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Bužančić I, Balen M, Arbanas D, Falamić S, Fehir Šola K, Galić Skoko A, Momčilović M, Orbanić A, Tatarević A, Ortner Hadžiabdić M. Development and Validation of a Tool to Explore Attitudes Towards meDication adHErence Using a Novel Self-Reported QuestionnairE (ADHERE-7). PHARMACY 2024; 12:113. [PMID: 39051397 PMCID: PMC11270287 DOI: 10.3390/pharmacy12040113] [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: 06/02/2024] [Revised: 07/02/2024] [Accepted: 07/11/2024] [Indexed: 07/27/2024] Open
Abstract
Despite the availability of various tools for measuring medication adherence, efficiently identifying non-adherence levels and reasons at the point of care remains challenging. Existing tools often lack the ease of use needed for practical clinical application. This study aimed to develop and validate a user-friendly tool to provide healthcare professionals with a concise yet comprehensive means of identifying adherence behaviors. The methodology consisted of two phases: tool items were first developed using the nominal group technique with healthcare professionals, followed by a cross-sectional pilot study involving community-dwelling adults in Croatia. Validation analysis indicated acceptable face and content validity and satisfactory criterion validity, with Attitudes towards meDication adHErence self-Reported questionnairE (ADHERE-7) scores correlating with both the self-reported five-item Medication Adherence Report Scale (MARS-5 tool) (ρ = 0.765; p < 0.001) and an objective measure of the proportion of days covered (PDC) from pharmacy prescription claims data (G = 0.586; p = 0.015). Construct validity revealed three factors: Aversion, Comfort, and Practical Non-Adherence, with Cronbach's alpha values of 0.617 for Aversion and 0.714 for Comfort Non-Adherence. The mean total score for ADHERE-7 was 26.27 ± 2.41 (range 17 to 28). This robust validation process confirms the ADHERE-7 tool as a reliable instrument for assessing medication adherence, addressing aversion, comfort, practical issues, and both intentional and unintentional nonadherence.
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Affiliation(s)
- Iva Bužančić
- City Pharmacies Zagreb, 10 000 Zagreb, Croatia
- Faculty of Pharmacy and Biochemistry, University of Zagreb, 10 000 Zagreb, Croatia
| | - Mislav Balen
- Faculty of Pharmacy and Biochemistry, University of Zagreb, 10 000 Zagreb, Croatia
| | | | - Slaven Falamić
- Faculty of Medicine, Josip Juraj Strossmayer University, 31 000 Osijek, Croatia
| | - Katarina Fehir Šola
- Faculty of Medicine, Josip Juraj Strossmayer University, 31 000 Osijek, Croatia
- ZU Ljekarna Bjelovar, 43 000 Bjelovar, Croatia
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Vidal T, Reychler G, Sorlat-Maire C, Perceval M, Nove-Josserand R, Durieu I, Reynaud Q. [Adherence to chest physiotherapy in adults with cystic fibrosis]. Rev Mal Respir 2024:S0761-8425(24)00230-4. [PMID: 38926024 DOI: 10.1016/j.rmr.2024.06.004] [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: 09/16/2022] [Accepted: 05/24/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION Chest-physiotherapy is a key element in treatment of cystic fibrosis and patient adherence is a major issue in global cystic fibrosis care. This study aims to assess adherence to chest physiotherapy in adults with cystic fibrosis who not treated with tritherapy and to analyze the impact of certain factors on adherence. METHODS Thus is a cross-sectional study, conducted using a questionnaire and a physiotherapy evaluation. Adherence to this treatment was measured in terms of quantitative and qualitative aspects. The impact on adherence of 15 factors was then assessed. RESULTS Only 47% of patients could be considered as adherent, with a significant disparity between a quantitative and qualitative assessment. Gender, working time, pathology severity, the fact of being regularly followed by a physiotherapist, the perceived benefit of the sessions and their replacement by physical activity, seem associated with adherence to this treatment. CONCLUSIONS Taking into account the qualitative aspect of the sessions, our study reveals a low rate, in our cohort, of adherence to respiratory physiotherapy, and highlights six factors likely to predominate. Regular follow-up by a physiotherapist seems to be a determining factor in adherence to this treatment.
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Affiliation(s)
- T Vidal
- Centre Hospitalier Lyon Sud, CRCM adulte de Lyon, Pierre-Bénite, France.
| | - G Reychler
- Institute of experimental and clinical research, université catholique de Louvain, Louvain-la-Neuve, Belgique
| | - C Sorlat-Maire
- Centre Hospitalier Lyon Sud, CRCM adulte de Lyon, Pierre-Bénite, France
| | - M Perceval
- Centre Hospitalier Lyon Sud, CRCM adulte de Lyon, Pierre-Bénite, France
| | - R Nove-Josserand
- Centre Hospitalier Lyon Sud, CRCM adulte de Lyon, Pierre-Bénite, France
| | - I Durieu
- Centre Hospitalier Lyon Sud, CRCM adulte de Lyon, Pierre-Bénite, France; Research on Healthcare Performance (RESHAPE), Inserm U1290, Lyon, France
| | - Q Reynaud
- Centre Hospitalier Lyon Sud, CRCM adulte de Lyon, Pierre-Bénite, France; Research on Healthcare Performance (RESHAPE), Inserm U1290, Lyon, France
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Hersh CM, Pang M, Miller DM, McGinley MP, Hyland M, Ziemssen T, Avila RL. Comparison of time to clinically meaningful improvement in quality of life in neurological disorders in patients treated with natalizumab versus ocrelizumab. Neurodegener Dis Manag 2024; 14:21-33. [PMID: 38623894 DOI: 10.2217/nmt-2023-0047] [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: 12/28/2023] [Accepted: 03/13/2024] [Indexed: 04/17/2024] Open
Abstract
Aim: To assess time to improvement in Quality of Life in Neurological Disorders (Neuro-QoL) domains for patients treated with natalizumab versus ocrelizumab. Methods: Patients enrolled in the MS PATHS network who initiated treatment with either natalizumab or ocrelizumab rated the Neuro-QoL domains of physical function, symptoms, emotional health, cognitive function and social ability. Results: Time to clinically meaningful improvement was significantly shorter with natalizumab versus ocrelizumab for cognitive function (event time ratio [95% CI]: 0.37 [0.24-0.57]; p < 0.001), sleep disturbance (0.45 [0.28-0.72]; p = 0.001), social role participation (0.37 [0.21-0.66]; p = 0.001) and social role satisfaction (0.5 [0.31-0.8]; p = 0.004). Conclusion: Natalizumab had shorter time to clinically meaningful improvement in cognitive, sleep, and social role Neuro-QoL domains versus ocrelizumab.
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Affiliation(s)
- Carrie M Hersh
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV 89106, USA
| | | | | | | | - Megan Hyland
- Department of Neurology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Tjalf Ziemssen
- University Clinic Carl-Gustav Carus, Dresden, 01307, Germany
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Gow K, Rashidi A, Whithead L. Factors Influencing Medication Adherence Among Adults Living with Diabetes and Comorbidities: a Qualitative Systematic Review. Curr Diab Rep 2024; 24:19-25. [PMID: 38112977 PMCID: PMC10798913 DOI: 10.1007/s11892-023-01532-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE OF REVIEW Medication adherence plays an important role in improving health outcomes related to diabetes and comorbidity. The potential factors influencing medication adherence and how they contribute to health behaviors have not been synthesized to date. This review synthesized qualitative studies that identified factors influencing medication adherence among adults living with diabetes and comorbidity. RECENT FINDINGS Twenty-eight findings were extracted and synthesized into four themes: perceived support, lack of knowledge, medication issues, and the importance of routine. The findings highlight the factors that support medication adherence and areas that can be targeted to support and promote medication adherence. The findings also support the potential role of healthcare providers in supporting people living with diabetes and comorbidity to adhere to and maintain medication regimes. Several factors were identified that are amenable to intervention within the clinical practice setting and have the potential to enhance medication adherence and improve health outcomes for people living with diabetes and comorbidities. The development of acceptable and effective interventions could have a positive effect on medication adherence and health outcomes.
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Affiliation(s)
- Kendall Gow
- Hollywood Private Hospital, 115 Monash Ave, Nedlands, WA, 6009, Australia
| | - Amineh Rashidi
- School of Nursing and Midwifery, Edith Cowan University Joondalup Campus, Joondalup, WA, 6027, Australia.
| | - Lisa Whithead
- School of Nursing and Midwifery, Edith Cowan University Joondalup Campus, Joondalup, WA, 6027, Australia
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Micale C, Golder S, O'Connor K, Weissenbacher D, Gross R, Hennessy S, Gonzalez-Hernandez G. Patient-Reported Reasons for Antihypertensive Medication Change: A Quantitative Study Using Social Media. Drug Saf 2024; 47:81-91. [PMID: 37995049 DOI: 10.1007/s40264-023-01366-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2023] [Indexed: 11/24/2023]
Abstract
INTRODUCTION Hypertension is the leading cause of heart disease in the world, and discontinuation or nonadherence of antihypertensive medication constitutes a significant global health concern. Patients with hypertension have high rates of medication nonadherence. Studies of reasons for nonadherence using traditional surveys are limited, can be expensive, and suffer from response, white-coat, and recall biases. Mining relevant posts by patients on social media is inexpensive and less impacted by the pressures and biases of formal surveys, which may provide direct insights into factors that lead to non-compliance with antihypertensive medication. METHODS This study examined medication ratings posted to WebMD, an online health forum that allows patients to post medication reviews. We used a previously developed natural language processing classifier to extract indications and reasons for changes in angiotensin receptor II blocker (ARB) and angiotensin-converting enzyme inhibitor (ACEI) treatments. After extraction, ratings were manually annotated and compared with data from the US Food and Drug administration (FDA) Adverse Events Reporting System (FAERS) public database. RESULTS From a collection of 343,459 WebMD reviews, we automatically extracted 1867 posts mentioning changes in ACEIs or ARBs, and manually reviewed the 300 most recent posts regarding ACEI treatments and the 300 most recent posts regarding ARB treatments. After excluding posts that only mentioned a dose change or were a false-positive mention, 142 posts in the ARBs dataset and 187 posts in the ACEIs dataset remained. The majority of posts (97% ARBs, 91% ACEIs) indicated experiencing an adverse event as the reason for medication change. The most common adverse events reported mapped to the Medical Dictionary for Regulatory Activities were "musculoskeletal and connective tissue disorders" like muscle and joint pain for ARBs, and "respiratory, thoracic, and mediastinal disorders" like cough and shortness of breath for ACEIs. These categories also had the largest differences in percentage points, appearing more frequently on WebMD data than FDA data (p < 0.001). CONCLUSION Musculoskeletal and respiratory symptoms were the most commonly reported adverse effects in social media postings associated with drug discontinuation. Managing such symptoms is a potential target of interventions seeking to improve medication persistence.
