scholarly journals Improved Patient-Reported Medication Adherence, Patient Satisfaction, and Glycemic Control in a Collaborative Care Pharmacist-Led Diabetes “Tune-Up” Clinic

2021 ◽  
Vol 18 (17) ◽  
pp. 9242
Author(s):  
Jan D. Hirsch ◽  
Nancy Kong ◽  
Kevin T. Nguyen ◽  
Christine L. Cadiz ◽  
Crystal Zhou ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Medication Adherence ◽  
Glycemic Control ◽  
Clinical Pharmacist ◽  
Inclusion Criteria ◽  
Diabetes Clinic ◽  
Percentage Points ◽  
Total Satisfaction ◽  
Patient Reported ◽  
The Relationship

Diabetes complications remain a leading cause of death, which may be due to poor glycemic control resulting from medication nonadherence. The relationship between adherence status and HbA1c (glycemic control) has not been well-studied for clinical pharmacist interventions. This study evaluated medication adherence, patient satisfaction, and HbA1c, in a collaborative pharmacist-endocrinologist diabetes clinic over 6 months. Of 127 referred, 83 patients met the inclusion criteria. Mean medication adherence scores, considered “good” at baseline, 1.4 ± 1.2, improved by 0.05 points (p = 0.018), and there was a 26% increase in patients with good adherence. A significant improvement of 0.40 percentage points (95% CI: −0.47, −0.34) was observed in mean HbA1c across the three time points (p < 0.001). Mean total satisfaction scores were high and increased, with mean 91.3 ± 12.2 at baseline, 94.7 ± 9.6 at 3 months, and 95.7 ± 10.8 at 6 months (p = 0.009). A multimodal personalized treatment approach from a pharmacist provider significantly and positively impacted glycemic control regardless of self-reported medication adherence, and patient satisfaction remained high despite changing to a clinical pharmacist provider and increased care intensity.

PELAYANAN PUBLIK KESEHATAN PUSKESMAS DALAM MEMBERIKAN KEPUASAN MASYARAKAT DI KABUPATEN SUMENEP

2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Aryo Wibisono ◽  
R. Amilia Destryana
Keyword(s):  
Public Health ◽  
Logistic Regression ◽  
Patient Satisfaction ◽  
Health Center ◽  
Public Service ◽  
Public Health Center ◽  
The Public ◽  
Regression Methods ◽  
Total Satisfaction ◽  
The Relationship

This study aims to determine the index of public satisfaction in public health center services in Sumenep Regency and the relationship between the services to the public satisfaction. The analysis measured the index of public satisfaction and logistic regression methods to determine the effect of the relationship on total satisfaction in the health services of Public Health Center. The results of the study are the alignment between interests and patient satisfaction is still not aligned, there are still differences between interests and satisfaction, the pattern of the result is the relationship between the assurance dimension to the service satisfaction of the public health center, and the results of the index of public satisfaction  values show that the results of the community assess the public health center performance is very good by getting an A grade. Keywords: public service, logistic regretion, index of public satisfaction

scholarly journals A Mobile App (mHeart) to Detect Medication Nonadherence in the Heart Transplant Population: Validation Study

10.2196/15957 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e15957 ◽  
Author(s):  
Mar Gomis-Pastor ◽  
Eulalia Roig ◽  
Sonia Mirabet ◽  
Jan T De Pourcq ◽  
Irene Conejo ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Medication Adherence ◽  
Psychometric Properties ◽  
Heart Transplant ◽  
Intervention Program ◽  
Early Stage ◽  
Mobile App ◽  
Medication Nonadherence ◽  
Patient Reported ◽  
The Impact

