scholarly journals T217. MEDICATION ADHERENCE AND ITS CORRELATES AMONG PATIENTS WITH RECURRENT SCHIZOPHRENIA: A LARGE-SCALE STUDY IN CHINA

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S315-S315
Author(s):  
Brendan Ross ◽  
Dongfang Wang ◽  
Chang Xi ◽  
Yunzhi Pan ◽  
Li Zhou ◽  
...  
Keyword(s):  
Hong Kong ◽  
Medication Adherence ◽  
Antipsychotic Medication ◽  
Clinical Characteristics ◽  
Rating Scale ◽  
Severity Of Illness ◽  
Older Age ◽  
Good Adherence ◽  
Acute Period ◽  
Adherence To Medication

Abstract Background The Medication Adherence Rating Scale (MARS) is a rapid, non-intrusive way of measuring adherence to medication in order to improve management of patients with schizophrenia. The current study evaluated the reliability of the Chinese (Mandarin) version of the MARS and explored clinical and demographic correlates to medication adherence in a large sample of patients with recurrent schizophrenia in China. Methods 1198 patients with recurrent schizophrenia were recruited from 37 different hospitals in 17 provinces/municipalities of China and evaluated with the Medication Adherence Rating Scale (MARS), Clinical Global Impression-Severity of illness (CGI-S) and Sheehan Disability Scale-Chinese version (SDS-C). Socio-demographic data included gender, age, marital status, education level, employment status and living with others or alone. Clinical data included duration of illness, number of relapses, and medication use, as well as current stage of disease evaluated by SCID. Pearson correlations were used to examine associations between MARS, socio-demographic, and clinical characteristics. Independent sample T-tests were used to compare MARS score between different socio-demographic and clinical characteristics. Finally, a cut-off score of 6 on the MARS (ranged from 1 to 10) was used to divide the sample into two groups (i.e. MARS score≥ 6 identified good adherence and MARS score< 6 indicated poor adherence). Bivariate logistic regression models with the two groups (MARS score<6 and MARS score≥6) as the dependent variable was used to identify influencing factors of medication adherence. Data processing and analyses were conducted on SPSS 22.0 and Mplus 7.4. Results The MARS showed good internal consistency and psychometric properties. MARS outcomes varied by demographic and clinical characteristics; only 28.5% recurrent schizophrenia patients met the criteria of good adherence to antipsychotic medication. Findings indicated older age (OR=1.04, 95%CI=1.02–1.06), unsteady income (OR=1.79, 95%CI=1.29–2.49), acute period (OR=4.23, 95%CI=3.21–5.59) and a higher CGI-S score (OR=1.44, 95%CI=1.03–2.01) had significantly predictive effects on poor medication adherence. MARS demonstrated good reliability in our sample (Cronbach’s α =0.83; Spearman-Brown = 0.72). Discussion This study of the MARS is unique for a few reasons. First, comparative reports on MARS use in mainland China have not been published internationally; similar tests on reliability and correlation have only been reported in Hong Kong and Taiwan (Hui et al., 2006; Kao and Liu, 2010). Second, in considering demographic and clinical correlates of medication adherence in patients with recurrent schizophrenia, our MARS study broadly represents China with 17 of 27 provinces/municipalities reporting data from multiple geographic regions, with the participation of hundreds of psychiatrists across China. Only 28.5% recurrent schizophrenia patients met the criteria of good adherence to antipsychotic medication in this study. Low levels of good medication adherence in schizophrenia patients are found across Asia, with 27% in Korea meeting the criteria of good adherence (Kim et al., 2006) and 26% in Hong Kong (Hui et al., 2006). Overall MARS total score in our study (3.68 ±2.90) is comparably lower to that of developed countries, as MARS total score had a mean of 6.0 to 7.7 in a UK sample (Fialko et al., 2008; Jaeger et al., 2012), and 5.5 for schizophrenia patients in France (Zemmour et al., 2016). Medication adherence of patients affected by recurrent schizophrenia in China was found to be relatively low. Risk factors for non-adherence to medication in recurrent schizophrenia patients include older age, unsteady income, acute period and severity of illness.

