Effectiveness and Cost-effectiveness of the Initial Medication Adherence Intervention

NCT ID: NCT05026775

Last Updated: 2022-10-12

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

4153 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-03-01

Study Completion Date

2023-09-30

Brief Summary

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The purpose of this study is to assess the effectiveness and the cost-effectiveness of the Initial Medication Adherence (IMA) Intervention.

Detailed Description

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A pragmatic cluster randomised control trial will be conducted to evaluate the effectiveness of the IMA intervention in comparison to usual care, in the increase of initiation of medicines for CVD and diabetes (antihypertensive, lipid-lowering, antidiabetic and antiplatelet medications) prescribed in Primary Care (PC). The impact of the IMA intervention on secondary adherence and clinical indicators will be evaluated.

A multicenter pragmatic RCT, with cluster allocation and 2 parallel branches (IMA intervention vs. usual care) based on health records or RWD will be conducted.

PC centres' personnel, including general practitioners (GP), nurses and community pharmacists, from different areas around Catalonia (Spain), will be cluster randomised 1:1 into intervention and control groups, stratified according to the type of PC centre, either rural or urban and taking into consideration the size and localization of the PC centre and the main predictors of non-initiation (socioeconomic status, mean age, % immigrant population of the PC centre).

The IMA intervention will provide clinicians with knowledge, skills and tools to help the patient make an informed decision. PC centre personnel in the intervention group will receive training on medication non-initiation, communication abilities, health literacy, shared decision making and the use of support tools such as leaflets and the IMA website.

Conditions

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Adherence, Medication

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
Participant: The randomization is conducted at the primary care centre level. Patients from intervention areas will receive enhanced care but will not be aware of the group assigned.

Investigator: Data analysists will not have information on which group is the intervention group when conducting the analysis.

Study Groups

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Initial Medication Adherence (IMA) intervention

General practitioners (GP) will apply the IMA intervention to all patients receiving a new prescription for treatment of cardiovascular disease or diabetes. Following the IMA intervention, nurses and community pharmacists will offer information support in line with the information provided by the GP.

Group Type EXPERIMENTAL

Initial Medication Adherence (IMA)

Intervention Type BEHAVIORAL

The IMA intervention is a shared-decision making intervention that promotes health literacy and patient participation in the decision making process during the recommendation and prescription of a new drug for the management of a cardiovascular disease and diabetes.

The IMA intervention has four main components: training for healthcare professionals (general practitioners (GP), nurses and community pharmacists) on non-initiation, shared-decision making, health literacy and use of decision aids; intervention decision aids (leaflets and website); implementation of the IMA intervention during the GP's consultation; and information support provided by the nurses and community pharmacists that will use the intervention decision aids to explore the patients's doubts and harmonise and standardise the discourse between primary healthcare professionals.

Usual care

Patients will receive the usual care when being prescribed a new prescription for treatment of cardiovascular disease or diabetes. Nurses and community pharmacists will be asked to also provide usual care to those patients.

Group Type ACTIVE_COMPARATOR

Usual care

Intervention Type OTHER

Health professionals in the usual care group will prescribe medication and provide information as usual.

Interventions

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Initial Medication Adherence (IMA)

The IMA intervention is a shared-decision making intervention that promotes health literacy and patient participation in the decision making process during the recommendation and prescription of a new drug for the management of a cardiovascular disease and diabetes.

The IMA intervention has four main components: training for healthcare professionals (general practitioners (GP), nurses and community pharmacists) on non-initiation, shared-decision making, health literacy and use of decision aids; intervention decision aids (leaflets and website); implementation of the IMA intervention during the GP's consultation; and information support provided by the nurses and community pharmacists that will use the intervention decision aids to explore the patients's doubts and harmonise and standardise the discourse between primary healthcare professionals.

Intervention Type BEHAVIORAL

Usual care

Health professionals in the usual care group will prescribe medication and provide information as usual.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Primary Care health professionals and pharmacists who:
* Agree to participate in the clinical trial and process evaluation.
* Attend the training course
* Are not plannig to be on sick leave during the study period (e.g. maternity leave).
* Patients who:
* Are prescribed a new treatment of cardiovascular disease o diabetes by a doctor who participates in the clinical trial.
* Are \>18 years old
* Do not reject to participate
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institut Català de la Salut

OTHER

Sponsor Role collaborator

Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina

OTHER

Sponsor Role collaborator

Parc Sanitari Sant Joan de Déu

OTHER

Sponsor Role collaborator

CIBER of Epidemiology and Public Health

UNKNOWN

Sponsor Role collaborator

Consell de Col·legis de Farmacèutics de Catalunya

UNKNOWN

Sponsor Role collaborator

Catalan Society of Family Medicine

OTHER

Sponsor Role collaborator

Fundació Sant Joan de Déu

OTHER

Sponsor Role lead

Responsible Party

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Maria Rubio-Valera

Head of Quality and Patient Safety

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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CAP Pou Torre

