title: Development and content of a group-based intervention to improve medication adherence in non-adherent patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To describe the systematic development and content of a short intervention to improve medication adherence to disease-modifying anti-rheumatic drugs in non-adherent patients with rheumatoid arthritis (RA).
  
  
  METHODS
  The intervention mapping (IM) framework was used to develop the intervention. The following IM steps were conducted: (1) a needs assessment; (2) formulation of specific intervention objectives; (3) inventory of methods and techniques needed to design the intervention and (4) production and piloting of the intervention.
  
  
  RESULTS
  The intervention (consisting of two group sessions led by a pharmacist, a homework assignment, and a follow-up call) aims to improve the balance between necessity and concern beliefs about medication, and to resolve practical barriers in medication taking. The central communication method used is motivational interviewing.
  
  
  CONCLUSIONS
  By applying the IM framework, we were able to create a feasible, time-efficient and promising intervention to improve medication adherence in non-adherent RA patients. Intervention effects are currently being assessed in a randomized controlled trial.
  
  
  CONCLUSIONS
  This paper could serve as a guideline for other health care professionals when developing similar interventions. If the RCT demonstrates sufficient effectiveness of this intervention in reducing medication non-adherence in RA patients, the intervention could be embedded in clinical practice.
authors.affiliation: Department of Rheumatology and Pharmacy, Sint Maartenskliniek, Nijmegen, The Netherlands. h.zwikker@maartenskliniek.nl
authors.forename: Hanneke
authors.initials: H
authors.lastname: Zwikker
authors.forename: Bart
authors.initials: B
authors.lastname: van den Bemt
authors.forename: Cornelia
authors.initials: C
authors.lastname: van den Ende
authors.forename: Wim
authors.initials: W
authors.lastname: van Lankveld
authors.forename: Alfons
authors.initials: A
authors.lastname: den Broeder
authors.forename: Frank
authors.initials: F
authors.lastname: van den Hoogen
authors.forename: Birgit
authors.initials: B
authors.lastname: van de Mosselaar
authors.forename: Sandra
authors.initials: S
authors.lastname: van Dulmen
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000523:psychology*; D003142:Communication; D003430:Cross-Sectional Studies; D017144:Focus Groups; D005500:Follow-Up Studies; D006126:Group Processes; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D062405:Motivational Interviewing; D020380:Needs Assessment; D009426:Netherlands; D017060:Patient Satisfaction; D010595:Pharmacists; D016730:Program Development; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic
chemical_list: D018501:Antirheumatic Agents