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 Barriers to Medication Adherence among Hypertensive Patients in Deprived Rural Areas

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Ebrahim Aliafsari Mamaghani ◽  
Edris Hasanpoor ◽  
Esmaiel Maghsoodi ◽  
Farzaneh Soleimani
Keyword(s):  
Medication Adherence ◽  
Rural Communities ◽  
Negative Correlation ◽  
Rural Areas ◽  
Medical Adherence ◽  
Medication Regimen ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Positive Correlation ◽  
Adherence To Medication

BACKGROUND: Poor adherence to medication regimen leads to poor health outcomes, increased medical costs and increased death rate due to hypertension. The aim of this study was to evaluate baseline barriers to medication adherence among hypertensive patients in deprived rural areas.METHODS: A cross-sectional study was conducted on 238 hypertensive patients living in deprived rural areas of Iran. Data were collected using a questionnaire consisting of demographic information, Morisky medication adherence scale and the barriers to medication adherence that were reliable and valid.RESULTS: The results of the study showed that medication adherence was significantly decreased and had a significant positive correlation with gender and economic status, while it had a negative correlation with age. Medication Adherence had a positive correlation with the duration of hypertension, while it had a negative correlation with the number of medications used and concurrently with other diseases.CONCLUSIONS: Based on the present study it can be concluded that enhanced knowledge about illness and treatment in rural communities is improves the medical adherence. Financial supports along with the reduced number of prescribed drugs are also found to be the determining factors in the medical adherence. 

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.

scholarly journals Adherence to medication among Tunisian adults with type 2 diabetes

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Amara ◽  
R Ghammem ◽  
N Zammit ◽  
S BenFredj ◽  
J Maatoug ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
University Hospital ◽  
Health Concern ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Adherence To Medication

Abstract Introduction Diabetes mellitus is a growing public health concern. Despite compelling evidence about the effectiveness of medications, studies have indicated that less than 50% of patients achieved therapeutic targets. The aim of this study was to assess the adherence to type 2 diabetes mellitus treatment and its determinants. Methods A cross-sectional study was conducted between April and June 2017 in the Endocrinology and internal medicine departments of Farhat Hached University Hospital in Sousse, Tunisia. A convenient sample of patients who fulfilled the eligibility criteria was recruited. A pre-tested questionnaire was used to gather information. This was followed by assessing patients' adherence to diabetes medications using the eight-item Morisky Medication Adherence Scale (MMAS-8). Results A total of 330 patients with Type 2 Diabetes Mellitus participated in this study. The mean ±SD age of patients was 58.96±10.3 with female predominance (60.3%). More than half of participants were with high cardiovascular risk. In most cases (70.6 %), participants were moderate adherent. Results showed that patients become non-adherent as the disease gets older (p = 0.001). In addition patients with health insurance were significantly more adherent comparing to those who did not have it (p = 0.01). Regarding self-care practices and other metabolic risk factors' effects, our data revealed that exercising 30 minutes below than 5 times in week and poor self-management of diet were associated with low adherence (p &lt; 10-3). On the other hand, patients who have started insulin therapy were less adherent than those who had not yet (0.01). Patients with diabetic retinopathy or maculopathy were significantly more prone to be non- adherent, with respective percentage of 39.1% and 37.5%. Conclusions This study provides insights into the determinants of non-adherence, ultimately guiding the effective interventions through development of structured long-term policies not yet implemented. Key messages In most cases (70.6 %), participants were moderate adherent. Patients with diabetic retinopathy or maculopathy were significantly more prone to be non- adherent.

scholarly journals Correlation between tumor necrosis factor-alpha and septic shock in children

2013 ◽  
Vol 53 (1) ◽  
pp. 1 ◽  
Author(s):  
Khrisanti Dinata ◽  
Ari L. Runtunuwu ◽  
Jose M. Mandei ◽  
Julius H. Lolombulan
Keyword(s):  
Septic Shock ◽  
Tumor Necrosis Factor ◽  
Tumor Necrosis Factor Alpha ◽  
Tumor Necrosis ◽  
Strong Positive Correlation ◽  
Necrosis Factor Alpha ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Factor Alpha ◽  
Necrosis Factor

Background The crucial role cytokines play in the pathophysiologyof sepsis is widely accepted. Infection stimulates the productionof cytokines in various cell types. Tumor necrosis factor-alpha(TNF-a) is one of the most extensively investigated cytokines inexperimental and clinical sepsis. Tumor necrosis factor-alpha hasbeen shown to mediate lethality in experimental sepsis.Objective To evaluate for a possible correlation between TNF-alevel and septic shock in children.Methods This cross-sectional study was conducted in Manadofrom June to September 2011. A total of 40 patients with arecent diagnosis of sepsis or septic shock were included. Plasmaspecimens were collected from subjects for measurement ofTNF-a concentration. Logistic regression analysis was used toassess the correlation between TNF-a level and sepsis, as well asthe probability of shock in children with sepsis, with P<0.05 asstatistically significant.Results There was a strong positive correlation betweenTNF-a level and the probability of shock in children with sepsis(regression coefficient = 0. 78, P = 0.002).Conclusions There is a strong positive correlation betweenTNF-a level with the probability of shock in children with sepsis.Higher plasma level ofTNF-a is associated with higher probabilityof septic shock.

