scholarly journals Regularity of Clinical Visits and Medication Adherence of Patients with Hypertension or Diabetes in Rural Yunnan Province of China

2020 ◽  
Vol 17 (24) ◽  
pp. 9297
Author(s):  
Qiufeng Gao ◽  
Lanxi Peng ◽  
Wenbin Min ◽  
Jingchun Nie ◽  
Aiqin Wang ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Yunnan Province ◽  
Rural China ◽  
Cross Sectional Study ◽  
Individual Characteristics ◽  
Self Management ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Structured Questionnaire

Chronic diseases can be controlled through effective self-management. The purpose of this study is to explore the regularity of clinical visits and medication adherence of patients with hypertension or diabetes (PWHD), and its association with the first experience with care and individual factors in rural Southwestern China. This cross-sectional study was carried out in Yunnan province in 2018 and recruited 292 PWHD and 122 village clinics from 122 villages in 10 counties. Participants were interviewed using a structured questionnaire. Results show around 39% of hypertensive and 25% of diabetic patients neither visited physicians nor took medicine regularly during the preceding three months of the interview date. The regression results further indicated that individual characteristics of the PWHD, including patient age, health status, and economic level, as well as their first experience with care, were significantly associated with their regular healthcare behavior. In addition to providing medical services, on average each sample village clinic, with around two physicians, simultaneously managed 180 hypertensive and 45 diabetic patients. This study revealed the need for further reforms in terms of improving self-management and thus recommends an increase in the quantity and the quality of human resources in the primary healthcare realm in rural China.

scholarly journals Regularity of clinical visits and medication adherence of patients with hypertension or diabetes in rural Yunnan province of China

2020 ◽  
Author(s):  
Qiufeng Gao ◽  
Lanxi Peng ◽  
Wenbin Min ◽  
Jingchun Nie ◽  
Aiqin Wang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Medication Adherence ◽  
Rural Areas ◽  
Yunnan Province ◽  
Rural China ◽  
Individual Characteristics ◽  
Self Management ◽  
Effective Control ◽  
Diabetic Patients ◽  
Logistic Regression Models

Abstract Objective Chronic diseases can be controlled through effective self-management. The purpose of this study is to explore the regularity of clinical visits and medication adherence of patients with hypertension or diabetes (PDH), and its association with the first experience with care and individual factors in rural Southwestern China.Methods The authors draw on a dataset which comprised of 292 PDH and 122 village clinics selected from 122 villages in 10 counties in the rural areas of Yunnan province. Data was gathered through interviews with these patients and the directors of the village clinics in January 2018. Logistic regression models were performed using STATA 15.0.Results The data shows around 31% of hypertensive and 25% of diabetic patients neither visited physicians nor took medicine regularly during the preceding three months of the interview date. We also documented PDH first experience with care and found that a proportion of them did not initially choose to seek care from health facilities. The logistic regression results indicated that individual characteristics of the PDH, including patient age, health status, and economic level, as well as their first experience with care were significantly associated with their regular healthcare behavior. Moreover, in addition to providing medical services, on average each sample village clinic with around two physicians simultaneously managed 180 hypertensive and 45 diabetic patients.Conclusions Our paper shows how current self-management trends among PDH in the sample area was unsatisfactory, threatening the effective control of hypertension and diabetes in China. Even though healthcare reforms in China have been launched since 2009, this study revealed the need for further reforms in terms of improving self-management. The authors recommend an increase in the quantity and the quality of human resources in the primary healthcare realm in rural China, which should help provide better education and supervision services for self-management.

scholarly journals THE IMPACT OF MEDICATION ADHERENCE ON HEALTH-RELATED QUALITY OF LIFE OF DIABETIC PATIENTS IN THE KINGDOM OF SAUDI ARABIA: FINDINGS FROM A CROSS-SECTIONAL STUDY

2020 ◽  
Vol 17 (34) ◽  
pp. 867-873
Author(s):  
Dhfer ALSHAYBAN ◽  
Royes JOSEPH
Keyword(s):  
Quality Of Life ◽  
Medication Adherence ◽  
Cross Sectional Study ◽  
P Value ◽  
Diabetic Patients ◽  
Health State ◽  
Cross Sectional ◽  
Related Quality ◽  
The Impact

