Effects of a person-centred, nurse-led follow-up programme on adherence to prescribed medication among patients surgically treated for intermittent claudication: randomized clinical trial

Abstract Background Management of intermittent claudication should include secondary prevention to reduce the risk of cardiocerebrovascular disease. Patient adherence to secondary prevention is a challenge. The aim of this study was to investigate whether a person-centred, nurse-led follow-up progra...

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Published in:British journal of surgery 2022-08, Vol.109 (9), p.846-856
Main Authors: Haile, Sara T, Joelsson-Alm, Eva, Johansson, Unn Britt, Lööf, Helena, Palmer-Kazen, Ulrika, Gillgren, Peter, Linné, Anneli
Format: Article
Language:English
Subjects:
Follow-Up Studies
Humans
Intermittent Claudication - drug therapy
Intermittent Claudication - surgery
Lipids
Medication Adherence
Nurse's Role
Randomized Clinical Trial
Secondary Prevention
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Summary:Abstract Background Management of intermittent claudication should include secondary prevention to reduce the risk of cardiocerebrovascular disease. Patient adherence to secondary prevention is a challenge. The aim of this study was to investigate whether a person-centred, nurse-led follow-up programme could improve adherence to medication compared with standard care. Methods A non-blinded RCT was conducted at two vascular surgery centres in Sweden. Patients with intermittent claudication and scheduled for revascularization were randomized to the intervention or control (standard care) follow-up programme. The primary outcome, adherence to prescribed secondary preventive medication, was based on registry data on dispensed medication and self-reported intake of medication. Secondary outcomes were risk factors for cardiocerebrovascular disease according to the Framingham risk score. Results Some 214 patients were randomized and analysed on an intention-to-treat basis. The mean proportion of days covered (PDC) at 1 year for lipid-modifying agents was 79 per cent in the intervention and 82 per cent in the control group, whereas it was 92 versus 91 per cent for antiplatelet and/or anticoagulant agents. The groups did not differ in mean PDC (lipid-modifying P = 0.464; antiplatelets and/or anticoagulants P = 0.700) or in change in adherence over time. Self-reported adherence to prescribed medication was higher than registry-based adherence regardless of allocation or medication group (minimum P 
ISSN:0007-1323
1365-2168
1365-2168
DOI:10.1093/bjs/znac241