scholarly journals Evaluation of Administration Time and Adherence Rates of Morning vs. Bedtime Dosing of Antihypertensive Medications

2019 ◽  
Vol 66 (1) ◽  
pp. 11-16
Author(s):  
Laura Perry ◽  
Suzanne Surowiec ◽  
Danielle Danso ◽  
Omuwa Kerobo ◽  
Ashley Anugwom ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Retrospective Chart Review ◽  
Cross Sectional Study ◽  
Time Of Day ◽  
Primary Objective ◽  
Single Center ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Reported Data

Purpose The primary objective of this study was to evaluate the time of day patients administer antihypertensive medications. Secondary objectives were to evaluate medication adherence rates between morning and bedtime dosing and possible barriers to bedtime administration. Methods A single-center, cross-sectional study using a mixed-methods model containing a retrospective chart review and telephone survey was administered to hypertensive patients at a multidisciplinary, private practice clinic. Patients above the age of 18 with a diagnosis of hypertension were eligible for inclusion. The primary endpoint was the number of patients administering one or more antihypertensive medications at bedtime. Secondary endpoints were medication adherence and potential barriers of adherence to bedtime dosing. Results A total of 139 responses were collected. Most patients (75.5%) administered all antihypertensive medications in the morning, with only 24.5% of patients administering at least one antihypertensive medication at bedtime. Adherence was higher for medications administered in the morning compared to medications administered at bedtime, 87.8% and 79.4%, respectively. Limitations to this study include the single-center design and potential for patient recall and reporting bias when using self-reported data. Conclusion Results of this study suggest that the prevalence of bedtime administration of antihypertensive medications is low. Although self-reported adherence rates were higher with morning dosing compared to bedtime dosing, adherence rates for bedtime dosing were still promising. Future studies should be conducted to expand on existing morbidity and mortality evidence as well as prevalence of and adherence to bedtime dosing of antihypertensive medications.

scholarly journals Epidemiological and pathological characteristics of post-surgical cases of invasive breast cancer among ethnicities of Iran in 2018: A single center cross-sectional study

2020 ◽  
Vol 26 (1) ◽  
pp. 6-9
Author(s):  
Soheila Sayad ◽  
Seyyed Ahmadi ◽  
Reza Nekouian ◽  
Mahshid Panahi ◽  
Khatereh Anbari
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Invasive Breast Cancer ◽  
Triple Negative ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Single Center ◽  
Cross Sectional ◽  
Familial History ◽  
Number Of Patients

Background: Present study aimed to investigate immunohistochemical parameters in post-surgical cases of invasive breast cancer. Methods: In this single center cross-sectional study we investigated ethnicity, familial history, type of cancer, stage of cancer, lymph node positivity, bilateral involvement, metastasis and immunohistochemical parameters (estrogen and progesterone receptor, human epidermal growth factor receptor 2, as well as frequency of triple positive and triple negative patients merely based on immunohistochemical parameters). Results: Frequency of positive familial history was 27.42% (16.31-38.52%). Lymph node involvement was detected in 55.93% (43.26-68.60%) of the cases. Frequency of positive HER2 was 38.60% (25.96-51.23%). There were 17.54% (7.67-27.42%) of triple positive and 7.02% (0.39-13.65%) of triple negative cases. The most common stage at the time of diagnosis was stage 3 with 43.33% (30.79-55.87%) frequency. In Lur/Lak population higher frequency of positive HER2 cases was detected whereas in Mazani population frequency of positive HER2 cases was low (p=0.0291). Conclusions: These results could contribute to understanding of breast cancer patterns among different ethnicities. In order to draw clear conclusion future investigations have to be done in several health centers, for longer time periods and with larger number of patients.

scholarly journals Measuring adherence to antihypertensive medication using an objective test in older adults attending primary care: cross-sectional study

2021 ◽  
Author(s):  
James P. Sheppard ◽  
Ali Albasri ◽  
Pankaj Gupta ◽  
Prashanth Patel ◽  
Kamlesh Khunti ◽  
...  
Keyword(s):  
Primary Care ◽  
Medication Adherence ◽  
Urine Sample ◽  
Antihypertensive Medication ◽  
Cross Sectional Study ◽  
Urine Samples ◽  
Sample Collection ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Adherence To Medication

