes beliefs, concerns about diabetes medicines, and diabetes self-efficacy. Wilcoxon signed rank tests assessed for differences in mean scores of outcome variables at baseline compared with 3-months follow-up. Semi-structured 60-minute interviews were conducted with each buddy to explore their acceptability of the intervention. To ensure the rigor of the qualitative data, we focused on analytic criteria such as credibility, confirmability, and transferability.ResultsMost buddies and ambassadors were female and about 56 years old. Feasibility outcomes included recruitment success rates of 73% for buddies and 85% for ambassadors relative to our goals. Retention rate for hemoglobin A1c and medication adherence outcome assessment was 95% for buddies. Both buddies and ambassadors had excellent intervention adherence, with buddies having a mean attendance of 7.76 out of 8 sessions/phone calls and ambassadors completing > 99% of the 105 intervention calls with Buddies. Results showed a signal of change in hemoglobin A1c (effect size = 0.14) and medication adherence (effect size = 0.35) among buddies, reduction in buddies’ negative beliefs about diabetes and an increase in necessity beliefs of diabetes medicines. Summative interviews with buddies showed they valued ambassador’s encouragement of self-management behaviors. ConclusionsResults support conduct of an efficacy trial to address medication adherence for African Americans with type 2 diabetes using a peer-supported tailored intervention.

scholarly journals Impact of a Pharmacy-Led Transition of Care Service on Post-Discharge Medication Adherence

Pharmacy ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 128
Author(s):  
Alaina Stroud ◽  
Georges Adunlin ◽  
Jessica W. Skelley
Keyword(s):  
Medication Adherence ◽  
Transitional Care ◽  
Care Service ◽  
Hospital Environment ◽  
Phone Call ◽  
Transition Of Care ◽  
Management Service ◽  
Adherence To Medication ◽  
Discharge Medication

This study assesses the effectiveness of a pharmacy-led transition of care (TOC) service on increasing patients’ understanding of, and reported adherence to, medication post hospital discharge. A cross-sectional survey was administered to patients who were discharged from the hospital with at least one medication received via bedside delivery from the TOC service. Adherence was assessed by asking the patient if they had taken their discharge medications as instructed by the prescriber. Satisfaction with the discharge medication counseling service was assessed through a five-point Likert scale. Descriptive statistics were conducted for all questionnaire items and qualitative data was examined using content analysis. The majority of patients (73%) were counseled on their medication(s) before leaving the hospital. Among those who received counseling, 76 patients had a better understanding of their medication(s). Ninety-five percent of the patients reported adherence, and all six of the patients reporting non-adherence claimed they were not counseled on their medications prior to discharge. Many patients had questions regarding their medication during the follow-up phone call, substantiating the need for further follow-up with patients once they have left the hospital environment. The implementation of medication bedside delivery and counseling services, followed by outpatient adherence monitoring via a transitional care management service, can result in higher levels of reported medication adherence.

Utilizing a Mobile Health Intervention to Manage Hypertension in an Underserved Community

2019 ◽  
Vol 42 (3) ◽  
pp. 201-209
Author(s):  
Peijia Zha ◽  
Rubab Qureshi ◽  
Sallie Porter ◽  
Ying-Yu Chao ◽  
Dula Pacquiao ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Urban Communities ◽  
Mobile Health ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Self Monitoring ◽  
Mhealth Intervention ◽  
Related Quality ◽  
Health Related

This 6-month pilot randomized controlled trial examined the effectiveness of a Mobile Health (mHealth) intervention for hypertension self-monitoring and management in an underserved urban community. The four health outcomes measured included changes in systolic and diastolic blood pressure (BP), BP monitoring adherence, perceived medication adherence self-efficacy, and health-related quality of life. Thirty participants were randomly assigned to the mHealth group or a standard follow-up group; 25 participants completed the study. The mHealth group had statistically significant improvement in systolic BP decrease ( p = .01). The mHealth group had better adherence to BP monitoring and improved perceived medication adherence self-efficacy at 6 months, compared with the standard follow-up group. The results suggest that an mHealth intervention has the potential to facilitate hypertension management in underserved urban communities.

