scholarly journals Impact of adherence goal awareness intervention on PDC in various settings: Does awareness help modify medication-taking behavior?

2021 ◽  
Vol 4 ◽  
pp. 100072
Author(s):  
A.R. Mercadante ◽  
S. Lee ◽  
K. Uh ◽  
A. Chau ◽  
U. Truong ◽  
...  
Keyword(s):  
Medication Taking Behavior

scholarly journals The Clinical Utility and Ecological Validity of the Medication Management Ability Assessment in Older Adults with and without Dementia

2020 ◽  
Author(s):  
Seth A Margolis ◽  
Emily S Hallowell ◽  
Jennifer D Davis ◽  
Lauren E Kenney ◽  
Geoffrey N Tremont
Keyword(s):  
Older Adults ◽  
Clinical Utility ◽  
Ecological Validity ◽  
Medication Management ◽  
Functional Decline ◽  
Retrospective Chart Review ◽  
Cognitively Impaired ◽  
Clinical Evaluations ◽  
Management Ability ◽  
Medication Taking Behavior

Abstract Objective Older adults are susceptible to medication nonadherence, which may signify functional decline. Thus, performance-based proxies of medication-taking behavior may help diagnose dementia. We assessed the Medication Management Ability Assessment’s (MMAA) clinical utility and ecological validity. Method This was a retrospective chart review of 180 outpatients (age = 72 ± 8 years) who completed the MMAA during clinical evaluations. Forty-seven were cognitively normal (CN), 103 had mild cognitive impairment (MCI), and 30 had dementia. Most (136) were independent in medication management, whereas 28 were assisted and 16 were dependent. Kruskal–Wallis tests assessed whether MMAA scores differed by diagnosis and independence. Receiver operating characteristic (ROC) analyses identified diagnostic cut-offs. Classification accuracy estimates were derived. Results MMAA performance differed across diagnosis as expected (p’s < .001). Those who were independent in medication management outperformed assisted and dependent counterparts (p’s < .001). Assisted and dependent cases were no different. At a cut-off = 23, the MMAA was good-to-strong in distinguishing dementia from CN cases (Sn = 0.96, Sp = 0.83), dementia from MCI (Sn = 0.70, Sp = 0.83), and dementia from functionally unimpaired cases (Sn = 0.78, Sp = 0.83). At a cut-off = 27, it had good sensitivity but weaker specificity when distinguishing both MCI and all cognitively impaired patients (MCI and dementia) from CN cases (Sn = 0.81, Sp = 0.66 and Sn = 0.81, Sp = 0.72, respectively). Conclusions The MMAA has ecological validity and clinical utility in identifying dementia. Its inclusion in neuropsychological practice may be especially useful when medication mismanagement is suspected.

scholarly journals An algorithm to identify medication nonpersistence using electronic pharmacy databases

2015 ◽  
Vol 22 (5) ◽  
pp. 957-961 ◽  
Author(s):  
Melissa M Parker ◽  
Howard H Moffet ◽  
Alyce Adams ◽  
Andrew J Karter
Keyword(s):  
Healthcare Systems ◽  
Healthcare Operations ◽  
Timely Manner ◽  
Pharmacy Records ◽  
Grace Period ◽  
Adult Diabetes ◽  
Primary Nonadherence ◽  
Medication Taking Behavior ◽  
Novel Algorithm

Abstract Objective Identifying patients who are medication nonpersistent (fail to refill in a timely manner) is important for healthcare operations and research. However, consistent methods to detect nonpersistence using electronic pharmacy records are presently lacking. We developed and validated a nonpersistence algorithm for chronically used medications. Materials and Methods Refill patterns of adult diabetes patients (n = 14,349) prescribed cardiometabolic therapies were studied. We evaluated various grace periods (30-300 days) to identify medication nonpersistence, which is defined as a gap between refills that exceeds a threshold equal to the last days’ supply dispensed plus a grace period plus days of stockpiled medication. Since data on medication stockpiles are typically unavailable for ongoing users, we compared nonpersistence to rates calculated using algorithms that ignored stockpiles. Results When using grace periods equal to or greater than the number of days’ supply dispensed (i.e., at least 100 days), this novel algorithm for medication nonpersistence gave consistent results whether or not it accounted for days of stockpiled medication. The agreement (Kappa coefficients) between nonpersistence rates using algorithms with versus without stockpiling improved with longer grace periods and ranged from 0.63 (for 30 days) to 0.98 (for a 300-day grace period). Conclusions Our method has utility for health care operations and research in prevalent (ongoing) and new user cohorts. The algorithm detects a subset of patients with inadequate medication-taking behavior not identified as primary nonadherent or secondary nonadherent. Healthcare systems can most comprehensively identify patients with short- or long-term medication underutilization by identifying primary nonadherence, secondary nonadherence, and nonpersistence.