AbstractAnalysis of urine samples using liquid chromatography-tandem mass spectrometry (LC-MS/MS) has previously revealed high rates of non-adherence to antihypertensive medication. It is unclear whether these rates represent those in the general population. This study aimed to investigate whether it is feasible to collect urine samples in a primary care setting and analyse them using LC-MS/MS to detect non-adherence to antihypertensive medication. This study used a prospective, observational cohort design. Consecutive patients were recruited opportunistically from five general practices in UK primary care. They were aged ≥65 years with hypertension and had at least one antihypertensive prescription. Participants were asked to provide a urine sample for analysis of medication adherence. Samples were sent to a laboratory via post and analysed using LC-MS/MS. Predictors of adherence to medication were explored with multivariable logistic regression. Of 349 consecutive patients approached for the study, 214 (61.3%) gave informed consent and 191 (54.7%) provided a valid urine sample for analysis. Participants were aged 76.2 ± 6.6 years and taking a median of 2 antihypertensive medications (IQR 1–3). A total of 27/191 participants (14.2%) reported not taking all of their medications on the day of urine sample collection. However, LC-MS/MS analysis of samples revealed only 4/27 (9/191 in total; 4.7%) were non-adherent to some of their medications. Patients prescribed more antihypertensive medications were less likely to be adherent (OR 0.24, 95%CI 0.09–0.65). Biochemical testing for antihypertensive medication adherence is feasible in routine primary care, although non-adherence to medication is generally low, and therefore widespread testing is not indicated.

scholarly journals Treatment adherence among patients with hypertension: findings from a cross-sectional study

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Fahad M. Algabbani ◽  
Aljoharah M. Algabbani
Keyword(s):  
Medication Adherence ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Adherence Rate ◽  
Sectional Study ◽  
Adherence To Treatment ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Adherence To Medication

Abstract Background Hypertension is a major risk factor for cardiovascular disease, which is the leading cause of mortality globally. Patient’s adherence to treatment is a cornerstone factor in controlling hypertension and its complications. This study assesses hypertension patients’ adherence to treatment and its associated factors. Methods This cross-sectional study conducted in Riyadh, Saudi Arabia. The study targeted outpatients aged ≥18 years who were diagnosed with hypertension. Participants were recruited using a systemic sampling technique. The two main measurements were assessing adherence rate of antihypertensive medications using Morisky scale and identifying predictors of poor medication adherence among hypertensive patients including socio-economic and demographic data, health status, clinic visits, medication side effects, medications availability, and knowledge. Descriptive and logistic regression analyses were performed to assess factors associated with poor adherence. Results A total of 306 hypertensive outpatients participated in this study. 42.2% of participants were adherent to antihypertensive medications. Almost half of participants (49%) who reported having no comorbidities were adherent to antihypertensive medications compared to participants with one or more than one comorbidities 41, 39% respectively. The presence of comorbid conditions and being on multiple medications were significantly associated with medication adherence (P-values, respectively, < 0.004, < 0.009). Patients with good knowledge about the disease and its complications were seven times more likely to have good adherence to medication (P <  0.001). Conclusions Non-adherence to medications is prevalent among a proportion of hypertensive patients which urges continuous monitoring to medication adherence with special attention to at risks groups of patients. Patients with comorbidities and on multiple medications were at high risk of medication non-adherence. Patients’ knowledge on the disease was one of the main associated factors with non-adherence.

scholarly journals Impact of complementary and alternative medicines on antiepileptic medication adherence among epilepsy patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Muhammad Junaid Farrukh ◽  
Mohd Makmor-Bakry ◽  
Ernieda Hatah ◽  
Tan Hui Jan
Keyword(s):  
Medication Adherence ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Cross Sectional Study ◽  
Assessment Tools ◽  
Cross Sectional ◽  
Alternative Medicines ◽  
Number Of Patients ◽  
Adherence Assessment ◽  
Complementary And Alternative

