Telehealth behavioral treatment for medication nonadherence

TLDR

The study aims to evaluate an individually tailored multicomponent nonadherence treatment protocol delivered via telehealth in adolescents with inflammatory bowel disease and to determine its impact on adherence and health outcomes at scale. Nine adolescents (mean age 13.7 years) received a brief, individually tailored telehealth intervention via Skype, during which medication adherence, disease severity, and feasibility/acceptability were assessed. The intervention markedly improved mesalamine adherence from 62 % to 91 % (Δ = 0.63), slightly reduced 6‑mercaptopurine/azathioprine adherence from 61 % to 53 %, achieved 100 % session attendance, was rated highly acceptable, saved $100 in mileage and 4 h travel per patient, and demonstrates feasibility and potential efficacy for improving adherence and reducing costs.

Abstract

Objective To evaluate an individually tailored multicomponent nonadherence treatment protocol using a telehealth delivery approach in adolescents with inflammatory bowel disease. Methods Nine participants, age 13.71±1.35 years, completed a brief treatment online through Skype. Medication nonadherence, severity of disease, and feasibility/acceptability data were obtained. Results Adherence increased markedly from 62% at baseline to 91% for mesalamine (δ=0.63), but decreased slightly from 61% at baseline to 53% for 6-mercaptopurine /azathioprine. The telehealth delivery approach resulted in cost savings of $100 in mileage and 4 h of travel time/patient. Treatment session attendance was 100%, and the intervention was rated as acceptable, particularly in terms of treatment convenience. Conclusion Individually tailored treatment of nonadherence through telehealth delivery is feasible and acceptable. This treatment shows promise for clinical efficacy to improve medication adherence and reduce costs. Large-scale testing is necessary to determine the impact of this intervention on adherence and health outcomes.