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

• Published in: Patient education and counseling 2018-08, Vol.101 (8), p.1419-1426
• Main Authors: Linn, Annemiek J., van Dijk, Liset, van Weert, Julia C.M., Gebeyehu, Beniam G., van Bodegraven, Ad. A., Smit, Edith G.
• Format: Article
• Language: English
• Subjects: Adult; Cluster randomized controlled trial; Counseling; Female; Gastrointestinal Agents - therapeutic use; Humans; Inflammatory Bowel Diseases - nursing; Inservice Training; Male; Medication Adherence; Middle Aged; Multimedia; Netherlands; Nurse-Patient Relations; Nursing; Nursing Staff, Hospital - education; Patient Education as Topic; Patient Satisfaction; Patient-provider communication; Self Efficacy; Surveys and Questionnaires; Synergy effect; Tailoring; Technology-mediated intervention; Text Messaging; Treatment Outcome
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2018.03.017

•Our tailored multimedia intervention capitalizes on the concept of synergy.•The intervention improved short-term patient satisfaction.•Patient short-term self-efficacy in the intervention group was significantly higher.•Long-term self-efficacy also improved.•New technologies optimized tailored interpersonal communication. 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. 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. 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. By combining tailored counseling with technology, this intervention resulted in positive changes in important prerequisites of medication adherence. Technology can contribute significantly to health care providers’ ability to tailor information to the patients’ needs.