A Multifaceted Nurse- and Web-Based Intervention for Improving Adherence to Treatment in Patients With Cardiovascular Disease: Rationale and Design of the MIRROR Trial.
BACKGROUND
Poor adherence to medication is one of the limitations in the treatment of cardiovascular diseases, thereby increasing the risk of premature death, hospital admissions, and related costs. There is a need for simple and easy-to-implement interventions that are based on patients' perspectives, beliefs, and perceptions of their illness and medication.


OBJECTIVE
The objective is to test the effectivity of this intervention to improve medication adherence in patients with established cardiovascular disease, that is, in secondary prevention.


METHODS
In this study the effect of a personalized visualization of cardiovascular risk levels through a website aiming at supporting self management in combination with a group consultation and communication intervention by a nurse on adherence to treatment in 600 patients with manifest cardiovascular diseases will be assessed. The health belief model was chosen as main theoretical model for the intervention.


RESULTS
Primary outcome is adherence to treatment calculated by refill data. Secondary outcomes include the Beliefs about Medication Questionnaire and the Modified Morisky Scale. Patients are followed for one year. Results are expected by 2015.


CONCLUSIONS
This study assesses adherence to treatment in a high-risk cardiovascular population by applying an intervention that addresses patients' capacity and practical barriers as well as patients' beliefs and perceptions of their illness and medication.


BACKGROUND
ClinicalTrials.gov NCT01449695; https://clinicaltrials.gov/ct2/show/NCT01449695 (Archived by WebCite at http://www.webcitation.org/6kCzkIKH3).
Radboud University Nijmegen Medical Centre, Department of Surgery, Division of Vascular Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands. angelien.sieben@radboudumc.nl.
Angelien
http://orcid.org/0000-0002-0364-3699
A
Sieben
Hein Aw
http://orcid.org/0000-0002-3272-2898
HA
van Onzenoort
Kees J
http://orcid.org/0000-0003-2166-7931
KJ
van Laarhoven
Sebastian Jh
http://orcid.org/0000-0002-6973-7540
SJ
Bredie
cardiovascular; eHealth; medication adherence; nursing