Announcement: Community Preventive Services Task Force Recommendation for Text Messaging Interventions to Improve Medication Adherence for Chronic Disease Management

Medication nonadherence remains a significant obstacle to achieving improved health outcomes in patients with chronic disease. Self-efficacy, the confidence in one’s ability to perform a given task such as taking one’s medications, is an important determinant of medication adherence, indicating the need for reliable and valid tools for measuring this construct. This study sought to develop a self-efficacy scale for medication adherence in chronic disease management that can be used in patients with a broad range of literacy skills. The Self-efficacy for Appropriate Medication Use (SEAMS) was developed by a multidisciplinary team with expertise in medication adherence and health literacy. Its psychometric properties were evaluated among 436 patients with coronary heart disease and other comorbid conditions. Reliability was evaluated by measuring internal consistency and test-retest reliability. Principal component factor analysis was performed to evaluate the validity of the SEAMS. Reliability and validity analyses were also performed separately among patients with low and higher literacy levels. The final 13-item scale had good internal consistency reliability (Cronbach’s α = 0.89). A two-factor solution was found, explaining 52.3% of the scale’s variance. The scale performed similarly across literacy levels. The SEAMS is a reliable and valid instrument that may provide a valuable assessment of medication self-efficacy in chronic disease management, and appears appropriate for use in patients with low literacy skills.

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Text Messaging Interventions for Chronic Disease Management and Health Promotion

eHealth Applications ◽

10.4324/9780203149096-18 ◽

2012 ◽

pp. 180-199

Keyword(s):

Health Promotion ◽

Chronic Disease ◽

Disease Management ◽

Text Messaging ◽

Chronic Disease Management

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The Linkages Between Reimbursement and Prevention: A Mixed-Methods Approach

Frontiers in Public Health ◽

10.3389/fpubh.2021.750122 ◽

2021 ◽

Vol 9 ◽

Author(s):

Ellen Zwaagstra Salvado ◽

Hilco J. van Elten ◽

Erik M. van Raaij

Keyword(s):

Mixed Methods ◽

Chronic Disease ◽

Disease Management ◽

Healthcare Professionals ◽

Chronic Disease Management ◽

Preventive Services ◽

Population Based ◽

Rapid Review ◽

Effective Prevention ◽

Mixed Methods Approach

Background: The benefits of prevention are widely recognized; ranging from avoiding disease onset to substantially reducing disease burden, which is especially relevant considering the increasing prevalence of chronic diseases. However, its delivery has encountered numerous obstacles in healthcare. While healthcare professionals play an important role in stimulating prevention, their behaviors can be influenced by incentives related to reimbursement schemes.Purpose: The purpose of this research is to obtain a detailed description and explanation of how reimbursement schemes specifically impact primary, secondary, tertiary, and quaternary prevention.Methods: Our study takes a mixed-methods approach. Based on a rapid review of the literature, we include and assess 27 studies. Moreover, we conducted semi-structured interviews with eight Dutch healthcare professionals and two representatives of insurance companies, to obtain a deeper understanding of healthcare professionals' behaviors in response to incentives.Results: Nor fee-for-service (FFS) nor salary can be unambiguously linked to higher or lower provision of preventive services. However, results suggest that FFS's widely reported incentive to increase production might work in favor of preventive services such as immunizations but provide less incentives for chronic disease management. Salary's incentive toward prevention will be (partially) determined by provider-organization's characteristics and reimbursement. Pay-for-performance (P4P) is not always necessarily translated into better health outcomes, effective prevention, or adequate chronic disease management. P4P is considered disruptive by professionals and our results expose how it can lead professionals to resort to (over)medicalization in order to achieve targets. Relatively new forms of reimbursement such as population-based payment may incentivize professionals to adapt the delivery of care to facilitate the delivery of some forms of prevention.Conclusion: There is not one reimbursement scheme that will stimulate all levels of prevention. Certain types of reimbursement work well for certain types of preventive care services. A volume incentive could be beneficial for prevention activities that are easy to specify. Population-based capitation can help promote preventive activities that require efforts that are not incentivized under other reimbursements, for instance activities that are not easily specified, such as providing education on lifestyle factors related to a patient's (chronic) disease.

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Association between participation in a chronic disease management program, medication adherence and decrease of blood pressure

Public Health and Preventive Medicine Archive ◽

10.15562/phpma.v6i2.136 ◽

2018 ◽

Vol 6 (2) ◽

pp. 119

Author(s):

I Ketut Indra Wiguna Cakera ◽

Ni Made Sri Nopiyani ◽

I Made Ady Wirawan

Keyword(s):

