Transtheoretical model intervention for adherence to lipid-lowering drugs.
Transtheoretical model intervention for adherence to lipid-lowering drugs.
复制标题
坚持降脂药物的跨理论模型干预。
DOI：
10.1089/dis.2006.9.102
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发表时间：
2006
影响因子：
--
通讯作者：
Bourne,Leslie
中科院分区：
文献类型：
--
作者：
Johnson,SaraS;Driskell,Mary-Margaret;Johnson,JanetL;Dyment,SharonJ;Prochaska,JamesO;Prochaska,JaniceM;Bourne,Leslie
An estimated 60% of individuals prescribed lipid-lowering medications are nonadherent. Failure to adhere increases morbidity, mortality, healthcare utilization, and healthcare costs. This study examined the effectiveness of a population-based, individualized Transtheoretical Model (TTM) expert system intervention to improve adherence and increase exercise and diet in a randomized 18-month trial involving 404 adults. Compared to usual care, treatment participants who started in a pre-action stage were significantly more likely to be in the Action and Maintenance (A/M) stages for adherence at end of treatment (55.3% versus 40%,z= 2.11,p< 0.05,h= 0.31) and at 18-months (56% versus 37.8%,z= 2.38,p< 0.01,h= 0.36). The treatment group scored significantly better on two measures of adherence at six and 12 months post-treatment (allp< 0.05, odds ratios [OR] 1.49–3.67). Among those who began in A/M, treatment participants were significantly more likely to remain in A/M at 18 months (85.2% versus 55.6%,z= 2.63,p< 0.01,h= 0.67). Those receiving treatment were significantly more likely to progress to A/M for exercise and dietary fat reduction (43.3% versus 24.7% for exercise, and 24.7% versus 12.5% for diet). TTM expert system interventions can have a significant impact on entire populations for adherence. Results for dietary fat and exercise suggest covariation of treatment effects. (Disease Management 2006;9:102–114)