scholarly journals Position of lips and tongue in rest in newborns with and without ankyloglossia

CoDAS ◽  
2021 ◽  
Vol 33 (6) ◽  
Author(s):  
Silvia Márcia Andrade Campanha ◽  
Roberta Lopes de Castro Martinelli ◽  
Durval Batista Palhares
Keyword(s):  
Visual Inspection ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Sectional Study ◽  
Hospital Data ◽  
Chi Square ◽  
Cross Sectional ◽  
Significance Level ◽  
Significant Difference ◽  
Chi Square Test

ABSTRACT Purpose Verify the position of lips and tongue at rest in newborns with and without ankyloglossia. Methods Cross-sectional study, carried out with 130 newborns in University Hospital. Data collection was performed by the researcher and speech-language pathologists from the Hospital. Information on gestational age, sex, weight, height and days of life was collected. The position of the lips and tongue at rest was evaluated through visual inspection with the newborns asleep. After the newborns were awakened, Neonatal Screening of the validated Protocol for the evaluation of the lingual frenulum for infants was performed to detect the alteration of the lingual frenulum. The data obtained were described and submitted to statistical analysis using the Chi-Square test to verify the association between the position of the lips with the tongue and to compare the position of the lips and tongue with and without ankyloglossia. The Mann-Whitney test was used to verify the behavior of the variables the differed between newborns with and without ankyloglossia. The significance level of 5% was adopted. Results When comparing the data, a significant difference was found between: weight and height with and without ankyloglossia; position of lips and tongue. An association between the position of the tongue and lips with and without ankyloglossia was also found. Conclusion Newborns without alteration of the lingual frenulum have a tendency to remain with their lips closed and their tongue elevated during rest and newborns with ankyloglossia have a tendency to keep their lips parted and their tongue low during rest.

scholarly journals Students’ Perception and Readiness towards Inter-Professional Learning

2018 ◽  
Vol 5 (3) ◽  
pp. 192-200
Author(s):  
Javaria Mukhtar ◽  
Muhammad Hussain ◽  
Kousar Perveen ◽  
Muhammad Afzal ◽  
Syed Amir Gilani
Keyword(s):  
Professional Learning ◽  
Professional Education ◽  
Cross Sectional Study ◽  
Team Work ◽  
Strong Positive Correlation ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Undergraduate Nursing ◽  
Relationship Of ◽  
The Relationship

Inter-professional learning is helpful for students to identify other professionals for team work and collaboration which results in improved patient care out come and also improve Communication among health professionals and patients. The purpose of this study was to explore the relationship between readiness and perception of students towards inter-professional learning. A correlation, cross-sectional study was done with Two hundred and eighty five undergraduate Nursing and Paramedical students from Jan, 2018 to May, 2018. Convenient sampling was used to collect data. The Readiness for Inter-Professional Learning Scale (RIPLS) and Interdisciplinary Education Perception Scale (IEPS) were used to measure the readiness and perception of students regarding inter-professional leaning. The data were analyzed using software Statistical Package for Social Science (SPSS) (Version 21). Spearman rho correlation test was used to explore the relationship of variables. The results showed statically significant positive correlation between the readiness and Perception of students regarding inter-professional learning (p=.000). This study indicated that there is strong positive correlation between readiness and perception of students towards inter-professional learning but students have least response towards team work and collaboration. Study suggests that inter-professional education should introduce in the curriculum of nursing and paramedical students to promote team work and share learning.Int. J. Soc. Sc. Manage. Vol. 5, Issue-3: 192-200

scholarly journals Adjacent Primary Care May Reduce Less Urgent Pediatric Emergency Department Visits

2020 ◽  
Vol 11 ◽  
pp. 215013272092627
Author(s):  
Julia Ellbrant ◽  
Jonas Åkeson ◽  
Helena Sletten ◽  
Jenny Eckner ◽  
Pia Karlsland Åkeson
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Patient Characteristics ◽  
Pediatric Emergency ◽  
Emergency Department Visits ◽  
University Hospital ◽  
Pediatric Emergency Department ◽  
Hospital Data ◽  
Cross Sectional ◽  
Ed Visits

