Treatment adherence and persistence in adult ADHD: Results from a twenty-four week controlled clinical trial with extended release methylphenidate

2014 ◽  
Vol 29 (5) ◽  
pp. 324-330 ◽  
Author(s):  
E. Sobanski ◽  
W. Retz ◽  
R. Fischer ◽  
C. Ose ◽  
B. Alm ◽  
...  
Keyword(s):  
Family History ◽  
Education Level ◽  
Treatment Discontinuation ◽  
Factors Associated ◽  
Lower Education Level ◽  
Titration Phase ◽  
Increased Risk ◽  
History Of ◽  
Lower Education ◽  
Medication Efficacy

AbstractPurpose:The aim of this analysis is to describe medication adherence, and treatment persistence, in adults with attention deficit/hyperactivity disorder (ADHD) treated for 24 weeks with extended release methylphenidate (MPH-ER). Additionally, patient-, disorder- and treatment-related factors associated with adherence and persistence will be identified.Method:Post-hoc analysis of the active treatment group of a placebo-controlled, randomised, 24 week trial with MPH-ER with univariate description and multiple logistic regression models and Hosmer and Lemeshow tests.Results:In the sample of 241 adults with ADHD (mean age of 35.2 ± 10.1 years), 9.4% of the patients were non-adherent, taking less than 80% of the dispensed medication. Factors associated with non-adherence included age < 25 years, education level lower than secondary education, lacking family history of ADHD, lower ADHD baseline severity and lower self- and observer-rated medication efficacy. Lacking family history of ADHD, lower education level and lower self-rated medication efficacy, predicted non-adherence with a prediction accuracy of 16%. Seventeen percent of the patients discontinued early with most discontinuing within the first five weeks of the MPH-ER titration phase. Mean persistence in the discontinuing group was 63.4 ± 49.4 days. Factors associated with discontinuation included male gender, lower education level, lacking family history of ADHD and lower self- and observer-rated medication efficacy. Treatment non-response, male gender and lower education level predicted treatment discontinuation with a prediction accuracy of 22.7%.Conclusion:Male adults without relatives with ADHD, with lower educational level and lower self- and observer-rated medication efficacy, who are newly treated with MPH-ER, are at increased risk of non-adherence and treatment discontinuation. Patients are at increased risk of treatment discontinuation during the medication titration phase.

scholarly journals Cardio-metabolic and socio-demographic risk factors associated with dependency in basic and instrumental activities of daily living among older Iranian adults: Bushehr elderly health program

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kazem Khalagi ◽  
Akram Ansarifar ◽  
Noushin Fahimfar ◽  
Mahnaz Sanjari ◽  
Safoora Gharibzdeh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Education Level ◽  
Lower Education Level ◽  
History Of ◽  
Elderly Health ◽  
Lower Education ◽  
Demographic Risk ◽  
Demographic Risk Factors

Abstract Background Iran’s population is aging. Disability is a major public health problem for older adults, not only in Iran but all over the world. The purpose of this study was to investigate the relationship between cardio-metabolic and socio-demographic risk factors and disability in people 60 years and older in Iran. Methods The baseline (cross-sectional) data of 2426 samples from the Bushehr Elderly Health (BEH) program was included in the analysis. The participants were selected through multi-stage random sampling in Bushehr, southern Iran. Socio-demographic characteristics, as well as the history of diabetes and other chronic diseases, and smoking were measured using standardized questionnaires. Anthropometric measurements and laboratory tests were performed under standard conditions. Dependency was determined by the questionnaires of basic activities of daily living (BADL) and instrumental activities of daily living (IADL) using Barthel and Lawton scales respectively. Multiple logistic regression was used in the analysis. Results Mean (Standard Deviation) of the participants’ age was 69.3 (6.4) years (range: 60 and 96 years), and 48.1% of the participants were men. After adjusting for potential confounders, being older, being female (OR (95%CI): 2.3 (1.9–2.9)), having a lower education level, a history of diabetes mellitus (OR: 1.4 (1.2–1.7)) and past smoking (OR: 1.3 (1.0–1.6)), and no physical activity (OR: 1.5 (1.2–1.9)) were significantly associated with dependency in IADL. Also, being older and female (OR: 2.4 (1.9–3.0)), having a lower education level, no physical activity (OR: 2.2 (1.6–2.9)) and daily intake of calories (OR: 0.99 (0.99–0.99)) were associated with dependency in BADL. Conclusion Dependency in older adults can be prevented by increasing community literacy, improving physical activity, preventing and controlling diabetes mellitus, avoiding smoking, and reducing daily calorie intake.

