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Selvadurai D, Coleshill MJ, Day RO, Briggs NE, Schulz M, Reath J, Aung E. Patient factors and health outcomes associated with illness perceptions in people with gout. Rheumatology (Oxford) 2024; 63:1927-1937. [PMID: 37769230 DOI: 10.1093/rheumatology/kead501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/10/2023] [Accepted: 09/01/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVE Illness perceptions are views and beliefs formed in response to a health threat, and they may influence self-management behaviours and chronic disease outcomes. Despite effective medication, sub-optimal outcomes in gout are common. This study aimed to quantitatively investigate illness perceptions in gout to examine how illness perceptions relate to health outcomes. METHODS Data were obtained from a randomized controlled trial in which people with gout (n = 493) completed surveys measuring illness perceptions [Brief Illness Perception Questionnaire (B-IPQ)], gout flares, medication adherence, health-related quality of life, health-care utilization, and productivity, alongside serum urate blood tests at baseline, and at 6- and 12-month follow-ups. Multivariable linear regression identified patient factors independently associated with each B-IPQ item score. Logistic and linear regression, adjusted for age and sex, determined whether baseline B-IPQ items could predict current and future health outcomes. RESULTS Younger individuals and those with severe gout were more likely to experience pessimistic illness perceptions at baseline. Optimistic illness perceptions were associated with lower odds of having had at least one flare in the preceding 6 months. Every 1-point increase in B-IPQ treatment control, indicating an increasingly optimistic view that gout is treatable, decreased the odds of a recent flare prior to baseline by 33% [odds ratio (OR): 0.67; 95% CI: 0.53, 0.85; P < 0.001] and prior to the 12-month follow-up by 15% (OR: 0.85; 95% CI: 0.76,0.96; P = 0.01). Pessimistic illness perceptions also predicted poorer medication adherence, health-related quality of life, and productivity, but not serum urate levels. CONCLUSION Modifying pessimistic illness perceptions, including, but not limited to, patient education, may promote prudent self-management behaviours and better outcomes in gout. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry; https://www.anzctr.org.au/, ACTRN12616000455460.
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Affiliation(s)
- Daniel Selvadurai
- St Vincent's Healthcare Clinical Campus, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia
- Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia
| | - Matthew J Coleshill
- Black Dog Institute, Sydney, Australia
- UNSW Medicine & Health, UNSW Sydney, Sydney, Australia
| | - Richard O Day
- St Vincent's Healthcare Clinical Campus, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia
- Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia
| | - Nancy E Briggs
- Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Sydney, Australia
| | - Marcel Schulz
- St Vincent's Healthcare Clinical Campus, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia
- Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia
| | - Jennifer Reath
- Department of General Practice, Western Sydney University, Sydney, Australia
| | - Eindra Aung
- St Vincent's Healthcare Clinical Campus, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia
- Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia
- Kolling Institute of Medical Research, Pain Management Research Institute, University of Sydney, Sydney, Australia
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Zewdie S, Bayked EM, Ayenew W, Seyfu A, Andargie A. Prevalence and predictors of medication adherence among adolescents and adults with asthma in Ethiopia: a systematic review and meta-analysis. J Asthma 2024:1-14. [PMID: 38512046 DOI: 10.1080/02770903.2024.2332920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/15/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVE This review aimed to estimate the pooled prevalence and predictors of medication adherence among adolescents and adults with asthma in Ethiopia. DATA SOURCES Primary studies were searched from PubMed, Scopus, HINARI, and Google Scholar from January 1, 2010 to December 10, 2023. In addition, we have used citation tracking. STUDY SELECTIONS Observational studies (cross sectional, case control, and cohort) conducted among asthmatic patients ≥15 years old in Ethiopia, published in English language were included. After screening, the studies were assessed using Joanna Briggs Institute (JBI) critical appraisal tool and data were extracted using a checklist. Heterogeneity was assessed using forest plot, Q-statistics and I2. RESULTS The review was performed among 13 institution-based studies with a total of 2901 participants with asthma. About 1058 participants had comorbid disease and 354 were cigarette smokers. The pooled prevalence of adherence to medications among patients with asthma was 40.50% (95% CI: 28.05, 52.96; p value < 0.001) with high heterogeneity (I2 = 98.25%, p < 0.001). Getting health education about asthma and having comorbid disease were predictors of medication adherence among adolescents and adults with asthma in Ethiopia. CONCLUSIONS The pooled prevalence of medication adherence among adolescents and adults with asthma in Ethiopia is low and indicated that three out of five adolescents and adults with asthma were non-adherent to medications. This implies the Ministry of Health should develop different strategies to improve medication adherence including patient education and strengthening the health care system. Multicenter longitudinal studies should be further conducted by using objective methods of adherence measurement and large sample size.
