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Ebeywa E, Gruss V, Koronkowski M. Promoting a Shared Medication Adherence Practice: A Call to Action. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Andreozzi F, Candido R, Corrao S, Fornengo R, Giancaterini A, Ponzani P, Ponziani MC, Tuccinardi F, Mannino D. Clinical inertia is the enemy of therapeutic success in the management of diabetes and its complications: a narrative literature review. Diabetol Metab Syndr 2020; 12:52. [PMID: 32565924 PMCID: PMC7301473 DOI: 10.1186/s13098-020-00559-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 06/08/2020] [Indexed: 12/17/2022] Open
Abstract
Diabetes mellitus is a chronic disease characterized by high social, economic and health burden, mostly due to the high incidence and morbidity of diabetes complications. Numerous studies have shown that optimizing metabolic control may reduce the risk of micro and macrovascular complications related to the disease, and the algorithms suggest that an appropriate and timely step of care intensification should be proposed after 3 months from the failure to achieve metabolic goals. Nonetheless, many population studies show that glycemic control in diabetic patients is often inadequate. The phenomenon of clinical inertia in diabetology, defined as the failure to start a therapy or its intensification/de-intensification when appropriate, has been studied for almost 20 years, and it is not limited to diabetes care, but also affects other specialties. In the present manuscript, we have documented the issue of inertia in its complexity, assessing its dimensions, its epidemiological weight, and its burden over the effectiveness of care. Our main goal is the identification of the causes of clinical inertia in diabetology, and the quantification of its social and health-related consequences through the adoption of appropriate indicators, in an effort to advance possible solutions and proposals to fight and possibly overcome clinical inertia, thus improving health outcomes and quality of care.
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Affiliation(s)
- F. Andreozzi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
| | - R. Candido
- Diabetes Center District 3, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - S. Corrao
- Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - R. Fornengo
- SSD of Diabetology and Metabolic Diseases, Hospital of Chivasso, Turin, Italy
| | | | - P. Ponzani
- Operative Unit of Diabetology, “La Colletta” Hospital, Genoa, Italy
| | - M. C. Ponziani
- SSD of Diabetology-Azienda Sanitaria Locale Novara, Novara, Italy
| | - F. Tuccinardi
- Diabetology and Endocrinology Unit “Clinica del Sole” Formia, Formia, Italy
| | - D. Mannino
- Section of Endocrinology and Diabetes, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy
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Patel A, Bakina D, Kirk J, von Lutcken S, Donnelly T, Stone W, Ashley-Collins H, Tibbals K, Ricker L, Adler J, Ewing J, Blechman M, Fox S, Leopold W, Ryan D, Wray D, Turkoz H. Patient counseling materials: The effect of patient health literacy on the comprehension of printed prescription drug information. Res Social Adm Pharm 2018; 14:851-862. [PMID: 29887494 DOI: 10.1016/j.sapharm.2018.04.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/25/2018] [Accepted: 04/30/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Counseling patients with written materials relies equally on patients' health literacy to understand their disease and its treatment, and the written materials' effectiveness communicating clearly in accessible and actionable ways. Only about 12% of the US population is adequately health literate. OBJECTIVES To explore the impact of reducing the health literacy demands of written patient health information. METHODS 805 patients were screened for health literacy, and recruited for balanced cohorts of adequate and low literacy, and high and normal blood pressure. Half of each patient cohort received either standard or "health literacy-friendly" drug summaries (i.e. Patient Package Inserts, or PPIs or "leaflets") along with a standardized health literacy assessment scale. RESULTS The literacy-friendly drug summary improved comprehension of drug-related information overall from 50% to 71% correct responses. Adequate literacy patients improved from 58% correct to 90%, while lower literacy patients improved from 42% to 52% correct in response to the health literacy-friendly PPIs. CONCLUSIONS Health literacy demands require special attention in developing and using written drug summary materials. Additionally, pharmacists should be provided additional information and counseling support materials to facilitate communications with low health literacy level patients.
