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Hikasa S, Ishihara M, Tsukiji M, Kunimoto Y, Nobori K, Kimura T, Onishi K, Yamamoto Y, Haruta K, Kasiwabara Y, Fujii K, Kimura T. Factors associated with patient satisfaction with antiretroviral therapy in Japan: A cross-sectional, multicenter study. J Infect Chemother 2024; 30:746-751. [PMID: 38365064 DOI: 10.1016/j.jiac.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Current antiretroviral therapy (ART) regimens are highly effective; therefore, to differentiate between various regimens, considering patient-reported outcomes is essential. This study aimed to assess patient satisfaction with their current ART regimens and investigate factors associated with the Human Immunodeficiency Virus Treatment Satisfaction Questionnaire: Status (HIVTSQs) score. METHODS This cross-sectional, multicenter study was conducted in Japan between April and December 2021. Patient-reported satisfaction with ART was assessed using the Japanese version of the HIVTSQs. Binary logistic regression was used to identify factors associated with a low total HIVTSQs score. RESULTS A total of 679 patients completed the questionnaire. The median total HIVTSQs score was 58 (interquartile range: 52.5-64). In the multivariable logistic regression analyses, a total HIVTSQs score in the lowest quartile (indicating low satisfaction) was independently associated with twice- or thrice-daily regimens compared with single-tablet, once-daily regimens (adjusted odds ratio: 2.80, 95% confidence interval: 1.29-6.06, p = 0.009) and depression (adjusted odds ratio: 2.30, 95% confidence interval: 1.32-4.01, p = 0.003). CONCLUSIONS Satisfaction with the current ART regimen was high. Depression and twice- or thrice-daily ART regimen were associated with low HIVTSQ. Switching to a single-tablet, once-daily regimen may improve patient satisfaction in patients receiving twice- or thrice-daily regimens.
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Affiliation(s)
- Shinichi Hikasa
- Department of Pharmacy, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan.
| | - Masashi Ishihara
- Department of Pharmacy, Gifu University Hospital, Gifu, Gifu, Japan
| | - Mariko Tsukiji
- Division of Pharmacy, Chiba University Hospital, Chiba, Chiba, Japan
| | - Yusuke Kunimoto
- Department of Hospital Pharmacy, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Kazuko Nobori
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Takeshi Kimura
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
| | - Kenta Onishi
- Division of Pharmacy, Wakayama Medical University Hospital, Wakayama, Wakayama, Japan
| | - Yuuki Yamamoto
- Division of Pharmacy, Himeji Medical Center, Himeji, Hyogo, Japan
| | - Kyohei Haruta
- Department of Pharmacy, Nara Medical University Hospital, Kashihara, Nara, Japan
| | - Yohei Kasiwabara
- Division of Pharmacy, Japanese Red Cross Kyoto Daiichi Hospital, Higashiyama, Kyoto, Japan
| | - Kenji Fujii
- Department of Pharmaceutical Services, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
| | - Takeshi Kimura
- Department of Pharmacy, Hyogo Medical University Hospital, Nishinomiya, Hyogo, Japan
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Medication Adherence of People Living with HIV in Japan-A Cross-Sectional Study. Healthcare (Basel) 2023; 11:healthcare11040451. [PMID: 36832986 PMCID: PMC9957380 DOI: 10.3390/healthcare11040451] [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: 12/23/2022] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
Long-term medical care for people living with HIV (PLHIV) is critical for treatment efficacy, and various studies have examined reasons for antiretroviral therapy (ART) non-adherence. In Japan, doctors assume patients maintain high adherence. However, little is known about real-world treatment adherence. We conducted an anonymous self-administered web-based survey asking about adherence for a total of 1030 Japanese PLHIV who were currently on ART. Adherence was determined using the eight-item Morisky Medication Adherence Scale (MMAS-8), for which scoring ranged from 0 to 8 and scores < 6 points were classified as low adherence. Data were analyzed based on patient-related factors; therapy-related factors; condition-related factors, such as a comorbidity with depression (utilizing the Patient Health Questionnaire 9, PHQ-9); and healthcare/system-related factors. Among 821 PLHIV who responded to the survey, 291 responders (35%) were identified as being in the low adherence group. A statistically significant relationship was found between the number of missed anti-HIV drug doses within the previous 2 weeks and long-term adherence, per the MMAS-8 score (p < 0.001). Risk factors for low adherence included age (younger than 21 years, p = 0.001), moderate to severe depression (p = 0.002, using the PHQ-9), and drug dependence (p = 0.043). Adherence was also influenced by a shared decision-making process, including treatment selection, doctor-patient relations, and treatment satisfaction. Adherence was mainly affected by treatment decision factors. Hence, support of care providers should be considered critical for improving adherence.