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Affiliation(s)
- Segenet Zewdie
- Department of Pharmacy, Injibara University, Injibara, Ethiopia
| | | | - Wondim Ayenew
- Department of Pharmaceutics, University of Gondar, Gondar, Ethiopia
| | - Abyou Seyfu
- Department of Pharmacy, Debre Birhan University, Debre Birhan, Ethiopia
| | - Assefa Andargie
- Department of Public Health, Injibara University, Injibara, Ethiopia
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Cai Q, Jin M, Li X, Zhang J, Xu Q, Ye L, Lyu Q. Effect of illness perceptions on asthma control and quality of life amongst adult outpatients with asthma in China. BMC Psychol 2023; 11:68. [PMID: 36907916 PMCID: PMC10009986 DOI: 10.1186/s40359-023-01097-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 02/24/2023] [Indexed: 03/13/2023] Open
Abstract
OBJECTIVE To investigated the influence of illness perceptions and other risk factors related to poor asthma control and quality of life in adult outpatients with asthma in China. METHODS Patients with a confirmed asthma diagnosis were recruited from the outpatient clinic at Zhongshan Hospital, Fudan University in Shanghai. Sociodemographic, psychological, and asthma related variables were assessed in all participants. Patients' illness perceptions, medication adherence, asthma control, and quality of life were assessed using validated questionnaires, such as the Brief Illness Perception Questionnaire, Medication Adherence Rating Scale (MARS-A), the Asthma Control Test, and the Mini Asthma Quality of Life Questionnaire. Multiple linear regressions and logistic regressions were used to examine the associations between illness perceptions, medication adherence behaviors, and disease outcome (i.e., asthma control and quality of life). RESULTS A total of two hundred thirty-one (231) outpatients with asthma were included in this cross-sectional study, 80 of whom (34.6%) had asthma that was uncontrolled. Patients who perceived their life (β = - 0.197, p < 0.001) and emotions (β = - 0.294, p < 0.001) as severely affected by the illness were more likely to have a lower quality of life, findings that were statistically significant. Also, patients who believed they had a higher degree of personal control over their illness (β = 0.333, p < 0.001), and had better medication adherence (β = 0.250, p < 0.001) were found to have a better quality of life. CONCLUSION Our study indicated that illness perceptions and medication adherence have a significant impact on disease outcome. Both of these factors should be considered when determining the best health care practices or constructing a predictive intervention model for patients with uncontrolled asthma.
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Affiliation(s)
- Qingqing Cai
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
| | - Meiling Jin
- Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.,Department of Allergy, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
| | - Xiaoyu Li
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
| | - Jieqing Zhang
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
| | - Qing Xu
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
| | - Ling Ye
- Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China. .,Department of Allergy, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
| | - Qianzhou Lyu
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
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Busse WW, Abbott CB, Germain G, Laliberté F, MacKnight SD, Jung Y, Duh MS, Averell CM. Adherence and Persistence to Single-Inhaler Versus Multiple-Inhaler Triple Therapy for Asthma Management. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2904-2913.e6. [PMID: 35752431 DOI: 10.1016/j.jaip.2022.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 05/23/2022] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Treatment guidelines recommend triple therapy for patients with asthma who remain uncontrolled on inhaled corticosteroid/long-acting β2-agonist therapy. Previously, triple therapy was only available via multiple inhalers. Single-inhaler fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) is approved as maintenance treatment for asthma; however, real-world information on adherence and persistence is limited. OBJECTIVE To compare adherence and persistence among adult patients with asthma receiving single-inhaler FF/UMEC/VI versus multiple-inhaler triple therapy (MITT) in the United States. METHODS This retrospective cohort study used IQVIA PharMetrics Plus data to evaluate patients with asthma who initiated once-daily FF/UMEC/VI 100/62.5/25 mcg or MITT between September 18, 2017, and September 30, 2019. Inverse probability weighting and multivariable regression adjusted for differences in characteristics between the FF/UMEC/VI and MITT cohorts. Adherence was assessed using proportion of days covered (PDC) and proportion of patients achieving PDC ≥0.8 and PDC ≥0.5. Non-persistence was identified as a >45-day gap between fills. RESULTS The study included 1396 FF/UMEC/VI and 5115 MITT initiators. Three months after initiation, FF/UMEC/VI users had significantly higher mean PDC versus MITT users (0.68 vs 0.59; P < .001) and 31% more likely to be adherent (PDC ≥0.8; 40.6% vs 31.3%; adjusted risk ratio [95% confidence interval (CI)]: 1.31 [1.13-1.54]; P < .001). Similar patterns were observed at 6 and 12 months post initiation. In addition, FF/UMEC/VI users were 49% more likely to persist at 12 months than MITT users (25.9% vs 15.1%, adjusted hazard ratio [95% CI]: 1.49 [1.39-1.60]; P < .001). CONCLUSIONS Patients with asthma initiating triple therapy with FF/UMEC/VI had significantly better adherence and persistence compared with MITT initiators.