Background Medication nonadherence in heart transplant recipients (HTxR) is related to graft loss and death. mHeart is a mobile app that uses electronic patient-reported outcome measures (ePROMs) to identify and manage medication nonadherence in the outpatient heart transplant (HTx) population. Objective The study primarily aimed to validate mHeart to measure medication nonadherence in early stage HTxR by assessing the psychometric properties of ePROMs. The secondary aims were to (1) measure patient satisfaction with the mHeart tool and its usability and (2) explore the impact of a theory-based treatment on medication nonadherence rates to determine its scalability to larger research. Methods A prospective study was conducted in the outpatient clinic of a tertiary hospital. All consecutive early stage HTxR (<1.5 years from HTx) were included. The ePROM psychometric properties assessed were validity, reliability, responsiveness, interpretability, and burden. ePROMs comprised the 4-item Morisky-Green-Levine questionnaire and an adapted version of the Haynes-Sackett questionnaire. The Simplified Medication Adherence Questionnaire (SMAQ) was also applied on-site. Three consecutive medication nonadherence assessments were performed by a transplant pharmacist. To improve medication nonadherence, theory-based interventions were delivered in a 1-month period. Patient satisfaction was assessed by a semiquantitative Web-based survey at the end of the study. Results We included 31 early stage HTxR (age: mean 54 years, SD 12 years), and 71% (22/31) of them were men. The HTxR were taking a mean 13 (SD 4; range 7-18) drugs per day. A total of 42% (13/31) of patients were unaware of the consequences of medication nonadherence, and 39% (12/31) of patients were nonadherent to immunosuppressive treatment. The content validity measure showed excellent levels of expert panel agreement for the Haynes-Sacket (14/14, 100%) and Morisky-Green-Levine (13/14, 93%) questionnaires. SMAQ and Morisky-Green-Levine ePROMs showed similar measurement domains (convergent validity, phi=0.6, P<.001), which, as expected, differed from Haynes-Sackett ePROMs (divergent validity, phi=0.3, P=.12). Reliability assessment revealed a very strong association between ePROM and on-site PROMs (phi>0.7, P<.001). Reproducibility was moderate (Haynes-Sackett κ=0.6, P<.002) or poor (Morisky-Green-Levine κ=0.3, P=.11) because of unexpected improved medication adherence rates during the test-retest period. According to responsiveness, the theory-based multifaceted intervention program improved medication nonadherence by 16% to 26% (P<.05). A burden analysis showed that ePROMs could potentially overcome traditional on-site limitations (eg, automatic recording of ePROM responses in the hospital information system). The mean score for overall patient satisfaction with the mHeart approach was 9 (SD 2; score range: 0-10). All 100% (29/29) of patients surveyed reported that they would recommend the mHeart platform to other HTxR. Conclusions ePROMs adhered to the quality standards and successfully identified medication nonadherence in the HTx population, supporting their widespread use. The theory-based intervention program showed a promising improvement in medication adherence rates and produced excellent patient satisfaction and usability scores in HTxR.

scholarly journals The Relationship of Illness Perception and Medication Adherence in Patients With Diabetes Mellitus Type II

2021 ◽  
Author(s):  
Sina Sabeti Bilondi ◽  
Ali Delshad Noghabi ◽  
Hosein Aalami
Keyword(s):  
Medication Adherence ◽  
Type Ii Diabetes ◽  
Pearson Correlation ◽  
Illness Perception ◽  
Personal Control ◽  
Diabetic Patients ◽  
Type Ii ◽  
Diabetes Clinic ◽  
The Mean ◽  
The Relationship

Abstract Background: One of the most well-known chronic diseases in the world is diabetes. Disease perception is the patient's organized cognitive representation of his or her illness and can affect treatment adherence. The aim of this study was to investigate the relationship between illness perception and adherence to the medical regimen in patients with type II diabetes. Methods: This descriptive-analytical cross-sectional study was performed on 260 patients with type II diabetes referred to Gonabad Diabetes Clinic by systematic random sampling in 2019. Data collection tools were demographic questionnaire, Morisky medication Adherence Scale (MMAS-8), and Brief illness Perception Questionnaire (BIPQ). Data were analyzed by SPSS 20 software. And using descriptive statistics, Pearson correlation coefficient. P < 0.05 was considered significant. Results: The results showed that the mean score of illness perception of type II diabetes was 46.39 ± 9.45 (range 0-70) and the mean score of medication Adherence was 2.93 ± 1.9 (range 0-8). The results of Pearson correlation test showed a significant relationship between illness perception and medication Adherence (P <0.001, r = 0.199). Also, the regression model showed that the dimensions of disease comprehension and personal control from illness perception were significantly related to medication Adherence of type II diabetic patients (P <0.001). Conclusion: By measuring the level of illness perception, the degree of medication Adherence can be predicted. Therefore, strengthening the illness perception in order to medication Adherence seems to be an important therapeutic strategy in educational interventions. Keywords: illness perception, medication Adherence, type II diabetes