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Patient satisfaction with primary healthcare services: are there any links with patients' symptoms of anxiety and depression? BMC FAMILY PRACTICE 2018; 19:90. [PMID: 29921234 PMCID: PMC6009850 DOI: 10.1186/s12875-018-0780-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 05/25/2018] [Indexed: 11/25/2022]
Abstract
Background The aim of our study was to determine the association of anxiety and depression symptoms, as well as the main socio-demographic factors, with patients’ satisfaction with primary healthcare services. Methods The respondents were asked to fill out an anonymous questionnaire that included information on the patients’ gender, age, place of residence, education, ethnicity, the type of clinic they visited and the presence of chronic diseases. Patient satisfaction was evaluated by using a short version of the Patient Satisfaction Questionnaire. We also used the Hospital Anxiety and Depression Scale. Results Poor evaluations of primary healthcare services were more characteristic of males, older patients, those living in district centres and villages, individuals with lower (secondary or lower) education levels, respondents of Russian ethnicity (compared to Lithuanian), patients with chronic diseases and higher anxiety and depression symptom scores. In the final regression analysis, better satisfaction with primary healthcare services was observed in respondents who were less depressed, of Polish ethnicity and who were living in a city rather than a village. Conclusions Being more depressed or anxious, living in the district centre or countryside related to patients’ worse satisfaction with primary healthcare services. The results of nationality of patients and their satisfaction are ambiguous. The is strong correlation between the symptoms of depression and anxiety.
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Testing of a Model with Latino Patients That Explains the Links Among Patient-Perceived Provider Cultural Sensitivity, Language Preference, and Patient Treatment Adherence. J Racial Ethn Health Disparities 2015; 3:63-73. [PMID: 26896106 PMCID: PMC4760999 DOI: 10.1007/s40615-015-0114-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 03/23/2015] [Accepted: 04/16/2015] [Indexed: 11/17/2022]
Abstract
Introduction Disparities in treatment adherence based on race and ethnicity are well documented but poorly understood. Specifically, the causes of treatment nonadherence among Latino patients living in the USA are complex and include cultural and language barriers. Purpose The purpose of this study was to examine whether patients’ perceptions in patient-provider interactions (i.e., trust in provider, patient satisfaction, and patient sense of interpersonal control in patient-provider interactions) mediate any found association between patient-perceived provider cultural sensitivity (PCS) and treatment adherence among English-preferred Latino (EPL) and Spanish-preferred Latino (SPL) patients. Methods Data from 194 EPL patients and 361 SPL patients were obtained using questionnaires. A series of language-specific structural equation models were conducted to test the relationship between patient-perceived PCS and patient treatment adherence and the examined mediators of this relationship among the Latino patients. Results No significant direct effects of patient-perceived PCS on general treatment adherence were found. However, as hypothesized, several significant indirect effects emerged. Preferred language appeared to have moderating effects on the relationships between patient-perceived PCS and general treatment adherence. Conclusion These results suggest that interventions to promote treatment adherence among Latino patients should likely include provider training to foster patient-defined PCS, trust in provider, and patient satisfaction with care. Furthermore, this training needs to be customized to be suitable for providing care to Latino patients who prefer speaking Spanish and Latino patients who prefer speaking English.
