scholarly journals Barriers, facilitators, and interventions for medication adherence across chronic conditions with the highest non-adherence rates: a scoping review with recommendations for intervention development

2020 ◽  
Author(s):  
Pinelopi Konstantinou ◽  
Angelos P Kassianos ◽  
Giοrgos Georgiou ◽  
Andreas Panayides ◽  
Alexia Papageorgiou ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Behavioral Health ◽  
Scoping Review ◽  
Low Income ◽  
Chronic Conditions ◽  
Health Interventions ◽  
Barriers And Facilitators ◽  
World Health ◽  
Medication Cost ◽  
Multicomponent Interventions

Abstract Medication non-adherence (MNA) constitutes a complex health problem contributing to increased economic burden and poor health outcomes. The Medication Adherence Model (MAM) supports that numerous processes are involved in medication adherence (MA). Based on the MAM and guidelines of the World Health Organization (WHO), this scoping review aimed to identify the barriers and facilitators associated with MA, and the behavioral health interventions and techniques among chronic conditions presenting with high non-adherence rates (asthma, cancer, diabetes, epilepsy, HIV/AIDS, and hypertension). PubMed, PsycINFO, and Scopus databases were screened, and 243 studies were included. A mixed methods approach was used to collate the evidence and interpret findings. The most commonly reported barriers to MA across conditions were younger age, low education, low income, high medication cost, side effects, patient beliefs/perceptions, comorbidities, and poor patient–provider communication. Additionally, digitally delivered interventions including components such as medication and condition education, motivational interviewing (MI), and reinforcement and motivational messages led to improvements in MA. This review highlights the importance of administrating multicomponent interventions digitally and personalized to the patients’ individual needs and characteristics, responding to the adherence barriers faced. This is the first review examining and synthesizing evidence on barriers and facilitators to MA and behavioral health interventions used for improving MA across chronic conditions with the highest non-adherence rates and providing recommendations to researchers and clinicians. Stakeholders are called to explore methods overcoming barriers identified and developing effective multicomponent interventions that can reduce the high rates of MNA.

scholarly journals Quality of life in people living with HIV-associated neurocognitive disorder: A scoping review study

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251944
Author(s):  
Kate Alford ◽  
Stephanie Daley ◽  
Sube Banerjee ◽  
Jaime H. Vera
Keyword(s):  
Quality Of Life ◽  
Cognitive Impairment ◽  
Scoping Review ◽  
Chronic Conditions ◽  
Healthy Aging ◽  
Cognitive Disorder ◽  
World Health ◽  
People Living With Hiv ◽  
Living With Hiv

Quality of life (QoL) is recognized as an essential end point in the disease management of chronic conditions such as HIV with calls to include good QoL as a ‘fourth 90’ in the 90-90-90 testing and treatment targets introduced by World Health Organization in 2016. Cognitive impairments impact a broad spectrum of experiences and are a common issue effecting people living with HIV (PLWH). Despite this, few studies have examined QoL in PLWH who also have a cognitive disorder. This study aimed to synthesize and describe what is known about QoL in those living with HIV-associated neurocognitive disorders (HAND). A scoping review of peer-reviewed literature was conducted to identify how QoL has been investigated and measured in PLWH with HAND, and how PLWH with HAND report and describe their QoL. We searched PsychInfo, Medline, Scopus, and Web of Science along with hand-searching reference lists from relevant studies found. Included studies were those published in English after 1st January 2003 which included PLWH with cognitive impairment not due to other pre-existing conditions. Fifteen articles met criteria for inclusion. Two studies measured QoL as a primary aim, with others including QoL assessment as part of a broader battery of outcomes. The MOS-HIV and SF-36 were the most commonly used measures of overall QoL, with findings generally suggestive of poorer overall QoL in PLWH with HAND, compared to PLWH without cognitive impairment. Studies which examined dimensions of QoL focused exclusively on functionality, level of independence, and psychological QoL domains. There is a considerable dearth of research examining QoL in PLWH with HAND. The initiatives which advocate for healthy aging and improved QoL in PLWH must be extended to include and understand the experiences those also living with cognitive impairment. Research is needed to understand the broad experiential impacts of living with these two complex, chronic conditions, to ensure interventions are meaningful to patients and potential benefits are not missed.

