Nurse-led intervention to improve knowledge of medications in survivors of stroke or transient ischemic attack: a cluster randomized controlled trial
Introduction: Limited evidence exists on effective interventions to improve knowledge of preventive medications in patients with chronic diseases, such as stroke. We investigated the effectiveness of a nurse-led intervention, where a component was to improve knowledge of prevention medications, in p...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2016-11-01
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| Series: | Frontiers in Neurology |
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| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fneur.2016.00205/full |
| _version_ | 1819263775553880064 |
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| author | Muideen Olaiya Dominique Cadilhac Dominique Cadilhac Joosup Kim Joosup Kim David Ung Mark Raymond Nelson Mark Raymond Nelson Velandai Srikanth Velandai Srikanth Christopher Bladin Richard Gerraty Sharyn Fitzgerald THANH G PHAN Judith Frayne Amanda G Thrift |
| author_facet | Muideen Olaiya Dominique Cadilhac Dominique Cadilhac Joosup Kim Joosup Kim David Ung Mark Raymond Nelson Mark Raymond Nelson Velandai Srikanth Velandai Srikanth Christopher Bladin Richard Gerraty Sharyn Fitzgerald THANH G PHAN Judith Frayne Amanda G Thrift |
| author_sort | Muideen Olaiya |
| collection | DOAJ |
| description | Introduction: Limited evidence exists on effective interventions to improve knowledge of preventive medications in patients with chronic diseases, such as stroke. We investigated the effectiveness of a nurse-led intervention, where a component was to improve knowledge of prevention medications, in patients with stroke or transient ischemic attack (TIA).Methods: Prospective sub-study of the Shared Team Approach between Nurses and Doctors For Improved Risk Factor Management (STAND FIRM), a randomized controlled trial of risk factor management. We recruited patients aged ≥18 years and hospitalized for stroke/TIA. The intervention comprised an individualized management program, involving nurse-led education, and management plan with medical specialist oversight. The outcome, participants’ knowledge of secondary prevention medications at 12 months, was assessed using questionnaires. A score of ≥5 was considered as good knowledge. Effectiveness of the intervention on knowledge of medications was determined using logistic regression. Results: Between May 2014 and January 2015, 142 consecutive participants from the main trial were included in this sub-study, 64 to usual care and 78 to the intervention (median age 68.9 years, 68% male, and 79% ischemic stroke). In multivariable analyses, we found no significant difference between intervention groups in knowledge of medications. Factors independently associated with good knowledge (score ≥5) at 12 months included higher socio-economic position (OR 4.79, 95% CI 1.76, 13.07), greater functional ability (OR 1.69, 95% CI 1.17, 2.45), being married/living with a partner (OR 3.12, 95% CI 1.10, 8.87), and using instructions on pill bottle/package as an administration aid (OR 4.82, 95% CI 1.76, 13.22). Being aged ≥65 years was associated with poorer knowledge of medications (OR 0.24, 95% CI 0.08, 0.71), while knowledge was worse among those taking three medications (OR 0.15, 95% CI 0.03, 0.66) or ≥4 medications (OR 0.09, 95% CI 0.02, 0.44), when compared to participants taking fewer (≤ 2) prevention medications.Conclusions: There was no evidence that the nurse-led intervention was effective for improving knowledge of secondary prevention medications in patients with stroke/TIA at 12 months. However, older patients and those taking more medications should be particularly targeted for more intensive education. |
| first_indexed | 2024-12-23T20:18:57Z |
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| id | doaj.art-ccda9c1fa9384cbe8ba093fec7c363d8 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-23T20:18:57Z |