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Lee WL, Abdullah KL, Bulgiba AM, Zainal Abidin I. Prevalence and predictors of patient adherence to health recommendations after acute coronary syndrome: data for targeted interventions? Eur J Cardiovasc Nurs 2013; 12:512-20. [DOI: 10.1177/1474515112470056] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Wan Ling Lee
- Department of Nursing Science, University of Malaya, Malaysia
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Boyer BA, Matour SJ, Crittenden KB, Larson KA, Cox JM, Link DD. Appraisals of Fear, Helplessness, and Perceived Life-Threat During Emergent Cardiac Surgery: Relationship to Pre-surgical Depression, Trauma History, and Posttraumatic Stress. J Clin Psychol Med Settings 2012. [DOI: 10.1007/s10880-012-9330-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Bekwelem W, VanWormer JJ, Boucher JL, Pereira RF. Cardiovascular risk factor screening satisfaction in the Heart of New Ulm Project. Clin Med Res 2012; 10:1-6. [PMID: 21817118 PMCID: PMC3280458 DOI: 10.3121/cmr.2011.1011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Community-based cardiovascular disease (CVD) risk factor screening programs have been used successfully in rural health improvement initiatives. However, little is known about what consumers like or dislike about them, which is a barrier to the design of future process improvements. The objective of this study was to examine the degree to which health risks and participant characteristics predicted screening satisfaction. DESIGN This study utilized a cross-sectional survey design. SETTING Data was collected as part of the broader Heart of New Ulm Project, which is a community-based CVD prevention demonstration project based in rural Minnesota. PARTICIPANTS There were 126 randomly invited individuals from the CVD risk factor screenings, with 118 individuals who agreed to participate and had complete data available for analyses. METHODS A multivariate logistic regression analysis was used to examine the association between demographics, lifestyle, and biometric risk factors and screening satisfaction. RESULTS Twenty percent of respondents indicated some level of dissatisfaction with the screening process. Satisfied participants were more likely to be female (OR=4.15), not have an optimal lifestyle (OR=3.47), and have an intention to improve their lifestyle habits (OR=3.26). Age, education, and CVD risk level were not significant predictors in the final model. CONCLUSION Satisfaction was high in this screening program, with healthy males being least satisfied with their experience. This has implications for the design of future intervention efforts, as they may require specific programmatic features and more specialized, targeted marketing strategies to attract a broad spectrum of participants likely to benefit.
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Affiliation(s)
- Wobo Bekwelem
- Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Jeffrey J. VanWormer
- Epidemiology Research Center, Marshfield Clinic Research Foundation, Marshfield, WI
- Department of Education, Minneapolis Heart Institute Foundation, Minneapolis, MN
- Corresponding Author: Jeffrey J. VanWormer, PhD; Epidemiology Research Center; Marshfield Clinic Research Foundation; 1000 North Oak Avenue; Marshfield, WI 54449; Phone: 715-221-6484; Fax: 715-389-3880;
| | - Jackie L. Boucher
- Department of Education, Minneapolis Heart Institute Foundation, Minneapolis, MN
| | - Raquel F. Pereira
- Department of Education, Minneapolis Heart Institute Foundation, Minneapolis, MN
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Howland RH. Critical appraisal and update on the clinical utility of agomelatine, a melatonergic agonist, for the treatment of major depressive disease in adults. Neuropsychiatr Dis Treat 2009; 5:563-76. [PMID: 19966905 PMCID: PMC2785860 DOI: 10.2147/ndt.s5453] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Indexed: 01/01/2023] Open
Abstract
This article describes the pharmacology of the novel atypical antidepressant drug agomelatine, critically reviews and evaluates its clinical use for the treatment of major depression, and suggests areas for further research. Agomelatine is a synthetic analog of the hormone melatonin. It stimulates the activity of melatonin MT1 and MT2 receptors and inhibits the activity of serotonin 5HT-2C receptor subtypes. Three acute trials demonstrated clinically modest, but statistically significant benefits over placebo. Three acute trials did not find agomelatine more effective than placebo. A meta-analysis of these six trials demonstrated a small, statistically significant, marginally clinically relevant difference between agomelatine and placebo. The only placebo-controlled study in elderly patients did not demonstrate a significant benefit for agomelatine. It was more effective than placebo in only one of two relapse prevention studies. Agomelatine was generally well tolerated compared to placebo. Its side-effect profile is different than and compares favorably to other antidepressant drugs. The overall tolerability of agomelatine in head-to-head comparisons was not substantially better than active drug comparators. Agomelatine is contraindicated in patients with impaired liver function and in patients taking drugs that potently inhibit CYP-1A2 metabolic enzymes. Because elevated liver enzymes are common, and there is a rare risk of more serious liver reactions, routine laboratory monitoring of liver function is recommended periodically throughout treatment. Agomelatine does not have clinically significant advantages compared to other antidepressant drugs, and it has certain limitations and disadvantages. Because of its unique pharmacology and relatively benign tolerability profile, however, it may be a useful alternative for patients who do not respond to or cannot tolerate other antidepressant drugs.