Aims: Pediatric emergency department (ED) overcrowding is a challenge. This study was designed to evaluate if a hospital-integrated primary care unit (HPCU) reduces less urgent visits at a pediatric ED. Methods: This retrospective cross-sectional study was carried out at a university hospital in Sweden, where the HPCU, open outside office hours, had been integrated next to the ED. Children seeking ED care during 4-week high- and low-load study periods before (2012) and after (2015) implementation of the HPCU were included. Information on patient characteristics, ED management, and length of ED stay was obtained from hospital data registers. Results: In total, 3216 and 3074 ED patient visits were recorded in 2012 and 2015, respectively. During opening hours of the HPCU, the proportions of pediatric ED visits (28% lower; P < .001), visits in the lowest triage group (36% lower; P < .001), patients presenting with fever ( P = .001) or ear pain ( P < .001), and nonadmitted ED patients ( P = .033), were significantly lower in 2015 than in 2012, whereas the proportion of infants ≤3 months was higher in 2015 ( P < .001). Conclusions: By enabling adjacent management of less urgent pediatric patients at adequate lower levels of medical care, implementation of a HPCU outside office hours may contribute to fewer and more appropriate pediatric ED visits.

scholarly journals People living with AIDS: Association between nursing diagnoses and sociodemographic/clinical characteristics

2018 ◽  
Vol 71 (5) ◽  
pp. 2535-2542 ◽  
Author(s):  
Richardson Augusto Rosendo da Silva ◽  
Romanniny Hévillyn Silva Costa ◽  
Laísi Catharina da Silva Barbalho Braz ◽  
Indira de Araújo Lucena ◽  
Kalyane da Silva Ferreira ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Illicit Drugs ◽  
Family Income ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Clinical Aspects ◽  
Access To Health Services ◽  
Hospital Data ◽  
Cross Sectional ◽  
Nursing Diagnoses

ABSTRACT Objective: To analyze the association between nursing diagnoses and sociodemographic and clinical characteristics in people living with AIDS. Method: Cross-sectional study with 100 people living with AIDS in a University Hospital. Data collection took place between January and July 2015, using an interview script and physical examination. The association occurred through Pearson's Chi-Square Test and Fisher's Exact Test. Results: The most prevalent nursing diagnoses were: ineffective protection, poor knowledge, lack of adherence and sexual dysfunction. Significant associations were observed among nursing diagnoses with the following sociodemographic and clinical characteristics: marital status, place of residence, level of schooling, family income, modes of transmission of acquired immunodeficiency virus, current opportunistic infection, abandonment of treatment, difficulty of access to health services and use of alcohol and illicit drugs. Conclusion: The diagnoses presented significant associations with sociodemographic and clinical aspects.

scholarly journals Sonolência diurna excessiva e os efeitos do trabalho na saúde de trabalhadores de enfermagem

2019 ◽  
Vol 19 (1) ◽  
pp. 263-301
Author(s):  
Kellen Da Silva ◽  
Ariane Naidon Cattani ◽  
Maiara Carmosina Hirt ◽  
Anahlú Peserico ◽  
Rosângela Marion Da Silva ◽  
...  
Keyword(s):  
Social Sciences ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Predictive Analytics ◽  
The Body ◽  
University Hospital ◽  
Hospital Data ◽  
Physical Damage ◽  
Cross Sectional ◽  
The Social