The relationship between first-trimester haemoglobin a1c and pregnancy loss in women with type 1 diabetes mellitus

2012 ◽  
Vol 19 (3) ◽  
pp. 229-236
Author(s):  
Alin Albai ◽  
Viorel Șerban ◽  
Romulus Timar ◽  
Adrian Vlad ◽  
Bogdan Timar ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Pregnancy Loss ◽  
First Trimester ◽  
Adverse Outcomes ◽  
Control Group ◽  
Haemoglobin A1c ◽  
Diabetes Clinic ◽  
Increasing Risk ◽  
The Relationship

Abstract Background and aims: A precarious glycemic control in the first 10 weeks ofpregnancy, the period defining organogenesis, increases the risk of pregnancy loss.The aim of this study was to estimate the relationship between pregnancy loss andHbA1c values in early pregnancy in type 1 diabetic women.Material and method: The present study included all pregnancies in type 1 diabetic women followed atDiabetes Clinic, Emergency County Clinical Hospital, Timişoara, from 1990-2011.Results: The risk of pregnancy loss was significantly increased compared with thebackground control group. In our study the relative risk of pregancy loss increasedwhen HbA1c exceeded 6.5%. We found a consistent increasing risk with stepwiseincreasing levels of HbA1c. Conclusions: A better glycemic control in this periodand throughout the pregnancy could reduce the risk of severe adverse outcomes intype 1 diabetic pregnancies.

Impact of cancer related stress on illness beliefs and glycemic control in breast cancer survivors with comorbid diabetes.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24053-e24053
Author(s):  
Jenny J. Lin ◽  
Janey James ◽  
Mita Goel ◽  
Yael T Harris
Keyword(s):  
Breast Cancer ◽  
Medication Adherence ◽  
Glycemic Control ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Illness Beliefs ◽  
Event Scale ◽  
Related Stress ◽  
The Impact ◽  
The Relationship

e24053 Background: Cancer and diabetes mellitus (DM) are leading causes of death in the US and survivors with comorbid DM have a significantly higher mortality. Furthermore, posttraumatic stress disorder (PTSD) can be triggered by life-threatening illnesses such as cancer; however, little is known about the impact of cancer-related PTSD (Ca-PTSD) on illness beliefs and glycemic control. We undertook this study to assess factors associated with DM management in breast cancer survivors with DM. Methods: We recruited women with Stage 0-IIIA breast cancer diagnosed in the past 10 years, who had completed chemotherapy and/or hormonal therapy and had pre-existing DM on ≥1 oral DM medication. The Impact of Event Scale-Revised (IES-R) was used to assess distress caused by cancer. A total IES-R score of ≥33 identified those with probable Ca-PTSD. Cancer and DM related beliefs were assessed using the Illness Perception Questionnaire. Objective adherence to DM medication was assessed using electronic caps that record bottle openings. Wilcoxon rank-sum tests were used to examine the relationship between Ca-PTSD and illness beliefs. Pearson correlation tests were used to assess the relationship between cancer related stress, DM medication adherence, and glycemic control. Results: Of 111 women recruited to date, mean age was 65.4 years and 37% were black, 31% white, 14% Hispanic, 6% Asian, and 8% other. Of these, 15% had probable Ca-PTSD. Survivors with Ca-PTSD were more likely to believe the consequences of cancer and DM were more severe (median score 23.5 vs. 19.0 [p < 0.001] and 24.0 vs. 16.0 [p < 0.001], respectively), that cancer and DM were more cyclical or recurrent (15.0 vs. 9.0 [p = 0.002] and 13.0 vs. 8.5 [p = 0.002], respectively), and there was greater emotional impact due to cancer and DM (24.0 vs. 16.5 [p < 0.001] and 23.0 vs. 14.0 [p < 0.001], respectively). Additionally, those with Ca-PTSD were less likely to understand their cancer (14.0 vs. 20.0, p = 0.004). Furthermore, as cancer-related stress scores increased, glycemic control worsened (r = 0.23, p = 0.03) and DM medication adherence decreased (r = -0.23, p = 0.04). Conclusions: Breast cancer survivors with comorbid DM who have Ca-PTSD are more likely to have negative beliefs about both cancer and DM. Cancer-related stress is also associated with poorer glycemic control and DM medication adherence. Providers should be aware of the impact of cancer related stress on beliefs about comorbid illnesses and increase interventions that support cancer survivors to better manage their comorbidities.

