scholarly journals The Relationship of Medication Adherence and Social Functioning of Persons with Schizophrenia in the Long-term Period

2021 ◽  
Vol 9 (T3) ◽  
pp. 16-18
Author(s):  
Jenny Marlindawani Purba ◽  
Roymond H. Simamora ◽  
Evi Karota

BACKGROUND: Medication adherence is an essential aspect of the daily lives of persons with schizophrenia, while in-compliance is related to their social functioning performance. AIM: The study aims to analyze the prolonged relationship between medication adherence and the social functioning of persons with chronic schizophrenia. METHODS: A descriptive correlation method was carried out on 60 persons with schizophrenia at Pasung in North Sumatra Province, Indonesia, using questionnaires. RESULTS: The results indicate that 68.3–51.7% of respondents had low adherence to medication and social functioning, respectively. Spearman rank claimed that there is a strong relationship between medication adherence and social functioning among chronic schizophrenia persons. Furthermore, the result reported that medication adherence positively affected social functioning among persons with schizophrenia. CONCLUSIONS: Medication adherence is a priority for maintaining the behavior of people living with schizophrenia to help them control their psychotic symptoms. Therefore, it can enhance their social functioning performance and daily living activity. Family participation is needed for continuous medication program and relapse rate prevention.

Author(s):  
Ana González-Menéndez ◽  
Tatiana Arboleya Faedo ◽  
David González-Pando ◽  
Nuria Ordoñez-Camblor ◽  
Elena García-Vega ◽  
...  

Psychosis is associated with self-stigmatization and loss of social functioning that increase the severity of the disorder. Psychological inflexibility (PI)—an individual’s tendency to suppress undesirable private events—plays a fundamental role in the emergence and worst prognosis of psychosis. The main objective of this study was to analyze whether self-stigma and social functioning mediate the association of PI with the severity of psychosis in adults with chronic schizophrenia. The study was carried out with a sample of 103 outpatients. The Acceptance and Action Questionnaire, the Internalized Stigma of Mental Illness Scale, and the Social Functioning Scale were used for clinical assessments. Data analyses were performed by using the PROCESS macro for SPSS. Results showed that the link between PI and the severity of psychosis is not direct, but is better explained by mediation of the self-stigma and social functioning of those assessed. PI also predicts worse social functioning without the need to take self-stigma into account. Moreover, self-stigma alone does not predict the severity of psychotic symptoms; this relationship has to be mediated by social functioning. These findings suggest that interventions designed to increase psychological flexibility, such as Acceptance and Commitment Therapy (ACT), may offer an alternative to attenuate the negative impact of self-stigma and to improve the social functioning.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Margaret Amankwah-Poku ◽  
Delight Abla Klutsey ◽  
Kwaku Oppong Asante

Abstract Background The prevalence of disclosure of status to children living with the Human Immunodeficiency Virus (HIV) is low in most sub-Saharan African countries, leading to poor compliance and adverse psychological outcomes in these children. This study examined the influence of disclosure on health outcomes in children living with HIV and their caregivers. Methods Using a cross-sectional design, 155 HIV-positive children between age 6–15 years and their caregivers were administered standardized questionnaires measuring adherence to medication, children's psychological well-being, caregiver burden, and caregivers’ psychological health. Results Results indicated that only 33.5% of the children sampled knew their status. Disclosure of HIV status was significantly related to medication adherence, psychological wellbeing, the burden of caregiving, and the length of the disclosure. A child’s age and level of education were the only demographic variables that significantly predicted disclosure of HIV status. In a hierarchical analysis, after controlling for all demographic variables medication adherence, psychological well-being and burden of caregiving were found to be significant predictors of disclosure of status in children living with HIV. Conclusions Findings suggest the need for disclosure of status among children living with HIV for a positive impact on their medication adherence and psychological health. These findings underscore the need for the development of context-specific interventions that will guide and encourage disclosure of status by caregivers to children living with HIV.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Aguiar ◽  
C Piñeiro ◽  
R Serrão ◽  
R Duarte

