Laura Bacelar de Araujo Lourenço

A randomized controlled trial of the effectiveness of planning strategies in the adherence to medication for coronary artery disease.

AIM To examine the effect of action and coping planning strategies in the adherence to medication among outpatients with coronary artery disease. BACKGROUND Action and coping planning strategies are based on implementation intention, which requires self-regulation by the individual, to prioritize intentionally planned responses over learned or habitual ones, from daily routines to stressful situations. DESIGN Randomized controlled trial. METHODS Participants (n = 115) were randomized into intervention (use of action and coping planning strategies, n = 59) or control (usual care, n = 56) groups. The study was conducted between June 2010-May 2011 in two in-person visits: baseline and 2-month follow-up. Participants in the intervention group received telephone reinforcement between baseline and 2-month follow-up. Adherence to medication for cardioprotection and symptoms relief was evaluated by proportion of adherence, global measure of adherence evaluation and Morisky Self-Reported Measure of Medication Adherence Scale at both baseline and 2-month follow-up. FINDINGS When using the measure of global measure of adherence, participants in the intervention group reported adherence to therapy more often than controls (odds ratio = 5.3), but no statistically significant change was observed in the other two outcome measures. CONCLUSION This study has shown that individuals who use action and coping planning report higher adherence to drug treatment, when measured by the global adherence evaluation. Further studies with longer follow-ups are needed to assess if the effect of planning strategies has long-term duration.

Action and coping plans related to the behavior of adherence to drug therapy among coronary heart disease outpatients

Objetivo: analisar os planos de acao e de enfrentamento de obstaculos, relacionados ao comportamento de adesao a terapia medicamentosa, elaborados por pacientes coronariopatas, em seguimento ambulatorial, e identificar as barreiras percebidas para adocao desse comportamento. Metodo: os participantes (n=59) foram convidados a elaborar planos de acao (action planning) e de enfrentamento de obstaculos (coping planning) para o comportamento de adesao aos medicamentos cardioprotetores e de alivio dos sintomas. Resultados: foram evidenciados planos de acao especificos para a tomada dos medicamentos que associaram o comportamento a marcadores temporais e ao ciclo vigilia/sono. Os obstaculos mais frequentemente relatados foram o esquecimento e a ausencia de rotina nas atividades de vida diaria. Os planos de enfrentamento, elaborados para superar o esquecimento, foram os mais especificos. Conclusao: os achados deste estudo subsidiam a aplicacao da implementacao da intencao para otimizar a adesao de coronariopatas a terapia medicamentosa.OBJECTIVE to analyze the action and coping plans related to the behavior of adhering to drug therapy, developed by coronary heart disease (CHD) outpatients, and to identify the barriers perceived to adopting this behavior. METHODS the participants (n=59) were invited to formulate action plans and coping plans for the behavior of adhering to the cardio-protective medications and the symptom-relief medications. RESULTS specific action plans for taking the medications associated with temporal markers and the sleep-wake cycle were shown. The most frequently reported obstacles were forgetfulness and absence of routine in daily living activities. The coping plans for overcoming forgetfulness were the most specific. CONCLUSION this studys findings support the application of implementation intentions aimed at optimizing adherence to drug therapy among patients with CHD.

Integrative review: behavioral interventions for physical activity practice

This study aimed to carry out an integrative literature review on the effectiveness of interventions in physical activity (PA) practice in the general population. The search was carried out in articles indexed in online databases: Scopus, CINAHL and Medline. Studies in English or Brazilian Portuguese were included, with evidence levels 2 or 3, published between 2004 and 2008. The final sample consisted of 14 studies. In 57.1% of the studies, interventions were effective for behavior change to practice PA. The diversity of target populations, assessment instruments and intervention designs makes it difficult to compare results and build evidence on the effectiveness of interventions for PA promotion.This study aimed to carry out an integrative literature review on the effectiveness of interventions in physical activity (PA) practice in the general population. The search was carried out in articles indexed in online databases: Scopus, CINAHL and Medline. Studies in English or Brazilian Portuguese were included, with evidence levels 2 or 3, published between 2004 and 2008. The final sample consisted of 14 studies. In 57.1% of the studies, interventions were effective for behavior change to practice PA. The diversity of target populations, assessment instruments and intervention designs makes it difficult to compare results and build evidence on the effectiveness of interventions for PA promotion.

