scholarly journals Adherence to therapy, lifestyle modification and medical support of cardiovascular patients

2020 ◽  
Vol 19 (6) ◽  
pp. 2665
Author(s):  
S. S. Bunova ◽  
N. I. Zhernakova ◽  
Yu. P. Skirdenko ◽  
N. A. Nikolaev

Aim. To study the quantitative parameters of adherence to lifestyle modification, medical support,  and therapy in patients with cardiovascular diseases (CVD).Material and methods. This cross-sectional study included 683 respondents: 168 patients  with hypertension  (HTN); 196 patients  with stable angina; 141 patients with atrial fibrillation (AF); 178 patients with heart failure (HF). We used N. A. Nikolaev  questionnaire  for adherence assessment. For all adherence parameters, the level ≤75% was regarded as insufficient. The study was carried out in accordance with Good Clinical Practice and Declaration ofHelsinki. The study protocol was approved by the Ethics Committees of all participating clinical centers. All patients signed written informed consent.Results. Approximately 1/3 of respondents agreed  to receive therapy. The adherence level was >75%. Patients with angina and AF were more likely to receive therapy. It turned out that that approximately 2/3 of patients  were not ready for medical support.  Patients  with angina were less ready for medical support, while those with HTN and HF hadhigher values of adherence. Adherence to lifestyle modification was owest among analyzed parameters. Only 18,5% of hypertensive patients, 25,5% of patients with angina, 26,2% of AF patients and 23,1% of patients with HF were ready to change the lifestyle.Conclusion. The study revealed a significant number (~2/3) of CVD patients with insufficient adherence, which specifies the need  to assess the effectiveness  of therapy and course of the disease  in conditions of low adherence and to develop individualized therapeutic strategies.

2022 ◽  
Vol 17 (6) ◽  
pp. 845-852
Author(s):  
N. A. Nikolaev ◽  
Yu. P. Skirdenko ◽  
A. A. Balabanova ◽  
A. V. Gorbenko ◽  
K. A. Andreev ◽  
...  

Aim: To update the definitions of selected questions of the "QAA-25" (quantitative adherence assessment) scale and evaluate it according to the criteria of validity and measure of agreement.Materials and Methods. In a descriptive cross-sectional study including 200 patients with coronary heart disease, adherence was determined using traditional and alternative versions of selected questions of the QAA-25 scale, followed by assessment of construct validity, factor validity, and measure of agreement.Results. Alternative question versions did not significantly affect test results, with 81% of respondents in the outpatient sample and 69% in the inpatient sample rating them as "more acceptable." The QAA-25 scale has good construct and internal validity (α – 0.818, αst – 0.832), with moderate agreement (κ – 0.562) and demonstrates high reliability of internal validity – when scale items are consistently excluded, α values remain in the 0.801-0.839 range.Conclusion. The QAA-25 scale with modified question definitions should be used instead of the previous version of the scale. Good construct validity and factor validity, sufficient measure of agreement and specificity, high sensitivity and reliability of the QAA-25 scale allow to recommend it as a tool for assessing adherence to drug therapy, medical support, lifestyle modification and integral adherence to treatment in scientific and clinical practice.


2020 ◽  
Vol 7 (2) ◽  
pp. 256-263
Author(s):  
Abdul Qodir

Penatalaksanaan farmakologis dan non farmakologis dipercaya dapat mengontrol tekanan darah dan mencegah komplikasi, tetapi banyak pasien hipertensi tekanan darahnya tidak terkontrol. Hal tersebut dikarenakan kepatuhan yang buruk dalam melaksanakan rekomendasi gaya hidup. Penelitian ini bertujuan untuk menganalisis determinan faktor yang berhungan dengan kepatuhan melaksanakan rekomendasi modifikasi gaya hidup. Penelitian ini menggunakan metode cross-sectional di pukesmas dinoyo Kota Malang tahun 2019. Teknik pengambilan sampel menggunakan Consecutive Sampling. Kuesioner yang digunakan meliputi : karakteristik demografi, pengetahuan dan rekomendasi mofifikasi gaya hidup pasien hipertensi. Hubungan antara rekomendasi modifikasi gaya hidup dengan variabel independen dianalisis menggunakan uji chi square dan analisis regresi logistik. 140 pasien hipertensi berpartisipasi dalam penelitian ini (60 laki-laki, 80 wanita). Prevalensi kepatuhan adalah 28,6 %. Tingkat pengetahuan berhubungan signifikan  dengan kepatuhan melaksanakan rekomendasi gaya hidup (p=0,00). Jenis kelamin, usia, dan tingkat pendidikan tidak mempunyai hubungan signifikan dengan kepatuhan rekomendasi modifikasi gaya hidup (p= 0,06; p=0,21; p=0,87). Pengetahuan mempunyai hubungan yang signifikan dengan kepatuhan rekomendasi modifikasi gaya hidup. Management of pharmacological and non-pharmacological is believed to control blood pressure and prevent complications,  but many hypertensive patients have uncontrolled blood pressure. This is due to poor adherence to recommended lifestyle modifications. This study was aimed to determine the factors associated with adherence to recommended lifestyle modifications of hypertensive patients. A cross-sectional study was conducted in Pukesmas Dinoyo Malang in 2019. Consecutive Sampling was used to select study subjects. The questionnaire included information about demographic characteristics, knowledge, practice of lifestyle-modification measures. Associations between adherence to lifestyle modification and independent variables were analyzed using chi square and multivariate logistic regression analysis. 140 hypertensive patients participated in the study (60 men, 80 women). The prevalence of adherence was 28.6%. The level of knowledge was significant associated with adherence to recommended lifestyle modifications (p = 0.00). Genders , age, and educational level were no significant associated with to recommended lifestyle modifications (p= 0.06; p=0.21; p=0.87). Knowledge was significant associated with adherence to recommended lifestyle modifications of hypertensive patients.


