Two-Year Follow-Up of a Communication Intervention on Medication Adherence and Health Literacy in Kidney Transplanted Recipients-A Randomised Controlled Study.
Tone K Vidnes, Astrid K Wahl, Marie H Larsen and 3 others
PMID 39930983WHAT IT FOUND
At 2 years after kidney transplant, patients who received four nurse-led communication sessions reported better medication adherence than controls.
They also reported better ability to navigate health services and less decline in social support.
Key findings
01At 2-year follow-up, 23 patients in the intervention group and 38 in the control group reported nonadherence on BAASIS, indicating better adherence in the intervention group (p < 0.02).
02At 2 years, the intervention group had a significant change in ability to navigate the healthcare system (Domain 7, p < 0.02), and the control group had a significant decrease in social support for health (Domain 4, p < 0.04).
03Norwegian Renal Registry clinician scores classified only 8 patients as nonadherent at 2 years, and only 3 of those also reported nonadherence on the self-reported questionnaire.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The trial was non-blinded, and medication adherence was self-reported. The self-reported BAASIS result was not mirrored by clinician registry scores, which classified only 8 patients as nonadherent at 2 years. It was a single centre in Norway, and the authors caution against transferring results to other contexts. Only patients able to understand Norwegian and complete questionnaires were included, possibly excluding those with lowest health literacy. The intervention was delivered by two trained transplant nurses, so it may not apply to staff without that training. The 2-year results are reported for 170 responders, while 195 were randomised.
The easy way to misread this
Do not conclude that motivational interviewing alone improves medication adherence. The intervention combined knowledge translation and motivational interviewing, was delivered by two trained transplant nurses, and adherence was self-reported in a single Norwegian centre.