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Description
The aim of the study was to explore the feasibility of culturally-competent counseling and use of pill boxes to improve metabolic outcomes mediated by improved medication adherence. The participants were recruited from the Linda Vista Healthcare Center in San Diego, California, with the inclusion criteria that they were at least 21 years of age and being treated for two or more chronic conditions: hypertension, high cholesterol, diabetes and/or asthma. The research design was a prospective randomized pilot study with an enrollment of 8 weeks. Twenty-seven participants' (mean age = 61.5, 85% female) metabolic laboratory measures were analyzed using clinical judgment criteria to compute differential change between groups. Fisher's exact probability test was used to test significance for between group measures. Adherence to the compliance aid use was measured by self-report at clinic visits and telephone appointments. Systolic blood pressure; total cholesterol; LDL-C, HDL-C, vLDL-C, and triglycerides were observed to have improved control at follow-up among intervention participants. Participants in the usual care control group showed improved control in HbA1c, fasting glucose, and diastolic blood pressure at 8 weeks. Six of the nine metabolic parameters monitored displayed a trend towards improvement in the intervention group greater than that of the usual care group. Culturally-sensitive interventions combining the elements of patient education, individual counseling, and medication management skills offer improved clinical outcomes in urban, immigrant populations where intensive treatment is needed and calls for further investigation.
