1
|
Su Y, Wang X, Xing Y, Wang Z, Bu H, Cui X, Yang Y, Cai B. The analysis of factors affecting medication adherence in patients with myasthenia gravis: a cross-sectional study. Ther Adv Neurol Disord 2024; 17:17562864231206877. [PMID: 38654744 PMCID: PMC11036929 DOI: 10.1177/17562864231206877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/27/2023] [Indexed: 04/26/2024] Open
Abstract
Background Clinically, patients with myasthenia gravis are generally treated with drugs to improve their physical condition, and poor medication adherence can hinder their recovery. Many studies have shown the importance of medication adherence for effective treatment. Various factors may affect a patient's medication adherence; however, studies concerning medication adherence in patients with myasthenia gravis are rare. Objectives This study aimed to identify the factors related to medication adherence in patients with myasthenia gravis, and determine the possibility of predicting medication adherence. Methods This cross-sectional observational study was conducted among inpatients and outpatients with myasthenia gravis of the First Affiliated Hospital of Guangzhou University of Chinese Medicine in China. Data on patient demographics, disease-related characteristics, and medical treatment were collected. We evaluated medication adherence of the patients using the Morisky Medication Adherence Scale-8, Beliefs about Medicines Questionnaire, and the Self-efficacy for Appropriate Medication Use Scale. Results We distributed 200 questionnaires and finally retrieved 198 valid questionnaires. A total of 139 (70.2%) women participated in this study, and 81 (40.9%) among the 198 participants were aged 40-59 years. In total, 103 (52.0%) participants exhibited bad adherence to pharmacological treatment, and factors such as taking medication irregularly [odds ratio (OR) = 0.242, 95% CI = 0.093-0.627], the necessity of taking medicine (OR = 1.286, 95% CI = 1.142-1.449), the concerns of taking medicine (OR = 0.890, 95% CI = 0.801-0.988), and the self-efficacy for taking medications under difficult circumstances (OR = 1.194, 95% CI = 1.026-1.389) had statistically significant impacts on medication adherence. Conclusion Our study shows that taking medication irregularly and concerns of taking medicine are the risk factors for medication adherence. Meanwhile, the necessity of talking medicine and self-efficacy for taking medications under difficult circumstances are the protective factors for medication adherence. Our findings can help medical staff to enhance patients' medication adherence by informing patients necessary medical knowledge, emphasizing the necessity for medication, relieving patients' concerns regarding medication, and improving the self-efficacy for taking medications under difficult circumstances.
Collapse
Affiliation(s)
- Yining Su
- The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xinxian Wang
- The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuemeng Xing
- The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhenni Wang
- The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hailing Bu
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaoyan Cui
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yunying Yang
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, No.16 Airport Road, Baiyun District, Guangzhou, Guangdong 510405, China
| | - Bingxing Cai
- The Second Affiliated Hospital of Chongqing Medical University, No. 76 Linjiang Road, Yuzhong District, Chongqing 400010, China
| |
Collapse
|
2
|
Nasidi I, Orek C, Majid A, Eldin SM, Kaygili O, Bulut N. Computational Study of Doping in Dopamine with Halogens to Control Optical and Spectroscopic Properties. ACS OMEGA 2023; 8:21074-21082. [PMID: 37323415 PMCID: PMC10268270 DOI: 10.1021/acsomega.3c01946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/16/2023] [Indexed: 06/17/2023]
Abstract
In this research, a comprehensive study of dopamine was conducted using the theoretical first principles method due to its crucial importance as a hormone for the neurotransmission process in the animal body. Many basis sets and functionals were used for optimization of the compound to attain stability and find the appropriate energy point for the overall calculations. Then, the compound was doped with the first three members of the halogen family (fluorine, chlorine, and bromine) to analyze the effect of their presence in terms of change in their electronic properties, such as band gap and density of states, and spectroscopic parameters, such as nuclear magnetic resonance and Fourier transform infrared. It was found that the band gap of the system changes depending on the doping of halogens.
