scholarly journals Pharmacists’ and patients’ perceptions about the importance of pharmacist services types to improve medication adherence among patients with diabetes in Indonesia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bobby Presley ◽  
Wim Groot ◽  
Milena Pavlova
Keyword(s):  
Medication Adherence ◽  
Patient Group ◽  
Medication Review ◽  
Group Discussion ◽  
Phone Call ◽  
Lower Probability ◽  
Improve Medication Adherence ◽  
Hospital Patients ◽  
Patients With Diabetes ◽  
Pharmacist Services

Abstract Background Various pharmacist services are available to improve medication adherence, including consultation, brochure, etc. Challenges arise on which services are best implemented in practice. Knowledge about patients’ and pharmacists’ preferences can help to prioritize services. This study explores the pharmacists’ and patients’ perceptions about the importance of pharmacist services to improve medication adherence among patients with diabetes in Indonesia. Methods This questionnaire-based cross-sectional study involved adult outpatients with diabetes type 2 and pharmacists from community health centers (CHCs) and hospitals in Surabaya, Indonesia. Random sampling was used to identify 57 CHCs in the study. In addition, based on convenient sampling, three hospitals participated. All pharmacists working at the CHCs and hospitals, who were willing to participate, were included in the study. For patients, minimum sample size was calculated using Slovin’s formula. Patients and pharmacists were asked to rank five pharmacist service types (consultation, brochure/leaflet, patient group discussion, medication review, and phone call refill reminder) according to their importance to improve medication adherence. A face validity test of the self-developed questionnaire was conducted before the data collection. Rank ordered probit models were estimated (STATA 15th software). Results A total of 457 patients from CHCs, 579 patients from hospitals, and 99 pharmacists from both medical facilities were included. Consultation (CHC patients 56.0% vs hospital patients 39.7% vs pharmacists 75.2%) and brochure (CHC patients 23.2% vs hospital patients 27.5% vs pharmacists 11.9%) were the most preferred pharmacist services. Patients with experience getting medication information from pharmacists valued consultation higher than brochure and patient group discussions. Older patients ranked a brochure higher than other services. Patients without formal education in CHCs had a lower probability of giving a high rank to a brochure to improve medication adherence. There was significant positive correlation between the ranking of phone call refill reminder and medication review (0.6940) for patients in CHCs. Conclusion For both patients and pharmacists, consultation, brochure, and group discussion were the highest-ranked services. Education, age, experience with pharmacist services, and medical facility features need to be considered when evaluating which pharmacist services to implement in Indonesia.

Improving Adherence and Reducing Medication Discrepancies in Patients with Diabetes

2003 ◽  
Vol 37 (7-8) ◽  
pp. 962-969 ◽  
Author(s):  
Richard W Grant ◽  
Nicole G Devita ◽  
Daniel E Singer ◽  
James B Meigs
Keyword(s):  
Medication Adherence ◽  
Medical Record ◽  
Controlled Trial ◽  
Community Health Center ◽  
Improve Medication Adherence ◽  
Medication Discrepancies ◽  
Patient Reported ◽  
Patients With Diabetes ◽  
Medical Regimens ◽  
Very High

OBJECTIVE: To improve medication adherence by reducing self-reported adherence barriers, and to identify medication discrepancies by comparing physician-prescribed and patient-reported medical regimens. DESIGN: Prospective, randomized, controlled trial. SETTING AND PARTICIPANTS: A single academically affiliated community health center. Eligible patients had type 2 diabetes, had undergone laboratory testing in the year preceding the study, and had visited the clinic in the 6 months preceding the study. INTERVENTION: A pharmacist administered detailed questionnaires, provided tailored education regarding medication use and help with appointment referrals, and created a summary of adherence barriers and medication discrepancies that was entered into the medical record and electronically forwarded to the primary care provider. MEASUREMENTS: Changes in self-reported adherence rates and barriers were compared 3 months after the initial interview. Intervention patients with medication discrepancies at baseline were assessed for resolution of discrepancies at 3 months. RESULTS: Rates of self-reported medication adherence were very high and did not improve further at 3 months (6.9 of 7 d, with all medicines taken as prescribed; p = 0.3). Medical regimen discrepancies were identified in 44% of intervention patients, involving 45 doses of medicines. At 3-month follow-up, 60% of discrepancies were resolved by corrections in the medical record, while only 7% reflected corrections by patients. CONCLUSIONS: In this community cohort, patients reported few adherence barriers and very high medication adherence rates. Our patient-tailored intervention did not further reduce these barriers or improve self-reported adherence. The high prevalence of medication discrepancies appeared to mostly reflect inaccuracies in the medical record rather than patient errors.

scholarly journals PENGARUH PEMBERIAN EDUKASI DENGAN METODE FOCUS GROUP DISCUSSION TERHADAP KEPATUHAN MINUM OBAT PENDERITA HIPERTENSI DI PUSKESMAS TAHUNA BARAT

