Abstract 4363574: Effects of a health belief model based educational programme on medication adherence among older adults with coronary artery disease: a pilot study

Abstract

Introduction: Coronary artery disease (CAD) is the leading cause of death worldwide. Medication management is the priority for its secondary prevention. However, medication adherence was sub-optimal among older adults with CAD, who had greater challenges than younger adults, due to more concerns about the side-effects, forgetfulness and polypharmacy. Comprehensive and rigorously designed educational programmes are needed to improve their medication adherence. Aim: To evaluate the effects of a Health Belief Model based educational programme in improving medication adherence and other related outcomes among older adults with CAD. Methods: This is a two-arm, single-blind, pilot randomised controlled trial, conducted from March to May 2025 in the cardiology department of a tertiary hospital, adopting convenience sampling. The intervention group received a Health Belief Model based educational programme and usual care, and the control group received usual care only. Feasibility (recruitment, completion, attrition rate) and acceptability (semi-structured interviews and satisfaction scales) were assessed. Preliminary effects were measured at immediate post-intervention in terms of the level of medication adherence, perceived benefits and concerns about medications, medication self-management capacity, self-efficacy of medication taking, and health-related quality of life. Between group comparisons were analysed by Mann-Whitney U test, with Hedges’ g effect size calculated by changing scores. Qualitative data were analysed via content analysis. Results: A total of 40 older adults with CAD were recruited, with a 44.9% recruitment and 2.5% attrition rate. In the intervention group, 85% participants attended all sessions. Three categories emerged in the interviews, including perceived benefits and advantages of the intervention, and suggestions for improvement. Significant improvements in the intervention group were observed in medication adherence and perceptions about the benefits of medications (Hedge’s g=0.79 and 1.19), comparing with the control group. The intervention group demonstrated greater improvement in medication self-management capacity and self-efficacy (Hedge’s g=0.62 and 0.46), and greater reduction in the concerns about medications (Hedge’s g=-0.56). Conclusion: The educational programme was feasible and acceptable for older adults with CAD. A large scale randomised controlled trial will be conducted to examine the longer-term effect of the programme.