Collapse
Affiliation(s)
- Ibrahim
Isah Nasidi
- Department
of Physics, Faculty of Science, Firat University, Elazig 23119, Turkey
| | - Cahit Orek
- Department
of Physics, Faculty of Science, Firat University, Elazig 23119, Turkey
- Research
and Application Center, Kastamonu University, Kastamonu 37100, Turkey
| | - Abdul Majid
- Department
of Physics, University of Gujrat, Gujrat 50700, Pakistan
| | - Sayed M. Eldin
- Faculty
of Engineering, Future University in Egypt New Cairo 11835, Egypt
| | - Omer Kaygili
- Department
of Physics, Faculty of Science, Firat University, Elazig 23119, Turkey
| | - Niyazi Bulut
- Department
of Physics, Faculty of Science, Firat University, Elazig 23119, Turkey
| |
Collapse
|
3
|
Vitturi BK, Pellegrinelli A, Valerio BCO. Medication adherence in patients with myasthenia gravis in Brazil: a cross-sectional study. Acta Neurol Belg 2020; 120:83-89. [PMID: 31555980 DOI: 10.1007/s13760-019-01209-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 09/16/2019] [Indexed: 10/25/2022]
Abstract
Advances in the treatment of MG have allowed most patients to effectively treat their disorder with oral medications. In parallel, non-adherence to medication treatment regimens is a worldwide health problem. Other chronic neurological disorders have already been associated with low adherence to treatment. However, the literature regarding adherence among patients with MG is definitely poor. The purpose of this study was to capture the prevalence and the associated factors of non-adherence to pharmacological treatment in patients with MG. We carried out a cross-sectional cohort study with 58 consecutive patients with MG from a university-affiliated referral hospital in São Paulo, Brazil. We registered clinical and sociodemographic data and patients were classified according to the MGFA classification. Clinical severity was assessed with myasthenia gravis composite (MGC) scale. Neuropsychiatric symptoms were evaluated with the Hospital Anxiety and Depression Scale (HADS) and quality of life with the 15-Item Quality Of Life Instrument for myasthenia gravis scale (MG-QOL15). Adherence to pharmacological treatment was evaluated using the 8-item Morisky Medication Adherence Scale (MMAS-8). There were 26 (44.8%) patients adherent to treatment. Low adherence was associated with poor educational attainment, longer time of disease and greater daily number of pills (p < 0.05). Patients with poor compliance to treatment presented worse quality of life and increased neuropsychiatric symptoms (p < 0.05). Adherence can be relatively challenging in patients with MG. Medical approach should recognize that therapeutic success in the treatment of MG goes through adherence to treatment.
Collapse
|
4
|
Santos García D, Suárez Castro E, Expósito I, de Deus T, Tuñas C, Aneiros A, López Fernández M, Núñez Arias D, Bermúdez Torres M. Comorbid conditions associated with Parkinson's disease: A longitudinal and comparative study with Alzheimer disease and control subjects. J Neurol Sci 2016; 373:210-215. [PMID: 28131190 DOI: 10.1016/j.jns.2016.12.046] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 12/17/2016] [Accepted: 12/22/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVE To study what comorbid conditions were present at baseline and 3years later in a cohort of Spanish Parkinson's disease (PD) patients, to compare comorbidity with both Alzheimer's disease (AD) and control groups and to analyze the role of comorbidity as predictor of mortality. METHODS One hundred and forty-seven non-demented PD patients (57.1% males; 70.9±8.6years old) were included in this 36months follow-up (2012-2015), monocenter, evaluation study. The International Classification of Diseases, Tenth Revision (ICD-10), Charlson Index (CI), Comorbidity-Polypharmacy Score (CPS) and Elixhauser Comorbidity Measure (ECM) were used to assess comorbidity at baseline and at 3years. Forty-four AD patients and 44 control subjects were included as comparator groups. RESULTS Total number of comorbidities (ICD-10) and polypharmacy at baseline were higher in PD and AD patients than controls (4.4±2.3 vs 5.2±2.4 vs 3.4±1.9 [p=0.001] and 81.6% vs 75% vs 56.8% [p=0.003], respectively). Diseases of the circulatory system (ICD-10/chapter-IX) and endocrine, nutritional and metabolic diseases (ICD-10/chapter-IV) were the most frequent in all groups. There was a significant increase in comorbidity (mean, +1.6±2.8) in all groups (p<0.0001) without differences between them. Seventeen patients died and 8 cases were did not follow-up. Comorbidity was a predictor of death in PD patients after adjust for other covariates (including age, sex, disease duration, disease stage, motor status and non-motor symptoms): ICD-10 (total number of comorbidities), hazard ratio 1.285 (95% confidence interval, 1.047-1.577; p=0.017); CI, hazard ratio 1.462 (95% confidence interval, 1.045-2.047; p=0.027). CONCLUSIONS Comorbidity is frequent in PD patients, increases significantly over time and predicts mortality.
