Please use this identifier to cite or link to this item:
Appears in Collections:Psychology Journal Articles
Peer Review Status: Refereed
Title: Improving medication adherence in stroke survivors: Mediators and moderators of treatment effects
Author(s): O'Carroll, Ronan
Chambers, Julie
Dennis, Martin
Sudlow, Cathie
Johnston, Marie
Contact Email:
Issue Date: Oct-2014
Date Deposited: 17-Nov-2014
Citation: O'Carroll R, Chambers J, Dennis M, Sudlow C & Johnston M (2014) Improving medication adherence in stroke survivors: Mediators and moderators of treatment effects. Health Psychology, 33 (10), pp. 1241-1250.
Abstract: OBJECTIVE: The purpose of the current study was to test theory-based predictions of mediators and moderators of treatment effects of a pilot randomized controlled trial, which aimed to increase adherence to preventive medication in stroke survivors via addressing both automatic (i.e., habitual responses) and reflective (i.e., beliefs and value systems) aspects of medication-taking behavior. METHOD: Sixty-two stroke survivors were randomly allocated to either an intervention or control group. Intervention participants received a brief 2-session intervention aimed at increasing adherence via (a) helping patients establish better medication-taking routines using implementation intentions plans (automatic), and (b) eliciting and modifying any mistaken patient beliefs regarding medication and/or stroke (reflective). The control group received similar levels of non-medication-related contact. Primary outcome was adherence to antihypertensive medicine measured objectively over 3 months using an electronic pill bottle. Secondary outcome measures included self-reported adherence (including forgetting) and beliefs about medication. RESULTS Intervention participants had 10% greater adherence on doses taken on schedule (intervention, 97%; control, 87%; 95% CI [0.2, 16.2], p = .048), as well as significantly greater increases in self-reported adherence and reductions in concerns about medication. Treatment effects were mediated by reductions in both forgetting and concerns about medication, and moderated by the presence of preexisting medication-taking routines. CONCLUSIONS: Addressing both automatic and reflective aspects of behavior via helping stroke survivors develop planned regular routines for medication-taking, and addressing any concerns or misconceptions about their medication, can improve adherence and thus potentially patient outcomes.
DOI Link: 10.1037/hea0000082
Rights: Publisher policy allows this work to be made available in this repository. Published in Health Psychology, 33 (10), pp. 1241-1250, 2014, by American Psychological Association. DOI: 10.1037/hea0000082

Files in This Item:
File Description SizeFormat 
Mediator paper HP final.pdfFulltext - Accepted Version600.14 kBAdobe PDFView/Open

This item is protected by original copyright

Items in the Repository are protected by copyright, with all rights reserved, unless otherwise indicated.

The metadata of the records in the Repository are available under the CC0 public domain dedication: No Rights Reserved

If you believe that any material held in STORRE infringes copyright, please contact providing details and we will remove the Work from public display in STORRE and investigate your claim.