Factors Associated with Poor Hemoglobin A1c Control in Patients with Type 2 Diabetes

2019 ◽  
Vol 15 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Salam Alqudah ◽  
Anan S. Jarab ◽  
Eman A. Alefishat ◽  
Fadia Mayyas ◽  
Maher Khdour ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Medication Adherence ◽  
Glycemic Control ◽  
Hemoglobin A1c ◽  
Diabetes Management ◽  
Blood Glucose Control ◽  
Clinical Pharmacy Service ◽  
Diabetes Clinic ◽  
Factors Associated

Background: The limited implementation of clinical pharmacy service programs and the lack of studies identifying barriers to achieve blood glucose control have all attributed to the increased proportion of type 2 diabetes patients who have poor glycemic control in Jordan. Objective: To explore factors associated with higher HbA1c in patients with type 2 diabetes in Jordan. Methods: Variables including socio-demographics, disease and treatment factors were collected from171 patients with type2 diabetes at an outpatient diabetes clinic in Amman. Validated questionnaires were used to assess medication adherence, self-care activities, diabetes knowledge and healthrelated quality of life in addition to data collected from medical records. After the single-predictor analysis, stepwise linear regression was performed to develop a model with variables that best predicted hemoglobin A1c. Results: Medication adherence was inversely associated with HbA1c values (β = -0.275; t = 2.666; P < 0.01), indicating better glycemic control. Receiving insulin therapy was also associated with less HbA1c values and better glycemic control (β = - 0.184; t = 2.080; P < 0.05). Patients who had one or more comorbid conditions (β = 0.215; t = 2.264; P < 0.05) and those with longer diabetes duration (β = 0.092; t = 1.339; P < 0.05) were found to have significantly higher HbA1c values. Conclusion: Emphasizing medication adherence, particularly for patients with longer duration of diabetes and those with multiple comorbid diseases should be strongly considered in future diabetes management programs implemented to improve glycemic control in patients with type 2 diabetes.

scholarly journals The Association Between Patient Satisfaction and Patient-Reported Health Outcomes

2018 ◽  
Vol 6 (3) ◽  
pp. 201-209 ◽  
Author(s):  
Qinyu Chen ◽  
Eliza W Beal ◽  
Victor Okunrintemi ◽  
Emily Cerier ◽  
Anghela Paredes ◽  
...  
Keyword(s):  
Mental Health ◽  
Patient Satisfaction ◽  
Health Outcomes ◽  
Medical Expenditure Panel Survey ◽  
Emergency Department Visits ◽  
Medical Expenditure ◽  
Health Score ◽  
Patient Reported ◽  
Relationship Of ◽  
The Relationship

Objective: Although patient satisfaction is increasingly used to rate hospitals, it is unclear how patient satisfaction is associated with health outcomes. We sought to define the relationship of self-reported patient satisfaction and health outcomes. Design: Retrospective cross-sectional analysis using regression analyses and generalized linear modeling. Setting: Utilizing the Medical Expenditure Panel Survey Database (2010-2014), patients who had responses to survey questions related to satisfaction were identified. Participants: Among the 9166 patients, representing 106 million patients, satisfaction was rated as optimal (28.2%), average (61.1%), and poor (10.7%). Main Outcome Measures: We sought to define the relationship of self-reported patient satisfaction and health outcomes. Results: Patients who were younger, male, black/African American, with Medicaid insurance, as well as patients with lower socioeconomic status were more likely to report poor satisfaction (all P < .001). In the adjusted model, physical health score was not associated with an increased odds of poor satisfaction (1.42 95% confidence interval [CI]: 0.88-2.28); however, patients with a poor mental health score or ≥2 emergency department visits were more likely to report poor overall satisfaction (3.91, 95% CI: 2.34-6.5; 2.24, 95% CI: 1.48-3.38, respectively). Conclusion: Poor satisfaction was associated with certain unmodifiable patient-level characteristics, as well as mental health scores. These data suggest that patient satisfaction is a complex metric that can be affected by more than provider performance.

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