scholarly journals Medicine package inserts from the users’ perspective: are they read and understood?

2019 ◽  
Vol 22 ◽  
Author(s):  
Tatiane da Silva Dal Pizzol ◽  
Cassia Garcia Moraes ◽  
Paulo Sérgio Dourado Arrais ◽  
Andréa Dâmaso Bertoldi ◽  
Luiz Roberto Ramos ◽  
...  
Keyword(s):  
Population Based ◽  
Education Level ◽  
Descriptive Statistics ◽  
Cross Sectional ◽  
Population Based Study ◽  
Package Inserts ◽  
Factors Associated ◽  
Written Information ◽  
Lower Education Level ◽  
Lower Education

ABSTRACT: Introduction: The written information on medicines has been acknowledged as an important tool for health education. Objective: To analyze the use and understanding of medicine package inserts by users and assess sociodemographic and medical factors associated with their comprehension. Method: Data in this analysis are part of the PNAUM National Survey - a cross-sectional population-based study conducted in Brazil. Descriptive statistics and the Pearson χ2 tests were performed to compare proportions between sociodemographic and medical characteristics, as well as use and understanding of medicine package inserts. Results: A total of 28.427 individuals responded to questions related to medicine package inserts. From these, 59.6% (95%CI 57.7 - 61.5) said they usually read the inserts, and 98.4% (95%CI 98.0 - 98.8) considered them necessary. Among people who read the medicine package inserts, more than half indicated difficulties with legibility (57.4%; 95%CI 55,2 - 59,6) and readability (54.1%; 95%CI 52.1 - 56.1). People from a lower education level reported greater difficulty in understanding them. Conclusion: The larger portion of the population usually read medicine package inserts. Nevertheless, people have difficulty in reading and understanding them.

PREVALENCE AND FACTORS ASSOCIATED WITH EARLY MARRIAGE IN CHIPULUKUSU TOWNSHIP OF NDOLA, ZAMBIA:cross sectional study (Preprint)

2019 ◽  
Author(s):  
Satiel Banda
Keyword(s):  
Economic Status ◽  
Cross Sectional Study ◽  
Education Level ◽  
Early Marriage ◽  
Child Marriage ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Lower Education Level ◽  
Lower Education

BACKGROUND In the statistics taken from media brief on ending child marriage in Zambia, (2014) states, “Zambia is the third highest country with cases of child marriages in the SADC region and 19th in the world. In Zambia, about 42 per cent of women aged 20-24 years are married by the age of 18 – a rate that has not evolved since 2002. The rates of child marriages vary from province to province, and are as high as 60 per cent in the Eastern Province. (www.girlsnotbrides.org.) accessed on 20th November 2014. At 13.42) The ZDHS [Zambia Demographic Health Survey] indicates that among married girls aged 15-19 in Zambia, 68 percent have already given birth. In addition, most of the births occurring to girls before age 18 are first births (85 percent), and a majority of these first births occur within marriage. A Central Statistical Office (CSO) report of 2010 carried out by Plan Zambia indicates that “only a few adolescent girls and boys complete upper primary education while the enrolment ratio in secondary education is 13.4% for males and 12.9% for females.” The report concludes that child marriage is the critical driver for this state of affairs. OBJECTIVE This study is aimed at determining the prevalence and factors associated with child marriage in Chipulukusu township of Ndola. Zambia. METHODS A cross-sectional study was conducted in Chipulukusu Township within the location of Ndola. A pretest questionnaire was used to collect information on child marriage prevalence and factors towards the practice of child marriage and other relevant socio-demographic characteristics. RESULTS the prevalence of early marriage in Chipulukusu township of Ndola district, Zambia was 20.7 % with it being significantly associated with lower social economic status (poverty), lower education level, orphanhood and teen pregnancies CONCLUSIONS the prevalence of early marriage in this study was high. Its prevalence was significantly associated with people of poor backgrounds (poverty), teen pregnancies, lower education level, and orphan hood.