Revisão integrativa: intervenções comportamentais para realização de atividade física

This study aimed to carry out an integrative literature review on the effectiveness of interventions in physical activity (PA) practice in the general population. The search was carried out in articles indexed in online databases: Scopus, CINAHL and Medline. Studies in English or Brazilian Portuguese were included, with evidence levels 2 or 3, published between 2004 and 2008. The final sample consisted of 14 studies. In 57.1% of the studies, interventions were effective for behavior change to practice PA. The diversity of target populations, assessment instruments and intervention designs makes it difficult to compare results and build evidence on the effectiveness of interventions for PA promotion.This study aimed to carry out an integrative literature review on the effectiveness of interventions in physical activity (PA) practice in the general population. The search was carried out in articles indexed in online databases: Scopus, CINAHL and Medline. Studies in English or Brazilian Portuguese were included, with evidence levels 2 or 3, published between 2004 and 2008. The final sample consisted of 14 studies. In 57.1% of the studies, interventions were effective for behavior change to practice PA. The diversity of target populations, assessment instruments and intervention designs makes it difficult to compare results and build evidence on the effectiveness of interventions for PA promotion.

Quality of life of coronary artery disease patients after the implementation of planning strategies for medication adherence

Comparar la calidad de vida relacionada a la salud (CVRS) - general y especifica de pacientes con enfermedad coronaria entre los grupos Intervencion y Control despues de la implementacion de las estrategias de Planificacion de Accion y de Enfrentamiento de Obstaculos para adherencia a medicamentos y verificar la relacion entre adherencia y CVRS. METODO: se trata de estudio controlado y aleatorio. RESULTADOS: la muestra (n=115) fue del tipo aleatorio en los grupos GI (n=59) y GC (n=56). Fueron obtenidas medidas de adherencia a medicamentos y de CVRS general y especifica, en la fase inicial del estudio y despues de dos meses de seguimiento. CONCLUSION: los hallazgos evidenciaron que la combinacion de estrategias de intervencion - Planificacion de Accion y de Enfrentamiento de Obstaculos para adherencia a medicamentos no influencio la CVRS de pacientes con enfermedad coronaria en seguimiento en ambulatorioObjetivo: comparar a qualidade de vida relacionada a saude - geral e especifica - de pacientes coronariopatas entre os grupos Intervencao e Controle, apos a implementacao das estrategias de Planejamento de Acao e de Enfrentamento de Obstaculos para adesao medicamentosa e verificar a relacao entre adesao e qualidade de vida, relacionada a saude. Metodo: trata-se de estudo controlado e randomizado. Resultados: a amostra (n=115) foi aleatorizada nos grupos Intervencao (n=59) e Controle (n=56). Foram obtidas medidas de adesao medicamentosa e de qualidade de vida relacionada a saude geral e especifica, na fase inicial do estudo e apos dois meses de seguimento. Conclusao: os achados evidenciaram que a combinacao de estrategias de intervencao - Planejamento de Acao e de Enfrentamento de Obstaculos para adesao medicamentosa nao influenciou a qualidade de vida relacionada a saude de pacientes coronariopatas em seguimento ambulatorial.OBJECTIVE: to compare the general and specific health-related quality of life (HRQoL) between the Intervention (IG) and Control (CG) groups of coronary artery disease patients after the implementation of Action Planning and Coping Planning strategies for medication adherence and to verify the relationship between adherence and HRQoL. METHOD: this was a controlled and randomized study. RESULTS: the sample (n=115) was randomized into two groups, IG (n=59) and CG (n=56). Measures of medication adherence and general and specific HRQoL were obtained in the baseline and after two months of monitoring. CONCLUSION: the findings showed that the combination of intervention strategies - Action Planning and Coping Planning for medication adherence did not affect the HRQoL of coronary artery disease patients in outpatient monitoring.

Qualidade de vida de coronariopatas após implementação de estratégias de planejamento para adesão medicamentosa