Antipsychotic Medication Adherence Scale (AMAS): Development and preliminary psychometric properties

2016 ◽  
Vol 33 (S1) ◽  
pp. s258-s259
Author(s):  
M.J. Martins ◽  
A.T. Pereira ◽  
C.B. Carvalho ◽  
P. Castilho ◽  
A.C. Lopes ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Psychometric Properties ◽  
Antipsychotic Medication ◽  
Convergent Validity ◽  
Rating Scale ◽  
Statistical Analysis Plan ◽  
Different Types ◽  
Adherence Scale ◽  
Relevant Variables ◽  
Competing Interest

IntroductionAlthough being highly consensual that antipsychotic adherence is an important outcome predictor in psychosis, existing reviews have found mean rates of adherence around 40–60%. Several aspects, such as patient-related, medication-related, environmental-related variables have been described as important predictors.AimsThis study aim is to develop, administer and present preliminary psychometric properties of a new scale for antipsychotic medication adherence that includes different types of predictors (clinical, psychosocial, and practical among others).MethodsThe “AMAS” was developed by a multidisciplinary team and was based on recent research on factors influencing antipsychotic adherence. The scale evolved from multiple drafts and experts were contacted in order to improve the final version. Over 50 patients with a diagnosis of a psychotic-spectrum disorder taking antipsychotic medication will be assessed with the “AMAS” and the Medication Adherence Rating Scale. Additionally, each patient's psychiatrist will fill in a form with demographic and clinical variables (such as type of symptoms, previous adherence problems, current adherence, insight and other relevant variables).ResultsThis is an ongoing study and the sample is still being collected (scheduled finish date: February/2016). Our statistical analysis’ plan includes: reliability analysis (Chronbach's alpha, alpha if item deleted, inter item correlations and covariances and item-total correlations); validity (convergent validity); factorial analysis.ConclusionsIt is hypothesized that the “AMAS” will be a practical, reliable and valid unidimentional instrument with clinical utility assessing adherence to antipsychotics. The “AMAS” can be also useful in assessing intervention targets (e.g. psychoterapeutical, psychoeducational) to enhance adherence.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Factors affecting self-reported medication adherence and hypertension knowledge: A cross-sectional study in rural villages, Yogyakarta Province, Indonesia

2017 ◽  
Vol 14 (3) ◽  
pp. 212-227 ◽  
Author(s):  
Riana Rahmawati ◽  
Beata Bajorek
Keyword(s):  
Medication Adherence ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Healthcare Services ◽  
Knowledge Gaps ◽  
Good Adherence ◽  
Cross Sectional ◽  
Rural Villages ◽  
Adherence To Medication ◽  
Hypertension Knowledge

Objectives This study assessed medication adherence and hypertension knowledge, and their predictive factors, in people with hypertension, living in rural communities in Indonesia. Methods Data were acquired from 384 people living in eight rural villages via a researcher-administered questionnaire, a validated adherence scale, and a standardized hypertension knowledge survey. Multivariate analysis was used to identify the predictors of adherence and knowledge. Results Fifty-nine (15%) participants had good hypertension knowledge (score ≥ 8 out of 10). Compared to participants with poor knowledge, these participants had higher formal education (odds ratio = 2.7, 95% confidence interval = 1.5–4.7), and lived closer to a community health center (odds ratio = 1.8, 95% confidence interval = 1.0–3.3). Knowledge gaps about the need for long-term medication, hypertension complications, and the target blood pressure were identified. Good hypertension knowledge predicted good adherence to medication (odds ratio = 7.1, 95% confidence interval = 3.3–15.2). Only 42 (11%) participants were considered to have good adherence. Reasons for intentional nonadherence were beliefs that medicines should be taken only when symptoms are evident, limited access to healthcare services, and a preference using traditional medicines. Conclusion Strategies for addressing knowledge gaps and misconceptions about hypertension medication are needed, particularly for people with a low educational level and those living some distances from healthcare facilities.

scholarly journals Adherence to antihypertensive medications in patients attending public hospitals in Kano State, Nigeria