Diabetes is a common chronic disease that is considered as one of the fastest-growing health problems in the world. Adherence to medications could be an important factor in reducing these complications and improving the quality of life. The purpose of this research was to assess the impact of treatment adherence on health-related quality of life in patients with type 2 diabetes. A multicenter cross-sectional study was carried out among 368 diabetes patients. General Medication Adherence Scale was used to assess the adherence level and EuroQol-5D to assess the quality of life. The results show that 19%, 21%, and 23% of patients had maintained low medication adherence due to patient’s intentional or unintentional behavior due to additional diseases or pills burden and due to financial constraints, respectively. Overall, 43% (n=162) participants had maintained high medication adherence, and 37% (n=138) had maintained low medication adherence to antidiabetic drugs. Nearly one-third (31%) of patients with high overall adherence had perfect health state in comparison with 4% among patients with low adherence. Further, the lower proportion (21%) of patients with high overall adherence had perfect health state in comparison with that among patients with low adherence (34%). In addition to the overall adherence, the association was statistically significant for the domains related to non-adherence due to the patient’s intentional or unintentional behavior (p-value 0.001) and non-adherence due to additional diseases or pills burden (p-value 0.001) after taking into account of socio-demographic and clinical characteristics. In conclusion, the findings suggest that the policymakers should establish an intervention to improve adherence to diabetic treatment, and thus improve the quality of life for the type 2 diabetic patients.

scholarly journals Healthcare Providers’ Knowledge, Attitude, and Perspective regarding Diabetes Self-Management during Ramadan Fasting: A Cross-Sectional Study

2021 ◽  
Vol 11 (1) ◽  
pp. 124-132
Author(s):  
Sh Sugiharto ◽  
Wiwiek Natalya ◽  
Bambang Widjanarko Otok
Keyword(s):  
Community Health Centers ◽  
Healthcare Providers ◽  
Sampling Technique ◽  
Management Training ◽  
Cross Sectional Study ◽  
Wilcoxon Test ◽  
Self Management ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Ramadan Fasting

Background: Evidence shows that most general practitioners have low knowledge related to diabetes self-management during Ramadan fasting. However, studies on healthcare providers’ competencies related to diabetes self-management during Ramadan fasting are still rare.Purpose: This study aimed to investigate healthcare providers’ knowledge, attitude, and perspective concerning diabetes self-management during Ramadan fasting.Methods: The study applied a cross-sectional design and was conducted in forty-one (41) community health centers in Pekalongan, Central Java, Indonesia. The study participants were medical doctors, nurses, nutritionists, pharmacists, and public health officers. The total sampling technique was used. There were 205 healthcare providers who met the inclusion criteria. Their knowledge, attitude, and perspective were assessed using a questionnaire developed by Zainudin and Hussain. The Wilcoxon test was used to analyze the data. Results: The healthcare providers’ knowledge of Ramadan fasting was very low (36.79±26.11). More than half of the respondents (53.17%) advised diabetic patients to manage diabetes in general, although specific counseling for diabetic patients related to fasting in Ramadan month was not provided (55.12%). The perspective of Ramadan fasting among healthcare providers was moderate (62.68%±30.40). The results also showed that general and safe practice knowledge significantly affected the healthcare providers’ perspective toward Ramadan fasting (Z=-12.49, p=0.000), (Z=-12.02, p=0.000), respectively. Conclusion: Healthcare providers’ knowledge and attitude concerning diabetes self-management during Ramadan fasting were low. Accordingly, this affected their perspective. It is strongly recommended that a formal Ramadan fasting management training program should be given regularly to provide appropriate consultations and services. 

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

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.

scholarly journals Assessment of quality of life in type 2 diabetes mellitus patients using World Health Organization quality of life-BREF questionnaire and appraisal of diabetes scale - a cross-sectional study

2021 ◽  
Vol 15 (3) ◽  
Author(s):  
Supriya Patil ◽  
Yamini Patil ◽  
Sanjay Kumar Patil
Keyword(s):  
Quality Of Life ◽  
Cross Sectional Study ◽  
World Health ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Mean ◽  
Health Organization

