Patient Adherence: Challenges, Myths, and Realities

2019 ◽  
pp. 381-400
Author(s):  
Joel Rodriguez-Saldana
Keyword(s):  
Patient Adherence

Patient adherence: The influence of non-virological factors in a real world setting

2013 ◽  
Vol 51 (01) ◽  
Author(s):  
T Witthöft ◽  
R Link ◽  
S Christensen ◽  
HW Busch ◽  
W Gickler ◽  
...  
Keyword(s):  
Real World ◽  
Patient Adherence ◽  
Real World Setting

New Hope for Resistant Hypertention

2012 ◽  
Vol 5 (1) ◽  
pp. 81-91
Author(s):  
Z Rahman ◽  
KK Karmaker ◽  
M Ahmed ◽  
M Aziz ◽  
S Chowdhury ◽  
...  
Keyword(s):  
Resistant Hypertension ◽  
Patient Adherence ◽  
Public Health Problem ◽  
Drug Regimen ◽  
Renal Sympathetic Denervation ◽  
Major Public Health Problem ◽  
Antihypertensive Medications ◽  
Baroreflex Activation Therapy ◽  
Activation Therapy ◽  
Increasing Trends

Hypertension is a major public health problem. Despite the increasing awareness of hypertension and its implications among patients and treating physicians, the prevalence of resistant hypertension    remains high.Resistant hypertension define as blood pressure that remains elevated above treatment goals despite administration of an optimal three drug regimen that include a diuretic1 The prevalence of resistant    hypertension is projected to increase, owing to the aging population and increasing trends in obesity, sleep apnea, and chronic kidney disease. It is estimated that at least 10% of all patients with hypertension are resistant to existing drugs. Management of resistant hypertension must begin with  a careful evaluation of the patient to confirm the diagnosis and exclude factors associated with “pseudo-resistance,” such as improper BP measurement technique, the white-coat effect, and poor patient adherence to life-style and/or antihypertensive medications. Despite the use of the appropriate dose and type of diuretic to overcome the management of resistant hypertension, we can’t achieve our goal. But there is at least two devices namely Baroreflex Activation Therapy and Catheter-based  renal sympathetic denervation make the new hope for the patient with resistant hypertension DOI: http://dx.doi.org/10.3329/cardio.v5i1.12278 Cardiovasc. j. 2012; 5(1): 81-91

Expedited Resolution of 5-Fluorouracil-Induced Erythema and Barrier Dysfunction with White Petrolatum

2019 ◽  
Vol 3 (4) ◽  
pp. 279-282
Author(s):  
Melody Maarouf ◽  
Bryan Kromenacker ◽  
Eric Brucks ◽  
Vivian Shi
Keyword(s):  
Squamous Cell Carcinoma ◽  
Wound Healing ◽  
Recovery Time ◽  
Patient Adherence ◽  
Precancerous Lesions ◽  
Transepidermal Water Loss ◽  
Petroleum Jelly ◽  
Barrier Dysfunction ◽  
Exposed Skin ◽  
Risk Of Progression

Actinic keratoses (AK) are precancerous lesions that develop on chronically sun-exposed skin. They frequently require prophylactic field treatment due to the risk of progression to squamous cell carcinoma. Topical treatment with 5-fluorouracil (5-FU) yields near complete AK resolution, yet leaves a patient with an exuberant erythematous treatment site, which may be embarrassing and/or uncomfortable. We report a case of a patient with diffuse facial AK who was treated with 5-FU twice daily for 2 weeks, resulting in fiery-red erythema and disrupted barrier indices. Application of pure ultra white petroleum jelly, an emollient preferred by dermatologists for post-operative wound healing, resulted in drastic decreased erythema and recovery time of post-treatment transepidermal water loss and hydration, compared to the contralateral, non-petrolatum-treated side. Additionally, petrolatum use did not disrupt the AK resolution endpoint. We suggest that petroleum jelly be used for the repair of 5-FU-induced barrier disruption and erythema to promote greater patient adherence. 

Arterial Stiffness, Cognitive Dysfunction and Adherence to Antihypertensive Agents. Is there a Link to Hypertensive Patients?

2020 ◽  
Vol 18 (4) ◽  
pp. 410-417 ◽  
Author(s):  
Rigas G. Kalaitzidis ◽  
Thalia Panagiotopoulou ◽  
Dimitrios Stagikas ◽  
Kosmas Pappas ◽  
Olga Balafa ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Arterial Stiffness ◽  
Cognitive Dysfunction ◽  
Antihypertensive Drugs ◽  
Patient Adherence ◽  
Antihypertensive Agents ◽  
Treatment Compliance ◽  
Poor Adherence ◽  
Large Artery ◽  
Adherence To Medication