Vaccines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 119 ◽  
Author(s):  
Rahul Shekhar ◽  
Abu Baker Sheikh ◽  
Shubhra Upadhyay ◽  
Mriganka Singh ◽  
Saket Kottewar ◽  
...  

Background: Acceptance of the COVID-19 vaccine will play a major role in combating the pandemic. Healthcare workers (HCWs) are among the first group to receive vaccination, so it is important to consider their attitudes about COVID-19 vaccination to better address barriers to widespread vaccination acceptance. Methods: We conducted a cross sectional study to assess the attitude of HCWs toward COVID-19 vaccination. Data were collected between 7 October and 9 November 2020. We received 4080 responses out of which 3479 were complete responses and were included in the final analysis. Results: 36% of respondents were willing to take the vaccine as soon as it became available while 56% were not sure or would wait to review more data. Only 8% of HCWs do not plan to get vaccine. Vaccine acceptance increased with increasing age, education, and income level. A smaller percentage of female (31%), Black (19%), Lantinx (30%), and rural (26%) HCWs were willing to take the vaccine as soon as it became available than the overall study population. Direct medical care providers had higher vaccine acceptance (49%). Safety (69%), effectiveness (69%), and speed of development/approval (74%) were noted as the most common concerns regarding COVID-19 vaccination in our survey.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e046959
Author(s):  
Atsushi Miyawaki ◽  
Dhruv Khullar ◽  
Yusuke Tsugawa

ObjectivesEvidence suggests that homeless patients experience worse quality of care and poorer health outcomes across a range of medical conditions. It remains unclear, however, whether differences in care delivery at safety-net versus non-safety-net hospitals explain these disparities. We aimed to investigate whether homeless versus non-homeless adults hospitalised for cardiovascular conditions (acute myocardial infarction (AMI) and stroke) experience differences in care delivery and health outcomes at safety-net versus non-safety-net hospitals.DesignCross-sectional study.SettingData including all hospital admissions in four states (Florida, Massachusetts, Maryland, and New York) in 2014.ParticipantsWe analysed 167 105 adults aged 18 years or older hospitalised for cardiovascular conditions (age mean=64.5 years; 75 361 (45.1%) women; 2123 (1.3%) homeless hospitalisations) discharged from 348 hospitals.Outcome measuresRisk-adjusted diagnostic and therapeutic procedure and in-hospital mortality, after adjusting for patient characteristics and state and quarter fixed effects.ResultsAt safety-net hospitals, homeless adults hospitalised for AMI were less likely to receive coronary angiogram (adjusted OR (aOR), 0.42; 95% CI, 0.36 to 0.50; p<0.001), percutaneous coronary intervention (aOR, 0.52; 95% CI, 0.44 to 0.62; p<0.001) and coronary artery bypass graft (aOR, 0.43; 95% CI, 0.26 to 0.71; p<0.01) compared with non-homeless adults. Homeless patients treated for strokes at safety-net hospitals were less likely to receive cerebral arteriography (aOR, 0.23; 95% CI, 0.16 to 0.34; p<0.001), but were as likely to receive thrombolysis therapy. At non-safety-net hospitals, we found no evidence that the probability of receiving these procedures differed between homeless and non-homeless adults hospitalised for AMI or stroke. Finally, there were no differences in in-hospital mortality rates for homeless versus non-homeless patients at either safety-net or non-safety-net hospitals.ConclusionDisparities in receipt of diagnostic and therapeutic procedures for homeless patients with cardiovascular conditions were observed only at safety-net hospitals. However, we found no evidence that these differences influenced in-hospital mortality markedly.