Diabetes is a chronic metabolic disorder that disturbs the quality of life (QOL) of patients. Therefore, evaluation of diabetes- related QOL could be a key outcome measure for its management. This study assessed the QOL in type 2 diabetes mellitus (T2DM) patients using the World Health Organization (WHO) quality of life (QOL)˗BREF questionnaire and disease-specific appraisal of diabetes scale (ADS). In this cross-sectional study, 520 T2DM patients were included. Patients’ demographic data, clinical information was collected through interviews, and the WHOQOL-BREF instrument and ADS were used for the QOL of patients. Statistical analysis was performed by using R software (Version 3.6.0). The mean ADS scores were lower in controlled diabetic subjects (18.50±3.08) and higher in uncontrolled diabetic subjects (19.29±2.73) (P<0.05). For WHOQOL-BREF, the mean scores for all the domains (overall general health, physical, psychological, social, and environmental) were significantly higher in controlled diabetic subjects (P<0.001). In addition, the age, duration of diabetes, associated comorbidities, treatment, and HbA1c level of patients showed a highly significant correlation with WHOQOL-BREF (P<0.001). Diabetic patients had poor-to-average QOL. Therefore, public health measures and education of diabetic patients are essential to create more awareness for improving the QOL of T2DM.

scholarly journals EVALUATION OF DIABETES SELF-MANAGEMENT EDUCATION IN PATIENTS WITH CONCOMITANT CHRONIC KIDNEY DISEASE

2020 ◽  
Vol 73 (10) ◽  
pp. 2170-2174
Author(s):  
Oleksii M. Korzh
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Management Training ◽  
Cross Sectional Study ◽  
Self Management ◽  
Average Score ◽  
Cross Sectional ◽  
Self Monitoring ◽  
Diabetes Educators

The aim: Was to evaluate the quality of DSME provided by primary care physicians to people with diabetes mellitus. Materials and methods: A descriptive cross-sectional study was conducted among 120 primary care physicians. The quality of diabetes self-management training provided by physicians was assessed on a personal scale of 39 Likert questions obtained from the American Association of Diabetes Educators in seven areas of diabetes self-monitoring. The Cronbach’s reliability coefficient for each domain / subscale was ≥ 0.7. The data were analyzed using an independent selective t-test and one-way ANOVA. Results: More than half of the doctors provided “inadequate quality” of diabetes self-management in all areas. Doctors had the highest average score in the domain of “drug intake” (4.46 ± 0.61). Average scores in the “problem-solving domain” (3.52 ± 0.63) and “ being active domain” (3.46 ± 0.75) were low. The quality of DSME provided by physicians was not related to any of the characteristics of the physician. Conclusions: The quality of doctors’ communication on DSME in this study was suboptimal. Most adequately informed cases of diabetic behavior associated with self-management have been associated with reduced risk factors and an orientation towards disease. Thus, training of primary care physicians in diabetic self-management is recommended because of the key role that these doctors play in managing diabetes.

scholarly journals Specialty Physician Designation in Referrals from a Vertically Integrated PCMH

2019 ◽  
Vol 6 ◽  
pp. 233339281985038
Author(s):  
Andrew D. Schreiner ◽  
Keri T. Holmes-Maybank ◽  
Jingwen Zhang ◽  
Justin Marsden ◽  
Patrick D. Mauldin ◽  
...  
Keyword(s):  
Medical Home ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Individual Characteristics ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Cross Sectional ◽  
Medical Specialties ◽  
The Individual

Introduction: Primary care referrals to specialty physicians once relied upon the medical skill of the specialist, the quality of past communication, and previous consultative experiences. As health systems vertically integrate, patterns of specialty physician referral designation are not known. Methods: This cross-sectional study from a patient-centered medical home (PCMH) evaluated the proportion of referrals with named specialists. All outpatient specialty referrals from the PCMH between July and December of 2014 were eligible for inclusion, and 410 patients were randomly selected for chart review. The outcome of interest was specialty physician designation. Other variables of interest included PCMH provider experience, the reason for referral, and time to specialty visit. Univariate analysis was performed with Fisher exact tests. Results: Of 410 specialty referrals, 43.7% were made to medical specialties, 41.7% to surgical specialties, and 14.6% to ancillary specialties. Resident physicians placed 224 referrals (54.6%), faculty physicians ordered 155 (37.8%), and advanced practice providers ordered 31 (7.6%). Only 11.2% of the specialty referral orders designated a specific physician. No differences appeared in the reason for referral, the referral destination, the proportion of visits scheduled and attended, or the time to schedule between those referrals with and without specialty physician designation. Faculty physicians identified a specific specialist in 21.4% of referrals compared to residents doing so in 4.9% ( P < .0001). Conclusion: Patient-centered medical home referrals named a specific specialty physician infrequently, suggesting a shift from the historical reliance on the individual characteristics of the specialist in the referral process.

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