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Affiliation(s)
- Cristina Micale
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Su Golder
- Department of Health Sciences, University of York, York, UK
| | - Karen O'Connor
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Davy Weissenbacher
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | - Robert Gross
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sean Hennessy
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Cofini V, Muselli M, Petrucci E, Lolli C, Pelaccia E, Guido M, Marinangeli F, Fabiani L, Necozione S. Factors associated with chronic pelvic pain in women with endometriosis: A national study on clinical and sociodemographic characteristics, lifestyles, quality of life, and perceptions of quality of care, during the COVID-19 pandemic. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241227361. [PMID: 38449294 PMCID: PMC10919124 DOI: 10.1177/17455057241227361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/15/2023] [Accepted: 01/04/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Endometriosis is a persistent inflammatory condition that affects women of reproductive age and causes pelvic pain. Chronic pelvic pain is a chronic regional pain syndrome involving the pelvic area. OBJECTIVES This survey aimed to characterize the clinical and sociodemographic characteristics, lifestyles, quality of life, and perceptions of quality of care in women with endometriosis who reported chronic pelvic pain during the Covid pandemic. DESIGN We conducted a cross-sectional survey among the Italian population from July to September 2021. METHODS Snowball sampling was used to interview a large sample of adult women who reported a diagnosis of endometriosis, through a self-reported questionnaire. Univariate and multivariable logistic regression analyses were performed to identify the factors associated with chronic pelvic pain. The primary outcome was describing women who reported chronic pelvic pain. RESULTS A total of 661 out of 1045 (63%) women who responded to the survey reported chronic pelvic pain. The multivariable analysis evidenced that chronic pelvic pain was related to physical and mental quality perception, pelvic floor disorders (adjusted odds ratio = 1.58; 95% CI = 1.10-2.27; p = 0.012), dyspareunia (adjusted odds ratio = 1.87; 95% CI = 1.31-2.65; p < 0.001), adhesions syndrome (adjusted odds ratio = 1.49; 95% CI = 1.05-2.11; p = 0.026), and the delay in diagnosing endometriosis (adjusted odds ratio = 1.04; 95% CI = 1.00-1.09; p = 0.034). The only social factor associated with chronic pelvic pain was marital status (adjusted odds ratio = 0.66; 95% CI = 0.46-0.93; p = 0.019). CONCLUSION In the pandemic period, there was a very high prevalence of chronic pelvic pain in women with endometriosis in Italy. The pandemic highlighted the need for careful attention to diagnose endometriosis and the need for psychological and partner support, which would allow better pain management and prevent chronicity.
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Affiliation(s)
- Vincenza Cofini
- Public Health Section, Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | - Mario Muselli
- Public Health Section, Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | - Emiliano Petrucci
- Public Health Section, Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
- Department of Anaesthesia and Intensive Care Unit, San Salvatore Hospital, L’Aquila, Italy
| | - Chiara Lolli
- Public Health Section, Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | - Erika Pelaccia
- Public Health Section, Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
- Obstetrics & Gynaecology Unit, San Salvatore Hospital, L’Aquila, Italy
| | - Maurizio Guido
- Public Health Section, Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
- Obstetrics & Gynaecology Unit, San Salvatore Hospital, L’Aquila, Italy
| | - Franco Marinangeli
- Public Health Section, Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
- Department of Anaesthesia and Intensive Care Unit, San Salvatore Hospital, L’Aquila, Italy
| | - Leila Fabiani
- Public Health Section, Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | - Stefano Necozione
- Public Health Section, Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
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Brady RE, Salwen-Deremer JK, Tunnell NC, Winter MW. Understanding Medication Nonadherence in Crohn's Disease Patients: A Qualitative Evaluation. Inflamm Bowel Dis 2023:izad296. [PMID: 38134389 DOI: 10.1093/ibd/izad296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Immune-modifying medications are widely available and recognized as valuable by most gastroenterologists. However, approximately 40% of patients with Crohn's disease (CD) do not comply with regimens using these medications, resulting in complications, hospitalization, and surgeries. We sought to identify factors that motivate adherence or nonadherence with medication recommendations for CD. METHODS We conducted qualitative interviews with patients living with CD who were identified as adherent or nonadherent to immune-modifying medication recommendations by their treating gastroenterologist. Semistructured interview guides were developed based on an established framework for understanding health behaviors. We conducted content analysis of the resulting qualitative data using an inductive-deductive approach to identify emergent themes that influence medication decision-making. RESULTS Twenty-five patients with CD completed interviews for this study. Interviews were independently coded and analyzed for thematic content. Two broad domains emerged comprising (1) themes reflected in the Theoretical Domains Framework and (2) novel themes specific to medication decision-making in CD. Adherent patients conveyed a sense of trust in science and healthcare provider expertise, while nonadherent patients were more likely to express beliefs in their ability to self-manage CD, concern about risks associated with medication, and a general ambivalence to treatment. CONCLUSIONS There are clear cognitive, behavioral, and relational factors that guide patients' medication-related decision-making. Several of the factors share features of other behavioral change and decision-making processes, while others are specific to the experience of patients with CD. A fuller understanding of these factors is essential to developing effective behavioral interventions to improve adherence to evidence-based treatment recommendations.
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Affiliation(s)
- Robert E Brady
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Jessica K Salwen-Deremer
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
- Department of Medicine, Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Natalie C Tunnell
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
- Department of Psychiatry and Behavioral Sciences, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Michael W Winter
- Department of Medicine, Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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Ben-Zacharia AB, Walker B, Ross AP, Tornatore C, Edwards NC, Lipman Y, Phillips AL. Factors Associated With Disease-Modifying Therapy Adherence and Persistence in Multiple Sclerosis: A Scoping Literature Review. Int J MS Care 2023; 25:188-195. [PMID: 37720259 PMCID: PMC10503813 DOI: 10.7224/1537-2073.2021-139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
BACKGROUND Patients with multiple sclerosis (MS) receiving disease-modifying therapies (DMT) show published adherence rates of 27.0% to 93.8% and published persistence rates of 49.7% to 96.5%. Improvements in DMT adherence and persistence are key to optimizing MS care, and enhanced understanding could improve MS disease management and identify research gaps. This scoping literature review aims to examine the nature and findings of the literature evaluating factors associated with DMT adherence and persistence in patients with MS. METHODS Eligible articles included in the literature review were quantitative clinical studies written in English, included adherence or persistence as primary outcomes, and accounted for covariates/confounders. The articles were assessed to identify factors associated with adherence/persistence and analyzed according to DMT type (self-injectable, oral, infusion). RESULTS Fifty-eight studies (103,450 patients) were included. Study distribution by DMT type was self-injectable only (n = 41), oral only (n = 2), infusion only (n = 1), and more than 1 type (n = 14). Older age and previous DMT use were associated with increased adherence and/or persistence. Increased alcohol consumption, DMT adverse events, higher education, and higher body mass index were negatively associated with adherence and/or persistence. Greater number and severity of relapses was associated with increased adherence but decreased persistence. CONCLUSIONS Most studies examined factors associated with adherence and persistence to self-injectable DMTs. These factors should be evaluated further for oral and infusion DMTs. Insights into the modifiable factors associated with adherence and persistence could guide treatment decisions and help improve adherence and clinical outcomes.
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Affiliation(s)
- Aliza Bitton Ben-Zacharia
- From Bellevue School of Nursing, Hunter College, New York, NY, USA (AB-Z)
- Mount Sinai Medical Center, New York, NY, USA (AB-Z)
| | - Bryan Walker
- Duke University School of Medicine, Durham, NC, USA (BW)
| | | | - Carlo Tornatore
- Medstar Georgetown University Hospital, Washington, DC, USA (CT)
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Brimavandi M, Abbasi P, Khaledi‐Paveh B, Salari N. Examining the relationship between depression and medication adherence among elderlies suffering from cardiovascular disease referring to the clinics affiliated with Kermanshah University of Medical Sciences: A cross-sectional study. Health Sci Rep 2023; 6:e1503. [PMID: 37599664 PMCID: PMC10435705 DOI: 10.1002/hsr2.1503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/22/2023] Open
Abstract
Background In recent years, around 30% of all mortalities worldwide has been related to cardiovascular disease (CVD). The most important predictor solution of cardiovascular events is enhancing medication adherence. Meanwhile, the main reason behind development of physical disorders among the elderly is depression. In this regard, the present research was performed to determine the relationship between depression and medication adherence among the elderly suffering from CVD. Methods A cross-sectional study was done via an analytical approach on 188 elderlies fulfilling the inclusion criteria. The participants were chosen through convenience nonrandomized sampling from March to July 2022. The data were collected through demographic and healthcare information form plus Madanloo chronic disease medication adherence and geriatric depression scale. The analysis of the data was done by SPSS 26 plus Stata 14.2. Results The mean depression score was 5.6(4.3) and the mean score of medication adherence in the elderlies was 168.03(23.85). The prevalence of depression was higher in women than in men (p = 0.015), and the elderlies differing from heart failure reported the minimum extent of medication adherence. The findings obtained from analysis of variance showed that age, level of education, and monthly level of income were among the effective demographic factors in the extent of depression and medication adherence (p < 0.05). Meanwhile, 26% of changes in medication adherence can be attributed to depression. Further, the results of the multiple linear regression model reported that depression, age, and polypharmacy are among the predictors of medication adherence. Discussion and Conclusion A weak to moderate relationship existed between depression and medication adherence among these elderlies. Given the growing elderly population, the importance of depression, and lack of medication adherence in incidence of CVD events, it is recommended to train the healthcare team to monitor the elderly regarding depression symptoms.
