Reach and Validity of an Objective Medication Adherence Measure Among Safety Net Health Plan Members with Diabetes: A Cross-Sectional Study

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.

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The relation between psychological distress and medication adherence in lung transplant candidates and recipients: A cross‐sectional study

Journal of Clinical Nursing ◽

10.1111/jocn.15931 ◽

2021 ◽

Author(s):

Marion J. Wessels‐Bakker ◽

Eduard A. van de Graaf ◽

Johanna M. Kwakkel‐van Erp ◽

Harry G. Heijerman ◽

Wiepke Cahn ◽

...

Keyword(s):

Psychological Distress ◽

Medication Adherence ◽

Lung Transplant ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Transplant Candidates

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Assessment of drug attitude, medication adherence and quality of life among psychiatric patients in South Indian population: a cross sectional study

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20185159 ◽

2018 ◽

Vol 8 (1) ◽

pp. 61

Author(s):

Suganya Ganesan ◽

Nitya Selvaraj ◽

Vinoth Krishna Dass ◽

Nalinidevi Jayabalan ◽

Meher Ali Rajamohammad ◽

...

Keyword(s):

Quality Of Life ◽

Medication Adherence ◽

Psychiatric Disorders ◽

Psychiatric Patients ◽

Cross Sectional Study ◽

Sectional Study ◽

Medication Nonadherence ◽

Cross Sectional ◽

Drug Attitude

Background: In spite of many progresses in treatment of psychiatric disorders, medication nonadherence plays an important role in worsening of clinical condition and affects quality of life among psychiatric patients. There are numerous factors contributing for medication nonadherence among patients with mental illness. So, this study was conducted to assess psychiatric patients’ adherence of medication and to improve their quality of life with psychiatric disorder. The objectives of the study were to analyze impact of pharmacophilia and pharmacophobia on medication adherence among patients with psychiatric disorders at a tertiary care hospital and to assess quality of life among pharmacophilic and pharmacophobic patients.Methods: A cross-sectional study was conducted in outpatient psychiatric department for a period of two months. After obtaining informed voluntary consent, patient’s socio-demographic details, diagnosis, and treatment were recorded from prescription slip. Patients above 18yr age with psychiatric diagnosis as per International Classification of Diseases 10 (ICD-10) and receiving at least one psychotropic medication for >1 month were enrolled in study and assessed using: Drug attitude inventory classification (DAI-10); Medication Rating Scale (MARS); Quality of life enjoyment and satisfaction Questionnaire-Short Form (Q-LES-Q-SF).Results: Among 130 patients, 116 were pharmacophilic and 14 were pharmacophobic as per DAI-10 scale. 81.9% of pharmacophilic were adherent to prescribed medication assessed using MARS scale only 14.3% were pharmacophobic. The quality of life was better in pharmacophilic compared to pharmacophobic group (p=0.002) using Q-LES-Q-SF.Conclusions: This study concluded that pharmacophilic patients have higher adherence and good quality of life index compared to pharmacophobic. Proper counselling of pharmacophobic patients by psychiatrists could improve adherence and QOL.

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Cross-sectional study of internalised stigma and medication adherence in patients with obsessive compulsive disorder

General Psychiatry ◽

10.1136/gpsych-2019-100180 ◽

2020 ◽

Vol 33 (2) ◽

pp. e100180

Author(s):

Eram Ansari ◽

Sudha Mishra ◽

Adarsh Tripathi ◽

Sujita Kumar Kar ◽

Pronob Kumar Dalal

Keyword(s):

Medication Adherence ◽

Obsessive Compulsive Disorder ◽

Cross Sectional Study ◽

Care Hospital ◽

Sectional Study ◽

Adherence To Treatment ◽

Obsessive Compulsive ◽

Cross Sectional ◽

Compulsive Disorder ◽

Current Medication

BackgroundPatients suffering from psychiatric disorders tend to stigmatise themselves which had been linked to poor adherence to treatment.AimsThe aim of the present study was to study internalised stigma and medication adherence and to assess the relationship between them in patients with obsessive compulsive disorder (OCD).MethodsA cross-sectional study was conducted on 112 patients diagnosed with OCD who were attending the Out-patient's department at Department of Psychiatry of a tertiary care hospital in North India. Internalised stigma and current medication adherence were assessed with Internalized Stigma of Mental Illness Scale (ISMI) and Medication Adherence Rating Scale, respectively. Yale-Brown Obsessive Compulsive Scale was used to assess the current severity of OCD symptoms. Sociodemographic and clinical details were also obtained from the patients by using a semistructured sociodemographic proforma.ResultsMost of the patients reported moderate level of internalised stigma with a mean ISMI score of 77.98 (10.82). Most of the patients were compliant while 41.96% reported poor medication adherence. Internalised stigma was negatively correlated with the current medication adherence. Current severity of OCD symptoms also showed a significant positive correlation with internalised stigma and a significant negative correlation with medication adherence.ConclusionHigh levels of internalised stigma were associated with lower adherence to treatment which suggests that internalised stigma may be a very important factor influencing medication adherence in patients with OCD.

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Medication-Related Burden and Medication Adherence Among Geriatric Patients in Kuwait: A Cross-Sectional Study

Frontiers in Pharmacology ◽

10.3389/fphar.2020.01296 ◽

2020 ◽

Vol 11 ◽

Author(s):

Abdelmoneim Awad ◽

Anwar Alhadab ◽

Abdullah Albassam

Keyword(s):

Medication Adherence ◽

Geriatric Patients ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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A New Lebanese Medication Adherence Scale: Validation in Lebanese Hypertensive Adults

International Journal of Hypertension ◽

10.1155/2018/3934296 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 6

Author(s):

R. Bou Serhal ◽

P. Salameh ◽

N. Wakim ◽

C. Issa ◽

B. Kassem ◽

...

Keyword(s):

Medication Adherence ◽

Scale Validation ◽

Sodium Intake ◽

Cross Sectional Study ◽

Sectional Study ◽

Hypertension Control ◽

Cross Sectional ◽

Adherence Scale ◽

Good Internal Consistency ◽

Average Measure

Background. A new Lebanese scale measuring medication adherence considered socioeconomic and cultural factors not taken into account by the eight-item Morisky Medication Adherence Scale (MMAS-8). Objectives were to validate the new adherence scale and its prediction of hypertension control, compared to MMAS-8, and to assess adherence rates and factors. Methodology. A cross-sectional study, including 405 patients, was performed in outpatient cardiology clinics of three hospitals in Beirut. Blood pressure was measured, a questionnaire filled, and sodium intake estimated by a urine test. Logistic regression defined predictors of hypertension control and adherence. Results. 54.9% had controlled hypertension. 82.4% were adherent by the new scale, which showed good internal consistency, adequate questions (KMO coefficient = 0.743), and four factors. It predicted hypertension control (OR = 1.217; p value = 0.003), unlike MMAS-8, but the scores were correlated (ICC average measure = 0.651; p value < 0.001). Stress and smoking predicted nonadherence. Conclusion. This study elaborated a validated, practical, and useful tool measuring adherence to medications in Lebanese hypertensive patients.

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