2021 ◽  
Vol 4 (1) ◽  
pp. 23-32
Author(s):  
Adebayo Akadri ◽  
Omobolanle Akadri

Objective: Lifestyle modification is an essential component of self-management of diabetes mellitus. This study assessed adherence to diet and exercise recommendations and elucidated the factors that influence adherence in patients living with diabetes. Method: A cross-sectional study involving 300 patients attending diabetes clinics in some selected hospitals in Ogun State, Nigeria. Structured questionnaires were used to obtain information on the socio-demographic characteristics, and PRECEDE factors of lifestyle-modification adherence in the study participants. Pearson’s correlation and Chi-square test were used to assess the association between the variables, while binary logistic regression was used to determine the predictors of adherence to dietary recommendations. Results: The mean age of the study respondents was 62.7 years. The proportion of respondents who adhered to dietary and exercise recommendations were 87.8% and 45.6% respectively. There were no statistically significant linear relationships between scores for each PRECEDE factor and scores for adherence to diet and exercise. Respondents’ age, body mass index, and duration of illness had a statistically significant association with adherence to diet (P< 0.001, P=0.021, and P=0.041 respectively). On logistic regression analysis, participants 60 years and older had a higher likelihood of adhering to dietary modification than younger participants [AOR=2.6, P < 0.001]. Conclusion: The adherence of patients living with diabetes to dietary recommendations was satisfactory while adherence to exercise recommendations was very poor. There is a need for health care workers, especially at the primary and secondary levels to implement strategies that will enhance reinforcing and enabling factors for exercise adherence.


2017 ◽  
Vol 33 (8) ◽  
pp. 391
Author(s):  
Safitri Dwicahyani ◽  
Yayi Suryo Prabandari

Determinants of exclusive breastfeeding in SlemanPurposeThe purpose of this paper was to determine the factors associated with the exclusive provision of breast milk in Sleman.MethodsA cross-sectional study was conducted using secondary data derived from HDSS Sleman Cycles I and II. The sample in this study were 218 mothers with children aged 7 to <24 months.ResultsThe ownership of health insurance and the use of bottles and pacifiers were significantly associated with exclusive breastfeeding. Maternal age, maternal education, and maternal occupation were not significantly associated with exclusive breastfeeding. Mothers with health insurance are 2.14 times more likely to exclusively breastfeed than those without health insurance. Infants who never use bottles, and pacifiers before the age of 6 months are 5.14 times more likely to receive exclusive breastfeeding than those who used bottles / dots before the age of 6 months.ConclusionThe use of bottles, and pacifiers is the most dominant factor associated with exclusive breastfeeding. Coverage of health insurance, especially in pregnant and lactating mothers and effective health promotion programs related to exclusive breastfeeding needs to be improved. HDSS Sleman needs to analyze the data more in-depth on exclusive breast-feeding.


Author(s):  
Farah Yasmin ◽  
Waleed Asghar ◽  
Maryam Salma Babar ◽  
Hiba Khan ◽  
Shoaib Ahmad ◽  
...  

Developing countries like Pakistan have previously suffered from barriers to acceptance of vaccination by the public because of financial and belief barriers. This study aims to explore these beliefs and highlight concerns regarding vaccine hesitancy in the general population of Pakistan since they are a hindrance to an effective coronavirus disease-19 (COVID-19) immunization in the country. A cross-sectional study was performed involving 1,778 participants from all four provinces of Pakistan. Results from the study showed more than half of the participants to be unsure of the safety (50%) and efficacy (51%) of the vaccine, whereas 42% were concerned about the side effects of the vaccine. About 72% of the respondents planned to get vaccinated, whereas 28% refused to do so. Internationally made imported vaccines were more trusted by the participants. Forty-four percent of the participants agreed to receive the vaccine upon recommendation from a physician. Lastly, participants who believed in the efficacy of the polio vaccination also considered the COVID-19 vaccine to be safe and effective.


Esculapio ◽  
2021 ◽  
Vol 17 (1) ◽  
pp. 30-33
Author(s):  
Bushra Asif Ali Khan ◽  
Faiza Muzahir ◽  
Sahar Abdul Rauf ◽  
Syeda Rubab Fatima ◽  
Abida Pervaiz ◽  
...  

Objective: The purpose of our study was to assess the trends of self-medication practices and to determine the prevalence, characteristics, related factors, and effects of self-medication among the patients conducted. Methods: This descriptive cross-sectional study was on patients of Combined Military Hospital Lahore on a sample size of 365. The data was collected and entered in a predesigned questionnaire about self-medication later analyzed using SPSS version 17.0. Results: The prevalence of self-medication was 95.3% and effectiveness was 87.7%. The common reasons for self-medication were prior knowledge of usefulness of remedy (63.3%), non-affordability of consultant charges (18.4%), and lack of time (21.9%). Frequently used medicines included antibiotics (30.1%), analgesics (69.6%), antipyretics (51.0%), and antihistamines (23.6%). Respondents claimed to receive information about these drugs from various sources including doctor (38.6%), previous prescription (31.8%), retailer seller (13.4%), family/friends (43.6%), media (7.9%) and other sources (1.6%). Conclusion: It had been concluded that there is a high prevalence of self-medication. There is a need to raise public awareness about the appropriate use in order to prevent potential hazards of self-medication. Key Words: trends, self-medication, out-patient department How to cite: Khan B.A.A, Muzahir F, Rauf S.A, Fatima S.R, Pervaiz A, Jamil S. Trends of self- medication amongst the patients visiting the out-patient department of Combined Military Hospital, Lahore. Esculapio.2021. 30-33


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