:The incidence of hypertension (HTN) and its cardiovascular (CV) complications are increasing throughout the world. Blood pressure (BP) control remains unsatisfactory worldwide. Medical inertia and poor adherence to treatment are among the factors that can partially explain, why BP control rate remains low. The introduction of a method for measuring the degree of adherence to a given medication is now a prerequisite. Complex treatment regimes, inadequate tolerance and frequent replacements of pharmaceutical formulations are the most common causes of poor adherence. In contrast, the use of stable combinations of antihypertensive drugs leads to improved patient adherence.:We aim to review the relationships between arterial stiffness, cognitive function and adherence to medication in patients with HTN.:Large artery stiffening can lead to HTN. In turn, arterial stiffness induced by HTN is associated with an increased CV and stroke risk. In addition, HTN can induce disorders of brain microcirculation resulting in cognitive dysfunction. Interestingly, memory cognitive dysfunction leads to a reduced adherence to drug treatment. Compliance with antihypertensive treatment improves BP control and arterial stiffness indices. Early treatment of arterial stiffness is strongly recommended for enhanced cognitive function and increased adherence.

Barriers to antiretroviral therapy adherence among prisoners in one prison in Iran

2019 ◽  
Vol 19 ◽  
Author(s):  
Behnam Farhoudi ◽  
Seyed Ahmad Seyedalinaghi ◽  
Masoud Jafarinasab ◽  
Seyed Mohammad Ghavam ◽  
Omid Dadras ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Patient Adherence ◽  
Social Stigma ◽  
Group Discussion ◽  
Life Quality ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Dramatic Improvement ◽  
Art Adherence ◽  
Opium Addiction

Background: Antiretroviral medications have improved the survival and life quality of people living with HIV and turned HIV into a chronic controllable disease. However, the success of HIV treatment depends on many factors; the patient adherence is one the most important indicators which. In this study, we explored the potential barriers to an effective adherence antiretroviral therapy (ART) among the HIV-positive prisoners of Ghezelhesar prison, Iran. Methods: To explore and identify the barriers toward ART adherence, a focus group discussion was held with six prisoners eligible for ART but rejected to be treated or did not retain on ART. The prisoners were recruited through purposive sampling method. All the words, behaviors and even body languages were precisely recorded and analyzed to reach the final results. Results: The most reported obstacles toward ART adherence were the lack of trust in effectiveness of medications and drug complications. Other reasons were inadequate nutrition, lack of amenities, social stigma, lack of economic and psychological support, misbehavior of prison staff and inadequate methadone prescription for those with opium addiction. Conclusion: Due to the results and the fact that adequate Methadone prescription for opium addiction, improving life quality and receiving emotional and medical support from staff could improve adherence to HIV medication in prisoners, comprehensive education of prisoners about their health condition along with staff education may improve the life condition of HIV infected prisoners and may cause dramatic improvement in ART adherence and prisoners health.

scholarly journals Predictors of loss to follow-up in art experienced patients in Nigeria: a 13 year review (2004–2017)

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Ahmad Aliyu ◽  
Babatunde Adelekan ◽  
Nifarta Andrew ◽  
Eunice Ekong ◽  
Stephen Dapiap ◽  
...  
Keyword(s):  
Patient Adherence ◽  
Cross Sectional Study ◽  
Emergency Plan ◽  
Cross Sectional ◽  
Loss To Follow Up ◽  
Viral Loads ◽  
Review Period ◽  
Lost To Follow Up ◽  
Differentiated Care

Abstract Background Expanded access to antiretroviral therapy (ART) leads to improved HIV/AIDS treatment outcomes in Nigeria, however, increasing rates of loss to follow-up among those on ART is threatening optimal standard achievement. Therefore, this retrospective cross-sectional study is aimed at identifying correlates and predictors of loss to follow-up in patients commencing ART in a large HIV program in Nigeria. Methods Records of all patients from 432 US CDC Presidents Emergency Plan for AIDS Relief (PEPFAR) supported facilities across 10 States and FCT who started ART from 2004 to 2017 were used for this study. Bivariate and multivariate analysis of the demographic and clinical parameters of all patients was conducted using STATA version 14 to determine correlates and predictors of loss to follow-up. Results Within the review period, 245,257 patients were ever enrolled on anti-retroviral therapy. 150,191 (61.2%) remained on treatment, 10,960 (4.5%) were transferred out to other facilities, 6926 (2.8%) died, 2139 (0.9%) self-terminated treatment and 75,041 (30.6%) had a loss to follow-up event captured. Males (OR: 1.16), Non-pregnant female (OR: 4.55), Patients on ≥ 3-monthly ARV refills (OR: 1.32), Patients with un-suppressed viral loads on ART (OR: 4.52), patients on adult 2nd line regimen (OR: 1.23) or pediatric on 1st line regimen (OR: 1.70) were significantly more likely to be lost to follow-up. Conclusion Despite increasing access to anti-retroviral therapy, loss to follow-up is still a challenge in the HIV program in Nigeria. Differentiated care approaches that will focus on males, non-pregnant females and paediatrics is encouraged. Reducing months of Anti-retroviral drug refill to less than 3 months is advocated for increased patient adherence.

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