Blood Pressure ◽

Chronic Disease ◽

Medication Adherence ◽

Disease Management ◽

Disease Management Program ◽

Chronic Disease Management ◽

Management Program ◽

Physical Activities ◽

Community Based ◽

Good Adherence

Background and purpose:The prevalence of hypertension is increasing globally. A comprehensive approach is necessary including a community based chronic disease management program which has been implemented in public health centres in Indonesia. Only few studies have been published in Indonesia that evaluate the program, especially regarding the management of hypertension in primary care settings. This study aims to examine the association between participation in a chronic disease management program, medication adherence and decrease of blood pressure.Methods: A cross-sectional study was conducted in public health centres in Tabanan District. A total of 136 patients with hypertension were recruited at five groups that participate in the community based chronic disease management program called Program Pengelolaan Penyakit Kronis (Prolanis). The Prolanis groups were purposively selected based on the size of participants in the program. One group was selected at urban area and four groups at rural areas. Data were collected from May to June 2017 by conducting interviews, blood pressure measurements, and secondary data extraction from the medical record of the Prolanis database. The logistic regression analysis was used to determine the association between participation in a chronic disease management program, medication adherence and decrease of blood pressure.Results: As many as 75.7% of respondents actively participated in the Prolanis Program, and 81.6% were found with decreased blood pressure. Our study found a significant association between blood pressure decrease and active participation in the Prolanis Program with an adjusted odds ratio (AOR) of 6.38 (95%CI: 1.96–20.79), the good adherence towards medication with AOR=11.94 (95% CI: 3.60–39.56), and routine physical activities with AOR=3.84 (95%CI: 1.16-12.73). Conclusion: Active participation in the Prolanis Program, good adherence to medication and routine physical activities are independent factors of decreased blood pressure. These findings suggest the need for scaling up the Prolanis Program and increasing its coverage.

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CDC Grand Rounds: Improving Medication Adherence for Chronic Disease Management — Innovations and Opportunities

MMWR Morbidity and Mortality Weekly Report ◽

10.15585/mmwr.mm6645a2 ◽

2017 ◽

Vol 66 (45) ◽

pp. 1248-1251 ◽

Cited By ~ 23

Author(s):

Andrea B. Neiman ◽

Todd Ruppar ◽

Michael Ho ◽

Larry Garber ◽

Paul J. Weidle ◽

...

Keyword(s):

Chronic Disease ◽

Medication Adherence ◽

Disease Management ◽

Chronic Disease Management ◽

Grand Rounds

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The Effect of Chronic Disease Management on the Treat-to-Target of Gout: A Cross-Sectional Study

10.21203/rs.3.rs-1191410/v1 ◽

2021 ◽

Author(s):

Ertao Jia ◽

Shasha Hu ◽

Zhiying Zhan ◽

Wukai Ma ◽

Hongling Geng ◽

...

Keyword(s):

Chronic Disease ◽

Medication Adherence ◽

Disease Management ◽

Chronic Disease Management ◽

Popular Science ◽

Cross Sectional Study ◽

Treat To Target ◽

Sectional Study ◽

Cross Sectional ◽

Poor Medication Adherence

Abstract Background: The treat-to-target (T2T) strategy is essential for patients with gout. However, the rate of T2T is low. This study aimed to explore doctor-led chronic disease management on the T2T of gout, survey the rate of T2T and assess the predictors associated with poor control of serum urate levels (SUA) in a large population of patients with gout receiving urate-lowering treatment (ULT). Methods: A multi-center, cross-sectional study was conducted. We surveyed the relevant information of outpatients who received ULT for more than six months using electronic questionnaires, including demographics, disease-related conditions, comorbid conditions, and management. The patients with gout were divided into the SUA > 360 µmol/L and ≤ 360 µmol/L, and the patient characteristics between the two groups were compared. We analyzed the predictors of SUA > 360 µmol/L and poor disease control.Results: We collected 425 (90.8% of the patients) valid questionnaires. There were significant differences in the gender, education level, regular visits, medication adherence, diabetes, economic burden and community doctor's help between the SUA > 360 µmol/L (n=311, 73.18%) and ≤ 360 µmol/L (n=114, 26.82%) groups. The predictors of SUA >360 µmol/L were general medication adherence (OR=2.35; 95% CI 1.17–4.77; p=0.016), poor medication adherence (OR=4.63; 95% CI 2.28–9.51; p<0.001) and community doctor’s help (OR=0.60; 95% CI 0.37–0.97; p=0.036 for full model, OR=0.58; 95% CI 0.36–0.93; p=0.023 for simplified model). There were significant differences in the gender, regular visits, medication adherence, gout popular science, established health files, and community doctor’s help between the not well controlled (n=361, 84.94%) and well controlled (n=61, 14.35%) groups. The predictors of not well controlled were Tophi (OR=2.48; 95% CI 1.17–5.61; p=0.023), general medication adherence (OR=2.78; 95% CI 1.28–6.05; p=0.009), poor medication adherence (OR=6.23; 95% CI 2.68–14.77; p<0.001) and no gout popular science (OR=4.07; 95% CI 1.41–13.91; p=0.015).Conclusion: The T2T and well controlled rates were very low. The medication adherence, the community doctor’s help and gout popular science which was the doctor-led chronic gout management should be further improved to increase the T2T and well controlled rate.Trial registration: ChiCTR, ChiCTR2000034700, Registered 15 July 2020. http://www.chictr.org.cn/showproj.aspx?proj=55778

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