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Affiliation(s)
- Mina Brimavandi
- Department of Nursing, Student Research CommitteeKermanshah University of Medical SciencesKermanshahIran
| | - Parvin Abbasi
- Department of Nursing, School of Nursing and MidwiferyKermanshah University of Medical SciencesKermanshahIran
| | - Behnam Khaledi‐Paveh
- Department of Psychiatry Nursing, School of Nursing and MidwiferyKermanshah University of Medical SciencesKermanshahIran
| | - Nader Salari
- Department of Biostatics, School of Nursing and MidwiferyKermanshah University of Medical SciencesKermanshahIran
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Biset N, Lelubre M, Pochet S, De Vriese C. Asthma and COPD: Comparison with International Guidelines and Medication Adherence in Belgium. Pharmaceuticals (Basel) 2023; 16:1030. [PMID: 37513942 PMCID: PMC10386066 DOI: 10.3390/ph16071030] [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: 06/28/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Asthma and chronic obstructive pulmonary disease (COPD) are major chronic conditions. It is possible to limit their impact by controlling symptoms, which limits exacerbations and worsening of the disease, by choosing the appropriate treatment and ensuring that the patient adheres to it. The main purpose of this study was to assess medication adherence and persistence with inhaled medications for chronic treatment of asthma and COPD, as well as to evaluate the factors influencing this adherence. Medication adherence was measured from January 2013 to December 2016 using continuous multiple-interval measures of medication availability (CMA). Persistence was evaluated by treatment episodes (TE). We analyzed the influence of different factors on CMA such as sex, age, type of device, and the realization of the "new medicines service" (NMS), introduced in Belgium in October 2013 to support patients in adhering to their treatment. We also analyzed the consumption of these inhaled medications within the Belgian population and compared them with the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations. Medication adherence varied greatly between the different pharmacological classes: inhaled corticosteroids (ICS) alone or in combination with long-acting beta agonists (LABA) had the lowest medication adherence and persistence, while adherence was highest for the long-acting muscarinic antagonists (LAMA) and LABA/LAMA associations. The NMS seemed to have a positive impact on medication adherence, although few patients completed the two guidance interviews offered by the service. In addition, only a minority of the targeted patients took advantage of this new service.
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Affiliation(s)
- Natacha Biset
- Department of Pharmacotherapy and Pharmaceutics, Faculty of Pharmacy, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
| | - Mélanie Lelubre
- Department of Pharmacotherapy and Pharmaceutics, Faculty of Pharmacy, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
| | - Stéphanie Pochet
- Department of Pharmacotherapy and Pharmaceutics, Faculty of Pharmacy, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
| | - Carine De Vriese
- Department of Pharmacotherapy and Pharmaceutics, Faculty of Pharmacy, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
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Holt G, Zabinski JS, Lewis V. MD/MSW: A Call for a New Dual-Degree Program. HEALTH & SOCIAL WORK 2023:7194691. [PMID: 37308315 DOI: 10.1093/hsw/hlad018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 10/15/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Grayson Holt
- MSW and a master of bioethics and medical humanities student, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA
| | - Jeffrey S Zabinski
- MD, MSW, is assistant professor of psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Victoria Lewis
- MD, MSW, MPP, is a Solnit Integrated Child/Adult Psychiatry resident, Child Study Center, Yale School of Medicine, New Haven, CT, USA
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Rickles NM, Mulrooney M, Sobieraj D, Hernandez AV, Manzey LL, Gouveia-Pisano JA, Townsend KA, Luder H, Cappelleri JC, Possidente CJ. A systematic review of primary care-focused, self-reported medication adherence tools. J Am Pharm Assoc (2003) 2023; 63:477-490.e1. [PMID: 36372640 DOI: 10.1016/j.japh.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 08/23/2022] [Accepted: 09/14/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Clinician recognition of nonadherence is generally low. Tools that clinicians have used to assess medication adherence are self-reported adherence instruments that ask patients questions about their medication use experience. There is a need for more structured reviews that help clinicians comprehensively distinguish which tool might be most useful and valuable for their clinical setting and patient populations. OBJECTIVES This systematic review aimed to (1) identify validated, self-reported medication adherence tools that are applicable to the primary care setting and (2) summarize selected features of the tools as an assessment of clinical feasibility and applicability. METHODS The investigators systematically reviewed MEDLINE via Ovid, Embase via Ovid, International Pharmaceutical Abstracts, and CINAHL from inception to December 1, 2020. Investigators independently screened 3394 citations, identifying 43 articles describing validation parameters for 25 unique adherence tools. After screening each tool, 17 tools met the inclusion criteria and were qualitatively summarized. RESULTS Findings highlight 25 various tool characteristics (i.e., descriptions, parameters and diseases, measures and validity comparators, and other information), which clinicians might consider when selecting a self-reported adherence tool with strong measurement validity that is practical to administer to patients. There was much variability about the nature and extent of adherence measurement. Considerable variation was noted in the objective measures used to correlate to the self-reported tools' measurements. There were wide ranges of correlation between self-reported and objective measures. Several included tools had relatively low to moderate criterion validities. Many manuscripts did not describe whether tools were associated with costs, had copyrights, and were available in other languages; how much time was required for patients to complete self-report tools; and whether patient input informed tool development. CONCLUSION There is a critical need to ensure that adherence tool developers establish a key list of tool characteristics to report to help clinicians and researchers make practical comparisons among tools.
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Ralat SI, Rodríguez-Gómez J. The RAS-24: Development and validation of an adherence-to-medication scale for severe mental illness patients. J Clin Transl Sci 2023; 7:e94. [PMID: 37125053 PMCID: PMC10130847 DOI: 10.1017/cts.2023.527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/04/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction Several studies have found that most patients with severe mental illness (SMI) and comorbid (physical) conditions are partially or wholly nonadherent to their medication regimens. Nonadherence to treatment is a serious concern, affecting the successful management of patients with SMIs. Psychiatric disorders tend to worsen and persist in nonadherent patients, worsening their overall health. The study described herein aimed to develop and validate a scale (the Ralat Adherence Scale) to measure nonadherence behaviors in a culturally sensitive way. Materials and Methods Guided by a previous study that explored the primary reasons for nonadherence in Puerto Rican patients, we developed a pool of 147 items linked to the concept of adherence. Nine experts reviewed the meaning, content, clarity, and relevance of the individual items, and a content validity ratio was calculated for each one. Forty items remained in the scale's first version. This version was administered to 160 patients (21-60 years old). All the participants had a diagnosis of bipolar disorder, major depressive disorder, or schizoaffective disorder. The STROBE checklist was used as the reporting guideline. Results The scale had very good internal consistency (Cronbach's alpha = 0.812). After a factor analysis, the scale was reduced to 24 items; the new scale had a Cronbach's alpha of 0.900. Conclusions This adherence scale is a self-administered instrument with very good psychometric properties; it has yielded important information about nonadherence behaviors. The scale can help health professionals and researchers to assess patient adherence or nonadherence to a medication regimen.
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Affiliation(s)
- Sandra I. Ralat
- Department of Psychiatry, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
- Address for correspondence: Sandra I. Ralat, PhD, Department of Psychiatry, Medical Sciences Campus, University of Puerto Rico, PO Box 365067, San Juan, Puerto Rico.
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Al-Tarawneh F, Ali T, Al-Tarawneh A, Altwalbeh D, Gogazeh E, Bdair O, Algaralleh A. Study of Adherence Level and the Relationship Between Treatment Adherence, and Superstitious Thinking Related to Health Issues Among Chronic Disease Patients in Southern Jordan: Cross-Sectional Study. Patient Prefer Adherence 2023; 17:605-614. [PMID: 36923785 PMCID: PMC10010127 DOI: 10.2147/ppa.s390997] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/27/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND For disease management, numerous drugs are prescribed. However, long-term treatment adherence is still unsatisfactory. Culture influences beliefs regarding medication, particularly irrational ideas that affect treatment adherence. The Middle East, notably Jordan, is affected by a lack of awareness of these attitudes with regard to treatment adherence. OBJECTIVE Investigating the adherence level among patients with chronic diseases in southern Jordan. To determine whether certain demographic traits, different disease factors, and superstitions have any impact on treatment adherence. PATIENTS AND METHODS A cross-sectional study that assessed treatment adherence and superstitious thinking-related health issues were conducted among chronic disease patients who had reviewed intrinsic medicine clinics at the Karak governmental hospital. RESULTS For 314 participants, treatment adherence was categorized into three levels low-adherent patients made up 27.7% highly-adherent patients made up 49.4%, and the remaining adhered at a medium level. Treatment non-adherence was more common in the elderly and female, according to the chi-square analysis. Additionally, the classification of superstitious beliefs into three categories revealed that different percentages of the study population held low superstitious beliefs 21%, medium superstitions 54.1% and high superstitions 24.8% beliefs. The chi-square analysis revealed that the elderly, female, and low-educated patient groups were the highest in superstitious thinking. Multiple regression analysis revealed that educational level and superstitious thinking explained 0.223 of the treatment adherence variances. Treatment adherence is positively influenced by educational level β (0.244) value, but superstitious thinking is negatively influenced by β (-0.302) value. CONCLUSION In conclusion, about half of the participants highly adhered. The results of the multiple-regression analysis indicate that superstition and education were two variables that impacted treatment adherence in this study. While superstitious beliefs lead to lower treatment adherence, education has the opposite effect. Finally, it is recommended to promote patient education to reduce superstitious beliefs, improve medication adherence.
