Clinician’s perspective regarding medication adherence in patients with obstructive lung diseases and the impact of COVID-19

Previous studies have reported an association between the impairment of cognitive performance and lung diseases. However, whether obstructive or restrictive lung diseases have an impact on cognitive function is still inconclusive. We aimed to investigate the association between cognitive function and obstructive or restrictive lung diseases in Taiwanese adults using the Mini-Mental State Examination (MMSE). In this study, we used data from the Taiwan Biobank. Cognitive function was evaluated using the MMSE. Spirometry measurements of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were obtained to assess lung function. Participants were classified into three groups according to lung function, namely, normal, restrictive, and obstructive lung function. In total, 683 patients enrolled, of whom 357 participants had normal lung function (52.3%), 95 had restrictive lung function (13.9%), and 231 had obstructive lung function (33.8%). Compared to the normal lung function group, the obstructive lung function group was associated with a higher percentage of cognitive impairment (MMSE < 24). In multivariable analysis, a low MMSE score was significantly associated with low FVC, low FEV1, and low FEV1/FVC. Furthermore, a low MMSE score was significantly associated with low FEV1 in the participants with FEV1/FVC < 70%, whereas MMSE was not significantly associated with FVC in the participants with FEV1/FVC ≥ 70%. Our results showed that a low MMSE score was associated with low FEV1, low FVC and low FEV1/FVC. Furthermore, a low MMSE score was associated with obstructive lung diseases but not with restrictive lung diseases.

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A qualitative exploration of the impact of knowledge and perceptions about hypertension in medication adherence in Middle Eastern refugees and migrants

Exploratory Research in Clinical and Social Pharmacy ◽

10.1016/j.rcsop.2021.100038 ◽

2021 ◽

pp. 100038

Author(s):

Wejdan Shahin ◽

Gerard A. Kennedy ◽

Ieva Stupans

Keyword(s):

Medication Adherence ◽

Middle Eastern ◽

Qualitative Exploration ◽

The Impact

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Improved adherence with Medicines Use Review service in Slovenia: a randomized controlled trial

BMC Health Services Research ◽

10.1186/s12913-021-06223-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Urška Nabergoj Makovec ◽

Igor Locatelli ◽

Mitja Kos

Keyword(s):

Medication Adherence ◽

Controlled Trial ◽

Test Group ◽

Multiple Linear Regression Model ◽

Relative Difference ◽

Control Group ◽

Adherence Support ◽

Medicines Use ◽

The Impact ◽

Medicines Use Review

Abstract Background Based on several existing patient-oriented activities, Medicines Use Review (MUR) service was standardized and officially adopted in Slovenia in 2015. Service aims to provide adherence support and ensure safe and effective medicines use. Therefore, the aim of the study was to evaluate the benefits of MUR in Slovenia, primarily the impact on medication adherence. Methods A randomised controlled trial was performed in community pharmacies to compare MUR with standard care. Patients were randomised into either the test (patients received MUR by a certified MUR provider at visit 1), or control group. The study primary outcome was self-reported adherence to multiple medications, assessed by electronic ©Morisky Widget MMAS-8 Software at the first visit (V1) and after 12 weeks (V2). A sub-analysis of intentional and unintentional non-adherence was performed. MUR impact was defined as the relative difference in ©MMAS-8 score after 12 weeks between the test and control group. A multiple linear regression model was used to predict MUR impact based on baseline adherence (low versus medium and high). Several secondary outcomes (e.g. evaluation of drug-related problems (DRPs)) were also assessed. Results Data from 153 (V1) and 140 (V2) patients were analysed. Baseline adherence was low, moderate and high in 17.6, 48.4 and 34.0% patients, respectively. In the low adherence subpopulation, test group patients showed a 1.20 point (95% CI = 0.16–2.25) increase in total ©MMAS-8 score (p = 0.025) compared to control group patients. A 0.84 point (95% CI = 0.05–1.63) increase was due to intentional non-adherence (p = 0.038), and a 0.36 point (95% CI = − 0.23-0.95) was due to unintentional non-adherence (p = 0.226). Additionally, statistically significant decrease in the proportion of patients with manifested DRPs (p < 0.001) and concerns regarding chronic medicines use (p = 0.029) were revealed. Conclusion MUR service in Slovenia improves low medication adherence and is effective in addressing DRPs and concerns regarding chronic medicines use. Trial registration ClinicalTrials.gov - NCT04417400; 4th June 2020; retrospectively registered.

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The impact of cognitive impairment on survival and medication adherence among older women with breast cancer

Breast Cancer ◽

10.1007/s12282-020-01155-3 ◽

2020 ◽

Author(s):

Yasser Alatawi ◽

Richard A. Hansen ◽

Chiahung Chou ◽

Jingjing Qian ◽

Vishnu Suppiramaniam ◽

...

Keyword(s):

Breast Cancer ◽

Cognitive Impairment ◽

Medication Adherence ◽

Older Women ◽

The Impact

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Enhancing Patient Motivation through Intelligibility in Cardiac Tele-rehabilitation

Interacting with Computers ◽

10.1093/iwc/iwz008 ◽

2019 ◽

Vol 31 (2) ◽

pp. 122-137

Author(s):

Supraja Sankaran ◽

Kris Luyten ◽

Dominique Hansen ◽

Paul Dendale ◽

Karin Coninx

Keyword(s):

Medication Adherence ◽

Exercise Training ◽

Physical Exercise ◽

Health Outcomes ◽

Cardiac Rehabilitation ◽

Field Studies ◽

Activity Levels ◽

Patient Motivation ◽

Physical Exercise Training ◽

The Impact

Abstract Physical exercise training and medication compliance are primary components of cardiac rehabilitation. When rehabilitating independently at home, patients often fail to comply with their prescribed medication and find it challenging to interpret exercise targets or be aware of the expected efforts. Our work aims to assist cardiac patients in understanding their condition better, promoting medication adherence and motivating them to achieve their exercise targets in a tele-rehabilitation setting. We introduce a patient-centric intelligible visualization approach to present prescribed medication and exercise targets to patients. We assessed efficacy of intelligible visualizations on patients’ comprehension in two lab studies. We evaluated the impact on patient motivation and health outcomes in field studies. Patients were able to adhere to medication prescriptions, manage their physical exercises, monitor their progress and gained better self-awareness on how they achieved their rehabilitation targets. Patients confirmed that the intelligible visualizations motivated them to achieve their targets better. We observed an improvement in overall physical activity levels and health outcomes of patients. Research Highlights Presents challenges currently faced in cardiac tele-rehabilitation. Demonstrates how intelligibility was applied to two core aspects of cardiac rehabilitation- promoting medication adherence and physical exercise training. Lab., field and clinical studies to demonstrate efficacy of intelligible visualization, impact on patient motivation and resultant health outcomes. Reflection on how similar HCI approaches could be leveraged for technology-supported management of critical health conditions such as cardiac diseases.

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