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Affiliation(s)
- Amit Patel
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA.
| | - Daria Bakina
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - Jim Kirk
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | | | - Tom Donnelly
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - William Stone
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | | | - Karen Tibbals
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - Lynn Ricker
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - Jeffrey Adler
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - John Ewing
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | | | - Sherry Fox
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - Will Leopold
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - Daniel Ryan
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - Donna Wray
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - Heather Turkoz
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
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Spence M, Makarem A, Reyes S, Nguyen C. Evaluation of an Outpatient Pharmacy Clinical Services Program on Adherence and Fractures among Patients with Osteoporosis. JOURNAL OF CONTEMPORARY PHARMACY PRACTICE 2017. [DOI: 10.37901/jcphp16-00032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Hall AE, Paul C, Bryant J, Lynagh MC, Rowlings P, Enjeti A, Small H. To adhere or not to adhere: Rates and reasons of medication adherence in hematological cancer patients. Crit Rev Oncol Hematol 2015; 97:247-62. [PMID: 26412718 DOI: 10.1016/j.critrevonc.2015.08.025] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 07/28/2015] [Accepted: 08/26/2015] [Indexed: 01/18/2023] Open
Abstract
To conduct a comprehensive review to examine among hematological cancer patients: (1) rates of adherence to self-administered cancer treatments; and (2) factors impacting on their adherence. Fifty two eligible publications were identified. The majority focused on Chronic Myeloid Leukaemia (CML) (n=40) and Acute Lymphoid Leukaemia (ALL) (n=11) patients. Adherence rates varied and depended on the definition and measures used. Patient understanding about their disease and treatment, and forgetting to take their medication impacted on patients' level of adherence; while the use of reminders reduced forgetfulness. There is a lack of valid and reliable information relating to medication adherence of hematological cancer patients. Based on the limited data available we provide a profile of CML and ALL patients at potential risk of medication non-adherence, as well as a proposed checklist that can be used by health care providers in assessing and supporting patients in adhering to their medication.
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Affiliation(s)
- Alix E Hall
- Priority Research Centre for Health Behaviour, Faculty of Health, The University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW 2308, Australia.
| | - Chris Paul
- Priority Research Centre for Health Behaviour, Faculty of Health, The University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW 2308, Australia.
| | - Jamie Bryant
- Priority Research Centre for Health Behaviour, Faculty of Health, The University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW 2308, Australia.
| | - Marita C Lynagh
- Priority Research Centre for Health Behaviour, Faculty of Health, The University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW 2308, Australia.
| | - Philip Rowlings
- Haematology Unit, Calvary Mater Hospital Newcastle, Waratah, NSW 2298, Australia; School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Anoop Enjeti
- Haematology Unit, Calvary Mater Hospital Newcastle, Waratah, NSW 2298, Australia; School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Hannah Small
- Priority Research Centre for Health Behaviour, Faculty of Health, The University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW 2308, Australia.
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Saffari M, Zeidi IM, Fridlund B, Chen H, Pakpour AH. A Persian Adaptation of Medication Adherence Self-Efficacy Scale (MASES) in Hypertensive Patients: Psychometric Properties and Factor Structure. High Blood Press Cardiovasc Prev 2015; 22:247-55. [PMID: 25986076 DOI: 10.1007/s40292-015-0101-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 05/09/2015] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Poor adherence to anti-hypertensive treatment significantly contributes to the failure to achieve well-controlled blood pressure in patients with hypertension. AIM To convert the original English version of Medication Adherence Self-efficacy Scale (MASES) into a Persian version for clinical application in hypertensive patients. METHODS The backward-forward translation method was used to produce the Persian version of the questionnaire. Then the internal consistency was assessed using Cronbach's alpha. Exploratory Factor Analysis was applied to extract the components of the questionnaire. Correlation between blood pressures and drug adherence was then determined using the Persian MASES in hypertensive patients. RESULTS Cronbach's alpha coefficient of the Persian version of MASES was >0.92, suggesting that it can yield consistent results. Exploratory Factor Analysis suggested an uni-dimensionality of the scale. Patients with uncontrolled hypertension showed poor adherence to hypertensive medications, therefore had significant lower self-efficacy scores than those with well-controlled blood pressure by medications. CONCLUSION The Persian version of MASES is valid and reliable to assess self-efficacy of antihypertensive medication adherence in hypertensive patient, which is helpful to improve medication compliance in such patients in order to achieve better blood pressure controls.
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Affiliation(s)
- Mohsen Saffari
- Health Research Center, Baqiyatallah University of Medical Science, Tehran, Iran
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Abstract
BACKGROUND medication adherence is one determining factor of treatment success. Poor medication adherence mitigates optimum clinical benefits and increases total health care costs. Current evidence suggests that for population-based adherence interventions to be effective, a multidisciplinary, multifactorial approach that can be tailored for each individual should be adopted. In the United States, national organizations such as the National Committee for Quality Assurance and the Centers for Medicare and Medicaid Services include medication adherence as a metric of health care system performance Aim of the COMMENTARY This article provides an overview of efforts at Kaiser Permanente Colorado to impact medication adherence-related metrics. Described interventions are supported by electronic data gathering processes with an emphasis on the role of pharmacists.
