Effect of Occupational Therapy in Promoting Medication Adherence in Primary Care: A Randomized Controlled Trial

The Integrative Medication Self-Management Intervention (IMedS) is a manualized occupational therapy intervention designed to improve adherence to medications. The intervention influences medication adherence and facilitates new medication habits and routines; however, it has not been tested in a community clinical setting.

To test the efficacy of the IMedS to address medication adherence rates among community-dwelling adults with hypertension (HTN), Type 2 diabetes mellitus (T2DM), or both.

Randomized controlled trial using a pretest-posttest control group design.

Primary care clinic in a large federally qualified health center.

Adults with uncontrolled HTN, T2DM, or both.

Participants were divided into two groups: The control group received treatment as usual (TAU) per the primary care protocol, and the intervention IMedS group received TAU and the IMedS intervention.

Primary outcome: seven-item version of the Adherence to Refills and Medication Scale (ARMS-7), pill count, blood pressure, hemoglobin A1c, or all of these.

The proportion of adherent participants increased in both groups, but between groups, changes were not statistically significant. Post hoc comparisons of the results of a mixed analysis of variance for ARMS-7 measurements indicated that the occupational therapy intervention had a unique effect, compared with that for the TAU control group (dc = 0.65). Effect scores for pill count (d = 0.55) also suggested that the occupational therapy intervention positively affected adherence.

Occupational therapists can provide assessment and intervention to positively influence medication adherence in a primary care setting. What This Article Adds: This article provides a better understanding of the occupational therapist's role in addressing medication management and adherence on the interdisciplinary primary care medical team.