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Jesica F. Kansil ◽  
Mario E. Katuuk ◽  
Maria J. Regar
Keyword(s):  
Medication Adherence ◽  
Group Discussion ◽  
Intervention Group ◽  
Control Group ◽  
Improve Medication Adherence ◽  
Chi Square ◽  
Control Group Design ◽  
Hypertensive Patients ◽  
Significance Level ◽  
Purposive Sampling

Abstract: Hypertension is one of the important factors as a trigger for Non Communicable Diseases such as Heart Disease, Stroke that were currently the number one cause of death in the world. Adherence in managing hypertension was very important because it can be affect the patient’s life in managing the disease. The effort that can be given to improve adherence was provided education. The Purpose: to know the effect of providing education with FGD Method towards medication adherence of hypertensive patients. This research method: is quasi experiment, with pretest-posttest with control group design. Samples: Sampling techniques in this research is purposive sampling of 34 respondents who have a criteria inclusion that consist of 17 respondents of intervention group and 17 respondents of control group. Data accumulation is using the questionnaire with 10 questions. The Results: by using Chi Square test at a significance level of 95 %, obtained a significant value p=0.028 or smaller than 0.05 (0.028< 0.05). Conclusions: that educational of FGD method is very effectively to improve medication adherence of hypertensive patients at Public Health Center of West Tahuna.Keywords : Education, FGD Method, Medication AdherenceAbstrak : Hipertensi merupakan salah satu faktor penting sebagai pemicu Penyakit Tidak Menular seperti Penyakit Jantung, Stroke dan lain-lain yang saat ini menjadi penyebab kematian nomor satu di dunia. Kepatuhan dalam memanajemen hipertensi sangat penting karena dapat mempengaruhi cara hidup pasien dalam mengelolah penyakitnya. Upaya yang bisa diberikan untuk meningkatkan kepatuhan yaitu dengan pemberian edukasi. Tujuan untuk mengetahui pengaruh pemberian edukasi dengan metode FGD terhadap kepatuhan minum obat penderita hipertensi. Metode penelitian ini adalah quasi eksperimen, dengan desain penelitian pretest-posttest with control group. Teknik sampling dalam penelitian ini adalah purposive sampling berjumlah 34 responden yang telah memenuhi kriteria inklusi yang terdiri dari kelompok intervensi 17 responden dan kelompok kontrol 17 responden. Pengumpulan data menggunakan kuesioner sebanyak 10 pertanyaan. Hasil penelitian dengan menggunakan uji Chi Square pada tingkat kemaknaan 95 % diperoleh nilai signifikan p = 0.028 atau lebih kecil dari 0.05 (0.028 < 0.05). Kesimpulan, hasil penelitian ini menunjukkan bahwa metode edukasi dengan FGD sangat efektif digunakan untuk meningkatkan kepatuhan minum obat penderita hipertensi di Puskesmas Tahuna Barat.Kata Kunci : Edukasi, Metode FGD, Kepatuhan Minum Obat

scholarly journals Reducing Loneliness in Stationary Geriatric Care with Robots and Virtual Encounters—A Contribution to the COVID-19 Pandemic

2021 ◽  
Vol 18 (9) ◽  
pp. 4846
Author(s):  
Andreas Follmann ◽  
Franziska Schollemann ◽  
Andrea Arnolds ◽  
Pauline Weismann ◽  
Thea Laurentius ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Social Isolation ◽  
Nursing Home Residents ◽  
Phone Call ◽  
Observational Trial ◽  
General Acceptance ◽  
Frequency Of Use ◽  
Geriatric Hospital ◽  
Hospital Patients ◽  
The Subject

The bans on visiting nursing homes during the COVID-19 pandemic, while intended to protect residents, also have the risk of increasing the loneliness and social isolation that already existed among the older generations before the pandemic. To combat loneliness and social isolation in nursing homes, this trial presents a study during which social networks of nursing home residents and elderly hospital patients were maintained through virtual encounters and robots, respectively. The observational trial included volunteers who were either residents of nursing homes or patients in a geriatric hospital. Each volunteer was asked to fill in a questionnaire containing three questions to measure loneliness. The questionnaire also documented whether video telephony via the robot, an alternative contact option (for example, a phone call), or no contact with relatives had taken place. The aim was to work out the general acceptance and the benefits of virtual encounters using robots for different roles (users, relatives, nursing staff, facilities). Seventy volunteers with three possible interventions (non-contact, virtual encounters by means of a robot, and any other contact) took part in this trial. The frequency of use of the robot increased steadily over the course of the study, and it was regularly used in all facilities during the weeks of visitor bans (n = 134 times). In the hospital, loneliness decreased significantly among patients for whom the robot was used to provide contact (F(1,25) = 7.783, p = 0.01). In the nursing homes, no demonstrable effect could be achieved in this way, although the subject feedback from the users was consistently positive.

