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 journalArticle

6 Citations (Scopus)
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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 languageEnglish
Pages (from-to)989-998
Number of pages10
JournalPatient preference and adherence
Volume9
Early online date10 Jul 2015
DOIs
Publication statusPublished - 10 Jul 2015

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Parkinson Disease
Disease
evaluation
medication
Medication Adherence
Therapeutics
spouse
Spouses
Caregivers
Randomized Controlled Trials
Research Personnel
Activities of Daily Living
Cognition
cognition
Action Potentials
quality of life
Communication
Quality of Life
Interviews
communication

Keywords

  • Parkinson Disease
  • adherence
  • medication
  • qualitative

Cite this

Qualitative evaluation of adherence therapy in Parkinson's disease : a multidirectional model. / Daley, David James; Deane, Katherine Helen O'Leary; Gray, Richard John; Hill, Rebekah; Myint, Phyo Kyaw.

In: Patient preference and adherence, Vol. 9, 10.07.2015, p. 989-998.

Research output: Contribution to journalArticle

Daley, David James ; Deane, Katherine Helen O'Leary ; Gray, Richard John ; Hill, Rebekah ; Myint, Phyo Kyaw. / Qualitative evaluation of adherence therapy in Parkinson's disease : a multidirectional model. In: Patient preference and adherence. 2015 ; Vol. 9. pp. 989-998.
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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, 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.",
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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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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.

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KW - adherence

KW - medication

KW - qualitative

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VL - 9

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JO - Patient preference and adherence

JF - Patient preference and adherence

SN - 1177-889X

ER -