Abstract Background The aim of this study was to assess the knowledge, attitude, and practice of complementary and alternative medicine (CAM) and its impact on antiepileptic drug (AED) adherence among patients with epilepsy. Methods A cross-sectional study was carried out on 100 epilepsy patients, aged 18 years or older that did not have any physical or psychiatric illness. A patient-administered questionnaire was used to assess their knowledge, attitude towards, practice, and perceived effectiveness (KAPP) of CAM. Established adherence assessment tools were used to determine patient medication adherence. Results The prevalence of CAM usage was found to be at 58%. CAM was used more frequently by males (n = 32, 60.4%) than by females (n = 26, 55.3%; p = 0.609). The most commonly used CAM included vitamins and minerals (36%), ginseng (16%), antioxidants (15%), and acupuncture (12%). A significant number of patients had low knowledge of (59%) and a positive attitude (54%) toward complementary and alternative medicine. Main reasons for using CAM were a lower price, better availability, and inadequate seizure control by AEDs. About 43% of the patients who used CAM informed their doctor. Prevalence of non-adherence to AED therapy was found to be 68%. A significant association was found between non-adherence and CAM usage (p < 0.01). Conclusion A high prevalence of CAM usage and non-adherence to AEDs among epilepsy patients was identified. CAM usage was associated with a non-adherence to AED therapy. This study highlights the need to explore CAM usage with patients before making clinical decisions to achieve the best outcomes from AED therapy.

scholarly journals Assessing the Role of Knowledge, Awareness, Practice in Achieving Medication Adherence among Hypertensive Patients

2021 ◽  
Vol 8 (5) ◽  
pp. 324-329
Author(s):  
Satish S ◽  
Minnu Sara Sam ◽  
A R Shabaraya
Keyword(s):  
Medication Adherence ◽  
Negative Impact ◽  
Complete Information ◽  
Cross Sectional Study ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Study Results ◽  
Provider Knowledge ◽  
Hypertension Knowledge ◽  
Morisky Scale

Medication adherence is that the degree to which the person's behaviour corresponds with the agreed recommendations from a health care provider. Knowledge and the awareness concerning the hypertension and the antihypertensive medications have an important role within the medication adherence, lack of this can have negative impact on the medication adherence. The assessment of medication adherence in the study was meted out by using morisky scale. It’s a cross sectional study conducted in 150 individuals in Kankanady, Valachil, Valencia, Jeppu, Padil of Mangalore in Karnataka. Patient data collection forms were used to collect the information. Present study reflected that patients had knowledge regarding normal BP, symptoms and complications, however majority thinks hypertension can be curable. A positive attitude and practice were observed among the patients apart from practice of normal exercise. Analysing the data using MAMS-8 scale, study showed only 11.3% of the population were found to be high adherent that shows the decrease in the adherence rates. 34% had moderate adherence and the remaining 54% were low adherent. Assessment of data suggests that majority lack complete information about hypertension and its management. The study results revealed that hypertension related knowledge, awareness and practice plays a serious role in improving medication adherence. Keywords: Medication adherence, Hypertension, Knowledge, Awareness, Morisky scale.

scholarly journals Factors influencing antihypertensive medication adherence among hypertensive patients: A cross-sectional study in two selected Eritrean hospitals

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Idris M Idris ◽  
◽  
Samuel J Wolday ◽  
Brkti Abraham ◽  
Daniel Abraham ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Scale Up ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Adherence Scale ◽  
Adherence Counseling

