scholarly journals Effects of the Full Coverage Policy of Essential Medicines on Inequality in Medication Adherence: A Longitudinal Study in Taizhou, China

2021 ◽  
Author(s):  
Zhi-gang Guo ◽  
Li-guang Zheng ◽  
Meng-yuan Fu ◽  
Huang-qian-yu Li ◽  
Lin Bai ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Medication Adherence ◽  
Longitudinal Data ◽  
Protective Factor ◽  
Essential Medicines ◽  
Full Coverage ◽  
Implementation Time ◽  
Longitudinal Study Design ◽  
Coverage Policy

Abstract Background The full coverage policy for essential medicines (FCPEMs) was proposed and implemented in Taizhou city of Zhejiang Province of China to promote equal access and adherence to medicines. This study aimed to examine the effects of FCPEMs on the inequality in medication adherence among local patients with hypertension and diabetes, and to explore their influencing factors Methods We collected electronic health records of patients with hypertension and diabetes of three districts of Taizhou from 2011–2016. With the implementation time of FCPEMs being different, we applied a retrospective longitudinal study design and selected the records of 1 baseline year before and 3 follow-up years after following the implementation of FCPEMs. All data entries of the same patient were aggregated and generated a dataset with 4-year longitudinal data. The concentration index (CI) and its decomposition method were employed to measure the factors contributing to inequality in medication adherence and the role played by FCPEMs. Results The sample size of the 4 years retrospective longitudinal data rose from 264,836 to 315,677, 340,512 and 355,676 individuals and the proportion of the patient taking the free medicines were 17.6–25.0% and 29.8% after FCPEMs. The proportion of patients with high adherence increased from 39.9–51.6%, 57.2%, 60.5% and CI changed from 0.073 to -0.011, -0.029, -0.035, where the rate of the contribution of FCPEMs were 54.792%, 1.223% and − 19.092% and ranked 2nd, 7th and 2nd after the implementation of FCPEMs. The changes in CI of medication adherence for every two years were − 0.084, -0.018, -0.006, and the contribution of FCPEMs were − 0.006, 0.006, 0.007, ranking the 2nd, 2nd and 1st and mainly attributed to the changes of CI of FCPEMs. Conclusions The medication adherence of patients with hypertension and diabetes improved after the implementation FCPEMs in Taizhou, but the inequality did not show a consistent rate of improvement. In general, FCPEMs contributed to improvements in the inequality in medication adherence. FCPEMs could be a protective factor against the income-related inequalities, but this would need further investigations and to be accompanied by other systematic efforts.

scholarly journals Effects of the Full Coverage Policy of Essential Medicines on Inequality in Medication Adherence: A Longitudinal Study in Taizhou, China

2021 ◽  
Author(s):  
Zhigang Guo ◽  
Liguang Zheng ◽  
Mengyuan Fu ◽  
Huangqianyu Li ◽  
Lin Bai ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Medication Adherence ◽  
Longitudinal Data ◽  
Protective Factor ◽  
Essential Medicines ◽  
Full Coverage ◽  
Implementation Time ◽  
Longitudinal Study Design ◽  
Coverage Policy

Abstract Background: The full coverage policy for essential medicines (FCPEMs) was proposed and implemented in Taizhou city of Zhejiang Province of China to promote equal access and adherence to medicines. This study aimed to examine the effects of FCPEMs on the inequality in medication adherence among local patients with hypertension and diabetes, and to explore their influencing factorsMethods: We collected electronic health records of patients with hypertension and diabetes of three districts of Taizhou from 2011-2016. With the implementation time of FCPEMs being different, we applied a retrospective longitudinal study design and selected the records of 1 baseline year before and 3 follow-up years after following the implementation of FCPEMs. All data entries of the same patient were aggregated and generated a dataset with 4-year longitudinal data. The concentration index (CI) and its decomposition method were employed to measure the factors contributing to inequality in medication adherence and the role played by FCPEMs.Results: The sample size of the 4 years retrospective longitudinal data rose from 264,836 to 315,677, 340,512 and 355,676 individuals and the proportion of the patient taking the free medicines were 17.6% to 25.0% and 29.8% after FCPEMs. The proportion of patients with high adherence increased from 39.9% to 51.6%, 57.2%, 60.5% and CI changed from 0.073 to -0.011, -0.029, -0.035, where the rate of the contribution of FCPEMs were 54.792%, 1.223% and -19.092% and ranked 2nd, 7th and 2nd after the implementation of FCPEMs. The changes in CI of medication adherence for every two years were -0.084, -0.018, -0.006, and the contribution of FCPEMs were -0.006, 0.006, 0.007, ranking the 2nd, 2nd and 1st and mainly attributed to the changes of CI of FCPEMs.Conclusions: The medication adherence of patients with hypertension and diabetes improved after the implementation FCPEMs in Taizhou, but the inequality did not show a consistent rate of improvement. In general, FCPEMs contributed to improvements in the inequality in medication adherence. FCPEMs could be a protective factor against the income-related inequalities, but this would need further investigations and to be accompanied by other systematic efforts.