scholarly journals Food Consumption and Characteristics Associated in a Brazilian Older Adult Population: A Cluster Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Laís M. R. Loureiro ◽  
Luciene F. F. Almeida ◽  
Carla J. Machado ◽  
Milene C. Pessoa ◽  
Maria Sônia L. Duarte ◽  
...  
Keyword(s):  
Older Adults ◽  
Food Consumption ◽  
Education Level ◽  
Community Dwelling ◽  
Processed Meats ◽  
Lower Education Level ◽  
Regular Consumption ◽  
Whole Milk ◽  
History Of ◽  
Lower Education

Epidemiological studies support diet as a factor in the prevention and treatment of non-communicable chronic diseases, whose occurrence increases with age due to the poor choices or the adoption of a monotonous diet. The aim of this study was to construct the food consumption profiles of older adults of a Brazilian city to identify the main food groups and eating habits that contribute to these profiles and to estimate its association with socioeconomic characteristics, health and use of health services, lifestyle, and anthropometric indicators. This is a population-based cross-sectional study conducted with a representative sample of 621 community-dwelling older adults (≥60 years) in Viçosa, Minas Gerais, Brazil. The food consumption profile was the dependent variable obtained from a Food Frequency Questionnaire, utilizing the two-step cluster method. The multiple multinomial logistic regression model was used to estimate the independent associations, obtaining the odds ratios and 95% confidence intervals. Three clusters were generated, namely, (1) “unhealthy” (2) “less unhealthy,” and (3) “fairly healthy.” The cluster “unhealthy” was characterized by a regular consumption of beans, fats, fatty/processed meats, and whole milk. The factors independently associated with this cluster were lower education level, lower individual income, history of at least one doctor's appointment in the year preceding this study, and being a former smoker. The cluster “less unhealthy” was characterized by a regular consumption of beans, green vegetables, vegetables and fruits, as well as fats, fatty/processed meats, and whole milk. The factors independently associated with the “less unhealthy” cluster were lower education level and history of at least six doctor's appointments in the prior year. The cluster “fairly healthy” was characterized by the same pattern of “less unhealthy,” except for skim milk and low-fat dairy products. The evidence of the associations indicates the profile of older adults who require greater attention and care related to improved nutrition. The illiterate or semi-literate aged individuals, those with low income, and those who neglect to seek medical advice must be the focus of healthy eating actions and programs.

scholarly journals Lower Education Level is a Major Risk Factor for Peritonitis Incidence in Chronic Peritoneal Dialysis Patients: A Retrospective Cohort Study with 12-Year Follow-Up

2013 ◽  
Vol 33 (5) ◽  
pp. 552-558 ◽  
Author(s):  
Yahn-Bor Chern ◽  
Pei-Shan Ho ◽  
Li-Chueh Kuo ◽  
Jin-Bor Chen
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
Univariate Analysis ◽  
Education Level ◽  
Time Dependent ◽  
Factors Associated ◽  
Lower Education Level ◽  
Lower Education