Objetivo: Analizar la somnolencia diurna excesiva y los efectos del trabajo en la salud de trabajadores de enfermería actuantes em la Unidad de Recuperación Post-Anestésica.Método: Estudio transversal, realizado con 39 trabajadores de enfermería de una Unidad de Recuperación Post-Anestésica de un Hospital Universitario. Los instrumentos de recolección de datos fueron el cuestionario de caracterización sociolaboral, la Escala de Somnolencia de Epworth y la Escala de Evaluación de los Daños Relacionados al Trabajo. Los datos fueron analizados con ayuda de Predictive Analytics Software, de la SPSS (Statistical Package for the Social Sciences), a través de pruebas estadísticas.Resultados: Indican que los daños físicos presentaron mayor promedio (2,33 ± 1,15), predominando dolores en el cuerpo, espalda y piernas, dicho una clasificación grave, lo cual potencia el sufrimiento en el trabajo. En cuanto a la presencia de somnolencia diurna excesiva, el 41% de los trabajadores la presentaron. No se identificó asociación significativa entre la somnolencia diurna excesiva y los efectos del trabajo en la salud de trabajadores de enfermería.Conclusión: Este estudio podrá auxiliar en la planificación de acciones con el objetivo de minimizar los daños relacionados al trabajo y promover la salud del trabajador. Objective: To analyze excessive daytime sleepiness and the effects of work on the health of nursing workers working in the Post-Anesthetic Recovery Unit.Method: A cross-sectional study carried out with 39 nursing workers from a Post-Anesthetic Recovery Unit of a University Hospital. Data collection instruments were the socio-labor characterization questionnaire, the Epworth Sleepiness Scale and the Work-Related Damage Assessment Scale. The data were analyzed with the aid of Predictive Analytics Software, SPSS (Statistical Package for the Social Sciences), through statistical tests.Results: Indicate that physical damage presented a higher mean (2.33 ± 1.15), and pain in the body, back and legs predominated, a severe classification, which potentiates suffering at work. As to the presence of excessive daytime sleepiness, 41% of the workers presented. No significant association was identified between excessive daytime sleepiness and the effects of work on the health of nursing workers.Conclusion: This study may help in the planning of actions with the intention of minimizing the damages related to work and promoting the health of the worker. Objetivo: Analisar a sonolência diurna excessiva e os efeitos do trabalho na saúde de trabalhadores de enfermagem atuantes na Unidade de Recuperação Pós-Anestésica.Método: Estudo transversal, realizado com 39 trabalhadores de enfermagem de uma Unidade de Recuperação Pós-Anestésica de um Hospital Universitário. Os instrumentos de coleta de dados foram o questionário de caracterização sociolaboral, a Escala de Sonolência de Epworth e a Escala de Avaliação dos Danos Relacionados ao Trabalho. Os dados foram analisados com auxílio do Predictive Analytics Software, da SPSS (Statistical Package for the Social Sciences), por meio de testes estatísticos.Resultados: Indicam que os danos físicos apresentaram maior média (2,33±1,15), sendo que dores no corpo, costas e pernas predominaram, dito uma classificação grave, o qual potencializa o sofrimento no trabalho. Quanto à presença de sonolência diurna excessiva, 41% dos trabalhadores apresentaram. Não foi identificada associação significativa entre a sonolência diurna excessiva e os efeitos do trabalho na saúde de trabalhadores de enfermagem.Conclusão: Este estudo poderá auxiliar no planejamento de ações com o intuito de minimizar os danos relacionados ao trabalho e promover a saúde do trabalhador.

scholarly journals Patient adherence to rivaroxaban in deep vein thrombosis, a cohort study in Switzerland: quantitative results

2019 ◽  
Vol 41 (6) ◽  
pp. 1625-1633
Author(s):  
Jennifer Dotta-Celio ◽  
Adriano Alatri ◽  
Isabella Locatelli ◽  
Monique Salvi ◽  
Olivier Bugnon ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Medication Adherence ◽  
Electronic Monitoring ◽  
Patient Adherence ◽  
Survival Curve ◽  
Vitamin K Antagonists ◽  
University Hospital ◽  
Fixed Dose ◽  
Vein Thrombosis ◽  
Deep Vein

AbstractBackground Direct oral anticoagulants (DOACs) have the advantage of being administered orally at a fixed dose without laboratory monitoring, in contrast to the frequent international normalized ratio measurements used to adjust for vitamin K antagonists dosing. Rivaroxaban, has a short half-life. The anticoagulation effect rapidly decreases if medication adherence is suboptimal. Objective The purpose of this quantitative study (called RIVA) is to longitudinally describe adherence to rivaroxaban (implementation and persistence) in patients with deep vein thrombosis (DVT). Setting The community pharmacy of the Center for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland in collaboration with the angiology division of the Lausanne University Hospital (CHUV). Methods This is an observational study. Patients received rivaroxaban for 3 or 6 months: 15 mg twice a day during the first 3 weeks and then 20 mg once a day until the end of the treatment. Adherence was measured using electronic monitoring. Implementation and adherence were modelled using a generalized estimating equation model. Persistence was represented using a Kaplan–Meier survival curve. Main outcome measure Medication adherence (implementation and persistence). Results Thirty-one consecutive patients were included (68% male, mean age: 47 years old). The collected adherence data consisted of 57 inter-visit phases, 2899 electronic monitoring openings and a median follow-up of 92 days (IQR: 87; 100). Implementation to rivaroxaban was initially high [96.3 (92.8; 98.1)] but decreased during the first 3 weeks, until it reached 89.3 (76.0; 95.6). After the switch from twice a day 15 mg to a once a day 20 mg regimen, implementation increased again and remained stable [95.4 (92.2; 97.3)] for 90 days. Four patients who experienced adverse events discontinued the treatment before the end of the study and were considered non-persistent (clinically appropriate discontinuation). Conclusion Adherence to rivaroxaban in deep vein trombosis is high in persistent patients. Discontinuation is related to rivaroxaban adverse effects/toxicity. Implementation should be reinforced during the twice a day-phase, and this first 3-week experience should help patients and healthcare professionals choose the best timing for the once a day phase.

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