Medication adherence and barriers among low-income, uninsured patients with multiple chronic conditions

2019 ◽  
Vol 15 (6) ◽  
pp. 744-753 ◽  
Author(s):  
Cesar I. Fernandez-Lazaro ◽  
David P. Adams ◽  
Diego Fernandez-Lazaro ◽  
Juan M. Garcia-González ◽  
Alberto Caballero-Garcia ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Low Income ◽  
Chronic Conditions ◽  
Multiple Chronic Conditions ◽  
Uninsured Patients

scholarly journals Mapping evidence on the distribution of paediatric cancers in sub-Saharan Africa: a scoping review protocol

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Sehlisiwe R. Ndlovu ◽  
Desmond Kuupiel ◽  
Themba G. Ginindza
Keyword(s):  
Scoping Review ◽  
Low Income ◽  
Relevant Literature ◽  
Sub Saharan Africa ◽  
World Health ◽  
Low Income Countries ◽  
Future Research ◽  
International Agency ◽  
Healthcare Needs ◽  
Sub Saharan

Abstract Background Paediatric cancers account for a minor fraction of deaths and hence receive little attention from policymakers. In low-income countries, the absence of comprehensive national paediatric strategies results in a lack of access for a majority of children with cancer. In sub-Saharan Africa (SSA), the burden of childhood cancers is underestimated due to a lack of paediatric cancer registries, poor health care systems and competing healthcare needs. The objective of this study is to map evidence on the distribution of paediatric cancers in the SSA region. Method A scoping review will be conducted to map literature on the distribution of paediatric cancers in SSA. An electronic literature search will be conducted from the following databases: PubMed, Google Scholar, EBSCOhost (CINAHL and Health Source) and World Health Organization (WHO)/International Agency for Research in Cancer (IARC) (GLOBOCAN databases). We will also search the reference lists of included studies to source relevant literature. A pilot search was conducted to determine the feasibility of the study. Study selection will be guided by the inclusion and exclusion criteria. After charting the data, a descriptive overview of the studies will be presented in a narrative format. An account of the study characteristics will be described in this narrative. The analysis will be mainly based on mapping the country-specific outcomes emerging from the studies, and a numerical summary of these outcomes will be conducted. Tables, maps and charts will be produced and presented in the result section. Discussion This review study will identify existing research gaps for future research to influence policy implementation and to improve the availability of diagnosis and treatment of paediatric cancers in SSA.

scholarly journals Actions Targeting the Double Burden of Malnutrition: A Scoping Review

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 81 ◽  
Author(s):  
Sonia Menon ◽  
José L. Peñalvo
Keyword(s):  
Nutrition Education ◽  
Scoping Review ◽  
Low Income ◽  
Sub Saharan Africa ◽  
World Health ◽  
Low Income Countries ◽  
Nutrient Deficiencies ◽  
Global Public Health ◽  
Double Burden ◽  
Double Burden Of Malnutrition

Background: In many developing countries, nutritional and epidemiological transitions are contributing to continuous undernutrition and escalating overnutrition, resulting in coexisting forms of malnutrition often referred as the “double burden of malnutrition” (DBM). This complex phenomenon constitutes an unprecedented challenge to global public health and has been prioritized by international health organizations, prompting governments to swift action. Specifically, five years ago the World Health Organization (WHO) proposed a roadmap to tackle the DBM though so-called “double-duty actions”. The objective of this review was to synthesize the literature on interventions which address the DBM. Methods: We developed a scoping review to identify interventions addressing the DBM. We searched PUBMED for papers reporting interventions until December 2019. Articles examining interventions, government policies, or tools at the individual, household, or community level to address the DBM were included. Results: Seven articles met the inclusion criteria. Three were from sub-Saharan Africa, one was from Southeast Asia, and one was from Central America. Two were modelling studies, with one covering 24 low-income countries and the other focusing on Ghana. Conclusion: Notwithstanding the pressing issue of the DBM, there is a paucity of studies examining double-duty actions despite the attention that it has garnered within the global nutrition community. Whilst nutrient deficiencies may be curbed by poverty reduction measures, for obesity prevention nutrition, education and promotion of physical activity, along with the encouragement of local food production, may be instrumental.