BackgroundPeritoneal dialysis (PD)-related peritonitis remains an important complication in PD patients, potentially causing technique failure and influencing patient outcome. To date, no comprehensive study in the Taiwanese PD population has used a time-dependent statistical method to analyze the factors associated with PD-related peritonitis.MethodsOur single-center retrospective cohort study, conducted in southern Taiwan between February 1999 and July 2010, used time-dependent statistical methods to analyze the factors associated with PD-related peritonitis.ResultsThe study recruited 404 PD patients for analysis, 150 of whom experienced at least 1 episode of peritonitis during the follow-up period. The incidence rate of peritonitis was highest during the first 6 months after PD start. A comparison of patients in the two groups (peritonitis vs null-peritonitis) by univariate analysis showed that the peritonitis group included fewer men (p = 0.048) and more patients of older age (≥65 years, p = 0.049). In addition, patients who had never received compulsory education showed a statistically higher incidence of PD-related peritonitis in the univariate analysis (p = 0.04). A proportional hazards model identified education level (less than elementary school vs any higher education level) as having an independent association with PD-related peritonitis [hazard ratio (HR): 1.45; 95% confidence interval (CI): 1.01 to 2.06; p = 0.045). Comorbidities measured using the Charlson comorbidity index (score >2 vs ≤2) showed borderline statistical significance (HR: 1.44; 95% CI: 1.00 to 2.13; p = 0.053).ConclusionsA lower education level is a major risk factor for PD-related peritonitis independent of age, sex, hypoalbuminemia, and comorbidities. Our study emphasizes that a comprehensive PD education program is crucial for PD patients with a lower education level.

scholarly journals Resilience: A Protective Factor from Depression and Anxiety in Mexican Dialysis Patients

2021 ◽  
Vol 18 (22) ◽  
pp. 11957
Author(s):  
Cristina J. González-Flores ◽  
Guillermo García-García ◽  
Abel Lerma ◽  
Héctor Pérez-Grovas ◽  
Rosa M. Meda-Lara ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Protective Factor ◽  
Education Level ◽  
Cognitive Distortion ◽  
Psychological Resilience ◽  
Depression And Anxiety ◽  
Factors Associated ◽  
Lower Education Level ◽  
Lower Education ◽  
Esrd Patients

Depression and anxiety are highly prevalent psychological disorders in end-stage renal disease (ESRD) that have a negative clinical impact. The purpose of our study was to identify factors associated with the presence of depression and anxiety, in a sample of ESRD patients treated with hemodialysis. We included 187 patients from two dialysis facilities, age 18–65 years. Beck’s depression and anxiety inventories, KDQOL36 questionnaire, the cognitive distortion scale and the Mexican scale of resilience were used. Socio-demographic and clinical information was obtained from medical records. Depression was present in 143 (76.4%) patients. Patient with depression were older (33 (26–52) years vs. 30 (24.43) years, p = 0.025), had a lower education level (36% vs. 9%, p = 0.001), used more medications (67% vs. 36%, p = 0.001), had a comorbidity (75% vs. 41%, p = 0.001), and a higher proportion were waiting for a kidney transplant. Anxiety was present in 112 (59.8%) cases. By multivariate analysis, depression was independently associated with lower education, absence of previous kidney transplant, anxiety, higher cognitive distortion, lower psychological resilience, and lower quality of life scores. In conclusion, lower psychological resilience, lower education level, and higher cognitive distortions are factors associated with depression and anxiety in ESRD patients.

scholarly journals Risk Factors Associated with the Occurrence of Autoimmune Diseases in Adult Coeliac Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Laura Conti ◽  
Edith Lahner ◽  
Gloria Galli ◽  
Gianluca Esposito ◽  
Marilia Carabotti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Autoimmune Diseases ◽  
Type I Diabetes ◽  
Type I ◽  
Factors Associated ◽  
Specific Risk ◽  
Increased Risk ◽  
History Of ◽  
Control Study