Objective: Hypertension is a major modifiable cause of cardiovascular and cerebrovascular disease affecting more than one billion individuals worldwide. Adherence to recommended antihypertensive medications is central to control hypertension. The purpose of this study was to assess medication adherence and its influencing factors among hypertensive patients in Halibet and Hazhaz Hospitals in Asmara, Eritrea. Methods: Hospital-based cross-sectional study was conducted among 360 hypertensive patients in Halibet and Hazhaz Hospitals of Asmara from February through May 2018. A convenience sampling was used to select study participants. Data related to medication adherence were collected using a structured 8-item Morisky Medication Adherence Scale. Data were analyzed using SPSS version 22. A bivariate and multivariate analysis was done to determine independent predictors of medication adherence among hypertensive patients. Adjusted odds ratio (at 95% CI) and p value < 0.05 was used to assert the effect of the independent variables. Results: Out of 360 patients enrolled in the study, two hundred forty nine (69.2%) had good medication adherence and the remaining 30.8% had poor adherence. The study found that Being female (AOR (95% CI): 1.8 (0.63, 4.85), p<0.05), having Monthly income ≥ 1000 nakfa (AOR (95% CI): 2.85 (0.76, 5.61), , p<0.05), having comorbid disease (AOR (95% CI): 2.7 (0.98, 4.23), p<0.05), family history of hypertension (AOR (95% CI): 2.12 (0.78, 5.76), p <0.05), longer duration of hypertension (AOR (95% CI): 1.32 (0.65, 4.89), p< 0.05), BP < 140/90 mmHg (AOR (95% CI): 2.4 (1.41, 8.73), P<0.05), and taking only one pill per day (AOR (95% CI): 2.7 (0.97, 6.84),P<0.05) were factors significantly influenced good medication adherence. Conclusion: Medication adherence among hypertensive patients was relatively high in this study. Increasing adherence counseling and patient education about the disease and its treatment are important measures to scale-up adherence status of patients.

scholarly journals Use of Ceftaroline in Hospitalized Patients with and without COVID-19: A Descriptive Cross-Sectional Study

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 763
Author(s):  
Daniele Roberto Giacobbe ◽  
Chiara Russo ◽  
Veronica Martini ◽  
Silvia Dettori ◽  
Federica Briano ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Bloodstream Infections ◽  
Cross Sectional Study ◽  
Primary Objective ◽  
Sectional Study ◽  
Cross Sectional ◽  
First Line Therapy ◽  
Large Teaching Hospital ◽  
Secondary Objective ◽  
Medical Wards

A single-center cross-sectional study was conducted to describe the use of ceftaroline in a large teaching hospital in Northern Italy, during a period also including the first months of the coronavirus disease 2019 (COVID-19) pandemic. The primary objective was to describe the use of ceftaroline in terms of indications and characteristics of patients. A secondary objective was to describe the rate of favorable clinical response in patients with bloodstream infections (BSI) due to methicillin-resistant Staphylococcus aureus (MRSA-BSI) receiving ceftaroline. Overall, 200 patients were included in the study. Most of them had COVID-19 (83%, 165/200) and were hospitalized in medical wards (78%, 155/200). Included patients with COVID-19 pneumonia were given empirical ceftaroline in the suspicion of bacterial co-infection or superinfection. Among patients with MRSA-BSI, ceftaroline was used as a first-line therapy and salvage therapy in 25% (3/12) and 75% (9/12) of cases, respectively, and as a monotherapy or in combination with daptomycin in 58% (7/12) and 42% (5/12) of patients, respectively. A favorable response was registered in 67% (8/12) of patients. Improving etiological diagnosis of bacterial infections is essential to optimize the use of ceftaroline in COVID-19 patients. The use of ceftaroline for MRSA-BSI, either as a monotherapy or in combination with other anti-MRSA agents, showed promising rates of favorable response.

scholarly journals POS1274 THERAPEUTIC MANAGEMENT OF RHEUMATOLOGISTS VERSUS OTORHINOLARYNGOLOGISTS OF CERVICOGENIC DIZZINESS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 921.2-922
Author(s):  
M. Yasmine ◽  
K. Maatallah ◽  
H. Ferjani ◽  
W. Triki ◽  
D. Ben Nsib ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Treatment Approach ◽  
Cross Sectional Study ◽  
Treatment Modalities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Standard Assessment ◽  
Number Of Patients ◽  
Cervicogenic Dizziness ◽  
No Gold Standard