2020 ◽  
Vol 12 (1) ◽  
pp. 395-400
Author(s):  
Umar Idris Ibrahim ◽  
Shafiu Mohammed ◽  
Abdulkadir Umar Zezi ◽  
Basira Kankia Lawal
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Antihypertensive Medication ◽  
Public Hospitals ◽  
Poor Adherence ◽  
Chronic Medical Condition ◽  
Public Healthcare ◽  
Good Adherence ◽  
Adherence To Medication ◽  
Arterial Blood

Hypertension is a chronic medical condition characterized by an elevated arterial blood pressure with increasing prevalence in developing countries including Nigeria. One of the integral elements in management of hypertension is adherence to medication and life-style modification. This study aimed to assess adherence level for anti-hypertensive medications among adult hypertensive patients attending public hospitals in Kano State, Nigeria. The study was a cross sectional prospective survey involving 600 patients from six public healthcare facilities selected by multistage sampling technique. Adherence status was assessed using Morisky medication adherence scale. Sociodemographic data and other factors that may influence adherence to hypertension medications were evaluated. Out of the 598 patients that participated in the study, only 178 (29.8%) have their BP controlled based on JNC8. Three hundred and thirty two (55.5%) out of 598 patients have good adherence, while 266 (45.5%) have poor adherence. Of the 178 patients who had good BP control, 120 (67.5%) have good adherence while 58 (32.5%) have poor adherence. BP control was significantly higher in those that adhered to antihypertensive medication compared with non-adhering patients (χ2 = 14.526; df = 1; p-value = < 0.001). Additionally, Chi-square test showed significant association between number of antihypertensives and blood pressure control. (χ2=37.556, df=3, p<0.001). The study established that 55.5% of the respondents have good adherence to their antihypertensive medication while 29.8% had their BP controlled. Adherence and number of antihypertensive medication a patient is taking were found to have significant relationship with BP control. Keywords: Medication, adherence, hypertension, antihypertensive

scholarly journals Antipsychotic medication adherence and preventive diabetes screening in Medicaid enrollees with serious mental illness: an analysis of real-world administrative data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Erica L. Stockbridge ◽  
Nathaniel J. Webb ◽  
Eleena Dhakal ◽  
Manasa Garg ◽  
Abiah D. Loethen ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Medication Adherence ◽  
Serious Mental Illness ◽  
Antipsychotic Medication ◽  
Clinical Characteristics ◽  
Care Quality ◽  
System Reform ◽  
Diabetes Screening

Abstract Background There is excess amenable mortality risk and evidence of healthcare quality deficits for persons with serious mental illness (SMI). We sought to identify sociodemographic and clinical characteristics associated with variations in two 2015 Healthcare Effectiveness Data and Information Set (HEDIS) measures, antipsychotic medication adherence and preventive diabetes screening, among Medicaid enrollees with serious mental illness (SMI). Methods We retrospectively analyzed claims data from September 2014 to December 2015 from enrollees in a Medicaid specialty health plan in Florida. All plan enrollees had SMI; analyses included continuously enrolled adults with antipsychotic medication prescriptions and schizophrenia or bipolar disorder. Associations were identified using mixed effects logistic regression models. Results Data for 5502 enrollees were analyzed. Substance use disorders, depression, and having both schizophrenia and bipolar disorder diagnoses were associated with both HEDIS measures but the direction of the associations differed; each was significantly associated with antipsychotic medication non-adherence (a marker of suboptimal care quality) but an increased likelihood of diabetes screening (a marker of quality care). Compared to whites, blacks and Hispanics had a significantly greater risk of medication non-adherence. Increasing age was significantly associated with increasing medication adherence, but the association between age and diabetes screening varied by sex. Other characteristics significantly associated with quality variations according to one or both measures were education (associated with antipsychotic medication adherence), urbanization (relative to urban locales, residing in suburban areas was associated with both adherence and diabetes screening), obesity (associated with both adherence and diabetes screening), language (non-English speakers had a greater likelihood of diabetes screening), and anxiety, asthma, and hypertension (each positively associated with diabetes screening). Conclusions The characteristics associated with variations in the quality of care provided to Medicaid enrollees with SMI as gauged by two HEDIS measures often differed, and at times associations were directionally opposite. The variations in the quality of healthcare received by persons with SMI that were identified in this study can guide quality improvement and delivery system reform efforts; however, given the sociodemographic and clinical characteristics’ differing associations with different measures of care quality, multidimensional approaches are warranted.