scholarly journals Evaluation of adherence monitoring system using evriMED with a differentiated response compared to standard of care among drug-sensitive TB patients in three provinces in South Africa: a protocol for a cluster randomised control trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Noriah Maraba ◽  
Catherine Orrell ◽  
Candice M. Chetty-Makkan ◽  
Kavindhran Velen ◽  
Rachel Mukora ◽  
...  
Keyword(s):  
South Africa ◽  
Treatment Success ◽  
Standard Of Care ◽  
Treatment Completion ◽  
Phone Call ◽  
Randomised Control Trial ◽  
Improve Medication Adherence ◽  
Tb Treatment ◽  
Differentiated Care

Abstract Background South Africa has achieved drug-susceptible TB (DS-TB) treatment success of only 77% among people with new and previously treated TB. Alternative approaches are required to improve medication adherence and treatment completion to limit transmission, TB relapse and the development of resistance. This study aims to implement and evaluate the use of adherence medication monitors (Wisepill evriMED 1000) with a differentiated response to patient care, among DS-TB patients in three provinces of South Africa. Methods In total, 18 public health clinics across three provinces were selected. Clinics were randomised to intervention or standard of care clinics. In each clinic, approximately 145 DS-TB patients are being enrolled to reach a total of 2610. All patients have their daily adherence monitored using medication monitors. In the intervention arm, patients are receiving medication monitor reminders and differentiated care in response to adherence data. This weekly review of daily real-time monitoring will be undertaken from a central database. The differentiated care model includes automated SMS reminders with a missed dose, research staff-initiated phone call to the patient with a second or third missed dose, a home visit if four or more doses are missed, and motivational counselling if four or more doses are missed repeatedly. Fidelity of the intervention will be measured through process evaluation. Patients in control clinics will receive medication monitors for adherence tracking, standard of care TB education, and normal clinic follow-up procedures. The primary outcome is the proportion of patients by arm with >80% adherence, as measured by the medication monitor. The feasibility and acceptability of the intervention will be assessed by in-depth interviews with patients, stakeholders, and study staff. A cost effectiveness analysis of the intervention and standard of care clinics will be conducted. Significance This trial will provide evidence for the use of an intervention, including medication monitors and differentiated care package, to improve adherence to TB treatment. Improved adherence should also improve TB treatment completion rates, thus reducing loss to follow-up rates, and TB relapse among people with TB. The intervention is intended to ultimately improve overall TB control and reduce TB transmission in South Africa. Trial registration Pan African Trial Registry PACTR201902681157721. Registered on 11 February 2019.

Interventions to Improve Medication Adherence in Schizophrenia

2002 ◽  
Vol 159 (10) ◽  
pp. 1653-1664 ◽  
Author(s):  
Annette Zygmunt ◽  
Mark Olfson ◽  
Carol A. Boyer ◽  
David Mechanic
Keyword(s):  
Medication Adherence ◽  
Improve Medication Adherence

Strategies to Improve Medication Adherence in Older Persons: Consensus Statement from the Senior Italia Federanziani Advisory Board

Drugs & Aging ◽  
2016 ◽  
Vol 33 (9) ◽  
pp. 629-637 ◽  
Author(s):  
Alessandra Marengoni ◽  
Alessandro Monaco ◽  
Elisio Costa ◽  
Antonio Cherubini ◽  
Alexandra Prados-Torres ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Older Persons ◽  
Consensus Statement ◽  
Advisory Board ◽  
Improve Medication Adherence

Abstract 113: Pharmacists' Perspectives of an Intervention to Improve Medication Adherence after ACS Hospitalization A Qualitative Analysis

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Kelty B Fehling ◽  
Anne Lambert-Kerzner ◽  
Ryan Davis ◽  
Jennifer Weaver ◽  
Casey Barnett ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Patient Education ◽  
Patient Adherence ◽  
Clinical Care ◽  
Qualitative Inquiry ◽  
Educational Process ◽  
Assessment Tools ◽  
Personal Contact ◽  
Improve Medication Adherence ◽  
Coronary Syndrome

