scholarly journals The Effectiveness of Telephone Intervention for Improving Patient Adherence to Medication among Diabetic Patients: A Systematic Review and Meta-analysis of Randomized Trials

2021 ◽  
Author(s):  
Debbie P. Monterona ◽  
Rhoda Alfonsa Matinong ◽  
Jeriel Reyes De Silos
Keyword(s):  
Medication Adherence ◽  
Usual Care ◽  
Patient Adherence ◽  
Text Message ◽  
Phone Call ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Telephone Intervention ◽  
Services Research ◽  
Adherence To Medication

Introduction: Diabetes is one of the chronic diseases that requires adherence to prescribed medications. With the current pandemic, mobile technology plays a role in caring for patients remotely. Objective: To determine the effectiveness of telephone intervention (phone call and text message) on medication adherence among diabetic patients. Methodology: Randomized controlled trials were searched in Cochrane Library, PubMed, Herdin, BMC Health Services Research using combination of terms through boolean operators (phone message OR phone call) AND (medication adherence AND diabetes) which compared telephone intervention vs usual care. mean, sample size and standard deviation of Medication Adherence in each study were extracted. Review Manager 5.4 software was used for statistical analysis. Results: Three trials met the inclusion criteria and were included in this study. The telephone intervention did not result in statistically significant improvement in medication adherence among diabetics (pooled mean difference: 0.05 95%CI -.08 to 0.17) Conclusion: The intervention was no more effective than the usual care. However, mobile use has potential application for remote care during this pandemic.

scholarly journals Health literacy and adherence to treatment of patients with heart failure

2019 ◽  
Vol 53 ◽  
Author(s):  
Monica Isabelle Lopes Oscalices ◽  
Meiry Fernanda Pinto Okuno ◽  
Maria Carolina Barbosa Teixeira Lopes ◽  
Ruth Ester Assayag Batista ◽  
Cassia Regina Vancini Campanharo
Keyword(s):  
Heart Failure ◽  
Medication Adherence ◽  
Health Literacy ◽  
White Women ◽  
Patient Adherence ◽  
Functional Health ◽  
Cross Sectional ◽  
Adherence To Medication ◽  
Patients With Heart Failure ◽  
Medical Questionnaire

ABSTRACT Objective: To relate the level of functional health literacy with adherence and barriers to non-adherence, rehospitalization, readmission and death in patients with heart failure. Method: A cross-sectional, analytical study with patients admitted to the emergency room with a diagnosis of heart failure. Literacy was assessed by the Newest Vital Sign. Patient adherence to medication treatment and barriers to non-compliance were assessed 90 days after discharge by the Morisky-Green test and the Brief Medical Questionnaire, respectively. Results: 100 patients participated in the study. The mean age was 63.3 years (± 15.2), with a predominance of white women. Medication adherence was low in 41.1% of participants, of which 55.9% presented inadequate literacy. Re-hospitalization and death were present in patients with inadequate literacy (p<0.001). Conclusion: The low level of literacy was directly related to lower adherence and the presence of barriers to medication adherence, as well as higher rehospitalization rates and death.

Effect of telemedicine intervention on hypoglycaemia in diabetes patients: A systematic review and meta-analysis of randomised controlled trials

2018 ◽  
Vol 25 (7) ◽  
pp. 402-413 ◽  
Author(s):  
Yuli Hu ◽  
Xiaohong Wen ◽  
Feifei Wang ◽  
Dongliang Yang ◽  
Shanshan Liu ◽  
...  
Keyword(s):  
Usual Care ◽  
Positive Impact ◽  
Blood Glucose Concentration ◽  
Mean Difference ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Control Group ◽  
Diabetic Patients ◽  
Hypoglycemic Event ◽  
Significant Difference

Introduction Hypoglycaemia is a clinical syndrome from various causes, which happens when the blood glucose concentration is too low. Many studies show that telemedicine intervention can improve glycemic control and has a positive impact on the management of diabetic patients. The purpose of this study was to evaluate the effect of telemedicine intervention on hypoglycemic event occurrences and results on hemoglobin A1c (HbA1c) and body mass index (BMI). Methods We searched the Cochrane Library, PubMed, Web of Science, the EBSCO host, and OVID to identify relevant studies published from January 2006 to December 2017. The work of searching, selecting and assessing risk of bias was administrated by two independent reviewers. The primary outcomes were hypoglycemic event rate and HbA1c; the secondary outcome was BMI. Results From 1246 articles, we identified 14 eligible RCTs ( n = 1324). Compared to usual care, telemedicine was found to reduce the odds of hypoglycaemia (odds ratio ( OR) = 0.42; 95% confidence interval ( CI) = 0.29–0.59; I2 = 32%; p < 0.00001). We found that the clinical relevance declined in HbA1c level compared to control group (mean difference = −0.28; 95% CI = −0.45 to −0.12; I2 = 53%; p = 0.0005), but that telemedicine had no effect on BMI (mean difference = −0.27; 95% CI = −0.86–0.31; I2 = 40%; p = 0.35). Discussion Compared to usual care, the use of telemedicine was found to improve HbA1c and reduce the risk of moderate hypoglycaemia in diabetic patients, but without significant difference in BMI.