Objectives. Autoimmune diseases (AD) may be associated with coeliac disease (CD), but specific risk factors have been poorly investigated. The aim of this study was to assess the spectrum of AD and its specific risk factors associated in a series of adult coeliac patients. Materials and Methods. We performed a single-center case-control study including adult newly diagnosed CD patients. To evaluate the risk factors of the association between AD and CD, 341 coeliac patients included were categorized on the basis of AD presence: 91 cases with at least one AD and 250 controls without AD were compared for clinical, serological, and histological features. Eighty-seven cases were age-gender-matched with 87 controls. Results. Among 341 CD patients, 26.6% of CD patients had at least one AD. Endocrine and dermatological diseases were the most prevalent AD encountered: autoimmune thyroiditis was present in 48.4% of cases, psoriasis in 17.6%, and type I diabetes and dermatitis herpetiformis in 11%, respectively. At logistic regression, factors associated with AD were a positive 1st-degree family history of AD (OR 3.7, 95% CI 1.93–7), a body mass index ≥ 25 kg/m2 at CD diagnosis (OR 2.95%, CI 1.1–3.8), and long standing presentation signs/symptoms before CD diagnosis (>10 years) (OR 2.1, 95% CI 1.1–3.7). Analysis on age-gender-matched patients confirmed these results. Conclusions. CD patients with family history of AD, overweight at CD diagnosis, and a delay of CD diagnosis had an increased risk of having another AD. The benefit of CD screening in these specific subsets of patients with AD awaits further investigation.

Factors Associated with Insulin Resistance in Women with Migraine: A Cross-Sectional Study

Pain Medicine ◽  
2019 ◽  
Vol 20 (10) ◽  
pp. 2043-2050
Author(s):  
Selen Gur-Ozmen ◽  
Ruhan Karahan-Ozcan
Keyword(s):  
Insulin Resistance ◽  
Family History ◽  
Descriptive Analysis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Increased Risk ◽  
History Of ◽  
The Impact

AbstractObjectiveStudies have shown a relationship between insulin resistance (IR) and migraine that is more evident in some migraineurs. Long-term use of various drugs and increased risk of diverse side effects is an unavoidable reality in this population of patients. Thus, in this study, we aimed to investigate factors associated with IR in migraine and the impact of chronic usage of various drugs, which might play a part in development of IR.DesignCross-sectional study.SettingGebze Fatih General Hospital, Kocaeli, Turkey.SubjectsMigraine patients (N = 150) were investigated.MethodsWeight, height, waist circumference, and blood pressure were measured. Fasting glucose, fasting insulin, glycated hemoglobin, and lipid profile were also measured. IR was selected as a dependent variable. The independent variables included age, cigarette smoking, alcohol consumption, family history of migraine, diabetes mellitus and hypertension, characteristics of pain, migraine triggers and subgroups, medication used during attack treatment, medication used as prophylactic treatment, and oral contraceptive treatment. Descriptive analysis and multivariate logistic regression were performed.ResultsCentral obesity (odds ratio [OR] = 7.131, 95% confidence interval [CI] = 2.451–20.741, P < 0.0001), metoclopramide treatment during an attack (OR = 3.645, 95% CI = 0.996–13.346, P = 0.041), family history of DM (OR = 3.109, 95% CI = 1.189–8.132, P = 0.035), nonsteroidal anti-inflammatory drug (NSAID) usage during an attack (OR = 2.578, 95% CI = 1.053–6.311, P = 0.043), and negative family history of hypertension (OR = 0.226, 95% CI = 0.085–0.602, P = 0.002) were significant factors for exhibiting IR in migraine.ConclusionsOur study demonstrates an association between metoclopramide and NSAID treatments and IR in migraine.