Determinants of Compliance in Epileptic Outpatients

1981 ◽  
Vol 15 (7-8) ◽  
pp. 572-577 ◽  
Author(s):  
Stephen G. Bryant ◽  
Larry Ereshefsky
Keyword(s):  
Health Care ◽  
Medication Compliance ◽  
Holistic Approach ◽  
Clinical History ◽  
Level Of Satisfaction ◽  
The Social ◽  
Attitudinal Characteristics ◽  
Belief Model ◽  
Medication Taking Behavior ◽  
Insight Into

The authors have investigated reasons for medication compliance in a population of epileptic patients. The hypothesis that the health care belief model would be predictive of medication-taking behavior was validated. A pilot study was constructed which investigated the comparative responses of compliant and noncompliant epileptic outpatients to questions regarding demographic, clinical history, and attitudinal characteristics. Noncompliant patients were characterized as having a longer duration of epilepsy, more complicated dosage regimens, and more changes in medication. In addition, noncompliant patients both demonstrated more confusion over medication directions and less insight into the need for anticonvulsants and feared addiction to their medication. They had a lower level of satisfaction with their health care and were more frequently subject to the social complications of epilepsy. The authors suggest that a more holistic approach be taken when attempting to reverse noncompliant behavior.

scholarly journals Predictors of Adherence Among Patients With Multiple Sclerosis Using the BETACONNECT® Autoinjector: A Prospective Observational Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Wolfgang Köhler ◽  
Kirsten Bayer-Gersmann ◽  
Thomas Neußer ◽  
Markus Schürks ◽  
Tjalf Ziemssen
Keyword(s):  
Multiple Sclerosis ◽  
Vitamin D ◽  
Cohort Study ◽  
Injection Site ◽  
Patient Characteristics ◽  
Primary Objective ◽  
Duration Of Treatment ◽  
Injection Site Reactions ◽  
Medication Taking Behavior ◽  
Predictors Of Adherence

Background: In patients with multiple sclerosis (MS), non-adherence to disease-modifying drug therapy is associated with an increased rate of MS relapses. Early identification of patients at risk of non-adherence would allow provision of timely and individualized support. The aim of the BETAPREDICT study was to investigate potential predictors of adherence in patients with MS in Germany treated with interferon β-1b (IFNβ-1b) using the BETACONNECT® autoinjector.Methods: BETAPREDICT was a national, multi-center, prospective, non-interventional, single-arm, 24-month cohort study of patients with relapsing–remitting MS or clinically isolated syndrome receiving IFNβ-1b via the BETACONNECT® autoinjector (ClinicalTrials.gov: NCT02486640). Injection data were captured by the autoinjector. The primary objective was to determine baseline predictors of compliance, persistence, and adherence to IFNβ-1b treatment after 12- and 24 months using multivariable-adjusted regression. Secondary objectives included evaluation of satisfaction with the autoinjector, injection site pain, vitamin and nutrient supplementation, clinical course, and patient-related outcome measures.Results: Of 165 patients enrolled, 153 were available for analysis (120 with autoinjector data). Seventy-two patients left the study prematurely. Compliance (N = 120), persistence (N = 153), and adherence (N = 120) at 24 months were 89.1, 53.6, and 41.7%, respectively. Compliance at 12- and 24 months was predicted by intake of vitamin D supplements and absence of specific injection site reactions. Positive predictors of persistence included age (at 12- and 24 months) and previous duration of treatment (at 12 months), while intake of vitamins/nutrients other than vitamin D was a negative predictor (at 12 months). Positive predictors of adherence at 24 months were age and being experienced with IFNβ-1b. Higher scores in specific SF-36 subscales were positive predictors of medication-taking behavior at 24 months. Satisfaction with the autoinjector was high at baseline and 24 months (median score: 9 out of 10).Conclusions: Compliance with IFNβ-1b treatment among participants still under observation remained high over a 24-month period, while persistence and adherence continuously declined. Multiple factors affected medication-taking behavior, including patient characteristics, treatment history, injection site reactions, patients' perception of their health and support programs. The importance of these factors may differ among patients according to their individual situation.

scholarly journals Knowledge about Disease, Medication Therapy, and Related Medication Adherence Levels among Patients with Hypertension

Medicina ◽  
2019 ◽  
Vol 55 (11) ◽  
pp. 715 ◽  
Author(s):  
Gavrilova ◽  
Bandere ◽  
Rutkovska ◽  
Šmits ◽  
Mauriņa ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Patient Outcomes ◽  
Study Data ◽  
The Self ◽  
Demographic Differences ◽  
Cross Sectional ◽  
Medication Therapy ◽  
Adherence Scale ◽  
Medication Taking Behavior ◽  
Insight Into

Background and Objectives: A particular problem in cardiology is poor adherence to pharmacological treatment among patients with hypertension. It is known that approximately half of these patients do not use their medications as prescribed by their doctor. Patients may choose not to follow the doctor’s recommendations and regularly do not control their blood pressure, owing to many factors. A convenient method for measuring the level of adherence is the Morisky Medication Adherence Scale, which also provides insight into possible remedies for low adherence. We investigated their therapy, knowledge about the disease and its control, and demographic differences to assess the adherence of patients with hypertension. Materials and Methods: This was a cross-sectional observational study. Data were collected through a survey of 12 pharmacies in Latvia. The study involved 187 participants with hypertension. Results: The prevalence of non-adherence was 46.20% in Latvia. The oldest patients were the most adherent (p = 0.001, β = 0.27). The higher the self-rated extent from 0 to 10, to which the patient takes their antihypertensives exactly as instructed by their physician, the higher the level of adherence (p < 0.0001, β = 0.38), where at “0”, the patient does not follow physician instructions at all, and at “10”, the patient completely follows the physician’s instructions. Non-adherent patients tend to assess their medication-taking behavior more critically than adherent patients. The longer the patient is known to suffer from hypertension, the more adherent he or she is (p = 0.014, β = 0.19). Conclusions: Medication non-adherence among patients with hypertension is high in Latvia. Further investigations are needed to better understand the reasons for this and to establish interventions for improving patient outcomes.

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