The Development and Effects of a Medication Adherence Intervention Program for Hypertensive Patients

범이론 모형을 적용한 고혈압 환자 약물순응 중재 프로그램 개발 및 적용 효과

  • Received : 2011.08.10
  • Accepted : 2011.09.20
  • Published : 2011.09.30

Abstract

Purpose: This study was to estimate the effectiveness of an intervention program using the trans-theoretical model on the stages of change, the process of change, decisional balance, self-efficacy, the levels of medication adherence, and blood pressure difference. Methods: A similar experiment was conducted using a nonequivalent control group pre- and post-test design. The study subjects were 108 hypertensive patients. The program was administered to the experimental group while educational materials were given to the control group. Descriptive analysis, 2-test, t-test, and repeated measures ANOVA were used with SPSS 17.0 to analyze collected data. Results: After treatment with this program, the experimental group showed stage of change ($x^2=52.917$, p<.001), cognitive (F=13,528, p<.001), behavioral process of change (F=10.808, p<.001), benefits (F=5.569, p=.012), loss of medication adherence (F=15.661, p<.001), self-efficacy (F=5.407, p=.011), levels of medication adherence (F=51.442, p<.001). Conclusion: There was a significant improvement in the experimental group who participated in the TTM medication adherence intervention program. Given that this intervention program motivated and stimulated hypertensive patients to adhere to the prescribed medications, the TTM medication adherence intervention program is expected to be an effective and practical intervention method for health improvement.

