TY - JOUR
T1 - Qualitative evaluation of adherence therapy in Parkinson's disease
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
VL - 9
SP - 989
EP - 998
JO - Patient preference and adherence
JF - Patient preference and adherence
SN - 1177-889X
ER -