Diabetes Transitional Care from Inpatient to Outpatient Setting

2012 ◽  
Vol 26 (2) ◽  
pp. 120-124 ◽  
Author(s):  
Mansi Shah ◽  
CaTanya A. Norwood ◽  
Sol Farias ◽  
Sonia Ibrahim ◽  
Pang H. Chong ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Transitional Care ◽  
Intervention Group ◽  
Outpatient Setting ◽  
Controlled Study ◽  
Adherence Rate ◽  
Control Group ◽  
Diabetes Medication ◽  
Counseling Intervention

Purpose: Diabetes transitional care from the inpatient to outpatient setting is understudied. This study evaluated the effect of inpatient pharmacist discharge counseling on outpatient diabetes medication adherence. Research methods: Prospective, randomized, controlled study compared pharmacist discharge counseling (intervention) with usual patient care (control) in 127 patients with established diabetes and an A1C ≥8% who had a provider and medications filled within the county health system. The primary outcome was diabetes medication adherence rate measured using the prescription of days covered (PDC) method. Results: Patients in the intervention, compared with control group, had greater diabetes medication adherence rate 150 days after discharge (55.2% vs 34.8%; P = .002), rate of follow-up visits (60.5% vs 43.9%; P = .01) and reduction in A1C (−1.97% vs +0.114%; P = .003). Being in the intervention group and having greater adherence with follow-up visits correlated independently with lower follow-up A1C. Conclusion: Transitional care in the form of inpatient education geared to improve self-management after hospital discharge. This may serve as a paradigm to improve outpatient adherence rate with medications, follow-up visits, and A1C reduction.

scholarly journals Revision and validation of the medication adherence self-efficacy scale (MASES) in hypertensive African Americans

2008 ◽  
Vol 31 (6) ◽  
pp. 453-462 ◽  
Author(s):  
Senaida Fernandez ◽  
William Chaplin ◽  
Antoinette M. Schoenthaler ◽  
Gbenga Ogedegbe
Keyword(s):  
Medication Adherence ◽  
African Americans ◽  
Self Efficacy

scholarly journals Protocol for partnering with peers intervention to improve medication adherence among African Americans with Type 2 Diabetes

2020 ◽  
Author(s):  
Olayinka O Shiyanbola ◽  
Martha Maurer ◽  
Earlise C Ward ◽  
Lisa Sharp ◽  
Jonas Lee ◽  
...  
Keyword(s):  
Medication Adherence ◽  
African Americans ◽  
Clinical Outcomes ◽  
Health Beliefs ◽  
Self Efficacy ◽  
Group Intervention ◽  
Controlled Trial ◽  
Phase 1 ◽  
Improve Medication Adherence ◽  
Management Interventions

AbstractAfrican Americans (AAs) with diabetes are more likely to develop diabetes-related complications and have the highest diabetes-related mortality rates, than all other racial/ethnic groups. These health disparities are primarily due to poor medication adherence (defined as not taking medications as prescribed). AAs have substantially lower adherence to diabetes medications than whites, which contributes to higher rates of diabetes-related complications, such as amputations and strokes. There is a critical need to develop diabetes self-management interventions that improve medication adherence, clinical outcomes and in turn reduce morbidity and mortality among AAs with diabetes. Focusing on psychosocial factors such as health beliefs, self-efficacy and patient-provider communication is instrumental to improving AAs medication adherence. To address this need, we developed, the Peers Supporting Health Literacy, Self-Efficacy, Self-Advocacy, and Adherence (Peers LEAD) intervention, which provides AAs with culturally adapted diabetes and medication beliefs information, one-on-one peer support from AAs with diabetes, and communication and self-efficacy skill development to enhance medication adherence. This pilot research is a pre-post single group intervention study design which will be conducted in two phases using a community engaged approach. The objective is to test the Peers LEAD intervention in Phase 1, and then examine specific intervention elements for refinement in Phase 2. We will employ both quantitative and qualitative methods to assess the feasibility, acceptability, and outcomes of Peers LEAD. Building on established community partnerships, we plan to recruit and enroll 30 Peer Buddies and 20 Peer Ambassadors to participate in the intervention. By utilizing patient feedback to refine Peers LEAD and piloting it to examine its feasibility, we will generate evidence regarding its real world use and provide support for a randomized controlled trial of its impact on AAs diabetes medication adherence and clinical outcomes.

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