scholarly journals Severity Of Relapse And Medication Adherence In Patient Of Schizophrenia: A Study From Nepal

2019 ◽  
Vol 8 (2) ◽  
pp. 54-58
Author(s):  
P.M. Singh ◽  
S. Karmacharya ◽  
S. Khadka
Keyword(s):  
Medication Adherence ◽  
Patient Group ◽  
Relapse Rate ◽  
Rating Scale ◽  
Psychiatric Inpatient ◽  
College Teaching ◽  
Clinical Syndrome ◽  
Cross Sectional ◽  
Adherent Patient ◽  
Adherence To Medication

Introduction: Schizophrenia is a clinical syndrome of variable, but profoundly disruptive psychopathology. Though it is one of the top ten illness contributing to global burden of disease, relapse rate in schizophrenia is high. Globally relapse rate varies from 50% to 92% and are similar in developed and developing countries. There are various factors associated with relapse, common being poor adherence to treatment. The estimated rate of non-adherence in schizophrenia are 50% widely ranging from 4% to 72%. This study was aimed to find the socio-demographic status of non-adherent group, contributing factors and their severity. Material and Method: A descriptive, cross-sectional study among 95 schizophrenia relapsed patients seeking psychiatric inpatient services at Nepal Medical College Teaching Hospital, Attarkhel, Nepal from the period of Baisakh 3rd 2074 to Baisakh 4th 2075. The socio-demographic variables and clinical data of patients were recorded on proforma developed by department of Psychiatry. The severity of illness was assessed by using The Brief Psychiatric Rating Scale (BPRS) and Positive And Negative Syndrome Scale (PANSS). Also, medication adherence was assessed using Medication Adherence Rating Scale (MARS). Results: Out of 95 relapsed patients, greater number (62.1%) were non-adherent to medication and (37.9%) were adherent to medication. Also, the symptom severity assessment showed significantly severe relapse in non-adherent patient group (43.1%) than adherent patient group (3.1%). Conclusion: Non-adherent to medication is associated with significantly severe relapse in patients of Schizophrenia. Therefore, improving adherence to medication can be achieved by focusing on the identified multitude of factors driving non-adherence.

Smartphone Apps for Diabetes Medication Adherence: A Systematic Review (Preprint)

2021 ◽  
Author(s):  
Sheikh Mohammed Shariful Islam ◽  
Vinaytosh Mishra ◽  
Muhammad Umer Siddiqui ◽  
Jeban Chandir Moses ◽  
Sasan Adibi ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Rating Scale ◽  
Healthy Lifestyle ◽  
Mobile App ◽  
Smartphone Apps ◽  
High Quality ◽  
Physiological Factors ◽  
Diabetes Medication ◽  
Glucose Levels ◽  
Adherence To Medication

BACKGROUND Diabetes is one of the leading noncommunicable chronic diseases globally. Since there is no cure, blood glucose levels need to be monitored regularly and managed. In addition, patients must live a healthy lifestyle and use regular medication to maintain their health and wellbeing. However, various factors contribute to poor adherence to medication. OBJECTIVE This study aims to systematically review and evaluate applications (apps) available for diabetes medication adherence, identify and analyze high-quality apps that are freely available to the public in the Android and Apple app stores, and present the technical features of the apps. METHODS Applying predefined selection criteria, we systematically searched the Apple App Store and Google Play Store for apps to assist in diabetes medication adherence. We assessed high-quality apps using the Mobile App Rating Scale. Apps that achieved a total mean quality score greater than 4 out of 5 in our study were considered high quality. RESULTS We selected eight apps for analysis in this study and discussed them in detail under three main categories: characteristics of the included apps, app features, and diabetes medication adherence. We formulated a task-technology fit matrix to evaluate the apps for diabetes medication adherence. On evaluation, we observed that 25% of the apps promoted high adherence and another 25% of the apps promoted moderate adherence. Finally, we found that 50% of the apps provided low adherence to diabetes medication. CONCLUSIONS Our framework to evaluate smartphone apps in promoting diabetes medication adherence considered physiological factors influencing diabetes and app features. Therefore, our findings could have positive implications for the design and development of apps for diabetes patients. Additionally, available apps can be evaluated according to our framework, and those promoting higher medication adherence could be prescribed for better health outcomes.