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Affiliation(s)
- William W Busse
- University of Wisconsin School of Medicine and Public Health, Madison, Wisc
| | - Carl B Abbott
- US Medical Affairs, GlaxoSmithKline, Research Triangle Park, NC
| | | | | | | | - Young Jung
- Groupe d'analyse, Ltée, Montréal, QC, Canada
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Tu H, Gong G, Zhang S, Fu Y, Wang T, Chu Q, Hu S, Wang K, Zhu C, Fan Y. The association between illness perception and quality of life among Chinese adults with epilepsy: The mediating role of coping style. Epilepsy Behav 2022; 130:108677. [PMID: 35398723 DOI: 10.1016/j.yebeh.2022.108677] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/13/2022] [Accepted: 03/19/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the associations between illness perception, quality of life (QOL), and coping style among patients with epilepsy (PWE), and to establish the behavior of coping style as a mediator of the interplay between illness perception and QOL. METHODS A cross-sectional study of 135 adult Chinese PWE was performed. All patients completed clinical and demographic questionnaires, the Chinese version of the Revised Illness Perception Questionnaire (CIPQ-R), the quality of life in epilepsy-31 inventory (QOLIE-31), and the Simplified Coping Style Questionnaire (SCSQ). Collected data were assessed through correlation analyses, structural equation modeling (SEM), and multiple stepwise linear regression assessments. RESULTS These patients exhibited a mean QOLIE-31 total score of 46.9 points, consistent with moderately low QOL. Under model III (F = 9.447, p < 0.01, R2 = 0.486), all included variables were found to explain 48.6% of the observed variation in QOL, with illness perception and coping style, respectively, explaining 27.3% and 7% of such variation. SEM findings illustrated that the total influence value of illness perception on QOL was 77.5% (β = -0.775, p < 0.001). Moreover, the illness perception was found to have a direct impact on QOL (β = -0.620, p = 0.001), negative coping (β = 0.309, p < 0.001), and positive coping (β = -0.265, p = 0.014), with negative coping (β = -0.256, p = 0.003), and positive coping (β = 0.288, p = 0.006) also having a direct impact on such QOL. Positive and negative coping styles also served as mediators of an indirect relationship between illness perception and QOL (β = -0.27*0.29 + 0.31* - 0.26 = -0.159, p = 0.001), with coping style thus serving as a significant mediator of the association between QOL and illness perception. The mediating impact of coping style on QOL accounted for 20.5% (-0.159/-0.775) of the total influence. CONCLUSION Both coping style and illness perception were detected to be significantly correlated with the QOL of Chinese adult PWE, with coping style serving as a mediator of the association between QOL and illness perception in this patient population. As such, when seeking to control seizures, medical workers should assess illness perceptions and coping styles among PWE as quickly as possible in order to select the optimal interventions most likely to improve the QOL of these patients.
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Affiliation(s)
- Houmian Tu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China; Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230032, PR China
| | - Guiping Gong
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230032, PR China
| | - Sichen Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China
| | - Yuansheng Fu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China
| | - Ting Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China
| | - Qinshu Chu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China
| | - Shaohua Hu
- Nursing Department, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230032, PR China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230032, PR China
| | - Chunyan Zhu
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, PR China.
| | - Yinguang Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China.
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Chen H, Xu X, Peng J, Ge X, Zhang J, Dong Q, Jiang X, Li P. Warfarin Adherence Among Patients with Atrial Fibrillation in Rural Area of Dongyang, China: A Questionnaire-Based Study. Patient Prefer Adherence 2022; 16:2345-2352. [PMID: 36046498 PMCID: PMC9423105 DOI: 10.2147/ppa.s374808] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/19/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Adherence to warfarin is associated with improved outcome in patients with atrial fibrillation (AF), but the adherence status of patients in rural areas of China is not known. METHODS A questionnaire-based study evaluating warfarin adherence of rural residents with AF was carried out in Dongyang, China. Potentially eligible patients were screened and contacted by telephone, and their demographic characteristics were collected. Illness perception was assessed using the Brief Illness Perception Questionnaire (BIPQ), and warfarin adherence was assessed using a Chinese-version adherence scale. Univariate and multivariate analyses were conducted to identify factors associated with unsatisfactory adherence. RESULTS A total of 201 patients (male, n=99; mean age, 70.3±8.12 years) were included, among whom 95 (47.3%) patients showed good adherence and 63 (31.3%) poor adherence. Number of co-dispensed drugs (multivariate analysis: odds ratio [OR]=3.64, 95% confidence interval [CI] 1.35-9.81, p=0.011) and BIPQ score (OR=1.25, 95% CI 1.17-1.33, p<0.001) were identified as factors associated with good adherence. CONCLUSION Medical adherence to warfarin needs to improve in rural patients with AF. Efforts that can reduce the number of co-dispensed drugs and increase illness perception may improve warfarin adherence. This study may benefit future management of warfarin administration to rural patients with AF.
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Affiliation(s)
- Huadong Chen
- Department of Pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, People’s Republic of China
- Correspondence: Huadong Chen, Department of Pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, 60th Wuning West Road, Dongyang, People’s Republic of China, Email
| | - Xing’e Xu
- Department of Pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, People’s Republic of China
| | - Jiren Peng
- Department of Vasculocardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, People’s Republic of China
| | - Xuan Ge
- Health Management Center, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, People’s Republic of China
| | - Jing’an Zhang
- Department of Pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, People’s Republic of China
| | - Qianqian Dong
- Department of Pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, People’s Republic of China
| | - Xiunan Jiang
- Department of Pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, People’s Republic of China
| | - Piaopiao Li
- Department of Pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, People’s Republic of China
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