Prediction of Prostate Cancer for Patients Receiving Finasteride: Results From the Prostate Cancer Prevention Trial

2007 ◽  
Vol 25 (21) ◽  
pp. 3076-3081 ◽  
Author(s):  
Ian M. Thompson ◽  
Donna Pauler Ankerst ◽  
Chen Chi ◽  
Phyllis J. Goodman ◽  
Catherine M. Tangen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Family History ◽  
Prostate Biopsy ◽  
Factors Associated ◽  
Negative Biopsy ◽  
Prostate Cancer Prevention ◽  
Increased Risk ◽  
History Of ◽  
The Impact

Purpose Using data from men in the finasteride group of the Prostate Cancer Prevention Trial (PCPT), we evaluated the impact of prostate-specific antigen (PSA) and other risk factors on the risk of prostate cancer. Methods Four thousand four hundred forty men in the finasteride group of the PCPT underwent prostate biopsy, had at least one PSA and a digital rectal exam (DRE) during the year before biopsy, had at least two PSA values from the 3 years before biopsy, and were on finasteride at the time of PSA evaluation. Logistic regression was conducted using the variables age, race, family history of prostate cancer, PSA, PSA velocity, and DRE adjusting for history of prior prostate biopsy. Results Six hundred forty-nine (14.6%) of 4,440 men were diagnosed with prostate cancer; 250 had Gleason 7 or higher cancer. Factors associated with an increased risk of prostate cancer included high PSA value and a rising PSA (24.9% risk for PSA value of 1.0 ng/mL and 24.8% risk for a rising PSA), family history of prostate cancer, abnormal DRE result, African American race, and older age. Factors associated with an increased risk of Gleason 7 or higher grade prostate cancer included PSA, abnormal DRE, and older age. A prior negative biopsy was associated with decreased risk of prostate cancer and high-grade prostate cancer. Conclusion Risk factors for prostate cancer on biopsy for men receiving finasteride include PSA, DRE, age, race, family history, and history of a prior negative biopsy. With the exception of the approximate reduction of PSA by half with finasteride, the impact of these risk factors is similar to men who do not receive finasteride.

scholarly journals Association of Cardio-Metabolic Risk Factors and Basic and Instrumental Activities of Daily Living Among Elderly People;Bushehr Elderly Health Program

2020 ◽  
Author(s):  
Kazem Khalagi ◽  
Akram Ansarifar ◽  
Noushin Fahimfar ◽  
Mahnaz Sanjari ◽  
Safoora Gharibzdeh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Daily Intake ◽  
Education Level ◽  
Lower Education Level ◽  
History Of ◽  
Elderly Health ◽  
Lower Education

Abstract Background: Iran's population is aging. One of the most common problems in Iranian public health is the high prevalence of cardio-metabolic risk factors. The purpose of this study was to investigate the relationship between cardio-metabolic and demographic risk factors and disability in people 60 years and older in Iran.Methods: Data from the Bushehr Elderly Health (BEH) program was used in the analysis. Demographic characteristics, as well as the history of diabetes and other chronic diseases, and smoking were measured using standardized questionnaires. Anthropometric measurements and laboratory tests were performed under standard conditions. Dependency was determined by the questionnaires of basic activities of daily living (BADL) and instrumental activities of daily living (IADL) using Barthel and Lawton scales respectively. Multiple logistic regression was used in the analysis.Results: Mean (Standard Deviation) of the participants’ age was 69.34 (6.4) years (range: 60 and 96 years), and 48.06% of the participants were men. After adjusting for potential confounders, being older, being female (OR (95%CI): 2.33 (1.89 - 2.86)), having a lower education level, a history of diabetes mellitus (OR: 1.43 (1.17 -1.74)) and past smoking (OR: 1.25 (1.00 - 1.55)), and no physical activity (OR: 1.54 (1.23 - 1.87)) were significantly associated with dependency in IADL. Also, being older and female (OR: 2.38 (1.85 - 3.03)), having a lower education level, no physical activity (OR: 2.17 (1.61 - 2.86)) and low daily intake of calories were associated with dependency in BADL.Conclusion: Age, gender, education level and physical activity are risk factors of the dependency in both of BADL and IADL in the elderly people. Diabetes mellitus and past smoking are risk factors of the dependency in IADL, and low HDL cholesterol and low daily intake of calories are risk factors of the dependency in BADL.

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