scholarly journals Pharmacovigilance quality system for vaccine monitoring (COVID-19) using quality indicators: a scoping review

2021 ◽  
Author(s):  
Mayra M. Moura de Oliveira ◽  
Gabriela Arantes Wagner ◽  
Vera L. Gattás ◽  
Larissa de Souza Arruda ◽  
Monica Taminato
Keyword(s):  
Signal Detection ◽  
Active Surveillance ◽  
Scoping Review ◽  
Low Income ◽  
Scientific Evidence ◽  
World Health ◽  
Low Income Countries ◽  
Public And Private ◽  
Health Organization ◽  
Detection Of Signals

This scoping review responds to the appeal of the scientific community for collaboration between different entities for pharmacovigilance and active surveillance of coronavirus disease 2019 (COVID-19) vaccines. The objective is to identify, systematically evaluate, and synthesize the best scientific evidence available on the indicators used in pharmacovigilance systems. Our results demonstrate that approximately 50% of the 25 studies used in this review have been carried out in the past 5 years. Of these, only four used the pharmacovigilance indicators proposed by the World Health Organization (WHO). Eighty-seven pharmacovigilance indicators were identified, of which seven (8.0%) related to signal detection. While the WHO advocates signal detection as routine pharmacovigilance, in special situations – such as accelerated clinical studies where adverse events are not yet well known – other indicators related to signal detection appear to be good options for maintaining quality pharmacovigilance and active surveillance in the development of the COVID-19 vaccine. However, the less robust pharmacovigilance systems in low-income countries will necessitate greater involvement of health professionals from public and private sectors, pharmaceutical companies, academic institutions, and the general public, to ensure information security and detection of signals for the COVID-19 vaccine.

Use of Mental Health Interventions by Physiotherapists to Treat Individuals with Chronic Conditions: A Systematic Scoping Review

2021 ◽  
pp. e20200066
Author(s):  
Elizabeth Alvarez ◽  
Amanda Garvin ◽  
Nicole Germaine ◽  
Lisa Guidoni ◽  
Meghan Schnurr
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Chronic Conditions ◽  
Health Management ◽  
Research Question ◽  
Behavioural Change ◽  
Behavioural Therapy ◽  
Health Interventions ◽  
Psychosocial Model ◽  
Mental Health Interventions

Purpose: Physiotherapists work with people with chronic conditions and can act as catalysts for behavioural change. Physiotherapy has also seen a shift to a bio-psychosocial model of health management and interdisciplinary care, which is important in the context of chronic conditions. This scoping review addressed the research question “How do physiotherapists use mental health–based interventions in their treatment of individuals with chronic conditions?” Method: The Embase, MEDLINE, PsycINFO, and CINAHL databases were searched, and a variety of study designs were included. Data were categorized and descriptively analyzed. Results: Data were extracted from 103 articles. Low back pain (43; 41.7%) and non-specified pain (16; 15.5%) were the most commonly researched chronic conditions, but other chronic conditions were also represented. Outpatient facilities were the most common setting for intervention (68; 66.0%). A total of 73 (70.9%) of the articles involved cognitive­–behavioural therapy, and 41 (40.0%) included graded exercise or graded activity as a mental health intervention. Conclusions: Physiotherapists can use a variety of mental health interventions in the treatment of chronic conditions. More detailed descriptions of treatment and training protocols would be helpful for incorporating these techniques into clinical practice.