Background: Despite the success of pharmacist-led interventions to improve medication adherence, pharmacists’ perspectives of these interventions are unknown. Our objective was to understand the pharmacists’ perspectives of a successful multifaceted intervention to improve medication adherence after acute coronary syndrome (ACS) hospitalization. Methods: We ascertained pharmacist perspectives’ through qualitative inquiry that included an open-ended survey, semi-structured interviews, and a focus group with the four pharmacists who participated in the intervention. Transcripts of surveys and interviews were analyzed using a content analysis approach. The intervention components included: 1) patient education; 2) assessment tools for potential medication adherence barriers; 3) collaborative care; and 4) automated medication refill reminders and educational messages. Pharmacists’ perspectives on each of these components were evaluated. Results: The pharmacists felt the intervention could be sustained in routine clinical care and identified key themes that facilitated intervention success. Pharmacists believed educating patients about their cardiovascular medications filled a gap in usual care. In addition, assessment tools that identified medication discrepancies and gaps in knowledge were helpful in tailoring patient education, while face-to-face conversations were more helpful in identifying mental and cognitive deficits that were barriers to adherence. Pharmacists also noted that the intervention led to the development of bi-directional relationships with patients through increased in-person and tele-health communication. As a result, poor adherence related to medication side effects was more readily addressed. Potential areas for improvement identified by the pharmacists included 1) emphasizing in-person visits to build relationships (begin the educational process while the patient is hospitalized and schedule both the follow-up clinic appointment and pharmacy visit at the same time); 2) utilizing the patient centered medical home concept to improve access to providers; 3) allowing sites to determine provider type to support the personal contact (i.e. pharmacist, nurse practitioner, registered nurse); and 4) employing interactive voice response (IVR) technology to facilitate communication. Conclusions: Pharmacists’ perspectives of a medication adherence intervention gave insights into reasons for the intervention success and suggestions for improvements and dissemination. We found that in-person meetings between pharmacists and patients led to bi-directional conversations and relationships with providers, which positively influenced patient adherence behavior. Future interventions designed to improve medication adherence should incorporate these pharmacist-identified factors.

Abstract 148: Association of Dosing Frequency on Medication Adherence in Patients with Non-Valvular Atrial Fibrillation

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Tanya Burton ◽  
Lauren J Lee ◽  
Ying Fan ◽  
Winghan Jacqueline Kwong
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Medication Adherence ◽  
Health Plan ◽  
Index Date ◽  
Improve Medication Adherence ◽  
Treatment Regimens ◽  
Pharmacy Claims ◽  
Comorbidity Burden ◽  
Dosing Frequency

Objective: Previous studies suggest that the complexity of a dosing regimen may affect medication adherence. We examined the association between dosing frequency and adherence for 2 concomitant medications commonly prescribed to patients with non-valvular atrial fibrillation (NVAF), metoprolol (MET) and carvedilol (CAR). Methods: A retrospective claims study from a large US commercial and Medicare Advantage health plan analyzed data of adults ( > 18 years) with 1 inpatient or 2 outpatient claims for NVAF between 1/1/2008 - 12/31/2010. Patients with > 2 pharmacy claims for MET or CAR were analyzed separately. Within MET and CAR samples, once-daily (QD) and twice-daily (BID) cohorts were defined by the dosing frequency on pharmacy claims. The index date was set as the date of the first MET or CAR claim. Patients were continuously enrolled in the health plan for 1 year before (pre-index) and 1 year after (post-index) the index date. MET patients were required to have > 1 pre-index claim for acute myocardial infarction, angina, heart failure, or hypertension; CAR patients were required to have ≥1 claim for heart failure or hypertension. Patients using both QD and BID formulations of the index medication were excluded. Adherence to the index medication was assessed by the proportion of days covered (PDC) during the post-index period. PDC between QD and BID patients was compared using logistic regression to adjust for demographic and pre-index clinical characteristics. The proportion of QD and BID patients who discontinued the index medication (defined by a gap > 30 days) during the post-index period was also compared. Results: The analysis included 11,621 MET patients (QD: 6,084; BID: 5,537) and 4,393 CAR patients (QD: 203; BID: 4,190). Mean (SD) age was 70 (12) years for MET and CAR patients; 59% of MET and 69% of CAR patients were male. Compared to patients with BID dosing, patients with QD dosing were on average younger, more likely to be male, and had a lower comorbidity burden. Fewer patients discontinued MET or CAR with QD than BID dosing (MET: 38% vs. 51%, p<0.001; CAR: 39% vs. 48%, p=0.009). The proportion of patients with PDC > 80% was greater for patients with QD than BID dosing (MET: 62% vs. 50%, p< 0.001; CAR: 63% vs. 53%, p=0.004). MET patients with BID dosing were less likely to achieve PDC > 80% than patients with QD dosing (adjusted OR: 0.66; 95% CI: 0.609-0.712). CAR patients with BID dosing were less likely to achieve PDC > 80% than patients with QD dosing (adjusted OR: 0.69; 95% CI: 0.508-0.934). Among MET and CAR patients, age <60 years was associated with lower adherence (p<0.001) while prior use of index medication was associated with higher adherence (p≤0.001) to the index medication. Conclusion: Medication adherence to MET and CAR was higher with QD than BID dosing. Quality initiatives that reduce the dosing frequency of treatment regimens may improve medication adherence among NVAF patients.

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