PSYCHOPHYSICAL HEALTH DURING PROLONGED UNEMPLOYMENT: LONGITUDINAL DATA

1970 ◽  
Vol 9 (4) ◽  
pp. 379
Author(s):  
Nebojša Majstorović ◽  
Boris Popov ◽  
Jelena Matanović ◽  
Vanja Slijepčević
Keyword(s):  
Longitudinal Study ◽  
Longitudinal Data ◽  
Health Effects ◽  
General Health ◽  
Job Loss ◽  
Longitudinal Study Design ◽  
The Republic ◽  
The Unemployed ◽  
Health Deterioration ◽  
Different Levels

Research on health effects of unemployment have shown inconsistent findings, both in terms of stability and factors of overall health during time without a job, and in terms of the significance of factors based on which one can reliably predict the health of the unemployed. The Psychophysical health scale was conducted on a sample of 222 unemployed individuals in the Republic of Serbia, in order to analyze factors of general psychophysical health. By applying a longitudinal study design, we measured general health of the unemployed from four regions in the Republic of Serbia on three occasions (March 2012, October 2012, and May 2013). During the course of the study, the results have indicated that, unemployed individuals show significantly fewer symptoms of ill-health, that women, as a group, are more vulnerable in most aspects of health, that the oldest unemployees report symptoms of health deterioration most often, and that job loss does not produce different effects on health in people with different levels of education. These results are discussed in light of findings from previous research studies.

Walking Up to One Hour Per Week Maintains Mobility as Older Women Age: Findings from an Australian Longitudinal Study

2017 ◽  
Vol 25 (2) ◽  
pp. 269-276 ◽  
Author(s):  
Bonnie Field ◽  
Tom Cochrane ◽  
Rachel Davey ◽  
Yohannes Kinfu
Keyword(s):  
Longitudinal Study ◽  
Longitudinal Data ◽  
Older Women ◽  
Old Age ◽  
Very Old ◽  
Australian Longitudinal Study ◽  
Data Analyses ◽  
Very Old Age ◽  
Mobility Aid

The aim of this study was to identify determinants of walking and whether walking maintained mobility among women as they transition from their mid-70s to their late 80s. We used 12 years of follow-up data (baseline 1999) from the Australian Longitudinal Study on Women’s Health (n = 10,322). Fifteen determinants of walking were included in the analysis and three indicators of mobility. Longitudinal data analyses techniques were employed. Thirteen of the 15 determinants were significant predictors of walking. Women in their mid-70s who walked up to 1 hr per week were less likely to experience loss of mobility in very old age, including reduced likelihood of using a mobility aid. Hence, older women who do no walking should be encouraged to walk to maintain their mobility and their independence as they age, particularly women in their 70s and 80s who smoke, are overweight, have arthritis, or who have had a recent fall.

scholarly journals Factors Associated with Free Medicine Use in Patients with Hypertension and Diabetes: A 4-Year Longitudinal Study on Full Coverage Policy for Essential Medicines in Taizhou, China

2021 ◽  
Vol 18 (22) ◽  
pp. 11966
Author(s):  
Zhigang Guo ◽  
Lin Bai ◽  
Zhenhuan Luo ◽  
Mengyuan Fu ◽  
Liguang Zheng ◽  
...  
Keyword(s):  
Descriptive Analysis ◽  
Access To Medicines ◽  
Essential Medicines ◽  
Local Policy ◽  
Medicine Use ◽  
Or Education ◽  
Policy Makers ◽  
Factors Associated ◽  
Full Coverage ◽  
Coverage Policy

