Decisional Influences and Inflammatory Bowel Disease (IBD) Patients' Medication Use

NCT ID: NCT00968721

Last Updated: 2016-05-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Total Enrollment

55 participants

Study Classification

OBSERVATIONAL

Study Start Date

2010-06-30

Study Completion Date

2011-12-31

Brief Summary

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The primary purpose of this study is to pilot test an instrument that the investigators will develop to assess decision influences on inflammatory bowel disease patients' medication adherence decision-making.

This pilot study will use an exploratory, descriptive cross-sectional survey approach to pilot test the instrument and answer the research questions.

The main hypothesis is that patients at risk for intentionally modifying their prescribed medication regimen will differ on influences on decision-making, health status, and utilization of the IBD clinic services compared to those who are intentionally adherent and who continue adherence over time.

Detailed Description

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Clinical research has produced significant advances in the pharmacologic management of inflammatory bowel disease (IBD). Preliminary research, however, suggest that patient non-adherence may be blunting medication effectiveness. The etiology of medication non-adherence likely depends on several coexisting factors. We believe that naturalistic decision making links patient level/ "micro" variables to services-level/ "macro" variables and behavioral outcomes. Every day, natural decisions about medication use are likely made in the context of patients' experience of their illness, knowledge about the illness and treatments, the physician-patient relationship, personal priorities and values, and other influences related to deciding to use medicine. By their very nature, illness related decisions are uncertain and risky because outcomes are unknown and patients often have limited knowledge and experience of the progression of their chronic illness. During the progression of an illness, patients may experiment with and analyze risks and benefits of therapies and relying on interpersonal interaction with health-care professionals to determine the self-management strategies best suited to patients and their life goals. Patient decision-making is thus and iterative process that evolves over time. An understanding of medication use decisions requires the description and understanding of those decision influences that may affect medication use decision-making over the course of the illness. Therefore, the primary purpose of this study is to develop and test a psychometric instrument that assesses influences on patients' decisions to use/not use their IBD medication.

The main hypothesis underlying the instrument development project is that patients at risk for intentionally modifying their prescribed medication regimen will differ on influences on decision-making, health status, and utilization of the IBD clinic services compared to those who are intentionally adherent and who continue adherence over time.

The following questions will be studied:

* What influences do therapeutic values, task difficulty, physician-patient relationship, information sources, personal beliefs and values have on patients' IBd medication adherence?
* What are the relationships between decision influences and illness activity?
* What associations exist among decision influences, illness activity, medication adherence and utilization of IBD Clinic services?

Conditions

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Crohn's Disease Ulcerative Colitis

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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IBD patients

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* All Vanderbilt University Medical Center IBD patients that are 18 years or older
* Those who volunteered to participate in this online web-based survey study.

Exclusion Criteria

* Vanderbilt University Medical Center patients unable to take the survey because they do not have an e-mail address or access to one.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Procter and Gamble

INDUSTRY

Sponsor Role collaborator

Vanderbilt University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lawrence S Gaines, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Vanderbilt University Medical Center

Locations

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Inflammatory Bowel Disease Clinic c/o Divison of Gastroenterology, Hepatology and Nutrition, Department of Medicine, School of Medicine, Vanderbilt University

Nashville, Tennessee, United States

Site Status

Countries

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United States

References

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Cerveny P, Bortlik M, Kubena A, Vlcek J, Lakatos PL, Lukas M. Nonadherence in inflammatory bowel disease: results of factor analysis. Inflamm Bowel Dis. 2007 Oct;13(10):1244-9. doi: 10.1002/ibd.20189.

Reference Type BACKGROUND
PMID: 17538983 (View on PubMed)

Ediger JP, Walker JR, Graff L, Lix L, Clara I, Rawsthorne P, Rogala L, Miller N, McPhail C, Deering K, Bernstein CN. Predictors of medication adherence in inflammatory bowel disease. Am J Gastroenterol. 2007 Jul;102(7):1417-26. doi: 10.1111/j.1572-0241.2007.01212.x. Epub 2007 Apr 16.

Reference Type BACKGROUND
PMID: 17437505 (View on PubMed)

Harvey RF, Bradshaw JM. A simple index of Crohn's-disease activity. Lancet. 1980 Mar 8;1(8167):514. doi: 10.1016/s0140-6736(80)92767-1. No abstract available.

Reference Type BACKGROUND
PMID: 6102236 (View on PubMed)

Hicks FD, Holm K. Self-management decision influences in heart failure: a preliminary investigation. Clin Nurs Res. 2003 Feb;12(1):69-84. doi: 10.1177/1054773803238741.

Reference Type BACKGROUND
PMID: 12583500 (View on PubMed)

Horne, R. The medication adherence report scale. University of Brighton, Brighton, UK, 2004.

Reference Type BACKGROUND

Johnson MJ. The Medication Adherence Model: a guide for assessing medication taking. Res Theory Nurs Pract. 2002 Fall;16(3):179-92. doi: 10.1891/rtnp.16.3.179.53008.

Reference Type BACKGROUND
PMID: 12472293 (View on PubMed)

Kane SV, Brixner D, Rubin DT, Sewitch MJ. The challenge of compliance and persistence: focus on ulcerative colitis. J Manag Care Pharm. 2008 Jan;14(1 Suppl A):s2-12; quiz s13-5. doi: 10.18553/jmcp.2008.14.s1-a.1a.

Reference Type BACKGROUND
PMID: 18240888 (View on PubMed)

Kane SV, Loftus EV Jr, Dubinsky MC, Sederman R. Disease perceptions among people with Crohn's disease. Inflamm Bowel Dis. 2008 Aug;14(8):1097-101. doi: 10.1002/ibd.20418.

Reference Type BACKGROUND
PMID: 18338774 (View on PubMed)

Riegel B, Carlson B, Moser DK, Sebern M, Hicks FD, Roland V. Psychometric testing of the self-care of heart failure index. J Card Fail. 2004 Aug;10(4):350-60. doi: 10.1016/j.cardfail.2003.12.001.

Reference Type BACKGROUND
PMID: 15309704 (View on PubMed)

Sewitch MJ, Abrahamowicz M, Dobkin PL, Tamblyn R. Measuring differences between patients' and physicians' health perceptions: the patient-physician discordance scale. J Behav Med. 2003 Jun;26(3):245-64. doi: 10.1023/a:1023412604715.

Reference Type BACKGROUND
PMID: 12845937 (View on PubMed)

Sewitch MJ, Abrahamowicz M, Barkun A, Bitton A, Wild GE, Cohen A, Dobkin PL. Patient nonadherence to medication in inflammatory bowel disease. Am J Gastroenterol. 2003 Jul;98(7):1535-44. doi: 10.1111/j.1572-0241.2003.07522.x.

Reference Type BACKGROUND
PMID: 12873575 (View on PubMed)

Powell-Tuck J, Bown RL, Lennard-Jones JE. A comparison of oral prednisolone given as single or multiple daily doses for active proctocolitis. Scand J Gastroenterol. 1978;13(7):833-7. doi: 10.3109/00365527809182199.

Reference Type BACKGROUND
PMID: 364626 (View on PubMed)

Wroe AL. Intentional and unintentional nonadherence: a study of decision making. J Behav Med. 2002 Aug;25(4):355-72. doi: 10.1023/a:1015866415552.

Reference Type BACKGROUND
PMID: 12136497 (View on PubMed)

Other Identifiers

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090527

Identifier Type: -

Identifier Source: org_study_id

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