Keywords

References

  1. Ahn, S. Y. (1999). Medication compliance of recently discharged elderly patients. Unpublished master's thesis, Seoul National University, Seoul.
  2. Boudreaux, E. D., Francis, J. l., Carmack Taylor, C. l., Scarinci, L. C., & Brantley, P. J. (2003). Changing multiple health behaviors: Smoking and exercise. Preventive Medicine, 36(4), 471-478. https://doi.org/10.1016/S0091-7435(02)00048-8
  3. Carbonari, J. P., & DiClemente, C. C. (2000). Using transtheoretical model profiles to differentiate level of alcohol abstinence success. Journal of Consult Clinical Psychology, 68(5), 180-817.
  4. Chobanian, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., Izzo, J. L., et al. (2003). The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: The JNC 7 report. The Journal of the American Medical Association, 290(2), 197. https://doi.org/10.1001/jama.290.2.197
  5. Cook, N. R., Cohen, J., Hebert, P. R., Taylor, J. O., & Hennekens, C. H. (2000). Implications of small reductions in diastolic blood pressure for primary prevention. Archives of Internal Medicine, 155(7), 701-709.
  6. Guillot, J., Kilpatrick, M., Hebert, E., & Hollander, D. (2004). Applying the transtheoretical model to exercise adherence in clinical settings. American Journal of Health Studies, 19(1), 1-11.
  7. Han, K. S. (2009). Relationship of blood pressure control with healthy lifestyle practice and medication adherence of hypertensive patients. Unpublished master's thesis, Chonbuk National University, Junju.
  8. Hong, M. Y. (1999). A study on the medication compliance of the hypertension patients. Unpublished master's thesis, Seoul National University, Seoul.
  9. Johnson, S. S., Driskell, M. M., Johnson, J. L., Dyment, S. J., Prochaska, J. M., & Bourne, L. (2006). Transtheoretical model intervention for adherence to lipid-lowering drugs. Disease Management, 9, 102-114. https://doi.org/10.1089/dis.2006.9.102
  10. Kim, K. E. (2006). Development and effect of a reducing alcohol intervention program for workers. Unpublished doctoral dissertation, Yonsei University, Seoul.
  11. Kim, H. J. (2009). Development and evaluation of a medication adherence improvement program for older adults with hypertension. Unpublished doctoral dissertation, Seoul National University, Seoul.
  12. Kim, Y. H. (2007). The effect of smoking cessation counseling program of public health center using transtheoretical model. Unpublished doctoral dissertation, Pusan National University, Busan.
  13. Kim, Y. O. (2008). Medication compliance and depression in older hypertensive adults. Unpublished master's thesis, Chung-Ang University, Seoul.
  14. Korea Ministry of Health, Welfare and Family Affairs, & Korea Center for Disease Control and Prevention. (2009). 2007 Korea national health and nutrition examination survey statistics: The 4th Korea national health and nutrition examination survey. Seoul: Author.
  15. Lee, H. J. (2002). Factors affecting medication compliance of hypertensive patients. Unpublished master's thesis, Dankook University, Cheonan.
  16. Lee, S. G., & Bae, S. S. (2001). The relationship between treatment intention and compliance in newly detected hypertensive patients. Journal of Preventive Medicine and Public Health, 34(4), 417-436.
  17. Lee, Y. J. (2008). The effects of TAI CHI exercise program using transtheoretical model applied to degressive arthritis patients. Unpublished doctoral dissertation, Hanyang University, Seoul.
  18. Lim, J. M. (2002). The study on the development of a smoking cessation counseling program and it's effect on adolescent smoking. Unpublished master's thesis, Sahmyook University, Seoul.
  19. Moon, H. J. (2008). Factors related to antihypertensive medication adherence and blood pressure control among older adults. Unpublished master's thesis, Yonsei University, Seoul.
  20. Park. J. H. (2006). Antihypertensive drug medication adherence of national health insurance beneficiaries and its affecting factors in Korea. Unpublished doctoral dissertation, Seoul National University, Seoul.
  21. Pearlman, D. N., Rakowski, W., & Ehrich, B.,(1997). The information environment of women and mammography screening: Assessing reciprocity in social relationships. Journal of Women's Health, 4(5), 541-553.
  22. Prochaska, J. O., & DiClemente, C. C. (1983). Stage and process of self-change of smoking: Toward and integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390-395. https://doi.org/10.1037/0022-006X.51.3.390
  23. Prochaska, J. O., Velicer, W. F., DiClemente, C. C., & Fava, J. (1988). Measuring process of change: Applications to the cessation of smoking. Journal of Consulting and Clinical Psychology, 56(4), 520-528. https://doi.org/10.1037/0022-006X.56.4.520
  24. Prochaska, J. O., Diclemente, C. C., & Norcross, J. C. (1992). In search of how people change: Application to addictive behaviors. American Psychologist, 47(9), 1102-1114. https://doi.org/10.1037/0003-066X.47.9.1102
  25. Rudd, P., Miller, H. N., Kaufman, J., Kraemer, H. C., Bandura, A., Greenwald, G., et al. (2004). Nurse management for hypertension. American Journal of Hypertension, 17(10), 921-927.
  26. Statistics Korea. (2010). Annual report on the cause of death statistics: 2009 Annual report on the cause of death statistics. Seoul: Author.
  27. Sun, G. S. (2003). The effect of web-based osteoporosis prevention program on the osteoporosis knowledge, self efficacy, health belief, stage of change in female college students. Unpublished doctoral dissertation, Chonnam National University, Gwangju.
  28. Vasilaka, E. I., Hosier, S. G., & Cox, W. M. (2006). The efficacy of motivational interviewing as a brief intervention for excessive drinking: A meta-analytic review. Alcohol and alcoholism (Oxford, Oxfordshire), 41(3), 328-335. https://doi.org/10.1093/alcalc/agl016
  29. Velicer, W. F., Diclemente, C. C., Rossi, J. S., Prochaska, J. O. & Bradenburg, W. (1985). A decisional balance measure for assessing and predicting smoking status. Journal of Personality and Social Psychology, 48, 1279-1289. https://doi.org/10.1037/0022-3514.48.5.1279
  30. Willey, C., Redding, C., Stafford, J., Garfield, F., Geletko, S., Flanigan, T., et al. (2000). Stages of change for adherence with medication regimens of a measure. Clinical Therapeutics, 22(7), 858-871. https://doi.org/10.1016/S0149-2918(00)80058-2