Effects of a Smart Patient Program on Medication Adherence, Pain, Physical Function and Depression among Korean Medical Aid Beneficiaries with Osteoarthritis

Background: Medication non-adherence is a growing concern to health care team because it is associated with adverse outcomes and higher costs of care. The purpose of this study was to identify the effects of a smart patient program for enhancing medication adherence on medication adherence, pain, physical function and depression among medical aid beneficiaries with osteoarthritis in a community of Korea. Methods: An experimental research design was employed. A total of 60 medical aid beneficiaries with osteoarthritis included high risk group, were recruited and assigned randomly to an experimental (n=30) or control group (n=30). The smart patient program (SPP) based on Cox's Interaction Model of Client Health Behavior was developed and implemented, which focused on patient-centered and tailored intervention with motivational interview and coaching strategies utilizing ‘smart card’ and ‘medication calendar’. The SPP had 8 sessions during 3 months and led by nurse as a case manager in partnership with pharmacist. Instruments were the Modified Morisky Scale, Korean Western Ontario McMaster Universities, Stanford Health Assessment Questionnaire, Korean Center for Epidemiologic Studies Depression Scale. Analysis included descriptive statistics, χ²-test, t-test and ANCOVA. Results: There were no differences between the groups in baseline measures except depression. Significant increase was observed for the experimental group as compared to the control group in medication adherence, pain, physical function, and decrease in depression. Conclusions: The Smart Patient Program was effective to improve medication adherence, pain, physical function and less depression. Further research is needed to clarify the long-term effects of the SPP through longitudinal study.