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Creating a synergy effect: a cluster randomized controlled trial testing the effect of a tailored multimedia intervention on patient outcomes.

Linn, A.J., Dijk, L. van, Weert, J.C.M. van, Gebeyehu, B.G., Bodegraven, A.A. van, Smit, E.G. Creating a synergy effect: a cluster randomized controlled trial testing the effect of a tailored multimedia intervention on patient outcomes. Patient Education and Counseling: 2018, 101(8), 1419-1426
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Objective
Improving adherence is a challenge and multiple barriers are likely to explain non-adherence. These barriers differ per patient and over course of the regimen. Hence, personalized interventions tailored to the specific barriers are needed. In a theoretical and evidence-based Tailored Multimedia Intervention, technology (online preparatory assessment, text messaging) was used as an add-on to a tailored counseling session (learned during a communication skills training), with the expectation of synergistic effects.

Methods
A cluster randomized controlled trial was conducted in six hospitals, eight nurses and 160 chronic patients. Patient satisfaction with communication, beliefs about medication, self-efficacy and medication adherence were assessed at initiation of the treatment and after six months.

Results
Intervention effects were found for patient satisfaction with nurses' affective communication and self-efficacy at the initiation of treatment. The effect on self-efficacy remained after six months.

Conclusion
By combining tailored counseling with technology, this intervention resulted in positive changes in important prerequisites of medication adherence. (aut. ref.)