Evaluation of software-based telephone counseling to enhance medication persistency among patients with multiple sclerosis

J Am Pharm Assoc (2003). Jul-Aug 2005;45(4):466-72. doi: 10.1331/1544345054475469.

Abstract

Objective: To evaluate the effect of a software-supported intervention based on the Transtheoretical Model of Change and motivational interviewing on decreasing discontinuation (or increasing persistency) of Avonex (interferon beta-1a--Biogen), a medication for treatment of multiple sclerosis (MS).

Design: Randomized controlled experimental design comparison of software-based telephone counseling (intervention group) and standard care (control group).

Setting: United States.

Participants: 366 patients with MS.

Intervention: Software-based telephone counseling.

Main outcome measure: Discontinuation of Avonex treatment and movement among stages of the Transtheoretical Model of Change.

Results: Patients in the software intervention group demonstrated a statistically significantly lower proportion of Avonex treatment (1.2%) discontinuation than the standard care group (8.7%). In addition, stage movement away from discontinuation of Avonex (i.e., toward continuation of therapy) was significantly higher in the treatment group.

Conclusion: The Transtheoretical Model of Change constructs and motivational interviewing processes were effectively incorporated into a software-based intervention program, and this significantly decreased the proportion of patients who discontinued treatment of MS with Avonex. The integration of behavioral theory with information systems offers a promising approach for pharmacists and other providers to promote medication persistency.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Counseling / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Interferon beta-1a
  • Interferon-beta / therapeutic use*
  • Male
  • Middle Aged
  • Multiple Sclerosis / drug therapy*
  • Multivariate Analysis
  • Patient Compliance / psychology
  • Patient Compliance / statistics & numerical data*
  • Reproducibility of Results
  • Sex Factors
  • Software
  • Telephone

Substances

  • Interferon-beta
  • Interferon beta-1a