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Affiliation(s)
- Fatima Al-Tarawneh
- Department of Allied Medical Sciences, Karak University College, Al-Balqa Applied University, Karak, Jordan
| | - Tasneem Ali
- Department of Allied Medical Sciences, Karak University College, Al-Balqa Applied University, Karak, Jordan
| | - Ahmad Al-Tarawneh
- Psychology Department, Faculty of Educational Sciences, Mutah University, Mutah, Jordan
| | - Diala Altwalbeh
- Department of Allied Medical Sciences, Karak University College, Al-Balqa Applied University, Karak, Jordan
- Correspondence: Diala Altwalbeh, Email
| | - Esraa Gogazeh
- Department of Allied Medical Sciences, Irbid University College, Al-Balqa Applied University, Irbid, Jordan
| | - Ola Bdair
- Department of Allied Medical Sciences, Salt University College, Al-Balqa Applied University, Salt, Jordan
| | - Abdulnaser Algaralleh
- Department of Counseling and Special Education, Faculty of Educational Sciences, Mutah University, Mutah, Jordan
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Hnatešen D, Radoš I, Dimitrijević I, Budrovac D, Omrčen I, Pavić R, Gusar I, Čebohin M, Šolić K. Influence of the Cognitive and Emotional Status of Patients with Chronic Pain on Treatment Success (Reduction in Pain Intensity and Adherence to Pharmacotherapy): A Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15968. [PMID: 36498036 PMCID: PMC9735997 DOI: 10.3390/ijerph192315968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
This prospective study aimed to determine the cognitive and emotional status among patients with chronic pain and to examine the potential influence on the treatment success, measured by the reduction in pain intensity and adherence to pharmacotherapy. A total of seventy patients were followed for two months. The results of the comparison between patients who did and did not follow the physician’s instructions regarding adherence to pharmacotherapy showed a significant difference in cognitive status and a reduction in pain intensity. Patients who followed the physician’s instructions on taking analgesics had significantly higher scores on the Montreal Cognitive Assessment (MoCA) of cognitive status and a substantially higher reduction in pain intensity. Scores on the MoCA test provide statistically significant indications regarding patients’ decision to follow instructions regarding adherence to pharmacotherapy. Scores on the MoCA test, anxiety, age, and pain intensity (measured with a numeric rating scale—NRS) on admission were identified as potential predictors for the reduction in pain intensity. The linear regression model was statistically significant (χ2 = 40.0, p < 0.001), explained between 43.5% and 61.1% of variance regarding the reduction in pain intensity. The findings of this study show that cognitive status, measured with MoCA, and emotional status, measured with the Depression, Anxiety, and Stress Scale (DASS-21), significantly influence the reduction in pain intensity and adherence to pharmacotherapy. The results suggest that cognitive and emotional status may be potential predictors of treatment success. This finding points to the importance of a biopsychosocial approach in the treatment of chronic pain, where an important emphasis can be placed on the psychosocial determinants of pain.
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Affiliation(s)
- Dijana Hnatešen
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Ivan Radoš
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Iva Dimitrijević
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Dino Budrovac
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Ivan Omrčen
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Roman Pavić
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Hospital of Traumatology, University Hospital Centre “Sestre Milosrdnice”, 10000 Zagreb, Croatia
| | - Ivana Gusar
- Department of Health Studies, University of Zadar, 23000 Zadar, Croatia
| | - Maja Čebohin
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Medical School Osijek, 31000 Osijek, Croatia
| | - Krešimir Šolić
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Faculty of Electrical Engineering, Computer Science and Information Technology Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
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Chung TK, Jeon Y, Hong Y, Hong S, Moon JS, Lee H. Factors affecting the changes in antihypertensive medications in patients with hypertension. Front Cardiovasc Med 2022; 9:999548. [PMID: 36247446 PMCID: PMC9561640 DOI: 10.3389/fcvm.2022.999548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/15/2022] [Indexed: 11/25/2022] Open
Abstract
As frequent changes in anti-hypertensive (HTN) medications may reduce adherence to the treatments, identifying modifiable factors leading to changes in anti-HTN medications can help clinicians optimize treatment strategies for individual patients. We performed this study to explore the pattern of anti-HTN medications and to identify factors that are associated with the changes in anti-HTN medications. To this end, we used a clinical database of Seoul National University Hospital, extracted, transformed, and loaded by the observational medical outcomes partnership common data model. Demographic and all recorded clinical diagnoses, medications, and procedures data of eligible subjects were collected. Of 636 subjects who were eligible for this study, 297 subjects with a record of ≥1 anti-HTN medication changes and other 297 subjects without a record of medication change were selected for the study population. High diastolic blood pressure (adjusted odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.001–1.040, p = 0.040), arrhythmia (adjusted OR: 10.01, 95% CI: 1.86–185.57, p = 0.030), and angina pectoris with antianginal agents (adjusted OR: 4.85, CI: 1.05–23.89, p = 0.046) were associated with the changes in anti-HTN medications, indicating that any patients with these covariates require additional attention to reduce the likelihood of changing anti-HTN medications.
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Affiliation(s)
- Tae Kyu Chung
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
- Center for Convergence Approaches in Drug Development, Seoul, South Korea
| | - Yoomin Jeon
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
- Center for Convergence Approaches in Drug Development, Seoul, South Korea
| | - YeSol Hong
- Center for Convergence Approaches in Drug Development, Seoul, South Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
| | - Suyeon Hong
- Center for Convergence Approaches in Drug Development, Seoul, South Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
| | - Jun Sik Moon
- Center for Convergence Approaches in Drug Development, Seoul, South Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
| | - Howard Lee
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
- Center for Convergence Approaches in Drug Development, Seoul, South Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, South Korea
- Advanced Institutes of Convergence Technology, Suwon, South Korea
- *Correspondence: Howard Lee
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Medication Non-Adherence among Patients with Chronic Diseases in Makkah Region. Pharmaceutics 2022; 14:pharmaceutics14102010. [PMID: 36297444 PMCID: PMC9607277 DOI: 10.3390/pharmaceutics14102010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/18/2022] [Accepted: 09/19/2022] [Indexed: 12/02/2022] Open
Abstract
Background: The Makkah region is the most populated region in Saudi Arabia. Studying medication adherence levels may help to improve general health outcomes and decrease overall health care expenditures. Methods: We used the ARMS scale to assess medication adherence. Bivariable analysis of medication non-adherence was performed. Simple and multiple logistic regression models were built to identify factors associated with medication non-adherence. Results: Participants from the Makkah region were more than two times more likely to be non-adherent to their medications compared to other regions (adjusted OR = 2.58, 95% CI: 1.49–4.46). Patients who dispensed their prescriptions at their own expense were two times more likely to be non-adherents (adjusted OR = 2.36, 95% CI: 1.11–4.98). Patients who had a monthly income ≤6000 SR were almost two times more likely to be non-adherents (unadjusted OR = 1.73, 95% CI: 1.05–2.84). Conclusion: Medication adherence is one of the most important factors to help managing the disease. We found that Makkah chronic patients are more likely to be non-adherent with their medications compared to other regions’ patients. Moreover, we found that lower monthly incomes and paying for medications out-of-pocket were significant predictors of medication non-adherence.
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Simeone G, Bergamini M, Verga MC, Cuomo B, D’Antonio G, Iacono ID, Mauro DD, Mauro FD, Mauro GD, Leonardi L, Miniello VL, Palma F, Scotese I, Tezza G, Vania A, Caroli M. Do Vegetarian Diets Provide Adequate Nutrient Intake during Complementary Feeding? A Systematic Review. Nutrients 2022; 14:nu14173591. [PMID: 36079848 PMCID: PMC9459879 DOI: 10.3390/nu14173591] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/27/2022] [Accepted: 08/28/2022] [Indexed: 11/28/2022] Open
Abstract
During the complementary feeding period, any nutritional deficiencies may negatively impact infant growth and neurodevelopment. A healthy diet containing all essential nutrients is strongly recommended by the WHO during infancy. Because vegetarian diets are becoming increasingly popular in many industrialized countries, some parents ask the pediatrician for a vegetarian diet, partially or entirely free of animal-source foods, for their children from an early age. This systematic review aims to evaluate the evidence on how vegetarian complementary feeding impacts infant growth, neurodevelopment, risk of wasted and/or stunted growth, overweight and obesity. The SR was registered with PROSPERO 2021 (CRD 42021273592). A comprehensive search strategy was adopted to search and find all relevant studies. For ethical reasons, there are no interventional studies assessing the impact of non-supplemented vegetarian/vegan diets on the physical and neurocognitive development of children, but there are numerous studies that have analyzed the effects of dietary deficiencies on individual nutrients. Based on current evidence, vegetarian and vegan diets during the complementary feeding period have not been shown to be safe, and the current best evidence suggests that the risk of critical micronutrient deficiencies or insufficiencies and growth retardation is high: they may result in significantly different outcomes in neuropsychological development and growth when compared with a healthy omnivorous diet such as the Mediterranean Diet. There are also no data documenting the protective effect of vegetarian or vegan diets against communicable diseases in children aged 6 months to 2–3 years.
