Qualitative evaluation of adherence therapy in Parkinson's disease: a multidirectional model

David James Daley; Katherine Helen O'Leary Deane; Richard John Gray; Rebekah Hill; Phyo Kyaw Myint

doi:10.2147/PPA.S80158

Qualitative evaluation of adherence therapy in Parkinson's disease: a multidirectional model

David James Daley, Katherine Helen O'Leary Deane, Richard John Gray, Rebekah Hill, Phyo Kyaw Myint

Research output: Contribution to journal › Article › peer-review

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Abstract

BACKGROUND: Medication can control the symptoms of Parkinson's disease (PD). Despite this, non-adherence with medication is prevalent in PD. Treatments for improving adherence with medication have been investigated in many chronic conditions, including PD. However, few researchers have evaluated their interventions qualitatively. We investigated the acceptability and potential mechanism of action of adherence therapy (AT) in PD patients and their spouse/carers who received the intervention as part of a randomized controlled trial.

METHODS: Sixteen participants (ten patients and six spouses/carers) who had recently completed the trial were purposely selected in order to cover a range of ages and disease severity. Semi-structured interviews were conducted in the participants' homes. Data were transcribed and analyzed using a thematic approach. A second researcher, naïve to PD and AT, analyzed the data independently to limit bias.

RESULTS: The trial showed that AT significantly improved both medication adherence and quality of life in people with PD. Specifically, patients who received AT reported improvements in mobility, activities of daily living, emotional wellbeing, cognition, communication, and body discomfort. General beliefs about medication also significantly improved in those who received AT compared with controls. In the current qualitative evaluation, a total of 175 codes were generated, which formed eleven subthemes. These could be grouped under three overarching themes, ie, perceptions prior to AT, positive effects of AT, and attributes of AT.

CONCLUSION: This randomized controlled trial is the first to investigate AT in PD. The acceptability and underlying mechanism of the intervention suggest a new multidirectional model of AT in PD which future research should seek to confirm. The findings provide a deeper understanding of AT and will allow clinicians to modify the delivery of the intervention by acknowledging various pathways to improved outcomes.

Original language	English
Pages (from-to)	989-998
Number of pages	10
Journal	Patient preference and adherence
Volume	9
Early online date	10 Jul 2015
DOIs	https://doi.org/10.2147/PPA.S80158
Publication status	Published - 10 Jul 2015

Bibliographical note

Acknowledgments
We wish to thank all participants for their contribution to this work. We thank Fiona Reading, Michelle Green, Rachael Rendell, Terri Johns, Bronwen Roper, and the lay members of the trial steering committee, ie, Garth Ravenhill and Philip Harrison, for their support. We give special thanks to Debbie Davey for her invaluable efforts as data clerk. This research was funded by a University of East Anglia PhD studentship.

Keywords

Parkinson Disease
adherence
medication
qualitative

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10.2147/PPA.S80158Licence: CC BY-NC

Qualitative evaluation of adherence therapy in Parkinson's disease
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Cite this

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title = "Qualitative evaluation of adherence therapy in Parkinson's disease: a multidirectional model",

abstract = "BACKGROUND: Medication can control the symptoms of Parkinson's disease (PD). Despite this, non-adherence with medication is prevalent in PD. Treatments for improving adherence with medication have been investigated in many chronic conditions, including PD. However, few researchers have evaluated their interventions qualitatively. We investigated the acceptability and potential mechanism of action of adherence therapy (AT) in PD patients and their spouse/carers who received the intervention as part of a randomized controlled trial.METHODS: Sixteen participants (ten patients and six spouses/carers) who had recently completed the trial were purposely selected in order to cover a range of ages and disease severity. Semi-structured interviews were conducted in the participants' homes. Data were transcribed and analyzed using a thematic approach. A second researcher, na{\"i}ve to PD and AT, analyzed the data independently to limit bias.RESULTS: The trial showed that AT significantly improved both medication adherence and quality of life in people with PD. Specifically, patients who received AT reported improvements in mobility, activities of daily living, emotional wellbeing, cognition, communication, and body discomfort. General beliefs about medication also significantly improved in those who received AT compared with controls. In the current qualitative evaluation, a total of 175 codes were generated, which formed eleven subthemes. These could be grouped under three overarching themes, ie, perceptions prior to AT, positive effects of AT, and attributes of AT.CONCLUSION: This randomized controlled trial is the first to investigate AT in PD. The acceptability and underlying mechanism of the intervention suggest a new multidirectional model of AT in PD which future research should seek to confirm. The findings provide a deeper understanding of AT and will allow clinicians to modify the delivery of the intervention by acknowledging various pathways to improved outcomes.",

keywords = "Parkinson Disease, adherence, medication, qualitative",

author = "Daley, {David James} and Deane, {Katherine Helen O'Leary} and Gray, {Richard John} and Rebekah Hill and Myint, {Phyo Kyaw}",

note = "Acknowledgments We wish to thank all participants for their contribution to this work. We thank Fiona Reading, Michelle Green, Rachael Rendell, Terri Johns, Bronwen Roper, and the lay members of the trial steering committee, ie, Garth Ravenhill and Philip Harrison, for their support. We give special thanks to Debbie Davey for her invaluable efforts as data clerk. This research was funded by a University of East Anglia PhD studentship.",

