Table 3 Usual Care activities in supporting adherence to OACA N = 208
| Â | physician | NP | nurse | pharmacist | |||||
|---|---|---|---|---|---|---|---|---|---|
NL 39a | Be 27a | NL 19a | Be 16a | NL 23a | Be 37a | NL 26a | Be 21a | ||
% | % | % | % | % | % | % | % | ||
Knowledge | PoT | Â | Â | Â | Â | Â | Â | Â | Â |
 Provide information on the disease | S | 100.0 | 100.0 | 100.0 | 100.0 | 82.6 | 70.3 | 23.1 | 9.5 |
 Provide information on the expected effect(s) of the drug | S | 100.0 | 100.0 | 100.0 | 75.0 | 86.4 | 59.5 | 38.5 | 19.0 |
 Discuss the action of the drug | S | 92.3 | 100.0 | 100.0 | 75.0 | 81.8 | 48.6 | 57.5 | 23.8 |
 Hand out brochures or written information about the disease and/or medication used for treatment | S | 62.2 | 74.1 | 84.4 | 87.5 | 87.6 | 54.1 | 84.6 | 28.6 |
 Discuss when the first effect of the medication can be expected | S | 100.0 | 100.0 | 84.4 | 56.3 | 72.7 | 37.8 | 26.9 | 14.3 |
 Monitor and/or discuss possible interactions with other medicines or foods | S | 75.7 | 96.3 | 100.0 | 87.5 | 73.9 | 62.2 | 96.2 | 33.3 |
 Discuss (changes in) sexuality | G | 35.1 | 28.0 | 82.4 | 50.0 | 47.4 | 35.1 | 0.0 | 0.0 |
Awareness | |||||||||
 Discuss the importance of treatment adherence | S | 84.2 | 88.5 | 82.4 | 93.8 | 85.0 | 78.4 | 64.0 | 28.6 |
 Discuss the consequences of non-adherence (to treatment) | S | 64.9 | 80.8 | 70.6 | 68.8 | 65.6 | 56.8 | 32.0 | 23.8 |
 Ask the patient if he/she has missed one or more doses | F | 68.4 | 60.0 | 94.1 | 68.8 | 78.9 | 59.5 | 12.0 | 19.0 |
 Discuss the use and results of the Medication Event Monitoring System (MEMS) | F | 2.8 | 8.0 | 6.3 | 6.3 | 5.3 | 5.4 | 4.0 | 0.0 |
Self-efficacy | |||||||||
 Encourage patients to timely plan the intake of medicines during holidays and weekends | S | 52.8 | 53.8 | 58.8 | 56.3 | 47.4 | 40.5 | 24.0 | 19.0 |
 Discuss potential barriers regarding treatment adherence | S | 51.4 | 61.5 | 68.8 | 56.3 | 65.0 | 45.9 | 28.0 | 23.8 |
 Discuss possible ways to overcome potential barriers regarding treatment adherence | S | 51.4 | 65.4 | 76.5 | 62.5 | 65.0 | 40.5 | 32.0 | 23.8 |
 Inquire after barriers regarding treatment adherence | F | 55.3 | 64.0 | 82.4 | 68.8 | 57.9 | 45.9 | 20.0 | 14.3 |
 Discuss ways to overcome potential barriers regarding treatment adherence | F | 51.4 | 64.0 | 76.5 | 62.5 | 57.9 | 35.1 | 20.0 | 14.3 |
Intention Formation | |||||||||
 Discuss the scheduled duration of medication treatment | S | 100.0 | 100.0 | 100.0 | 81.3 | 77.3 | 45.9 | 46.2 | 14.3 |
 Explain how often the medicine should be taken. If necessary, explain the treatment schedule | S | 84.6 | 100.0 | 100.0 | 93.8 | 91.3 | 89.2 | 96.2 | 52.4 |
 Discuss the intake of the medicines relative to that of meals and why | S | 60.0 | 88.9 | 100.0 | 93.8 | 91.3 | 86.5 | 92.3 | 47.6 |
 Discuss what to do if there is vomiting shortly after ingestion of the medicine | S | 41.7 | 85.2 | 88.9 | 93.8 | 81.8 | 73.0 | 38.5 | 28.6 |
 Explain what to do if a dose is missed | S | 51.4 | 76.9 | 94.1 | 100.0 | 94.7 | 64.9 | 48.0 | 38.1 |
 Development of an individual written medication schedule | S | 17.1 | 42.3 | 75.0 | 87.5 | 52.6 | 48.6 | 32.0 | 23.8 |
Implementation | |||||||||