Collapse
Affiliation(s)
- D Santos García
- Section of Neurology, Complejo Hospitalario Universitario de Ferrol (CHUF), Hospital A. Marcide, Ferrol, A Coruña, Spain.
| | - E Suárez Castro
- Section of Neurology, Complejo Hospitalario Universitario de Ferrol (CHUF), Hospital A. Marcide, Ferrol, A Coruña, Spain
| | - I Expósito
- Section of Neurology, Complejo Hospitalario Universitario de Ferrol (CHUF), Hospital A. Marcide, Ferrol, A Coruña, Spain
| | - T de Deus
- Section of Neurology, Complejo Hospitalario Universitario de Ferrol (CHUF), Hospital A. Marcide, Ferrol, A Coruña, Spain
| | - C Tuñas
- Section of Neurology, Complejo Hospitalario Universitario de Ferrol (CHUF), Hospital A. Marcide, Ferrol, A Coruña, Spain
| | - A Aneiros
- Section of Neurology, Complejo Hospitalario Universitario de Ferrol (CHUF), Hospital A. Marcide, Ferrol, A Coruña, Spain
| | - M López Fernández
- Section of Neurology, Complejo Hospitalario Universitario de Ferrol (CHUF), Hospital A. Marcide, Ferrol, A Coruña, Spain
| | - D Núñez Arias
- Department of Psychiatry, Complejo Hospitalario Universitario de Ferrol (CHUF), Hospital Naval, Ferrol, A Coruña, Spain
| | - M Bermúdez Torres
- Department of Family Medicine, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| |
Collapse
|
5
|
Castro ES, Santos-García D, de Deus Fonticoba T, Expósito Ruíz I, Tuñas Gesto C, Arribí MM. Causes and factors related to dopamine agonist withdrawal in Parkinson's disease. Brain Behav 2016; 6:e00453. [PMID: 27247848 PMCID: PMC4864043 DOI: 10.1002/brb3.453] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 01/09/2016] [Accepted: 02/03/2016] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Although dopamine agonists (DAs) are useful in Parkinson's disease (PD), they are not frequently used in elderly patients due to adverse effects. However, there is a lack of evidence because few elderly PD patients are enrolled in clinical trials. AIMS OF THE STUDY The aims of this study were to analyze the reasons of DA withdrawal (DAW) in a group of PD patients in clinical practice and to identify the related factors. Specifically, we studied the effect of age, comorbidity, and polypharmacy as potential risk factors for DAW. METHODS A retrospective chart review of the follow-up (from May, 2012 to March, 2015) of a subgroup of PD patients receiving a DA (n = 68; 60.3% males, 69.3 ± 9.2 years old) from a cohort (n = 150) previously studied in detail in 2012 was used to identify predictive factors of DAW. RESULTS The DAW percentage was 18.2% (12/66; follow-up of 690.2 ± 232.6 days). DAW causes were cognitive impairment (3), reduction therapy (3), hallucinations (2), dyskinesia (2), and excessive diurnal somnolence (2). Only a higher levodopa daily dose (HR 1.003; 95% CI 1.001-1.006; P = 0.044) was an independent predictor of DAW after adjustment for other explanatory variables. CONCLUSIONS The frequency of DAW was low. Advanced age alone is not a contraindication to the administration of DAs.
