English conference proceeding
Theunissen,
N.C.M., De-Ridder, D.T.D., & Witteman, C.L.M. (2000). Improving
adherence by improving patient-provider interaction. Book of abstracts:
International conference on Health & Communication Barcelona, Spain,
September 20-22, 49-50.
Abstract
Summary: The aim is to investigate if the adherence of patients with hypertension
will improve, when General Practitioners are trained to communicate about
the patients illness representations and daily routines.
Abstract: The aim is to investigate if the adherence of patients with
hypertension will improve, when General Practitioners (GP) communicate
about the patients lay illness representations and daily routines.
Communication is manipulated in experimental conditions guided by two
stages of Leventhals Self-Regulatory Model of Illness: (1) the cognitive
representation of the health threat by which the patient identifies the
meaning of the health threat, also known as illness representations; (2)
the development and implementation of an action plan or coping procedure
to deal with the threat.
Three conditions were planned that each consists of a 15 minutes conversation
between a GP-trainee and a patient. Condition 0 acts as a care-as-usual
condition; Condition I ("mind-switch") aimed at stage 1 about
illness representations; Condition II, ("action-plan"), aimed
at stage 2.
Hundred-forty patients with hypertension using anti-hypertensive medication
were randomly assigned to the three conditions. Fourteen GP-trainees each
performed a Condition 0 conversation with about 4 patients. Afterwards
the GP-trainees were randomly divided in two groups. They received a training
-- using role-play -- in either Condition I or II. Next, each GP-trainee
performed the trained condition with about 6 patients.
Conversations were video-recorded. Patients filled in questionnaires immediately
before and after the conversation (assessing illness representations,
stages of change, adherence & quality of interaction). One month later
they received a similar questionnaire at home. In addition, medication
refill compliance and blood-pressure measurements were obtained. The findings
of the experiment will be presented during the conference.
Keywords
hypertension; self-regulatory
model of illness; illness representations; action plans; adherence; intervention;