The Effect of Applying the Information-Motivation-Behavioral Skills Model on Treatment Adherence in Patients with Cardiovascular Disease: A Quasi-Experimental Study.
Nasrin Zahmatkeshan, Mahnaz Rakhshan, Ladan Zarshenas and 2 others
PMID 34222543WHAT IT FOUND
Patients with cardiovascular disease who received nine months of information, motivation, and skills training plus telephone follow-up reported better overall treatment adherence and medication adherence than those receiving usual care alone.
Key findings
01Patients who received the IMB-based program had higher total treatment adherence than control patients three and six months after the end of the intervention.
02They also reported higher medication adherence than control patients at both follow-up points.
03In the intervention group, the 0-100 treatment adherence score increased from 51.10 at baseline to 66.40 at three months and 73.80 at six months.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Patients knew whether they were in the intervention or control group, and blinding was not possible because the intervention was education and follow-up. The study was quasi-experimental rather than randomised, and the paper does not describe how patients were allocated beyond selection and division. Adherence was self-reported with questionnaires, not measured directly. Six-month data were collected electronically because of coronavirus, after paper questionnaires were used earlier. Two patients in the control group died and were excluded from analysis. The intervention was delivered by one nursing PhD candidate, so results may not transfer to teams without that role. Patients had to be able to read and write, live in Shiraz, and have no disabling ailments or cognitive disorders, limiting generalisability. The number of medications was not considered, although it may affect medication adherence.
The easy way to misread this
Do not conclude that the IMB model alone caused the improvement. The intervention combined education, motivational interviewing, behavioral coaching, telephone follow-up, and usual care, and the study was unblinded and quasi-experimental.