A Scoping Review of Methods Used to Assess Medication Adherence in Patients with Chronic Conditions

2021 ◽  
Author(s):  
Pinelopi Konstantinou ◽  
Orestis Kasinopoulos ◽  
Christiana Karashiali ◽  
Geοrgios Georgiou ◽  
Andreas Panayides ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Quality Indicators ◽  
Scoping Review ◽  
Chronic Conditions ◽  
Electronic Monitoring ◽  
Intervention Development ◽  
Assessment Methods ◽  
Self Report ◽  
Evidence Based ◽  
Gold Standard Method

Abstract Background Medication nonadherence of patients with chronic conditions is a complex phenomenon contributing to increased economic burden and decreased quality of life. Intervention development relies on accurately assessing adherence but no “gold standard” method currently exists. Purpose The present scoping review aimed to: (a) review and describe current methods of assessing medication adherence (MA) in patients with chronic conditions with the highest nonadherence rates (asthma, cancer, diabetes, epilepsy, HIV/AIDS, hypertension), (b) outline and compare the evidence on the quality indicators between assessment methods (e.g., sensitivity), and (c) provide evidence-based recommendations. Methods PubMed, PsycINFO and Scopus databases were screened, resulting in 62,592 studies of which 71 met criteria and were included. Results Twenty-seven self-report and 10 nonself-report measures were identified. The Medication Adherence Report Scale (MARS-5) was found to be the most accurate self-report, whereas electronic monitoring devices such as Medication Event Monitoring System (MEMS) corresponded to the most accurate nonself-report. Higher MA rates were reported when assessed using self-reports compared to nonself-reports, except from pill counts. Conclusions Professionals are advised to use a combination of self-report (like MARS-5) and nonself-report measures (like MEMS) as these were found to be the most accurate and reliable measures. This is the first review examining self and nonself-report methods for MA, across chronic conditions with the highest nonadherence rates and provides evidence-based recommendations. It highlights that MA assessment methods are understudied in certain conditions, like epilepsy. Before selecting a MA measure, professionals are advised to inspect its quality indicators. Feasibility of measures should be explored in future studies as there is presently a lack of evidence.

Development of a blended learning approach to delivering HIV assisted contact tracing in Malawi: applied theory and formative research (Preprint)

2021 ◽  
Author(s):  
Nora Ellen Rosenberg ◽  
Tapiwa A Tembo ◽  
Katherine R Simon ◽  
Katie Mollan ◽  
Sarah E Rutstein ◽  
...  
Keyword(s):  
Low Income ◽  
Cognitive Theory ◽  
Health Workers ◽  
Scale Up ◽  
Barriers And Facilitators ◽  
World Health ◽  
Contact Tracing ◽  
Hiv Positive ◽  
Applied Theory ◽  
Implementation Package

UNSTRUCTURED Despite progress towards the UNAIDS “95-95-95” targets (95% of HIV-positive persons tested, 95% of tested persons on treatment, and 95% of treated persons virally suppressed), a gap remains in achieving the first 95% target. Assisted contact tracing (ACT), in which health workers support HIV-positive indexes to recruit their contacts (sexual partners and children) for HIV testing, efficiently identify HIV-positive persons in need of treatment. ACT is recommended in the World Health Organization’s 2016 guidance, and although many countries, including Malawi, began implementing ACT, testing outcomes in routine settings have been worse than those in trial settings. To bridge the gap between research and practice and support scale-up in Malawi, a set of implementation strategies (“implementation package”) was developed using frameworks and theories. First, the Consolidated Framework for Implementation Research (CFIR) guided qualitative research to identify key barriers and facilitators to intervention delivery. Limited clinic coordination and health worker capacity to address the complexities of ACT were identified as key barriers; ongoing individual training and group problem-solving were identified as facilitators. Next, the theory of expertise, social cognitive theory and principles of continuous quality improvement informed the development of the implementation package to address these barriers and facilitators. Finally, human-centered design principles guided the translation of the implementation package from in-person to digital delivery. This trajectory highlights the key roles behavioral theories, implementation frameworks, and technology can play in bringing an evidence-based intervention, such as ACT, to scale in a low-income setting like Malawi.

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