Comparar la calidad de vida relacionada a la salud (CVRS) - general y especifica de pacientes con enfermedad coronaria entre los grupos Intervencion y Control despues de la implementacion de las estrategias de Planificacion de Accion y de Enfrentamiento de Obstaculos para adherencia a medicamentos y verificar la relacion entre adherencia y CVRS. METODO: se trata de estudio controlado y aleatorio. RESULTADOS: la muestra (n=115) fue del tipo aleatorio en los grupos GI (n=59) y GC (n=56). Fueron obtenidas medidas de adherencia a medicamentos y de CVRS general y especifica, en la fase inicial del estudio y despues de dos meses de seguimiento. CONCLUSION: los hallazgos evidenciaron que la combinacion de estrategias de intervencion - Planificacion de Accion y de Enfrentamiento de Obstaculos para adherencia a medicamentos no influencio la CVRS de pacientes con enfermedad coronaria en seguimiento en ambulatorioObjetivo: comparar a qualidade de vida relacionada a saude - geral e especifica - de pacientes coronariopatas entre os grupos Intervencao e Controle, apos a implementacao das estrategias de Planejamento de Acao e de Enfrentamento de Obstaculos para adesao medicamentosa e verificar a relacao entre adesao e qualidade de vida, relacionada a saude. Metodo: trata-se de estudo controlado e randomizado. Resultados: a amostra (n=115) foi aleatorizada nos grupos Intervencao (n=59) e Controle (n=56). Foram obtidas medidas de adesao medicamentosa e de qualidade de vida relacionada a saude geral e especifica, na fase inicial do estudo e apos dois meses de seguimento. Conclusao: os achados evidenciaram que a combinacao de estrategias de intervencao - Planejamento de Acao e de Enfrentamento de Obstaculos para adesao medicamentosa nao influenciou a qualidade de vida relacionada a saude de pacientes coronariopatas em seguimento ambulatorial.OBJECTIVE: to compare the general and specific health-related quality of life (HRQoL) between the Intervention (IG) and Control (CG) groups of coronary artery disease patients after the implementation of Action Planning and Coping Planning strategies for medication adherence and to verify the relationship between adherence and HRQoL. METHOD: this was a controlled and randomized study. RESULTS: the sample (n=115) was randomized into two groups, IG (n=59) and CG (n=56). Measures of medication adherence and general and specific HRQoL were obtained in the baseline and after two months of monitoring. CONCLUSION: the findings showed that the combination of intervention strategies - Action Planning and Coping Planning for medication adherence did not affect the HRQoL of coronary artery disease patients in outpatient monitoring.

Calidad de vida de pacientes con enfermedad coronaria después de implementación de estrategias de planificación para adherencia a medicamentos

Comparar la calidad de vida relacionada a la salud (CVRS) - general y especifica de pacientes con enfermedad coronaria entre los grupos Intervencion y Control despues de la implementacion de las estrategias de Planificacion de Accion y de Enfrentamiento de Obstaculos para adherencia a medicamentos y verificar la relacion entre adherencia y CVRS. METODO: se trata de estudio controlado y aleatorio. RESULTADOS: la muestra (n=115) fue del tipo aleatorio en los grupos GI (n=59) y GC (n=56). Fueron obtenidas medidas de adherencia a medicamentos y de CVRS general y especifica, en la fase inicial del estudio y despues de dos meses de seguimiento. CONCLUSION: los hallazgos evidenciaron que la combinacion de estrategias de intervencion - Planificacion de Accion y de Enfrentamiento de Obstaculos para adherencia a medicamentos no influencio la CVRS de pacientes con enfermedad coronaria en seguimiento en ambulatorioObjetivo: comparar a qualidade de vida relacionada a saude - geral e especifica - de pacientes coronariopatas entre os grupos Intervencao e Controle, apos a implementacao das estrategias de Planejamento de Acao e de Enfrentamento de Obstaculos para adesao medicamentosa e verificar a relacao entre adesao e qualidade de vida, relacionada a saude. Metodo: trata-se de estudo controlado e randomizado. Resultados: a amostra (n=115) foi aleatorizada nos grupos Intervencao (n=59) e Controle (n=56). Foram obtidas medidas de adesao medicamentosa e de qualidade de vida relacionada a saude geral e especifica, na fase inicial do estudo e apos dois meses de seguimento. Conclusao: os achados evidenciaram que a combinacao de estrategias de intervencao - Planejamento de Acao e de Enfrentamento de Obstaculos para adesao medicamentosa nao influenciou a qualidade de vida relacionada a saude de pacientes coronariopatas em seguimento ambulatorial.OBJECTIVE: to compare the general and specific health-related quality of life (HRQoL) between the Intervention (IG) and Control (CG) groups of coronary artery disease patients after the implementation of Action Planning and Coping Planning strategies for medication adherence and to verify the relationship between adherence and HRQoL. METHOD: this was a controlled and randomized study. RESULTS: the sample (n=115) was randomized into two groups, IG (n=59) and CG (n=56). Measures of medication adherence and general and specific HRQoL were obtained in the baseline and after two months of monitoring. CONCLUSION: the findings showed that the combination of intervention strategies - Action Planning and Coping Planning for medication adherence did not affect the HRQoL of coronary artery disease patients in outpatient monitoring.