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Affiliation(s)
- Giovanni Simeone
- AUSL Brindisi 1, ASL Brindisi, 72023 Mesagne, BR, Italy
- Correspondence: ; Tel.: +39-339-387-9059
| | | | | | - Barbara Cuomo
- Department of Pediatrics, Belcolle Hospital, 01010 Viterbo, VT, Italy
| | | | | | - Dora Di Mauro
- Department of Primary Cares, AUSL Modena, 41012 Carpi, MO, Italy
| | | | | | - Lucia Leonardi
- Maternal Infantile and Urological Sciences Department, Sapienza University, 00161 Rome, RM, Italy
| | - Vito Leonardo Miniello
- Nutrition Unit, Department of Pediatrics, “Giovanni XXIII” Children Hospital, “Aldo Moro” University of Bari, 70126 Bari, BA, Italy
| | - Filomena Palma
- Health District 65, ASL Salerno, 84091 Battipaglia, SA, Italy
| | | | - Giovanna Tezza
- Department of Pediatrics, San Bortolo Hospital, 36100 Vicenza, VI, Italy
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Hawthorne J, Katsaros D, Rinaldi A, Brigham K, D'Auria M, Bajars E, Franzese C, Coyne M. The current paradigm for biologic initiation: A confirmatory quantitative analysis of self-injection training practices. Expert Opin Drug Deliv 2022; 19:733-742. [PMID: 35582857 DOI: 10.1080/17425247.2022.2078300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Self-injected biologic therapies have gained significant prevalence across numerous therapeutic areas. A lack of specific guidance on best practices may lead to inadequate biologic initiation and training. We previously conducted a small-sample, qualitative analysis designed to identify gaps in self-injection training. METHODS A total of 277 HCPs performing routine biologic initiation and 264 patients currently self-injecting biologics completed this quantitative study remotely using an online survey. The primary objective was to validate previous qualitative findings and firmly characterize the current paradigm. As an exploratory objective, the study examined associations that may exist between training experiences and patient-reported outcomes. RESULTS Most patients (91.7%) reported receiving formal self-injection training, commonly conducted over one or two sessions. The mean overall training time reported was 37.8 and 30.4 minutes by patients and HCPs, respectively. Over one-third of patients reported lacking confidence that they could correctly self-inject during the first 6 months of treatment. CONCLUSION Current training practices may not be adequate to prepare patients to start their therapies. Considerable attention must be paid to providing patients with multiple opportunities for training sessions, training devices, and medical information for home access. Further studies should prospectively examine the impact of training techniques on patient-reported outcomes.
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Affiliation(s)
- James Hawthorne
- Matchstick LLC, 141 Hawkins Place #122, Boonton, NJ 07005 USA.,University of Rhode Island College of Pharmacy: 7 Greenhouse Road, Kingston, RI 02881, USA
| | - Dimos Katsaros
- Matchstick LLC, 141 Hawkins Place #122, Boonton, NJ 07005 USA.,University of Rhode Island College of Pharmacy: 7 Greenhouse Road, Kingston, RI 02881, USA
| | - Amy Rinaldi
- Matchstick LLC, 141 Hawkins Place #122, Boonton, NJ 07005 USA
| | | | - Matthew D'Auria
- Matchstick LLC, 141 Hawkins Place #122, Boonton, NJ 07005 USA
| | - Erika Bajars
- Matchstick LLC, 141 Hawkins Place #122, Boonton, NJ 07005 USA
| | - Chris Franzese
- Matchstick LLC, 141 Hawkins Place #122, Boonton, NJ 07005 USA.,University of Rhode Island College of Pharmacy: 7 Greenhouse Road, Kingston, RI 02881, USA
| | - Marty Coyne
- Matchstick LLC, 141 Hawkins Place #122, Boonton, NJ 07005 USA.,University of Rhode Island College of Pharmacy: 7 Greenhouse Road, Kingston, RI 02881, USA
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Tarutani S, Omori M, Ido Y, Yano M, Komatsu T, Okamura T. Effects of 4G-beta-D-Galactosylsucrose in patients with depression: A randomized, double-blinded, placebo-controlled, parallel-group comparative study. J Psychiatr Res 2022; 148:110-120. [PMID: 35123322 DOI: 10.1016/j.jpsychires.2022.01.059] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/24/2021] [Accepted: 01/26/2022] [Indexed: 12/20/2022]
Abstract
Advances in genetic research on microbiome have led to several trials on the effectiveness of synbiotics or probiotics in patients with depression; however, none have evaluated the efficacy of prebiotics. 4G-beta-D-Galactosylsucrose (Lactosucrose, LS) is selectively assimilated by Bifidobacterium as a prebiotic and improves microbiome diversity. However, as it is not clear if LS consumption can improve symptoms of depression, we investigated whether LS intake can improve depressive symptoms, quality of life (QOL), and self-efficacy by conducting a single cite, double-blinded, randomized controlled trial in 20 outpatients with depressive episodes (F32, ICD-10) for 24 weeks. Participants (age range, 36-72 years) were randomized to the LS (n = 9) or placebo groups (n = 11). Primary outcome was improvement in total Montgomery Asberg Depression Rating Scale (MADRS) score, and the secondary outcomes were MADRS subscores, global self-efficacy scale (GSES) score, World Health Organization QOL (WHO/QOL-26) score, and 16S rRNA analysis of the fecal microbiome. LS consumption did not significantly improve total MADRS scores (-2 (-16 to 16) vs 0 (-6 to 10), p = 0.552), but GSES tended to improve in the LS group (2.00 ± 4.24 vs -1.36 ± 4.15, p = 0.091) with a large effect size (Cohen's d = 0.802). Sequencing of 16S rRNA revealed individual-level differences in microbiome diversity changes due to the intervention. Thus, we show that LS intake can improve self-efficacy, but not depressive symptoms, even in a small sample. Additional studies that also regulate diet and ensure adherence may help determine a correlation between depression and the gut microbiome.
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Affiliation(s)
- Seiichiro Tarutani
- Department of Psychiatry, Shin-Abuyama Hospital, Osaka Institute of Clinical Psychiatry, 4-10-1, Nasahara, Takatsuki, Osaka, 569-1041, Japan.
| | - Maiko Omori
- Faculty of Human Life and Science, Doshisha Women's College, Teramachi Nishiiru, Imadegawa-dori, Kamigyo-ku, Kyoto, 602-0893, Japan; Department of Food Science and Nutrition, Faculty of Agriculture, Kinki University, 3327-204 Nakamachi, Nara, Nara, 631-8505, Japan.
| | - Yumiko Ido
- Faculty of Health and Nutrition Baika Women's University, 2-19-5, Shukunosho, Ibaraki, Osaka, 567-0051, Japan; Department of Food and Nutrition, Faculty of Home Economies, Kyoto Women's University, 35 Kitahiyoshi-cho, Imakumano, Higashiyama-ku, Kyoto, 605-8501, Japan.
| | - Megumu Yano
- Research Institute for Nutrition Sciences, Mukogawa Women's University, 6-46, Ikebiraki, Nishinomiya, Hyogo, 663-8558, Japan.
| | - Tatsushi Komatsu
- Faculty of Human Life and Science, Doshisha Women's College, Teramachi Nishiiru, Imadegawa-dori, Kamigyo-ku, Kyoto, 602-0893, Japan.
| | - Takehiko Okamura
- Department of Psychiatry, Shin-Abuyama Hospital, Osaka Institute of Clinical Psychiatry, 4-10-1, Nasahara, Takatsuki, Osaka, 569-1041, Japan.
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Akamine A, Nagasaki Y, Tomizawa A, Arai M, Atsuda K. Risk Factors for Non-Adherence to Medications That Affect Surgery: A Retrospective Study in Japan. Patient Prefer Adherence 2022; 16:1623-1635. [PMID: 35818372 PMCID: PMC9270897 DOI: 10.2147/ppa.s365348] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/24/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Data on risk factors for non-adherence to doctors' and pharmacists' instructions to discontinue medications prior to surgery are lacking. This study aimed to identify characteristics and risk factors for such non-adherent patients. PATIENTS AND METHODS Data (including patient age, sex, prescription medications, comorbidities, presence of roommate at home, and number of days between receiving instruction and surgery) of 887 patients who used medications affecting surgery at a university hospital from April 2017 to March 2020 were retrospectively evaluated. The primary endpoint was to investigate the rate of non-adherence and to explore independent risk factors for non-adherence (with age categorized as ≥65 [versus <65] years). Secondary endpoints included analysis of limited number of departments subgroup and a sensitivity analysis (with age categorized as ≥75 [versus <75] years) to confirm the robustness of the primary endpoint results. Independent risk factors for non-adherence were identified using logistic regression analysis. RESULTS The non-adherence rate was 11.4% (n=101/887), median age (interquartile range) at admission was 73 (70-79) years, and proportion of male patients was 81.2% (n=82). The main analysis adjusted for age ≥65 (versus <65) years showed age as a risk factor for increased non-adherence (adjusted odds ratio: 2.1, 95% confidence interval: 1.09-4.05; p=0.027). However, analyses adjusted for departments (other than urology, gynecology, and breast surgery, with a large sex bias in hospitalized patients) and for age ≥75 (versus <75) years showed no such risk. CONCLUSION Age ≥65 years was associated with a higher risk of non-adherence to medications that should be discontinued before surgery. It is important for doctors and pharmacists to ensure that patients at high risk for non-adherence are aware of the importance of adherence. Our findings may help identify patients at high risk for non-adherence to such medications.