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Affiliation(s)
- Robert H Howland
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh PA, USA.
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Baigi A, Bering C, Hildingh C, Almerud S. Non-Attendees' Attitudes to the Design of a Cardiac Rehabilitation Programme Focused on Information of Risk Factors and Professional Involvement. Eur J Cardiovasc Nurs 2009; 8:62-6. [DOI: 10.1016/j.ejcnurse.2008.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2007] [Revised: 04/02/2008] [Accepted: 04/04/2008] [Indexed: 10/22/2022]
Affiliation(s)
- Amir Baigi
- R&D Unit, Primary Health Care, POB 113, 311 22, Halland County Council, Falkenberg, Sweden
- Department of Primary Health Care, Göteborg University, Göteborg, Sweden
| | | | - Cathrine Hildingh
- Department of Primary Health Care, Göteborg University, Göteborg, Sweden
- School of Social and Health Sciences, Halmstad University, Halmstad, Sweden
| | - Sofia Almerud
- School of Health Sciences and Social Work, Växjö University, Växjö, Sweden
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Karlsson AK, Lidell E, Johansson M. Depressed Mood Over Time after Open Heart Surgery Impacts Patient Well-Being: A Combined Study. Eur J Cardiovasc Nurs 2008; 7:277-83. [DOI: 10.1016/j.ejcnurse.2007.12.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2007] [Revised: 12/13/2007] [Accepted: 12/19/2007] [Indexed: 11/26/2022]
Abstract
Background: Depression is a common cause of decreased well-being after open heart surgery (OHS) and a risk factor for new cardiac events. Little is known about the long-term prevalence of depressive symptoms after OHS or their effect on well-being. The aim of this study was to explore the presence of depressed mood in patients during the recovery phase after open heart surgery as well as depressed mood and well-being 3 years later. Method: Eighty consecutively included patients completed a questionnaire about depressed mood at 5 weeks, 5 months and 3 years after OHS. A telephone interview took place after receipt of the third questionnaire to explore their well-being. Quantitative and qualitative data were analysed separately and thereafter together. Result: Depressed mood occurred in 52% of the patients during recovery or 3 years after OHS. The qualitative content analysis produced the theme of transition, which was based on three categories. Conclusion: Depressed mood was reported by the majority of patients during recovery after OHS and had a long-term effect on their well-being. OHS constituted a transition for all patients, but those with depressed mood had difficulty finishing the transition process and reorientating life.
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Affiliation(s)
- Ann-Kristin Karlsson
- Department of Internal Medicine, Hospital Varberg, Sweden
- Department of Public Health and Community Medicine/Primary Health Care, Göteborg University, Gothenburg, Sweden
| | - Evy Lidell
- School of Social and Health Sciences, Halmstad University, Halmstad, Sweden
| | - Mats Johansson
- Department of Internal Medicine, Hospital Varberg, Sweden
- Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Abstract
Although most patients will derive some benefit from appropriately prescribed medication for various mental disorders, many patients do not always take medication reliably. Therefore, medication adherence is a practically important issue in pharmacotherapy practice. In this article, I discuss the importance of medication adherence, the factors associated with poor adherence, and some approaches for improving adherence.
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Affiliation(s)
- Robert H Howland
- University of Pittsburgh, School of Medicine, Western Psychiatric Institute and Clinic, Pennsylvania 15213, USA.
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