| publishDate | 2016-11-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-ccda9c1fa9384cbe8ba093fec7c363d82022-12-21T17:32:36ZengFrontiers Media S.A.Frontiers in Neurology1664-22952016-11-01710.3389/fneur.2016.00205226039Nurse-led intervention to improve knowledge of medications in survivors of stroke or transient ischemic attack: a cluster randomized controlled trialMuideen Olaiya0Dominique Cadilhac1Dominique Cadilhac2Joosup Kim3Joosup Kim4David Ung5Mark Raymond Nelson6Mark Raymond Nelson7Velandai Srikanth8Velandai Srikanth9Christopher Bladin10Richard Gerraty11Sharyn Fitzgerald12THANH G PHAN13Judith Frayne14Amanda G Thrift15Monash UniversityMonash UniversityThe Florey Institute of Neuroscience and Mental HealthMonash UniversityThe Florey Institute of Neuroscience and Mental HealthMonash UniversityMenzies Institute of Medical ResearchMonash UniversityMonash UniversityMenzies Institute of Medical ResearchBox Hill HospitalEpworth HealthcareMonash UniversityMonash UniversityThe Alfred HospitalMonash UniversityIntroduction: Limited evidence exists on effective interventions to improve knowledge of preventive medications in patients with chronic diseases, such as stroke. We investigated the effectiveness of a nurse-led intervention, where a component was to improve knowledge of prevention medications, in patients with stroke or transient ischemic attack (TIA).Methods: Prospective sub-study of the Shared Team Approach between Nurses and Doctors For Improved Risk Factor Management (STAND FIRM), a randomized controlled trial of risk factor management. We recruited patients aged ≥18 years and hospitalized for stroke/TIA. The intervention comprised an individualized management program, involving nurse-led education, and management plan with medical specialist oversight. The outcome, participants’ knowledge of secondary prevention medications at 12 months, was assessed using questionnaires. A score of ≥5 was considered as good knowledge. Effectiveness of the intervention on knowledge of medications was determined using logistic regression. Results: Between May 2014 and January 2015, 142 consecutive participants from the main trial were included in this sub-study, 64 to usual care and 78 to the intervention (median age 68.9 years, 68% male, and 79% ischemic stroke). In multivariable analyses, we found no significant difference between intervention groups in knowledge of medications. Factors independently associated with good knowledge (score ≥5) at 12 months included higher socio-economic position (OR 4.79, 95% CI 1.76, 13.07), greater functional ability (OR 1.69, 95% CI 1.17, 2.45), being married/living with a partner (OR 3.12, 95% CI 1.10, 8.87), and using instructions on pill bottle/package as an administration aid (OR 4.82, 95% CI 1.76, 13.22). Being aged ≥65 years was associated with poorer knowledge of medications (OR 0.24, 95% CI 0.08, 0.71), while knowledge was worse among those taking three medications (OR 0.15, 95% CI 0.03, 0.66) or ≥4 medications (OR 0.09, 95% CI 0.02, 0.44), when compared to participants taking fewer (≤ 2) prevention medications.Conclusions: There was no evidence that the nurse-led intervention was effective for improving knowledge of secondary prevention medications in patients with stroke/TIA at 12 months. However, older patients and those taking more medications should be particularly targeted for more intensive education.http://journal.frontiersin.org/Journal/10.3389/fneur.2016.00205/fullEducation, NursingSecondary PreventionStrokerandomized controlled trialMedication knowledge |
| spellingShingle | Muideen Olaiya Dominique Cadilhac Dominique Cadilhac Joosup Kim Joosup Kim David Ung Mark Raymond Nelson Mark Raymond Nelson Velandai Srikanth Velandai Srikanth Christopher Bladin Richard Gerraty Sharyn Fitzgerald THANH G PHAN Judith Frayne Amanda G Thrift Nurse-led intervention to improve knowledge of medications in survivors of stroke or transient ischemic attack: a cluster randomized controlled trial Frontiers in Neurology Education, Nursing Secondary Prevention Stroke randomized controlled trial Medication knowledge |
| title | Nurse-led intervention to improve knowledge of medications in survivors of stroke or transient ischemic attack: a cluster randomized controlled trial |
| title_full | Nurse-led intervention to improve knowledge of medications in survivors of stroke or transient ischemic attack: a cluster randomized controlled trial |
| title_fullStr | Nurse-led intervention to improve knowledge of medications in survivors of stroke or transient ischemic attack: a cluster randomized controlled trial |
| title_full_unstemmed | Nurse-led intervention to improve knowledge of medications in survivors of stroke or transient ischemic attack: a cluster randomized controlled trial |
| title_short | Nurse-led intervention to improve knowledge of medications in survivors of stroke or transient ischemic attack: a cluster randomized controlled trial |
| title_sort | nurse led intervention to improve knowledge of medications in survivors of stroke or transient ischemic attack a cluster randomized controlled trial |
| topic | Education, Nursing Secondary Prevention Stroke randomized controlled trial Medication knowledge |
| url | http://journal.frontiersin.org/Journal/10.3389/fneur.2016.00205/full |
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