Planos de ação e de enfrentamento de obstáculos relacionados ao comportamento de adesão à terapia medicamentosa em coronariopatas

Objetivo: analisar os planos de acao e de enfrentamento de obstaculos, relacionados ao comportamento de adesao a terapia medicamentosa, elaborados por pacientes coronariopatas, em seguimento ambulatorial, e identificar as barreiras percebidas para adocao desse comportamento. Metodo: os participantes (n=59) foram convidados a elaborar planos de acao (action planning) e de enfrentamento de obstaculos (coping planning) para o comportamento de adesao aos medicamentos cardioprotetores e de alivio dos sintomas. Resultados: foram evidenciados planos de acao especificos para a tomada dos medicamentos que associaram o comportamento a marcadores temporais e ao ciclo vigilia/sono. Os obstaculos mais frequentemente relatados foram o esquecimento e a ausencia de rotina nas atividades de vida diaria. Os planos de enfrentamento, elaborados para superar o esquecimento, foram os mais especificos. Conclusao: os achados deste estudo subsidiam a aplicacao da implementacao da intencao para otimizar a adesao de coronariopatas a terapia medicamentosa.OBJECTIVE to analyze the action and coping plans related to the behavior of adhering to drug therapy, developed by coronary heart disease (CHD) outpatients, and to identify the barriers perceived to adopting this behavior. METHODS the participants (n=59) were invited to formulate action plans and coping plans for the behavior of adhering to the cardio-protective medications and the symptom-relief medications. RESULTS specific action plans for taking the medications associated with temporal markers and the sleep-wake cycle were shown. The most frequently reported obstacles were forgetfulness and absence of routine in daily living activities. The coping plans for overcoming forgetfulness were the most specific. CONCLUSION this studys findings support the application of implementation intentions aimed at optimizing adherence to drug therapy among patients with CHD.

Planes de acción y de enfrentamiento de obstáculos relacionados al comportamiento de adhesión a la terapia medicamentosa en pacientes con coronariopatía

Objetivo: analisar os planos de acao e de enfrentamento de obstaculos, relacionados ao comportamento de adesao a terapia medicamentosa, elaborados por pacientes coronariopatas, em seguimento ambulatorial, e identificar as barreiras percebidas para adocao desse comportamento. Metodo: os participantes (n=59) foram convidados a elaborar planos de acao (action planning) e de enfrentamento de obstaculos (coping planning) para o comportamento de adesao aos medicamentos cardioprotetores e de alivio dos sintomas. Resultados: foram evidenciados planos de acao especificos para a tomada dos medicamentos que associaram o comportamento a marcadores temporais e ao ciclo vigilia/sono. Os obstaculos mais frequentemente relatados foram o esquecimento e a ausencia de rotina nas atividades de vida diaria. Os planos de enfrentamento, elaborados para superar o esquecimento, foram os mais especificos. Conclusao: os achados deste estudo subsidiam a aplicacao da implementacao da intencao para otimizar a adesao de coronariopatas a terapia medicamentosa.OBJECTIVE to analyze the action and coping plans related to the behavior of adhering to drug therapy, developed by coronary heart disease (CHD) outpatients, and to identify the barriers perceived to adopting this behavior. METHODS the participants (n=59) were invited to formulate action plans and coping plans for the behavior of adhering to the cardio-protective medications and the symptom-relief medications. RESULTS specific action plans for taking the medications associated with temporal markers and the sleep-wake cycle were shown. The most frequently reported obstacles were forgetfulness and absence of routine in daily living activities. The coping plans for overcoming forgetfulness were the most specific. CONCLUSION this studys findings support the application of implementation intentions aimed at optimizing adherence to drug therapy among patients with CHD.

REVISIÓN INTEGRATIVA: INTERVENCIONES COMPORTAMENTALES PARA REALIZACIÓN DE ACTIVIDAD FÍSICA

This study aimed to carry out an integrative literature review on the effectiveness of interventions in physical activity (PA) practice in the general population. The search was carried out in articles indexed in online databases: Scopus, CINAHL and Medline. Studies in English or Brazilian Portuguese were included, with evidence levels 2 or 3, published between 2004 and 2008. The final sample consisted of 14 studies. In 57.1% of the studies, interventions were effective for behavior change to practice PA. The diversity of target populations, assessment instruments and intervention designs makes it difficult to compare results and build evidence on the effectiveness of interventions for PA promotion.This study aimed to carry out an integrative literature review on the effectiveness of interventions in physical activity (PA) practice in the general population. The search was carried out in articles indexed in online databases: Scopus, CINAHL and Medline. Studies in English or Brazilian Portuguese were included, with evidence levels 2 or 3, published between 2004 and 2008. The final sample consisted of 14 studies. In 57.1% of the studies, interventions were effective for behavior change to practice PA. The diversity of target populations, assessment instruments and intervention designs makes it difficult to compare results and build evidence on the effectiveness of interventions for PA promotion.