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Roberts ME, Wheeler KJ, Neiheisel MB. Medication adherence Part three: Strategies for improving adherence. J Am Assoc Nurse Pract 2014; 26:281-7. [PMID: 24616472 DOI: 10.1002/2327-6924.12113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE This is the third of a three part series on Medication Adherence in which the authors describe the continuum of adherence to nonadherence of medication usage. DATA SOURCES Research articles through Medline and PubMed. CONCLUSIONS Understanding the magnitude and scope of the problem of medication nonadherence is the first step in reaching better adherence rates. The second step is to evaluate the risk factors for each patient for medication adherence/nonadherence. Steps are then taken to prevent nonadherence. IMPLICATIONS FOR PRACTICE The implications for nurse practitioners include using time with patients to assist them in adherence, building a trusting relationship with patients, and developing protocols for assessing and preventing nonadherence.
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Patel HK, Johnson ML, Sansgiry SS. Consumers' intention to use generic-drug discount programmes. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2012. [DOI: 10.1111/j.1759-8893.2012.00103.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Abstract
Objective
Generic-drug discount programmes (GDDPs) offer generic drugs at subsidized costs to both insured and uninsured consumers in the USA. Understanding predictors of intention to use GDDPs could help in developing interventions to direct more consumers to take advantage of such programmes. The objective of this study was to identify predictors of intention to use GDDPs using the theory of planned behaviour (TPB).
Methods
A paper-based survey was self-administered to randomly selected individuals from the greater Houston area in Texas, USA. The validated questionnaire included potential predictors of intention to use GDDPs that were derived and measured using the premise of TPB and the concept of awareness. Logistic regression was performed to evaluate if awareness, attitude towards GDDPs and generic drugs, perceived behavioural control (PBC) and subjective norms predicted intention to use GDDPs after controlling for demographics, income, number of chronic conditions and number of prescription drugs taken.
Key findings
A response rate of 59.5% was achieved (n = 663). Approximately 62.4% (414) respondents were aware of and 80% (528) had an intention to use GDDPs. After controlling for demographics and predisposing factors (current prescription drug use, chronic conditions and insurance status), attitude towards GDDPs (odds ratio, OR = 5.08; 95% confidence interval, CI = 3.228–8.003; P < 0.0001), attitude towards generic drugs (OR = 1.733; CI = 1.231–2.441; P = 0.0016) and PBC (OR = 1.57; CI = 1.067–2.320; P = 0.0222) significantly predicted intention to use GDDPs. Individuals of Hispanic and African American origin were 3.1 times (P = 0.0016) and 2.6 times (P = 0.0173) more likely, respectively, than white people to have an intention to use GDDPs.
Conclusions
Attitude towards GDDPs and generic drugs, PBC, location and race/ethnicity were significantly associated with intention to use GDDPs. Interventions by stakeholders to promote positive attitudes and highlighting the ease with which GDDPs can be used would be beneficial to eventually increase consumer utilization of GDDPs.
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Affiliation(s)
- Harshali K Patel
- Department of Clinical Sciences and Administration, College of Pharmacy, University of Houston, Houston, Texas, USA
| | - Michael L Johnson
- Department of Clinical Sciences and Administration, College of Pharmacy, University of Houston, Houston, Texas, USA
| | - Sujit S Sansgiry
- Department of Clinical Sciences and Administration, College of Pharmacy, University of Houston, Houston, Texas, USA
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Handler J, Lackland DT. Translation of hypertension treatment guidelines into practice: a review of implementation. ACTA ACUST UNITED AC 2011; 5:197-207. [PMID: 21640688 DOI: 10.1016/j.jash.2011.03.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 03/01/2011] [Accepted: 03/02/2011] [Indexed: 01/06/2023]
Abstract
Compared with the history of national guideline development, the science attached to implementation of guidelines is relatively new. Effectiveness of a highly evidence-based guideline, such as the 8th Joint National Committee recommendations on the treatment of high blood pressure, depends on successful translation into clinical practice. Implementation relies on several steps: clear and executable guideline language, audit and feedback attached to education of practitioners charged with carrying out the guidelines, team-based care delivery, credibility of blood pressure measurement, and measures to address therapeutic inertia and medication adherence. An evolving role of the electronic health record and patient empowerment are developments that will further promote implementation of the hypertension guideline. Further research will be needed to assess the efficacy and cost effectiveness of various implementation tools and strategies.
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