Randomized, Controlled Trial of a Behavioral Adherence Intervention for Adolescents With Cystic Fibrosis: I Change Adherence and Raise Expectations (iCARE)

CHEST Journal ◽  
2011 ◽  
Vol 140 (4) ◽  
pp. 908A ◽  
Author(s):  
Alexandra Quittner ◽  
Cara Kimberg ◽  
Kristen Marciel ◽  
Jie Zhang ◽  
Kristin Riekert
Keyword(s):  
Cystic Fibrosis ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Adherence Intervention

scholarly journals Mechanisms of Action of a Web-Based Intervention With Health Professional Support to Increase Adherence to Nebulizer Treatments in Adults With Cystic Fibrosis: Qualitative Interview Study (Preprint)

2019 ◽  
Author(s):  
Sarah J Drabble ◽  
Alicia O'Cathain ◽  
Alexander J Scott ◽  
Madelynne A Arden ◽  
Samuel Keating ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Randomized Controlled Trial ◽  
Behavior Change ◽  
Controlled Trial ◽  
Qualitative Interview ◽  
Mechanisms Of Action ◽  
Self Management ◽  
Randomized Controlled ◽  
Qualitative Interview Study ◽  
Adherence Data

BACKGROUND Adherence to nebulizer treatments in adults with cystic fibrosis (CF) is often low. A new complex intervention to help adults with CF increase their adherence to nebulizer treatments was tested in a pilot randomized controlled trial (RCT) in 2 UK CF centers. Patients used a nebulizer with electronic monitoring capabilities that transferred data automatically to a digital platform (CFHealthHub) to monitor adherence over time and to a tailored website to display graphs of adherence data and educational and problem-solving information about adherence. A trained interventionist helped patients identify ways to increase their adherence. OBJECTIVE This study aims to explore the mechanisms of action underpinning the intervention. METHODS A qualitative interview study was conducted concurrently with a pilot RCT. In total, 25 semistructured interviews were conducted with 3 interventionists at 2 time points, 14 patients in the intervention arm of the trial, and 5 members of the multidisciplinary teams offering wider care to patients. A framework approach was used for the analysis. RESULTS The intervention was informed by a theoretical framework of behavior change. There was evidence of the expected behavior change mechanisms of action. There was also evidence of additional mechanisms of action associated with effective telehealth interventions for self-management support: relationships, visibility, and fit. Patients described how building a relationship with the interventionist through face-to-face visits with someone who cared about them and their progress helped them to consider ways of increasing adherence to medication. Rather than seeing the visibility of adherence data to clinicians as problematic, patients found this motivating, particularly if they received praise about progress made. The intervention was tailored to individuals, but there were challenges in how the intervention fitted into some patients’ busy lives when delivered through a desktop computer. CONCLUSIONS The mechanisms of action associated with effective telehealth interventions for self-management operated within this new intervention. The intervention was modified to strengthen mechanisms of action based on these findings, for example, delivery through an app accessed via mobile phones and then tested in an RCT in 19 UK CF centers. CLINICALTRIAL International Standard Randomized Controlled Trial Number 13076797; http://www.isrctn.com/ISRCTN13076797

scholarly journals Clustered randomized controlled trial of a clinic-based problem-solving intervention to improve adherence in adolescents with cystic fibrosis

2019 ◽  
Vol 18 (6) ◽  
pp. 879-885 ◽  
Author(s):  
Alexandra L. Quittner ◽  
Michelle N. Eakin ◽  
Adrianne N. Alpern ◽  
Alana K. Ridge ◽  
Katherine A. McLean ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Randomized Controlled Trial ◽  
Problem Solving ◽  
Controlled Trial ◽  
Randomized Controlled

A Randomized Controlled Trial of Nebulized Gentamicin in Non–Cystic Fibrosis Bronchiectasis

2011 ◽  
Vol 183 (4) ◽  
pp. 491-499 ◽  
Author(s):  
Maeve P. Murray ◽  
John R. W. Govan ◽  
Catherine J. Doherty ◽  
A. John Simpson ◽  
Thomas S. Wilkinson ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Randomized Controlled
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