Begues, Barcelona, Spain

Site Status

CAP Calaf

Calaf, Barcelona, Spain

Site Status

CAP Corbera de Llobregat

Corbera de Llobregat, Barcelona, Spain

Site Status

CAP La Llagosta

La Llagosta, Barcelona, Spain

Site Status

CAP Martorell

Martorell, Barcelona, Spain

Site Status

CAP Montornès del Vallès

Montornès del Vallès, Barcelona, Spain

Site Status

CAP Ripollet

Ripollet, Barcelona, Spain

Site Status

CAP Vinyets

Sant Boi de Llobregat, Barcelona, Spain

Site Status

Parc Sanitari Sant Joan de Déu

Sant Boi de Llobregat, Barcelona, Spain

Site Status

CAP Sant Sadurni d'Anoia

Sant Sadurní d'Anoia, Barcelona, Spain

Site Status

CAP Sant Vicenç de Castellet

Sant Vicenç de Castellet, Barcelona, Spain

Site Status

CAP Sitges

Sitges, Barcelona, Spain

Site Status

CAP Montcada i Reixac

Montcada i Reixac, Barcelon, Spain

Site Status

CAP Sort

Sort, Lleida, Spain

Site Status

CAP de Tremp

Tremp, Lleida, Spain

Site Status

CAP Cornudella de Montsant

Cornudella de Montsant, Tarragona, Spain

Site Status

CAP Sant Pere

Reus, Tarragona, Spain

Site Status

CAP Santa Coloma de Queralt

Santa Coloma de Queralt, Tarragona, Spain

Site Status

CAP Drassanes

Barcelona, , Spain

Site Status

CAP Horta

Barcelona, , Spain

Site Status

CAP La Marina

Barcelona, , Spain

Site Status

CAP Montilivi

Girona, , Spain

Site Status

CAP Sant Pere i Sant Pau

Tarragona, , Spain

Site Status

CAP Bonavista

Tarragona, , Spain

Site Status

Countries

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Spain

References

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Corral-Partearroyo C, Sanchez-Vinas A, Aznar-Lou I, Penarrubia-Maria MT, Gil-Girbau M, Gallardo-Gonzalez C, Olmos-Palenzuela MDC, Rubio-Valera M. Effectiveness of a patient-centred complex intervention to improve Initial Medication Adherence to cardiovascular disease and diabetes treatments in primary care (the IMA-cRCT study): a pragmatic cluster randomised controlled trial using real-world data. BMJ Qual Saf. 2025 Jul 1:bmjqs-2024-018402. doi: 10.1136/bmjqs-2024-018402. Online ahead of print.

Reference Type DERIVED
PMID: 40592577 (View on PubMed)

Corral-Partearroyo C, Sanchez-Vinas A, Penarrubia-Maria MT, Gil-Girbau M, Aznar-Lou I, Palma-Vasquez C, Gallardo-Gonzalez C, Olmos-Palenzuela MDC, Rubio-Valera M. Implementation of a patient-centred complex intervention to improve Initial Medication Adherence to cardiovascular disease and diabetes treatments in primary care (the IMA-cRCT study): a mixed-methods process evaluation. BMJ Qual Saf. 2025 Jun 8:bmjqs-2024-018403. doi: 10.1136/bmjqs-2024-018403. Online ahead of print.

Reference Type DERIVED
PMID: 40484629 (View on PubMed)

Corral-Partearroyo C, Sanchez-Vinas A, Gil-Girbau M, Penarrubia-Maria MT, Aznar-Lou I, Gallardo-Gonzalez C, Olmos-Palenzuela MDC, Rubio-Valera M. Complex multidisciplinary intervention to improve Initial Medication Adherence to cardiovascular disease and diabetes treatments in primary care (the IMA-cRCT study): mixed-methods process evaluation protocol. BMJ Open. 2022 Oct 31;12(10):e067468. doi: 10.1136/bmjopen-2022-067468.

Reference Type DERIVED
PMID: 36316078 (View on PubMed)

Sanchez-Vinas A, Corral-Partearroyo C, Gil-Girbau M, Penarrubia-Maria MT, Gallardo-Gonzalez C, Olmos-Palenzuela MD, Aznar-Lou I, Serrano-Blanco A, Rubio-Valera M. Effectiveness and cost-effectiveness of an intervention to improve Initial Medication Adherence to treatments for cardiovascular diseases and diabetes in primary care: study protocol for a pragmatic cluster randomised controlled trial and economic model (the IMA-cRCT study). BMC Prim Care. 2022 Jul 5;23(1):170. doi: 10.1186/s12875-022-01727-6.

Reference Type DERIVED
PMID: 35790915 (View on PubMed)

Other Identifiers

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948973

Identifier Type: -

Identifier Source: org_study_id

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