Full coverage policies for medicines have been implemented worldwide to alleviate medicine cost burden and promote access to medicines. However, few studies have explored the factors associated with free medicine use in patients with chronic diseases. This study aimed to analyze the utilization of free medicines by patients with hypertension and diabetes after the implementation of the full coverage policy for essential medicines (FCPEM) in Taizhou, China, and to explore the factors associated with free medicine use. We conducted a descriptive analysis of characteristics of patients with and without free medicine use and performed a panel logit model to examine factors associated with free medicine use, based on an electronic health record database in Taizhou from the baseline year (12 months in priori) to three years after FCPEM implementation. After FCPEM implementation, the proportion of patients without any free medicine use decreased from 31.1% in the baseline year to 28.9% in the third year, while that of patients taking free medicines rose from 11.0% to 22.8%. Patients with lower income or education level, those with agricultural hukou, patients aged 65 and above, married patients, and patients in the Huangyan district were more likely to take free medicines. In conclusion, FCPEM contributed to improved medicine access, especially in vulnerable populations. Local policy makers should consider expanding the coverage of FCPEM to other types of medicines and cultivate the potential of social supports for patients to enhance the effectiveness of FCPEM policies.

scholarly journals Can Physical Activity Reduce the Risk of Cognitive Decline in Apolipoprotein e4 Carriers? A Systematic Review

2021 ◽  
Vol 18 (14) ◽  
pp. 7238
Author(s):  
Jose Luis Perez-Lasierra ◽  
Jose Antonio Casajús ◽  
José Antonio Casasnovas ◽  
Jose Miguel Arbones-Mainar ◽  
Antonio Lobo ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Longitudinal Study ◽  
General Population ◽  
Cognitive Decline ◽  
Protective Factor ◽  
Scientific Evidence ◽  
Partial Support ◽  
Longitudinal Study Design ◽  
The Relationship

Physical activity (PA) reduces the risk of cognitive decline (CD) in the general population. However, little is known about whether the presence of the apolipoprotein E epsilon 4 allele (APOE e4) could modify this beneficial effect. The aim of this systematic review was to analyze and synthetize the scientific evidence related to PA levels and CD risk in cognitively healthy APOE e4 carriers. Four electronic databases were analyzed. Only original articles with longitudinal study design were selected to analyze the relationship between PA and CD in APOE e4 carriers. Five studies were included in the systematic review. All studies except one stated that PA is a protective factor against CD in APOE e4 carriers. Moreover, partial support was found for the hypothesis that a greater amount and intensity of PA are more beneficial in CD prevention. The results support the idea that PA is a protective factor against CD in APOE e4 carriers. Nevertheless, it would be necessary to carry out further studies that would allow these findings to be contrasted.

The bidirectional association between Internet addiction and depression: a large-sample longitudinal study among Chinese university students (Preprint)

2020 ◽  
Author(s):  
Wan-Jun Guo ◽  
Xia Yang ◽  
Yu-Jie Tao ◽  
Ya-Jing Meng ◽  
Hui-Yao Wang ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Internet Addiction ◽  
Causal Effects ◽  
Causal Relationships ◽  
Depression Severity ◽  
Large Sample ◽  
Panel Model ◽  
Bidirectional Association ◽  
Predictive Effect

BACKGROUND Evidence indicates that Internet addiction (IA) is associated with depression, but longitudinal studies have rarely been reported, and no studies have yet investigated potential common vulnerability or a possible specific causal relationship between these disorders. OBJECTIVE To overcome these gaps, the present 12-month longitudinal study based on a large-sample employed a cross-lagged panel model (CLPM) approach to investigate the potential common vulnerability and specific cross-causal relationships between IA and CSD (or depression). METHODS IA and clinically-significant depression (CSD) among 12 043 undergraduates were surveyed at baseline (as freshmen) and in follow-up after 12 months (as sophomores). Application of CLPM revealed two well-fitted design between IA and CSD, and between severities of IA and depression, adjusting for demographics. RESULTS Rates of baseline IA and CSD were 5.47% and 3.85%, respectively; increasing to 9.47% and 5.58%, respectively at follow-up. Among those with baseline IA and CSD, 44.61% and 34.48% remained stable at the time of the follow-up survey, respectively. Rates of new-incidences of IA and CSD over 12 months were 7.43% and 4.47%, respectively. Application of a cross-lagged panel model approach (CLPM, a discrete time structural equation model used primarily to assess causal relationships in real-world settings) revealed two well-fitted design between IA and CSD, and between severities of IA and depression, adjusting for demographics. Models revealed that baseline CSD (or depression severity) had a significant net-predictive effect on follow-up IA (or IA severity), and baseline IA (or IA severity) had a significant net-predictive effect on follow-up CSD (or depression severity). CONCLUSIONS These correlational patterns using a CLPM indicate that both common vulnerability and bidirectional specific cross-causal effects between them may contribute to the association between IA and depression. As the path coefficients of the net-cross-predictive effects were significantly smaller than those of baseline to follow-up cross-section associations, vulnerability may play a more significant role than bidirectional-causal effects. CLINICALTRIAL Ethics Committee of West China Hospital, Sichuan University (NO. 2016-171)