scholarly journals Medication adherence and associated factors among elderly hypertension patients with uncontrolled blood pressure in rural area, Northeast Thailand

2018 ◽  
Vol 32 (6) ◽  
pp. 449-458 ◽  
Author(s):  
Nanthakan Woodham ◽  
Surasak Taneepanichskul ◽  
Ratana Somrongthong ◽  
Nanta Auamkul
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Rural Area ◽  
Associated Factors ◽  
World Health ◽  
Common Disease ◽  
Good Adherence ◽  
Uncontrolled Blood Pressure ◽  
Content Type ◽  
Adherence To Medication

Purpose Hypertension is a common disease among elderly. Adherence to antihypertensive medication is a key predictor of optimal blood pressure control that prevents the risk of cardiovascular disease and potentially death. The purpose of this paper is to assess adherence to antihypertension and identify associated factors among the elderly in a rural area, Buengkan province, Thailand. Design/methodology/approach A health facilities based cross-sectional study was conducted in Buengkan district. A simple random sampling method was used to select 408 participants. A structured questionnaire adapted from the World Health Organization STEPwise approach was used to collect data. The medication adherence level was identified by pill count with percentage ⩾70 defined as good adherence. Descriptive and summary statistics were used. Bivariate analysis was done using Pearson’s χ2 test, and multivariable analyses were also carried out. Findings A total of 408 (143 males and 265 females) elderly hypertension patients with uncontrolled blood pressure participated in this study. Most of the participants were found to have lower adherence to medication treatment (86.8 percent), whereas the remaining ones (13.2 percent) were found to have good adherence. The multivariable logistic regression analysis showed that having a daughter as a care taker (adjust odd ratio=7.99, 95% confidence interval: 1.23–51.778) was significantly associated with high medical adherence. Originality/value Hypertension medication adherence among elderly patients with uncontrolled blood pressure was poor. Having a care taker, especially a daughter, is a key to improve adherence. Effective strategy to improve adherence should focus on and involve family participation into the program.

scholarly journals Disclosure and health-related outcomes among children living with HIV and their caregivers

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Margaret Amankwah-Poku ◽  
Delight Abla Klutsey ◽  
Kwaku Oppong Asante
Keyword(s):  
Medication Adherence ◽  
Psychological Health ◽  
Positive Impact ◽  
Well Being ◽  
Demographic Variables ◽  
Hiv Status ◽  
African Countries ◽  
Psychological Well Being ◽  
Adherence To Medication ◽  
Living With Hiv

Abstract Background The prevalence of disclosure of status to children living with the Human Immunodeficiency Virus (HIV) is low in most sub-Saharan African countries, leading to poor compliance and adverse psychological outcomes in these children. This study examined the influence of disclosure on health outcomes in children living with HIV and their caregivers. Methods Using a cross-sectional design, 155 HIV-positive children between age 6–15 years and their caregivers were administered standardized questionnaires measuring adherence to medication, children's psychological well-being, caregiver burden, and caregivers’ psychological health. Results Results indicated that only 33.5% of the children sampled knew their status. Disclosure of HIV status was significantly related to medication adherence, psychological wellbeing, the burden of caregiving, and the length of the disclosure. A child’s age and level of education were the only demographic variables that significantly predicted disclosure of HIV status. In a hierarchical analysis, after controlling for all demographic variables medication adherence, psychological well-being and burden of caregiving were found to be significant predictors of disclosure of status in children living with HIV. Conclusions Findings suggest the need for disclosure of status among children living with HIV for a positive impact on their medication adherence and psychological health. These findings underscore the need for the development of context-specific interventions that will guide and encourage disclosure of status by caregivers to children living with HIV.

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