A randomized controlled trial of the effectiveness of planning strategies in the adherence to medication for coronary artery disease

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AimTo examine the effect of action and coping planning strategies in the adherence to medication among outpatients with coronary artery disease.BackgroundAction and coping planning strategies are based on implementation intention, which requires self-regulation by the individual, to prioritize intentionally planned responses over learned or habitual ones, from daily routines to stressful situations.DesignRandomized controlled trial.MethodsParticipants (n = 115) were randomized into intervention (use of action and coping planning strategies, n = 59) or control (usual care, n = 56) groups. The study was conducted between June 2010–May 2011 in two in-person visits: baseline and 2-month follow-up. Participants in the intervention group received telephone reinforcement between baseline and 2-month follow-up. Adherence to medication for cardioprotection and symptoms relief was evaluated by proportion of adherence, global measure of adherence evaluation and Morisky Self-Reported Measure of Medication Adherence Scale at both baseline and 2-month follow-up.FindingsWhen using the measure of global measure of adherence, participants in the intervention group reported adherence to therapy more often than controls (odds ratio = 5·3), but no statistically significant change was observed in the other two outcome measures.ConclusionThis study has shown that individuals who use action and coping planning report higher adherence to drug treatment, when measured by the global adherence evaluation. Further studies with longer follow-ups are needed to assess if the effect of planning strategies has long-term duration.

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