scholarly journals Does parental permissiveness toward cigarette smoking and alcohol use influence illicit drug use among adolescents? A longitudinal study in seven European countries

2021 ◽  
Author(s):  
Emina Mehanović ◽  
Federica Vigna-Taglianti ◽  
Fabrizio Faggiano ◽  
Maria Rosaria Galanti ◽  
Barbara Zunino ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Drug Use ◽  
Cigarette Smoking ◽  
Longitudinal Data ◽  
Illicit Drug ◽  
Large Population ◽  
Illicit Drug Use ◽  
European Countries ◽  
The Impact

Abstract Purpose Adolescents’ perceptions of parental norms may influence their substance use. The relationship between parental norms toward cigarette and alcohol use, and the use of illicit substances among their adolescent children is not sufficiently investigated. The purpose of this study was to analyze this relationship, including gender differences, using longitudinal data from a large population-based study. Methods The present study analyzed longitudinal data from 3171 12- to 14-year-old students in 7 European countries allocated to the control arm of the European Drug Addiction Prevention trial. The impact of parental permissiveness toward cigarettes and alcohol use reported by the students at baseline on illicit drug use at 6-month follow-up was analyzed through multilevel logistic regression models, stratified by gender. Whether adolescents’ own use of cigarette and alcohol mediated the association between parental norms and illicit drug use was tested through mediation models. Results Parental permissive norms toward cigarette smoking and alcohol use at baseline predicted adolescents’ illicit drug use at follow-up. The association was stronger among boys than among girls and was mediated by adolescents’ own cigarette and alcohol use. Conclusion Perceived parental permissiveness toward the use of legal drugs predicted adolescents’ use of illicit drugs, especially among boys. Parents should be made aware of the importance of norm setting, and supported in conveying clear messages of disapproval of all substances.

scholarly journals Social isolation, rather than loneliness, is associated with cognitive decline in older adults: the China Health and Retirement Longitudinal Study

2021 ◽  
pp. 1-8
Author(s):  
Bin Yu ◽  
Andrew Steptoe ◽  
Yongjie Chen ◽  
Xiaohua Jia
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Decline ◽  
Social Isolation ◽  
Mental Status ◽  
Chinese Older Adults ◽  
Confounding Variables

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.

scholarly journals Multimorbidity, Disadvantage, and Trends in Disability-Free Life Expectancy: The CFAS Studies

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 641-641
Author(s):  
Andrew Kingston ◽  
Holly Bennett ◽  
Louise Robinson ◽  
Lynne Corner ◽  
Carol Brayne ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Life Expectancy ◽  
Longitudinal Data ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Health Conditions ◽  
Disadvantaged Groups ◽  
Disability Free Life Expectancy ◽  
Reported Health

Abstract The combined contribution of multi-morbidity and socio-economic position (SEP) to trends in disability free life expectancy (DFLE) is unknown. We use longitudinal data from the Cognitive Function and Ageing Studies (CFAS I: 1991; CFAS II: 2011), with two year follow up. Disability was defined as difficulty in activities of daily living, and SEP as area-level deprivation. Multi-morbidity was constructed from nine self-reported health conditions and categorised as 0-1, 2-3, 4+ diseases. In 1991 and 2011, shorter total and disability-free years were associated with greater multi-morbidity. Between 1991 and 2011, gains in life expectancy and DFLE were observed at all levels of multi-morbidity, the greatest gain in DFLE being 4 years for men with 0-1 diseases. As multi-morbidity is more prevalent in more disadvantaged groups, further analyses will investigate whether SEP differences remain at all levels of multi-morbidity.

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