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Non-adherence to medication and lifestyle recommendations is a common problem across various diseases. It seems that many patients do not take medication as prescribed, stop treatments prematurely or do not follow recommendations for physical activity (which seems to be a well-known phenomenon in the healthy population as well, for example in researchers).
To address the non-adherence problem regarding medication, prof. dr. Marijn de Bruin developed an effective intervention for HIV patients: the Adherence Improving self-Management Strategy (AIMS). In AIMS, patients use an electronic monitoring device and discuss their adherence behavior with the health care professional. The intervention targets determinants of behavior like knowledge, motivation and self-efficacy and uses multiple methods to acquire behavior change.
So why not test if we can apply this strategy to other patient groups and other behaviors? In my research project, I focus on women who have had breast cancer and are taking adjuvant endocrine therapy (AET). The major reason for non-adherence in this population are side effects of the medication. Next to medication intake behavior and keeping up the motivation for treatment, the AIMS intervention for AET addresses side effect management with physical activity as its core strategy. Patients measure their physical activity behavior with a pedometer. In the adaptation process, we followed the steps of intervention mapping. Next to literature, we incorporated the feedback of patients and health care professionals to design the AIMS AET intervention.
At the same time, AIMS has been adapted to address self-care behavior in heart failure patients by Joëlle Dam and to approach sitting behavior in patients with coronary heart disease by Bram van Bakel. Right now, the effects of the adapted AIMS interventions are being tested in randomized clinical trials.
The results of our studies might deliver effective strategies for health care professionals to address multiple non-adherence behaviors and eventually contribute to better healthcare outcomes if non-adherence is decreasing.
A blog by Anna Janssen
Editing by Estel Collado Camps, Nina Wubben & Hasan Erkan