Background:The treatment of patients presenting with cervicogenic dizziness (CGD) may be challenging. Indeed, there is no consensual treatment approach for CGD, nor is there no gold-standard assessment for diagnosis.Objectives:Our study aimed to assess the management of CGD by rheumatologists versus otorhinolaryngologists.Methods:We conducted a cross-sectional study including Tunisian doctors dealing with CGD. Rheumatologists (RTO) and otorhinolaryngologists (ORL) were invited to answer a questionnaire via google form about CGD daily management. Outcomes of interest were treatment modalities.Results:The study included 30 RTO and 32 ORL. Most of the doctors (RTO, vs ORL) were females (88.3%, vs 56.3%), aged between 35 and 45 (43.3%, vs 62.5%), and worked at a private practice (33.3%, vs 59.4%). The number of patients diagnosed with CGD by RTO was as follows: 1-2 per year (33.3%), 1-2 per month (18.8%), 1-2 per week (20%), less than one patient a year (10%) and none in 3.3% of cases. The number of patients diagnosed with CGD by ORL was as follows: 1-2 per year (50%), 1-2 per month (33.3%), 1-2 per week (6.2%), less than one patient a year (15.7%) and none (9.4%). Most patients presenting with CGD were females in both groups (93.1%, vs 82.8% respectively) with a mean age between 36 and 65 (79.3%, vs 82.1%). Most of the respondents declared treating patients with CGD (93.1%, vs 79.1%). Regarding treatment modalities, physical therapy was the most prescribed in both specialties (81.5% and 48.3%, respectively). Only RTO (18.5%) prescribed manual therapy. Concerning medical treatment, anti-inflammatory were the most prescribed drugs in both groups (92.6, and 34.5%, respectively). Sixty-seven percent of RTO prescribed anti-vertigo medication. Interestingly, it was the least prescribed drug by ORL (6.9%). Only RTO (59.3%) prescribed Muscle relaxants.Conclusion:Despite the disparities in the management of CGD, physical therapy remains the first prescribed treatment by Tunisian doctors. Further studies are needed to establish a consensus to treat CGD.Disclosure of Interests:None declared

scholarly journals The status of integrated care on the chronic abuse of alcohol response - A cross-sectional study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Moreira de Sousa ◽  
L Lopes ◽  
P Costa ◽  
G Martins-Coelho ◽  
R Capucho
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Abuse ◽  
Negative Impact ◽  
Cross Sectional Study ◽  
Treatment Team ◽  
Health Administration ◽  
Sectional Study ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Index Value

Abstract Background In 2017, the risk-weighted prevalence of alcohol consumption was the health indicator with a more negative impact on the Institute for Health Metrics and Evaluation Sustainable Development Goals Health Index Value in Portugal. According to data from 2012-14, the Alto Tâmega and Barroso (ATB) had the highest value of Years of potential life lost (YPLL) in North Portugal - 4570,1/10.000 people. Liver chronic disease was the specific cause of death that contributed to the value of YPLL - 465,4/10.000 people. Methods A cross-sectional study was conducted with data from the Northern Health Administration and the General Directorate for Intervention on Addictive Behaviours and Dependencies. We compared the number of patients with chronic alcohol consumption (CAC) in 2018, the leading causes of death between 2012-14, the main morbidity causes according to data from primary healthcare (PHC) physicians in 2018 and the number of patients in specialized treatment team (STT) for alcohol abuse treatment in 2018 in ATB. Results In 2018, 2643 patients of ATB had a diagnosis of CAC; only 178 were followed by an STT. Although CAC had a massive influence on YPLL, this was only the 11º cause of morbidity in ATB according to the data from PHC. The number of women with CAC was stable between 2012 (n = 284) and 2018 (n = 291). In the same period, there was an increase of 52,86% of CAC on men (n = 1523 to n = 2348). Even though 18,4% of YPLL due to chronic liver disease happen in women, only 11,2%of the patients with CAC in the PHC are women. Conclusions There is a need for the improvement of CAC diagnosis in PHC, and the improvement of referral of patients to STT and hospital care. Besides, to reach the SDG3, there is the need to work intensely on SDG 17 (partnership for the goals). The Public Health Unit of ATB is organizing Operation PROMETEU to improve communication, institutional collaboration, and monitoring of the existing health activities that are tackling CAC. Key messages The need to integrate data from different healthcare sources for a better analysis on health problems. The urgent need to tackle the alcohol abuse problem in ATB.

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