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Affiliation(s)
- Akihiko Akamine
- Department of Pharmacy, Kitasato University Hospital, Sagamihara, Kanagawa, 252-0373, Japan
- Correspondence: Akihiko Akamine, Department of Pharmacy, Kitasato University Hospital, Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan, Tel +81-42-778-8123, Fax +81-42-778-8650, Email
| | - Yuya Nagasaki
- Department of Pharmacy, Kitasato University Hospital, Sagamihara, Kanagawa, 252-0373, Japan
| | - Atsushi Tomizawa
- Department of Pharmacy, Kitasato University Hospital, Sagamihara, Kanagawa, 252-0373, Japan
| | - Mariko Arai
- Department of Pharmacy, Kitasato University Hospital, Sagamihara, Kanagawa, 252-0373, Japan
| | - Koichiro Atsuda
- Department of Pharmacy, Kitasato University Hospital, Sagamihara, Kanagawa, 252-0373, Japan
- Research and Education Center for Clinical Pharmacy, Division of Clinical Pharmacy, Laboratory of Pharmacy Practice and Science 1, Kitasato University School of Pharmacy, Tokyo, Japan
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22
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Validation of a Virtual Assistant for Improving Medication Adherence in Patients with Comorbid Type 2 Diabetes Mellitus and Depressive Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212056. [PMID: 34831811 PMCID: PMC8620667 DOI: 10.3390/ijerph182212056] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/08/2021] [Accepted: 11/13/2021] [Indexed: 12/30/2022]
Abstract
Virtual assistants are programs that interact with users through text or voice messages simulating a human-based conversation. The development of healthcare virtual assistants that use messaging platforms is rapidly increasing. Still, there is a lack of validation of these assistants. In particular, this work aimed to validate the effectiveness of a healthcare virtual assistant, integrated within messaging platforms, with the aim of improving medication adherence in patients with comorbid type 2 diabetes mellitus and depressive disorder. For this purpose, a nine-month pilot study was designed and subsequently conducted. The virtual assistant reminds patients about their medication and provides healthcare professionals with the ability to monitor their patients. We analyzed the medication possession ratio (MPR), measured the level of glycosylated hemoglobin (HbA1c), and obtained the patient health questionnaire (PHQ-9) score in the patients before and after the study. We also conducted interviews with all participants. A total of thirteen patients and five nurses used and evaluated the proposed virtual assistant using the messaging platform Signal. Results showed that on average, the medication adherence improved. In the final interview, 69% of the patients agreed with the idea of continuing to use the virtual assistant after the study.
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23
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Hartman L, Cutolo M, Bos R, Opris-Belinski D, Kok MR, Griep-Wentink HJRM, Klaasen R, Allaart CF, Bruyn GAW, Raterman HG, Voshaar MJH, Gomes N, Pinto RMA, Klausch LT, Lems WF, Boers M. Medication adherence in older people with rheumatoid arthritis is lower according to electronic monitoring than according to pill count. Rheumatology (Oxford) 2021; 60:5239-5246. [PMID: 33682887 PMCID: PMC8566247 DOI: 10.1093/rheumatology/keab207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/14/2021] [Indexed: 12/11/2022] Open
Abstract
Objectives Suboptimal medication adherence is a serious problem in the treatment of chronic inflammatory diseases. To measure medication adherence, electronic monitoring is regarded as superior to pill count. GLORIA is an ongoing two-year trial on the addition of low-dose (5 mg/d) prednisolone or placebo to standard care in older people (65+ years) with RA. During the entire trial, adherence is measured with electronic caps, and with pill counts. The objective is to describe medication adherence patterns, and to compare the adherence results of the two methods. Methods The recorded adherence patterns of patients (blinded for treatment group) were classified according to descriptive categories. The cutoff for good adherence was set at 80% of prescribed pills taken. Results Trial inclusion closed in 2018 at 451 patients, but trial follow-up is ongoing; the current dataset contains adherence data of 371 patients. Mean number of recorded 90-day periods per patient was 4 (range 1–8). Based on pill count over all periods, 90% of the patients had good adherence; based on cap data, only 20%. Cap data classified 30% of patients as non-user (<20% of days an opening) and 40% as irregular user (different adherence patterns, in or between periods). Conclusion In our trial of older people with RA, the majority appeared to be adherent to medication according to pill count. Results from caps conflicted with those of pill counts, with patterns suggesting patients did not use the bottle for daily dispensing, despite specific advice to do so. Trial registration NCT02585258. ClinicalTrials.gov (https://www.clinicaltrials.gov/)
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Affiliation(s)
- Linda Hartman
- Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, Location VUmc.,Epidemiology & Data Science, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Maurizio Cutolo
- Department of Rheumatology, University of Genoa, Genoa, Italy
| | - Reinhard Bos
- Department of Rheumatology, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Daniela Opris-Belinski
- Department of Internal Medicine and Rheumatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Marc R Kok
- Department of Rheumatology and Clinical immunology, Maasstad Hospital, Rotterdam
| | | | - Ruth Klaasen
- Department of Rheumatology, Meander Medical Center, Amersfoort
| | | | | | | | - Marieke J H Voshaar
- Department of Pharmacy, Radboud University, Nijmegen.,Tools Patient Empowerment, Amsterdam, The Netherlands
| | | | - Rui M A Pinto
- Bluepharma, Indústria Farmacêutica, S.A, Coimbra, Portugal
| | - L Thomas Klausch
- Epidemiology & Data Science, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Willem F Lems
- Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, Location VUmc
| | - M Boers
- Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, Location VUmc.,Epidemiology & Data Science, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
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24
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Factors related to self-care drug treatment and medication adherence of elderly people in Japan. PUBLIC HEALTH IN PRACTICE 2021; 2:100106. [PMID: 36101625 PMCID: PMC9461522 DOI: 10.1016/j.puhip.2021.100106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 03/01/2021] [Accepted: 03/12/2021] [Indexed: 11/21/2022] Open
Abstract
Objectives Study design Methods Results Conclusions Medication adherence was significantly positively associated with health literacy. Good communication with doctors was closely related to medication adherence. Promoting health literacy and communication when supporting self-care drug treatment for elderly people.
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25
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Basu S. Accurately estimating medication non-adherence through patient self-report: possibilities and limitation of a new scale. Curr Med Res Opin 2021; 37:1349-1351. [PMID: 34060950 DOI: 10.1080/03007995.2021.1937088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Saurav Basu
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
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26
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Atal S, Ray A, Ahmed SN, Singh P, Fatima Z, Sadasivam B, Pakhare A, Joshi A, Joshi R. Medication adherence, recall periods and factors affecting it: A community-based assessment on patients with chronic diseases in urban slums. Int J Clin Pract 2021; 75:e14316. [PMID: 34014034 DOI: 10.1111/ijcp.14316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/03/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To evaluate medication adherence, the effect of recall periods on self-reported adherence and factors influencing medication adherence among patients of chronic diseases, such as hypertension and diabetes, particularly in the community. METHODS A cross-sectional cohort study was conducted among individuals with hypertension and/or diabetes coming as outpatients in community camps organised in a cluster of urban slums. Responses towards questions regarding self-reported quantitative and qualitative adherence for one week and one month along with information on pill burden, socio-demographic and other factors were recorded using a mobile application. RESULTS Among 379 participants living in urban slum communities, who were prescribed anti-hypertensive or oral anti-diabetic medications previously, mean medication adherence over previous one week was 67.99% (standard deviation (SD) ± 38.32) and 6.87 (SD ± 3.62) on a ten-point numeric scale. The medication adherence for one month showed a strong significantly positive correlation with that of 1 week for both percentage-based (r = +0.910, 95% CI = 0.864 to 0.950, P < .0001) and Likert (ρ = +0.836, 95% CI = 0.803 to 0.863, P < .0001) scales. Age (r = 0.219, 95% CI = 0.120 to 0.313, P = .043) and pill burden (r = -0.231, 95% CI = -0.145 to -0.322, P < .0001) were found to significantly affect medication adherence. The odds of random blood sugar reduction were found to be significant (OR 1.98, 95% CI = 1.30 to 3.00, P = .001) with adequate adherence. A linear regression equation was developed to predict medication adherence percentage for a patient which was found to have 61.8% predictive power using multilayer perceptron modelling. CONCLUSION Overall, medication adherence was sub-optimal. Adherence assessments can be reliably performed using either one week or one month recall periods. With further refinement and validation, the regression equation could prove to be a useful tool for physicians.
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Affiliation(s)
- Shubham Atal
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS) Bhopal, Bhopal, India
| | - Avik Ray
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS) Bhopal, Bhopal, India
| | - Shah Newaz Ahmed
- Department of Pharmacology, MJN Medical College and Hospital, Coochbehar, India
| | - Pooja Singh
- Department of Pharmacology, Rabindra Nath Tagore Medical College, Udaipur, India
| | - Zeenat Fatima
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS) Bhopal, Bhopal, India
| | - Balakrishnan Sadasivam
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS) Bhopal, Bhopal, India
| | - Abhijit Pakhare
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS) Bhopal, Bhopal, India
| | - Ankur Joshi
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS) Bhopal, Bhopal, India
| | - Rajnish Joshi
- Department of General Medicine, All India Institute of Medical Sciences (AIIMS) Bhopal, Bhopal, India
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27
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Al-Noumani H, Al-Harrasi M, Jose J, Al-Naamani Z, Panchatcharam SM. Medication Adherence and Patients' Characteristics in Chronic Diseases: A National Multi-Center Study. Clin Nurs Res 2021; 31:426-434. [PMID: 34287084 DOI: 10.1177/10547738211033754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chronic diseases constitute a significant threat to health. Worldwide, medication adherence in chronic diseases remains unsatisfactory. Understanding factors affecting adherence is essential. This study examined medication adherence by characteristics of patients with chronic diseases. This cross-sectional study included 800 patients. The Adherence to Chronic Diseases Scale was used to measure adherence. Descriptive statistics and logistic regression was used to examine factors influencing medication adherence. Low adherence was found in 19.5% of the patients, 45% had medium adherence, and 35.5% had high adherence. Logistic regression showed that retired (OR 0.496, 95% CI [0.33-0.75]), having COPD (OR 0.460, 95% CI [0.32-0.67]) and duration of disease ≤5 years (OR 1.554, 95% CI [1.11-2.17]) remain independent predictors for high adherence. Mixed findings regarding the relationship between medication adherence and patients' characteristics were noticed. Patients' characteristics should be examined with the individual population when examining and attempting to improve medication adherence in clinical practice.