Collapse
Affiliation(s)
- Ester Suárez Castro
- Section of Neurology Complejo Hospitalario Universitario de Ferrol (CHUF) Hospital A. Marcide Ferrol Spain
| | - Diego Santos-García
- Section of Neurology Complejo Hospitalario Universitario de Ferrol (CHUF) Hospital A. Marcide Ferrol Spain
| | - Teresa de Deus Fonticoba
- Section of Neurology Complejo Hospitalario Universitario de Ferrol (CHUF) Hospital A. Marcide Ferrol Spain
| | - Irene Expósito Ruíz
- Section of Neurology Complejo Hospitalario Universitario de Ferrol (CHUF) Hospital A. Marcide Ferrol Spain
| | - Cintia Tuñas Gesto
- Section of Neurology Complejo Hospitalario Universitario de Ferrol (CHUF) Hospital A. Marcide Ferrol Spain
| | - Mercedes Macías Arribí
- Section of Neurology Complejo Hospitalario Universitario de Ferrol (CHUF) Hospital A. Marcide Ferrol Spain
| |
Collapse
|
6
|
Bazán-Rodríguez L, Cervantes-Arriaga A, Llorens-Arenas R, Calderón-Fajardo H, Rodríguez-Violante M. No Difference on Adherence Between Immediate-Release Versus Extended-Release Dopamine Agonists in Uninsured Subjects with Parkinson's Disease. Mov Disord Clin Pract 2015; 3:68-72. [PMID: 30363523 DOI: 10.1002/mdc3.12226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 06/29/2015] [Accepted: 06/29/2015] [Indexed: 11/05/2022] Open
Abstract
Background Pharmacological management of subjects with Parkinson's disease (PD) is complex. Regardless of drug selection, adherence is one of the main concerns. Nonadherence is associated with poor symptomatic control and low quality of life. In general, adherence to once-a-day formulations is thought to be better in comparison to 3-times-daily dosing. Methods A cross-sectional study was carried out. Consecutive uninsured subjects diagnosed with PD were treated either with an immediate- or extended-release dopamine agonist formulation. Clinical and demographic data were collected. Subjects were assessed using the International Parkinson and Movement Disorder Society UPDRS. Adherence was evaluated using the Morisky-Green test (MGT). Results A total of 314 (175 males and 139 females) subjects with PD were included. In regard to treatment, 188 (59.9%) were on an immediate-release dopamine agonist and 126 (40.1%) on an extended-release dopamine agonist. According to the MGT, 21 (6.7%) subjects were classified as nonadherent, 273 (86.9%) with a low adherence, and only 20 (6.4%) were considered with high adherence. Dopamine agonist levodopa equivalent daily dose was higher in the extended-release group (296.6 ± 112.4 vs. 231.3 ± 133.4; P = 0.011); also, these subjects had more years of formal education (12.3 ± 5.2 vs. 9.5 ± 5.2; P = 0.630). No difference in adherence levels was found (P = 0.802) between subjects treated with an immediate-release dopamine agonist and those receiving an extended-release formulation. Conclusions Overall adherence in subjects with PD is low. Use of an extended-release over an immediate-release dopamine agonist formulation in this study population is not associated with a better adherence.
Collapse
Affiliation(s)
- Lisette Bazán-Rodríguez
- Neurodegenerative Disease Clinical Research Unit National Institute of Neurology and Neurosurgery Mexico City Mexico
| | - Amin Cervantes-Arriaga
- Neurodegenerative Disease Clinical Research Unit National Institute of Neurology and Neurosurgery Mexico City Mexico
| | - Rodrigo Llorens-Arenas
- Neurodegenerative Disease Clinical Research Unit National Institute of Neurology and Neurosurgery Mexico City Mexico.,Movement Disorder Clinic National Institute of Neurology and Neurosurgery Mexico City Mexico
| | - Humberto Calderón-Fajardo
- Neurodegenerative Disease Clinical Research Unit National Institute of Neurology and Neurosurgery Mexico City Mexico.,Movement Disorder Clinic National Institute of Neurology and Neurosurgery Mexico City Mexico
| | - Mayela Rodríguez-Violante
- Neurodegenerative Disease Clinical Research Unit National Institute of Neurology and Neurosurgery Mexico City Mexico.,Movement Disorder Clinic National Institute of Neurology and Neurosurgery Mexico City Mexico
| |
Collapse
|
7
|
Van der Schyf CJ. Rational drug discovery design approaches for treating Parkinson’s disease. Expert Opin Drug Discov 2015; 10:713-41. [DOI: 10.1517/17460441.2015.1041495] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
8
|
Díaz C, García C, Iturriaga-Vásquez P, Aguirre MJ, Muena JP, Contreras R, Ormazábal-Toledo R, Isaacs M. Experimental and theoretical study on the oxidation mechanism of dopamine in n-octyl pyridinium based ionic liquids–carbon paste modified electrodes. Electrochim Acta 2013. [DOI: 10.1016/j.electacta.2013.08.103] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|