 Identify daily routines and encourage patients to align the taking of medicines with their routines | S | 45.9 | 69.2 | 100.0 | 81.3 | 90.0 | 62.2 | 28.0 | 19.0 |
 Encourage patients to use a seven day pillbox | S | 13.5 | 23.1 | 50.0 | 50.0 | 21.1 | 43.2 | 16.0 | 19.0 |
 Encourage patients to use the Medication Event Monitoring System (MEMS) | S | 0.0 | 11.5 | 12.5 | 6.3 | 0.0 | 5.4 | 4.0 | 4.8 |
 Encourage patients to use alarm devices for properly timing their medication intake | S | 5.6 | 19.2 | 58.8 | 37.5 | 21.1 | 29.7 | 12.5 | 14.3 |
Social Support | |||||||||
 Involve partner and/or relatives in the treatment | S | 86.8 | 84.6 | 87.5 | 87.5 | 85.0 | 81.1 | 32.0 | 23.8 |
 Encourage patients to organize social support | G | 55.6 | 40.0 | 58.8 | 50.0 | 60.0 | 48.6 | 4.0 | 0.0 |
 Refer a patient to a patients’ association | G | 73.7 | 24.0 | 76.5 | 43.8 | 47.4 | 21.6 | 4.0 | 0.0 |
Adverse Events Management | |||||||||
 Discuss the common adverse events of the drug | S | 94.9 | 100.0 | 100.0 | 87.5 | 87.0 | 83.8 | 61.5 | 28.6 |
 Discuss options to mitigate the impact of adverse events (at start of treatment) | S | 70.3 | 96.3 | 97.1 | 93.8 | 85.0 | 83.8 | 48.9 | 33.3 |
 Discuss the possibility of dose adjustment if adverse events occur | S | 86.8 | 96.3 | 77.8 | 68.8 | 77.3 | 62.2 | 26.9 | 28.6 |
 Inquire after (perceived) adverse events of treatment | F | 100.0 | 100.0 | 100.0 | 100.0 | 89.5 | 83.8 | 72.0 | 23.8 |
 Inquire after the severity of the adverse events | F | 100.0 | 100.0 | 100.0 | 93.8 | 89.5 | 86.5 | 56.0 | 23.8 |
 Discuss options to mitigate the impact of adverse events (during treatment) | F | 89.5 | 96.0 | 100.0 | 87.5 | 94.7 | 73.0 | 52.0 | 28.6 |
 Give the patient a telephone number and tell who to contact in the case of adverse events | G | 82.9 | 88.0 | 100.0 | 93.8 | 94.7 | 73.0 | 24.0 | 19.0 |
Facilitation | |||||||||
 Explain how and where the product is available | S | 81.6 | 85.2 | 94.4 | 87.5 | 90.5 | 59.5 | 76.9 | 42.9 |
 Discuss drug storage recommendations | S | 16.7 | 55.6 | 64.7 | 81.3 | 70.0 | 62.2 | 88.5 | 81.0 |
 Give feedback about treatment efficacy | F | 100.0 | 100.0 | 82.4 | 56.3 | 73.7 | 35.1 | 16.0 | 9.5 |
 Inquire after positive effects of treatment | F | 100.0 | 92.0 | 76.5 | 86.3 | 89.5 | 59.5 | 28.0 | 19.0 |
 Ensure the timely transfer of medication information to other health care providers | G | 86.5 | 72.0 | 62.5 | 56.3 | 60.0 | 29.7 | 100.0 | 23.8 |
 Call the patient after the start of treatment to ask about experiences | G | 11.8 | 4.0 | 64.7 | 37.5 | 68.4 | 18.9 | 8.0 | 0.0 |
 Give the patient a telephone number and tell who to contact in case of problems with treatment adherence | G | 69.4 | 64.0 | 82.4 | 93.8 | 78.9 | 54.1 | 28.0 | 19.0 |
 Inform the patient about 24 hour availability of assistance | G | 91.7 | 76.0 | 100.0 | 62.5 | 90.0 | 64.9 | 28.0 | 23.8 |
 Intensify the number of follow-up visits if patients have problems with treatment adherence | G | 45.9 | 28.0 | 58.8 | 43.8 | 42.1 | 18.9 | 8.0 | 9.5 |
 Refer patients to another health care provider for (co-) treatment (e.g., in the case of adverse events) | G | 57.9 | 64.0 | 70.6 | 56.3 | 47.4 | 40.5 | 40.0 | 14.3 |
 Refer to another health care provider in case of (suspected) psychosocial problems | G | 75.7 | 80.0 | 88.2 | 75.0 | 78.9 | 75.7 | 0.0 | 14.3 |