scholarly journals Effectiveness of eHealth Interventions in Improving Treatment Adherence for Patients With COPD or Asthma: Systematic Review (Preprint)

2021 ◽  
Author(s):  
Mieke Hendrika Johanna Schulte ◽  
Jiska Joëlle Aardoom ◽  
Lisa Loheide-Niesmann ◽  
Leonie L.L. Verstraete ◽  
Hans C. Ossebaard ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Treatment Adherence ◽  
Exercise Adherence ◽  
Mixed Effects ◽  
Risk Of Bias ◽  
Health Concern ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Control Group ◽  
Adherence To Medication

BACKGROUND Poor treatment adherence in patients with chronic obstructive pulmonary disease (COPD) or asthma is a global public health concern with severe consequences in terms of patient health and societal costs. eHealth is a promising tool for addressing poor compliance. OBJECTIVE This review investigates the effects of eHealth interventions on adherence to medication treatment in patients with COPD or asthma and adherence to exercise regimens by patients with COPD. METHODS A systematic literature search was conducted in the databases of Cochrane Library, PsycINFO, PubMed, and Embase. We selected randomized controlled trials, conducted on adult patients with COPD or asthma, which evaluated the effectiveness of an eHealth intervention in terms of medication adherence or exercise behavior (for COPD), or medication adherence only (for asthma). Risk of bias in the included studies was examined using the Cochrane Collaboration’s risk-of-bias tool. RESULTS Thirteen studies focusing on COPD, and seven focusing on asthma, were analyzed. Of the COPD studies, five targeted medication adherence, seven targeted exercise adherence, and one examined both. Adherence was a primary outcome in four studies and a secondary outcome in nine. As to medication adherence, two studies reported non-significant effects of the eHealth interventions, one study found a significant improvement, and three reported mixed effects. Regarding exercise adherence, four studies reported no significant effects of the eHealth interventions, three found significant improvements, and one found mixed results. Of the seven studies focusing on medication adherence in asthma, three found significant effects, two reported non-significant effects, and two reported mixed effects. Across all studies, 12 were standalone interventions, whereas eight were added to care as usual. Most studies used care as usual as a control group, whereas a small number of studies used a face-to-face intervention provided by a healthcare professional or waitlist control condition. CONCLUSIONS The mixed results on the effectiveness of eHealth interventions in improving treatment adherence for asthma and COPD are presumably related to the type, context, and intensity of the interventions, as well as to differences in the operationalization and measurement of adherence outcomes. Much remains to be learned about the potentials of eHealth to optimize treatment adherence in COPD and asthma.

scholarly journals Impact of a Pharmacy-Led Transition of Care Service on Post-Discharge Medication Adherence

Pharmacy ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 128
Author(s):  
Alaina Stroud ◽  
Georges Adunlin ◽  
Jessica W. Skelley
Keyword(s):  
Medication Adherence ◽  
Transitional Care ◽  
Care Service ◽  
Hospital Environment ◽  
Phone Call ◽  
Transition Of Care ◽  
Management Service ◽  
Adherence To Medication ◽  
Discharge Medication

This study assesses the effectiveness of a pharmacy-led transition of care (TOC) service on increasing patients’ understanding of, and reported adherence to, medication post hospital discharge. A cross-sectional survey was administered to patients who were discharged from the hospital with at least one medication received via bedside delivery from the TOC service. Adherence was assessed by asking the patient if they had taken their discharge medications as instructed by the prescriber. Satisfaction with the discharge medication counseling service was assessed through a five-point Likert scale. Descriptive statistics were conducted for all questionnaire items and qualitative data was examined using content analysis. The majority of patients (73%) were counseled on their medication(s) before leaving the hospital. Among those who received counseling, 76 patients had a better understanding of their medication(s). Ninety-five percent of the patients reported adherence, and all six of the patients reporting non-adherence claimed they were not counseled on their medications prior to discharge. Many patients had questions regarding their medication during the follow-up phone call, substantiating the need for further follow-up with patients once they have left the hospital environment. The implementation of medication bedside delivery and counseling services, followed by outpatient adherence monitoring via a transitional care management service, can result in higher levels of reported medication adherence.

scholarly journals Does the Polypill Improve Patient Adherence Compared to Its Individual Formulations? A Systematic Review