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doi = "10.2147/PPA.S80158",

language = "English",

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T2 - a multidirectional model

AU - Daley, David James

AU - Deane, Katherine Helen O'Leary

AU - Gray, Richard John

AU - Hill, Rebekah

AU - Myint, Phyo Kyaw

N1 - Acknowledgments We wish to thank all participants for their contribution to this work. We thank Fiona Reading, Michelle Green, Rachael Rendell, Terri Johns, Bronwen Roper, and the lay members of the trial steering committee, ie, Garth Ravenhill and Philip Harrison, for their support. We give special thanks to Debbie Davey for her invaluable efforts as data clerk. This research was funded by a University of East Anglia PhD studentship.

PY - 2015/7/10

Y1 - 2015/7/10

N2 - BACKGROUND: Medication can control the symptoms of Parkinson's disease (PD). Despite this, non-adherence with medication is prevalent in PD. Treatments for improving adherence with medication have been investigated in many chronic conditions, including PD. However, few researchers have evaluated their interventions qualitatively. We investigated the acceptability and potential mechanism of action of adherence therapy (AT) in PD patients and their spouse/carers who received the intervention as part of a randomized controlled trial.METHODS: Sixteen participants (ten patients and six spouses/carers) who had recently completed the trial were purposely selected in order to cover a range of ages and disease severity. Semi-structured interviews were conducted in the participants' homes. Data were transcribed and analyzed using a thematic approach. A second researcher, naïve to PD and AT, analyzed the data independently to limit bias.RESULTS: The trial showed that AT significantly improved both medication adherence and quality of life in people with PD. Specifically, patients who received AT reported improvements in mobility, activities of daily living, emotional wellbeing, cognition, communication, and body discomfort. General beliefs about medication also significantly improved in those who received AT compared with controls. In the current qualitative evaluation, a total of 175 codes were generated, which formed eleven subthemes. These could be grouped under three overarching themes, ie, perceptions prior to AT, positive effects of AT, and attributes of AT.CONCLUSION: This randomized controlled trial is the first to investigate AT in PD. The acceptability and underlying mechanism of the intervention suggest a new multidirectional model of AT in PD which future research should seek to confirm. The findings provide a deeper understanding of AT and will allow clinicians to modify the delivery of the intervention by acknowledging various pathways to improved outcomes.

AB - BACKGROUND: Medication can control the symptoms of Parkinson's disease (PD). Despite this, non-adherence with medication is prevalent in PD. Treatments for improving adherence with medication have been investigated in many chronic conditions, including PD. However, few researchers have evaluated their interventions qualitatively. We investigated the acceptability and potential mechanism of action of adherence therapy (AT) in PD patients and their spouse/carers who received the intervention as part of a randomized controlled trial.METHODS: Sixteen participants (ten patients and six spouses/carers) who had recently completed the trial were purposely selected in order to cover a range of ages and disease severity. Semi-structured interviews were conducted in the participants' homes. Data were transcribed and analyzed using a thematic approach. A second researcher, naïve to PD and AT, analyzed the data independently to limit bias.RESULTS: The trial showed that AT significantly improved both medication adherence and quality of life in people with PD. Specifically, patients who received AT reported improvements in mobility, activities of daily living, emotional wellbeing, cognition, communication, and body discomfort. General beliefs about medication also significantly improved in those who received AT compared with controls. In the current qualitative evaluation, a total of 175 codes were generated, which formed eleven subthemes. These could be grouped under three overarching themes, ie, perceptions prior to AT, positive effects of AT, and attributes of AT.CONCLUSION: This randomized controlled trial is the first to investigate AT in PD. The acceptability and underlying mechanism of the intervention suggest a new multidirectional model of AT in PD which future research should seek to confirm. The findings provide a deeper understanding of AT and will allow clinicians to modify the delivery of the intervention by acknowledging various pathways to improved outcomes.

KW - Parkinson Disease

KW - adherence

KW - medication

KW - qualitative

U2 - 10.2147/PPA.S80158

DO - 10.2147/PPA.S80158

M3 - Article

C2 - 26203231

SN - 1177-889X

VL - 9

SP - 989

EP - 998

JO - Patient preference and adherence

JF - Patient preference and adherence

ER -

Qualitative evaluation of adherence therapy in Parkinson's disease: a multidirectional model

Abstract

Bibliographical note

Keywords

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