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28
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Bischof G, Bischof A, Rumpf HJ. Motivational Interviewing: An Evidence-Based Approach for Use in Medical Practice. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:109-115. [PMID: 33835006 DOI: 10.3238/arztebl.m2021.0014] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 05/14/2020] [Accepted: 09/08/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Motivational factors in health-relevant modes of behavior are an important matter in medical practice. Motivational interviewing (MI) is a technique that has been specifically developed to help motivate ambivalent patients to change their behav - ior. METHODS This review is based on pertinent publications retrieved by a selective search in the PubMed, Cochrane, and Web of Science databases. Special attention was paid to systematic reviews and meta-analyses concerning the efficacy of MI in the medical care of various target groups. The present review focuses on the relevance of MI for patients with highly prevalent disorders. RESULTS Meta-analyses reveal statistically significant mean intervention effects of MI in medical care with respect to a variety of health-relevant modes of behavior, in comparison to standard treatment and no treatment in the control groups (odds ratio [OR]: 1.55; 95% confidence interval: [1.40; 1.71]). Statistically significant effect sizes were reported for substance consumption, physical activity, dental hygiene, body weight, treatment adherence, willingness to change behavior, and mortality; effects on healthpromoting behavior were mixed. Studies of the factors that contribute to the efficacy of MI suggest that it exerts its effects largely through the selective reinforcement of statements made by the patients themselves about potential changes in their behavior. CONCLUSION MI has been found useful for strengthening the motivation for behavioral change in patients with various behavioral - ly influenced health problems and for promoting treatment adherence. It can be used to optimize medical interventions. Further research is needed with respect to its specific mechanisms of action, its efficacy in reinforcing health-promoting modes of be - havior, differential indications for different patient groups, and the cost-efficiency of the technique across the spectrum of disorders in which it is used.
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Affiliation(s)
- Gallus Bischof
- Lübeck University, Department of Psychiatry and Psychotherapy, Lübeck
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29
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Wang Y, Wang X, Wang X, Naqvi AA, Zhang Q, Zang X. Translation and validation of the Chinese version of the general medication adherence scale (GMAS) in patients with chronic illness. Curr Med Res Opin 2021; 37:829-837. [PMID: 33719815 DOI: 10.1080/03007995.2021.1901680] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To translate the English version of general medication adherence scale (GMAS) into a Chinese version and test its reliability and validity in Chinese patients with chronic diseases. METHODS After translating the original English version into Chinese (GMAS-C) following the forward-backward translation and expert review procedure, we conducted a pilot study among 10 chronic disease patients. Each patient took about 10 min to complete the scale and was asked about the difficulty of understanding or filling the scale. Then a total of 312 patients aged 18 years or older with chronic illness were selected from the outpatient departments of two tertiary hospitals and a community center in Tianjin from April 2019 to May 2020 by convenience sampling. Cronbach's α coefficient, item-total correlation and test-retest reliability were used to evaluate the scale reliability; expert evaluation method was used to evaluate the content validity of the scale; and exploratory factor analysis, confirmatory factor analysis, and known group validity were used to evaluate the construct validity of the scale. RESULTS As a result of the adaptation process, the GMAS-C's structure was determined. It included 3 dimensions and 11 items and was reliable and valid for Chinese patients with chronic diseases. Total Cronbach's α coefficient of the scale was 0.781 and test-retest reliability coefficient was 0.883 after two weeks. The item-level content validity indexes (CVIs) were ≥ 0.78 for all items. A Kaiser-Meyer-Olkin test and Bartlett' test of sphericity test indicated that the sample met the requirements of factor analysis. Exploratory factor analysis extracted three factors with eigenvalue >1, and 60% of the total variance was explained by three-factor solution. Confirmatory factor analysis showed acceptable fit indices (χ2/df = 1.58, IFI = 0.96, TLI = 0.94, CFI = 0.96 and RMSEA = 0.05). CONCLUSIONS The GMAS-C demonstrates satisfactory reliability and validity. This scale can be a clinically useful tool to identify the levels of medication adherence and possible barriers for adherence of the medication regime in patients with chronic diseases.
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Affiliation(s)
- Yan Wang
- School of Nursing, Tianjin Medical University, Tianjin, PR China
| | - Xiaoxu Wang
- School of Nursing, Tianjin Medical University, Tianjin, PR China
| | - Xiaobing Wang
- School of Nursing, Tianjin Medical University, Tianjin, PR China
| | - Atta Abbas Naqvi
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), Penang, Malaysia
| | - Qing Zhang
- School of Nursing, Tianjin Medical University, Tianjin, PR China
| | - Xiaoying Zang
- School of Nursing, Tianjin Medical University, Tianjin, PR China
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30
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Bago M, Butkovic A, Preloznik Zupan I, Faganel Kotnik B, Prga I, Bacic Vrca V, Zupancic Salek S. Association between reported medication adherence and health-related quality of life in adult patients with haemophilia. Int J Clin Pharm 2021; 43:1500-1507. [PMID: 33928481 DOI: 10.1007/s11096-021-01270-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/22/2021] [Indexed: 11/28/2022]
Abstract
Background Medication adherence is an important issue, not just health-related, for patients with haemophilia. Poor medication adherence to long-term therapies limits the potential of effective treatments to improve patients' health-related quality of life. Objective The aim of this study was to investigate the association of reported medication adherence and health-related quality of life in patients with haemophilia. Setting Data were collected from patients at University Hospital Centre Zagreb, Croatia and at University Medical Centre Ljubljana, Slovenia. Method Adult male patients with severe or moderate haemophilia receiving prophylactic treatment were eligible for the study. Main outcome measure Implementation phase of medication adherence was assessed with the self-reported VERITAS-Pro instrument and health-related quality of life with SF-36v2. Results A total of 82 participants were included in the study (median age was 44.50, range 18-73 years). The majority of our participants reported being adherent to medication (83%). Participants showed better health in the mental health domains and Mental Component Summary than in the physical health domains and Physical Component Summary. After controlling for demographic, socioeconomic and clinical predictors, better reported medication adherence explained an additional 4-6% of better health variance in Bodily Pain and Social Functioning domains and Mental Component Summary. Conclusion We found that reported medication adherence can contribute to better health-related quality of life in patients with haemophilia. Since life with a chronic condition is demanding, it is an important finding that medication adherence to replacement therapy can improve life conditions for patients with haemophilia.
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Affiliation(s)
- Martina Bago
- Andrija Stampar Teaching Institute of Public Health, Zagreb, Croatia.
| | - Ana Butkovic
- Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Irena Preloznik Zupan
- University Medical Center Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Barbara Faganel Kotnik
- University Medical Center Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Ivana Prga
- Andrija Stampar Teaching Institute of Public Health, Zagreb, Croatia
| | - Vesna Bacic Vrca
- Clinical Hospital Dubrava, Zagreb, Croatia.,Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | - Silva Zupancic Salek
- University Hospital Centre Zagreb, Zagreb, Croatia.,Faculty of Medicine, University of Zagreb, Zagreb, Croatia
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Roman YM, Lor K, Xiong T, Culhane-Pera K, Straka RJ. Gout prevalence in the Hmong: a prime example of health disparity and the role of community-based genetic research. Per Med 2021; 18:311-327. [PMID: 33787318 DOI: 10.2217/pme-2020-0107] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Individuals of distinct Asian backgrounds are commonly aggregated as Asian, which could mask the differences in the etiology and prevalence of health conditions in the different Asian subgroups. The Hmong are a growing Asian subgroup in the United States with a higher prevalence of gout and gout-related comorbidities than non-Hmong. Genetic explorations in the Hmong suggest a higher prevalence of genetic polymorphisms associated with an increased risk of hyperuricemia and gout. History of immigration, acculturation, lifestyle factors, including dietary and social behavioral patterns, and the use of traditional medicines in the Hmong community may also increase the risk of developing gout and lead to poor gout management outcomes. Engaging minorities such as the Hmong population in biomedical research is a needed step to reduce the burden of health disparities within their respective communities, increase diversity in genomic studies, and accelerate the adoption of precision medicine to clinical practice.
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Affiliation(s)
- Youssef M Roman
- Assistant Professor, Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia 23298, USA
| | - Kajua Lor
- Associate Professor & Chair, Medical College of Wisconsin, School of Pharmacy, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - Txia Xiong
- Clinical Pharmacist, West Side Community Health Services, St. Paul, MN 55106, USA
| | | | - Robert J Straka
- Professor & Department Head, University of Minnesota College of Pharmacy, Minneapolis, Minnesota 55455, USA
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Franke GH, Nentzl J, Jagla-Franke M, Prell T. Medication Adherence and Coping with Disease in Patients from a Neurological Clinic: An Observational Study. Patient Prefer Adherence 2021; 15:1439-1449. [PMID: 34234417 PMCID: PMC8253891 DOI: 10.2147/ppa.s311946] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/05/2021] [Indexed: 01/17/2023] Open
Abstract
PURPOSE Medication non-adherence is a huge concern for the medical community. For chronic, especially neurological diseases, taking medication is a central pillar of treatment. To improve adherence to these oftentimes complex medication regimens, the construct needs to be understood in more depth. The aim of this study was to investigate associations between adherence with sociodemographics, clinical variables, and coping in neurological patients. PATIENTS AND METHODS The sample consisted of 545 patients from a German neurological clinic. Adherence was assessed with the Stendal Adherence to Medication Score (SAMS). Patients were grouped as completely adherent (SAMS = 0), non-adherent (upper 25% of the sample), and moderately adherent. Associations with coping were assessed using the Essen Coping Questionnaire. RESULTS Medication adherence was low compared to other non-neurological patient samples. Differences between adherence groups were found regarding gender and facets of coping, namely "trivialisation, wishful thinking and defence" and "finding of inner stability". CONCLUSION Interventions to improve medication adherence should focus on facets of coping with disease, increasing acceptance of disease, willpower, and confidence in treatment.