Pharmaceutics ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 190
Author(s):  
Ana Baumgartner ◽  
Katarina Drame ◽  
Stijn Geutjens ◽  
Marja Airaksinen
Keyword(s):  
Systematic Review ◽  
Medication Adherence ◽  
Patient Adherence ◽  
Chronic Illnesses ◽  
Cochrane Library ◽  
Small Range ◽  
Therapy Regimen ◽  
Improve Patient Adherence ◽  
Meta Analyses ◽  
Multiple Drugs

Many patients, especially those with a high pill burden and multiple chronic illnesses, are less adherent to medication. In medication treatments utilizing polypills, this problem might be diminished since multiple drugs are fused into one formulation and, therefore, the therapy regimen is simplified. This systematic review summarized evidence to assess the effect of polypills on medication adherence. The following databases were searched for articles published between 1 January 2000, and 14 May 2019: PubMed, Web of Science, Cochrane Library, and Scopus. Medication adherence was the only outcome assessed, regardless of the method of measuring it. Sixty-seven original peer-reviewed articles were selected. Adherence to polypill regimens was significantly higher in 56 articles (84%) compared to multiple pill regimens. This finding was also supported by the results of 13 out of 17 selected previously published systematic reviews and meta-analyses dealing with this topic. Adherence can be improved through the formulation of polypills, which is probably why the interest in researching them is growing. There are many polypills on the market, but the adherence studies so far focused mainly on a small range of medical conditions.

scholarly journals InspirerMundi—Remote Monitoring of Inhaled Medication Adherence through Objective Verification Based on Combined Image Processing Techniques

2021 ◽  
Author(s):  
Pedro Vieira-Marques ◽  
Rute Almeida ◽  
João F. Teixeira ◽  
José Valente ◽  
Cristina Jácome ◽  
...  
Keyword(s):  
Image Processing ◽  
Medication Adherence ◽  
Remote Monitoring ◽  
Patient Adherence ◽  
Self Management ◽  
Management Decision ◽  
Image Processing Techniques ◽  
Adherence To Medication ◽  
Adherence Assessment ◽  
Processing Techniques

Abstract Background The adherence to inhaled controller medications is of critical importance for achieving good clinical results in patients with chronic respiratory diseases. Self-management strategies can result in improved health outcomes and reduce unscheduled care and improve disease control. However, adherence assessment suffers from difficulties on attaining a high grade of trustworthiness given that patient self-reports of high-adherence rates are known to be unreliable. Objective Aiming to increase patient adherence to medication and allow for remote monitoring by health professionals, a mobile gamified application was developed where a therapeutic plan provides insight for creating a patient-oriented self-management system. To allow a reliable adherence measurement, the application includes a novel approach for objective verification of inhaler usage based on real-time video capture of the inhaler's dosage counters. Methods This approach uses template matching image processing techniques, an off-the-shelf machine learning framework, and was developed to be reusable within other applications. The proposed approach was validated by 24 participants with a set of 12 inhalers models. Results Performed tests resulted in the correct value identification for the dosage counter in 79% of the registration events with all inhalers and over 90% for the three most widely used inhalers in Portugal. These results show the potential of exploring mobile-embedded capabilities for acquiring additional evidence regarding inhaler adherence. Conclusion This system helps to bridge the gap between the patient and the health professional. By empowering the first with a tool for disease self-management and medication adherence and providing the later with additional relevant data, it paves the way to a better-informed disease management decision.

scholarly journals Medication Adherence and its Association with Glycaemic Control, Blood Pressure Control, Glycosuria and Proteinuria Among People Living With Diabetes (PLWD) in the Ho Municipality, Ghana

2018 ◽  
Vol 11 (1) ◽  
pp. 552-561
Author(s):  
James Osei-Yeboah ◽  
Sylvester Yao Lokpo ◽  
William K. B. A. Owiredu ◽  
Beatrice Bella Johnson ◽  
Verner Ndudiri Orish ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Glycaemic Control ◽  
Fasting Blood Glucose ◽  
Clinical Information ◽  
Pressure Control ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Adherence To Medication

Background:Adherence is the active, voluntary, and collaborative involvement of the patient in a mutually acceptable course of behaviour to produce a therapeutic result. The study is aimed at assessing adherence to medication and its relation to therapeutic outcomes among people living with diabetes in the Ho Municipality.Methodology:A cross-sectional study was conducted involving 150 diabetic patients attending the diabetic clinic at the Ho Municipal Hospital. Urine glucose and urine protein were measured using a two-parameter dipstick. The current fasting blood glucose and blood pressure, as well as the measurements of two previous visits, were documented. A semi-structured questionnaire including the Diabetes Complication Checklist and the Morisky, Green and Levine Adherence Scale were used to capture biodata, clinical information and medication adherence.Results:Optimal medication adherence was 60.67%. Glycaemic control and controlled blood pressure were 33.33% and 58.67%, respectively. The prevalence of glycosuria and proteinuria was 10.67% and 3.3%, respectively. Percentage glycaemic control and controlled blood pressure were found to be higher among the medication adherent group, while glycosuria and proteinuria were the highest among participants presenting with low medication adherence.Conclusion:In this group of patients living with diabetes in the Ho Municipality, high level of uncontrolled glycaemia and blood pressure exist.However, these two treatment outcomes may be modulated by optimal medication adherence.

