Low adherence to prescribed medications has been associated with additional costs of medical care, longer therapies, less control of disease symptoms, and greater, medical complications. The effectiveness of medicinal therapy can be further reduced by food/drug Interactions from inappropriate food and beverage choices. Progress in reducing this problem has been hampered by the lack of appropriate materials and programs, and by the lack of well designed clinical trials addressing this issue. The proposed project will develop and assess the effectiveness of a computer assisted instruction (CAl) drug-nutrition intervention designed to promote improved drug adherence and food choices. The CAl will provide individuals with a medication chart, icon-based reminders, and information messages related to appropriate food and beverage choices. The clinical trial which will include eight intervention sessions and four maintenance sessions will be conducted in an outpatient clinic serving a predominantly African American and low income population from Buffalo, New York. Following a baseline assessment, 222 patients will be randomly assigned to Group A (intervention and hands-on microcomputer experience), Group B (intervention without microcomputer experience), and Group C (usual care). The intervention will be evaluated by a pill vial with microcircuitry and dietary analysis. A repeated measures, analysis of variance model will be used to test the differences of drug adherence and dietary intake among and between the groups at the end-of-treatment, end-of-maintenance, and 12-month follow-up. This is an important step in the development of a CAl intervention which can be used by health professionals in health promotion programs to improve patient drug adherence, and general nutrition.