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Affiliation(s)
- Gabriele Helga Franke
- Department of Applied Human Sciences, Magdeburg-Stendal University of Applied Sciences, Stendal, Germany
| | - Julia Nentzl
- Department of Applied Human Sciences, Magdeburg-Stendal University of Applied Sciences, Stendal, Germany
| | - Melanie Jagla-Franke
- Department of Applied Human Sciences, Magdeburg-Stendal University of Applied Sciences, Stendal, Germany
| | - Tino Prell
- Department of Neurology, Jena University Hospital, Jena, Germany
- Center for Healthy Ageing, Jena University Hospital, Jena, Germany
- Correspondence: Tino Prell Department of Neurology, Jena University Hospital, Jena, Germany Email
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Olfactory training ball improves adherence and olfactory outcomes in post-infectious olfactory dysfunction. Eur Arch Otorhinolaryngol 2020; 277:2125-2132. [DOI: 10.1007/s00405-020-05939-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 03/20/2020] [Indexed: 01/02/2023]
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Yang C, Hui Z, Zeng D, Liu L, Lee DTF. Examining and adapting the information-motivation-behavioural skills model of medication adherence among community-dwelling older patients with multimorbidity: protocol for a cross-sectional study. BMJ Open 2020; 10:e033431. [PMID: 32209623 PMCID: PMC7202708 DOI: 10.1136/bmjopen-2019-033431] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Multimorbidity is highly prevalent among older patients and has been shown to be associated with poor health outcomes and lower quality of life. Adherence to medication treatments is essential in order to maximise the efficacy of treatments and improve health outcomes. However, nearly half of the older patients with multimorbidity fail to adhere to their medications, which can result in an increased risk of adverse health events, lower quality of life and higher healthcare cost. Only a few studies have explored the underlying mechanism and influencing factors of medication adherence among older patients with multimorbidity, which are inadequate to provide robust evidence for the development and evaluation of the medication adherence interventions. This study aims to examine and adapt the information-motivation-behavioural skills (IMB) model, a widely used social behaviour theory, to explain the medication adherence behaviour among community-dwelling older patients with multimorbidity. METHODS AND ANALYSIS A cross-sectional study will be conducted in community settings in China. Around 309 older patients with multimorbidity will be recruited to complete questionnaires on adherence knowledge, adherence motivation, adherence self-efficacy, medication adherence, medication treatment satisfaction, depressive symptoms, treatment burden, disease burden and basic demographic information. Structural equation modelling will be used to analyse and validate the relationships among variables in the IMB model. ETHICS AND DISSEMINATION This study has been approved by the Survey and Behavioral Research Ethics Committee of the Chinese University of Hong Kong (reference number SBRE-18-675). The study results will be published in peer-reviewed journals and presented in academic conferences and workshops. TRIAL REGISTRATION NUMBER ChiCTR1900024804.
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Affiliation(s)
- Chen Yang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zhaozhao Hui
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Dejian Zeng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Li Liu
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Diana Tze Fan Lee
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Skladany L, Vnencakova J, Laffers L, Skvarkova B, Hrubá E, Molcan P, Koller T. Adherence to Oral Nutritional Supplements After Being Discharged from the Hospital is Low but Improves Outcome in Patients with Advanced Chronic Liver Disease. Patient Prefer Adherence 2020; 14:2559-2572. [PMID: 33447017 PMCID: PMC7802017 DOI: 10.2147/ppa.s283034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/20/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Patients with advanced chronic liver disease (ACLD) often have a poor nutritional status. In the management, current guidelines recommend dietary counseling and oral nutritional supplements (ONS). Nutritional goals and adherence to ONS are difficult to achieve while studies addressing adherence are scarce. We aimed to evaluate adherence to ONS, the associated factors, and its impact on outcome among ALCD patients who are discharged from the hospital. PATIENTS AND METHODS We identified consecutive hospitalized patients with ACLD from the cirrhosis registry and ONS prescription at discharge. Baseline demographics, anthropometrics, hand-grip strength (HGS), nutritional, and laboratory parameters were recorded. Adherence was assessed at 30, 90, and 180 days, but not in patients who did not survive or in those who underwent liver transplantation (LT) before the time-point. RESULTS From the registry containing 1004 patients, we included 450 cases, the median age was 56.3 (IQR 47-62), 60% were males, 63.8% had alcoholic etiology, and the median model for end-stage liver disease score (MELD) was 16 (11-21). During follow-up, 13.6%, 23.6%, and 31.1% of patients have died within 30, 90, and 180 days, respectively, and 21 underwent LT. Adherence to ONS in surviving patients was observed in 46%, 26.1%, and 16.9% within 30, 90, and 180 days, respectively. Baseline refractory ascites (HR=0.43, 0.24-0.76), HGS (HR=1.03, 1.01-1.06), and mid-arm circumference (HR=0.93, 0.88-0.99) were independently associated with 30-day adherence. Among patients who survived beyond 30 days, adherents for >30 days had improved synthetic liver function, HGS, a higher probability of LT (HR=1.7, 1.03-2.8) and lower risk of death (HR=0.65, 0.45-0.89), particularly those with MELD>16 (OR=0.55, 0.36-0.85) and low HGS (OR=0.61, 0.39-0.93). CONCLUSION In ACLD patients after discharge, adherence to ONS steeply declined and was associated with baseline refractory ascites and low muscle strength. Adherence to ONS also improved liver function, muscle strength, and survival.
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Affiliation(s)
- Lubomir Skladany
- Hepatology, Gastroenterology and Transplantation (HEGITO) Department of the 2nd Department of Medicine, Slovak Medical University, FD Roosevelt Hospital, Banska Bystrica, Slovakia
| | - Jana Vnencakova
- Hepatology, Gastroenterology and Transplantation (HEGITO) Department of the 2nd Department of Medicine, Slovak Medical University, FD Roosevelt Hospital, Banska Bystrica, Slovakia
| | - Lukas Laffers
- Department of Mathematics, Faculty of Natural Sciences, Matej Bel University, Banska Bystrica, Slovakia
| | - Beata Skvarkova
- Hepatology, Gastroenterology and Transplantation (HEGITO) Department of the 2nd Department of Medicine, Slovak Medical University, FD Roosevelt Hospital, Banska Bystrica, Slovakia
| | - Eva Hrubá
- Hepatology, Gastroenterology and Transplantation (HEGITO) Department of the 2nd Department of Medicine, Slovak Medical University, FD Roosevelt Hospital, Banska Bystrica, Slovakia
| | - Pavol Molcan
- Hepatology, Gastroenterology and Transplantation (HEGITO) Department of the 2nd Department of Medicine, Slovak Medical University, FD Roosevelt Hospital, Banska Bystrica, Slovakia
| | - Tomas Koller
- Gastroenterology and Hepatology Subdiv. of the 5th Department of Medicine, Comenius University Faculty of Medicine, University Hospital Bratislava, Bratislava, Slovakia
- Correspondence: Tomas Koller Gastroenterology and Hepatology Subdiv. of the 5th Department of Medicine, Comenius University Faculty of Medicine, University Hospital Bratislava, Ruzinovska 6, Bratislava82606, SlovakiaTel +42190518692 Email
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Parente M, Pignata I, Gnavi R, Spadea T, Di Martino M, Baratta F, Brusa P. Assessment of Non-Adherence to Oral Metformin and Atorvastatin Therapies: A Cross-Sectional Survey in Piedmont (Italy). Patient Prefer Adherence 2020; 14:261-266. [PMID: 32103910 PMCID: PMC7028384 DOI: 10.2147/ppa.s226206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/16/2019] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION It is not possible to recover from chronic diseases; however, a healthy lifestyle and correct adherence to therapy can avoid complications and co-morbidities. The aim of this study was the cross-sectional evaluation, by means of a questionnaire, of real-world data on the prevalence of non-adherence to metformin and atorvastatin oral therapies in a sample of patients that attend community pharmacies in the Piedmont Region. The secondary aim was to evaluate the presence of correlations between non-adherence and a number of variables detected by the questionnaire. MATERIALS AND METHODS Data were gathered from face-to-face interviews in six community pharmacies in Piedmont. The questionnaire was divided into two sections: the first included the Morisky, Green and Levine Medication Adherence Questionnaire (MAQ) (to assess therapy adherence); the second included questions on gender, age, level of education and the pharmacy in which the questionnaire was administered. Comparisons between proportions and mean values were performed using the χ2 test. Modified Poisson regression with robust standard errors was used for multivariate analysis. The level of significance was fixed at 0.05, CI at 95%. RESULTS The sample analysed was composed of 408 subjects (receiving either metformin or atorvastatin). According to MAQ, 62 patients were non-adherent (15% of the total cohort). Crude and multivariate analysis did not show any statistically significant correlation between gender, age, level of education and non-adherence. It emerged that there was a correlation between non-adherence and being a customer of two of the pharmacies involved [PR = 3.31 (p=0.028) and PR = 3.11 (p=0.027)]. CONCLUSIONS Community pharmacies can be an appropriate setting to identify non-adherent patients. Therefore, healthcare professionals could realize an integrated and structured intervention to improve adherence. However, MAQ could underestimate the number of non-adherent patients. Further studies to test the association between non-adherence prevalence and being the customer of a specific pharmacy should be performed.
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Affiliation(s)
- Marco Parente
- Department of Drug Science and Technology, University of Turin, Turin, Italy
| | - Irene Pignata
- Department of Drug Science and Technology, University of Turin, Turin, Italy
| | | | | | - Mirko Di Martino
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Francesca Baratta
- Department of Drug Science and Technology, University of Turin, Turin, Italy
| | - Paola Brusa
- Department of Drug Science and Technology, University of Turin, Turin, Italy
- Correspondence: Paola Brusa Department of Drug Science and Technology, University of Turin, Via Pietro Giuria 9, Turin10125, ItalyTel +39 011 670 66 65 Email
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