Association between Patients’ Knowledge and Adherence to Anticoagulants, and Its Effect on Coagulation Control

Pharmacology ◽  
2020 ◽  
pp. 1-10
Author(s):  
Hazem Ahmed ◽  
Enas Ahmed Saddouh ◽  
Mohamed Elhadi Abugrin ◽  
Alya Muftah Mohammed Ali ◽  
Elham Omran Elgdhafi ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Patient Adherence ◽  
Drug Effects ◽  
Final Analysis ◽  
University Hospital ◽  
Strong Positive Correlation ◽  
Hospital Data ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Adherence To Medication

<b><i>Background:</i></b> Warfarin requires strict monitoring by measuring prothrombin time (PT), international normalized ratio (INR), and time in therapeutic range (TTR). Several factors can lead to poor PT/INR control including vitamin K status, medication adherence, knowledge, and quality of life. The present study aims to assess patient adherence to warfarin treatment and its correlation with INR control. <b><i>Methods:</i></b> A cross-sectional study was conducted between October 2017 and January 2018 at Tripoli University Hospital. Data were collected by structured questionnaires which included; demographic and clinical characteristics, the Oral Anticoagulation Knowledge (OAK) test, and the Morisky Medication Adherence Scale (MMAS-8). <b><i>Results:</i></b> The final analysis included 88 out of 140 patients (73.33%). There were significant differences in age range, gender, marital status, and education level between the 2 groups (poor knowledge and adequate knowledge) (<i>p</i> &#x3c; 0.05). There was a significant positive correlation between OAK test score and TTR. Overall, 76.2% of patients were adherent to warfarin (MMAS score ≥6) and 20.45% of patients were of high adherence (MMAS score of 8). The median score was 6 (IQR 6–7). A statistically significant, strong positive correlation between adherence to medication and TTR as an indicator of INR control was found (rs[86] = 0.472, <i>p</i> &#x3c; 0.0001). <b><i>Conclusion:</i></b> The study addressed and identified several areas for future improvement of patient outcomes. The implementation of new approaches to enhance patient knowledge and adherence is warranted, and measures to provide treatment for all patients that require it are needed, to improve outcomes and decrease adverse drug effects.

scholarly journals Glycemic control, medication adherence, and injection practices among diabetic patients treated in the 3 tertiary referral hospitals in Bhutan: a call for more action

2018 ◽  
Vol 12 (1) ◽  
pp. 27-33
Author(s):  
Thinley Dorji ◽  
Pempa Lhamo ◽  
Tshering Tshering ◽  
Lungten Zangmo ◽  
Kencho Choden ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Glycemic Control ◽  
Blood Sugar ◽  
Injection Technique ◽  
Diabetic Patients ◽  
Tertiary Referral ◽  
Good Glycemic Control ◽  
Adherence To Medication ◽  
Referral Hospitals ◽  
Injection Practices

AbstractBackgroundThe burden of diabetes has increased rapidly with an increasing cost of treatment.ObjectivesTo describe the glycemic control, injection practices, and treatment adherence among diabetic patients treated with insulin.MethodsThis cross-sectional study was conducted using a convenience sampling method at the 3 tertiary referral hospitals in Bhutan. Sociodemographic, injection practices, and clinical details were collected. Good glycemic control was defined as glycated hemoglobin A (HbA1c) <7% if available or fasting blood sugar 70–130 mg/dL and 2 h postprandial blood sugar <180 mg/dL if HbA1c values were unavailable. Medication adherence was assessed using the Morisky, Green and Levine (MGL) scale. The injection technique was assessed using a 10-item checklist.ResultsWe studied 207 patients. Good glycemic control was achieved by only 58 (28.0%) of patients. Using the MGL scale score, the objective adherence with insulin therapy was mostly low to medium and a gross discordance was with self-declared adherence (P < 0.001). The injection technique was fair to poor in half of the participants. Those with good injection techniques also had good adherence to medication (P = 0.025, adjusted odds ratio = 4.4, 95% confidence interval 1.2–16.4). The majority (154, 74.4%) had self-injected insulin, while the remaining were dependent on their home caregivers. Forty percent of the participants used storage practices that were not recommended. The disposal of the used insulin needles was generally unsafe.ConclusionsGlycemic control and adherence to insulin administration recommendations were poor. The injection technique needs to be improved and standardized, and methods of safe disposal of sharps need to be developed.

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