Abstract Background Antiretroviral therapy (ART) has the most effective treatment for people with HIV, but its effectiveness depends on the individual medication adherence. Morisky Medication Adherence Scale (MMAS-8) is one of the most widely used scales to assess patient adherence. Thus, we aimed to validate a Portuguese version of MMAS-8 and determine its psychometric properties in HIV positive patients. Methods A cross-sectional survey was conducted in Centro Hospitalar Universitário São João (Porto, northern Portugal) at the infectious diseases department. After authorization to use the scale - granted by the author - and, a standard forward-backwards procedure to translate MMAS-8 to Portuguese, the questionnaire was applied to 233 patients with HIV doing ART. Reliability was assessed using Cronbach's alpha and test-retest reliability. Three levels of adherence were considered: 0 to < 6 (low), 6 to < 8 (medium), 8 (high). Results In the studied sample, the mean age was 45.03 years (SD = 11.63), 80.3% men, 19.3% women and 1 transgender, and 53.8% had ≤9 years of education. The mean number of prescribed ART per patient was 1.76. The mean score for the medication adherence scale was 7.29 (SD = 6.74). For the reliability analysis, 12 patients were excluded due to missing data (n = 221). Regarding the level of adherence, 22.5% were low adhering, 71.6% medium and 5.9% high. Corrected item-total correlations showed that 1 item does not correlate very well with the overall scale and was dropped. Scale reliability analysis for the remaining 7 items revealed an overall Cronbach's alpha of 0.661. Women had a protective effect on adherence (OR = 0.31;95%CI:0.15-0.66). Number of years doing ART, age of participants, and type of residence didn't show to be correlated with adherence. Conclusions MMAS-8 is a reliable and valid measure to detect patients at risk of non-adherence. A satisfactory Cronbach's alfa (0.661) was obtained. In general, adherence to medication was medium or high. Key messages This scale can be applied nationwide in other different hospitals, as it could serve as a tool for measuring adherence to ART that can allow for better health care to the ones that are low adhering. A Portuguese version of the MMAS-8 was created for measuring adherence to ART that maintained a similar structure to the original MMAS-8 and good psychometric properties.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mirko Di Martino ◽  
Michela Alagna ◽  
Adele Lallo ◽  
Kendall Jamieson Gilmore ◽  
Paolo Francesconi ◽  
...  

Abstract Background The benefits of chronic polytherapy in reducing readmissions and death after myocardial infarction (MI) have been clearly shown. However, real-world evidence shows poor medication adherence and large geographic variation, suggesting critical issues in access to optimal care. Our objectives were to measure adherence to polytherapy, to compare the amount of variation attributable to hospitals of discharge and to community-based providers, and to identify determinants of adherence to medications. Methods This is a population-based study. Data were obtained from the information systems of the Lazio and Tuscany Regions, Italy (9.5 million inhabitants). Patients hospitalized with incident MI in 2010–2014 were analyzed. The outcome measure was medication adherence, defined as a Medication Possession Ratio (MPR) ≥ 0.75 for at least 3 of the following drugs: antiplatelets, β-blockers, ACEI/ARBs, statins. A 2-year cohort-study was performed. Cross-classified multilevel models were applied to analyze geographic variation. The variance components attributable to hospitals of discharge and community-based providers were expressed as Median Odds Ratio (MOR). Results A total of 32,962 patients were enrolled. About 63% of patients in the Lazio cohort and 59% of the Tuscan cohort were adherent to chronic polytherapy. Women and patients aged 85 years and over were most at risk of non-adherence. In both regions, adherence was higher for patients discharged from cardiology wards (Lazio: OR = 1.58, p < 0.001, Tuscany: OR = 1.59, p < 0.001) and for patients with a percutaneous coronary intervention during the index admission. Relevant variation between community-based providers was observed, though when the hospital of discharge was included as a cross-classified level, in both Lazio and Tuscany regions the variation attributable to hospitals of discharge was the only significant component (Lazio: MOR = 1.30, p = 0.001; Tuscany: MOR = 1.31, p = 0.001). Conclusion Adherence to best practice treatments after MI is not consistent with clinical guidelines, and varies between patient groups as well as within and between regions. The variation attributable to providers is affected by the hospital of discharge, up to two years from the acute episode. This variation is likely to be attributable to hospital discharge processes, and could be reduced through appropriate policy levers.


2001 ◽  
Vol 16 (5) ◽  
pp. 293-298 ◽  
Author(s):  
G. Donohoe ◽  
N. Owens ◽  
C. O’Donnell ◽  
T. Burke ◽  
L. Moore ◽  
...  

SummaryObjective. To identify clinically useful predictors of adherence to medication among persons with schizophrenia. Method. We evaluated levels of compliance with neuroleptic medication among 32 consecutive admissions with DSM-III-R schizophrenia from a geographically defined catchment area using a compliance interview. We also assessed symptomatology, insight, neurological status and memory. Results. Less than 25% of consecutive admissions reported being fully compliant. Drug attitudes were the best predictor of regular compliance, symptomatology the best predictor of noncompliance, and memory the best predictor of partial compliance with neuroleptic medication. Conclusions. These data emphasise the complexity of factors that influence whether a person adheres to his medication regimen. Furthermore, they suggest that these factors may vary within the same person over time.


2004 ◽  
Vol 45 (6) ◽  
pp. 469-474 ◽  
Author(s):  
Yuta Miura ◽  
Masafumi Mizuno ◽  
Chiyo Yamashita ◽  
Koichiro Watanabe ◽  
Masaaki Murakami ◽  
...  

1990 ◽  
Vol 157 (3) ◽  
pp. 430-433 ◽  
Author(s):  
Nicholas Argyle

Of 20 patients attending a clinic for maintenance therapy of schizophrenia, seven had regular panic attacks, and these were often associated with agoraphobia and social phobia. Similar fears and avoidance in other cases were associated with paranoid ideas and negative symptoms. The relationship of panic to psychotic symptoms varied greatly. In two patients neuroleptics were associated with an increase in panic attacks.


2001 ◽  
Vol 29 (1) ◽  
pp. 45-55 ◽  
Author(s):  
Nicholas Tarrier ◽  
Caroline Kinney ◽  
Ellis McCarthy ◽  
Anja Wittkowski ◽  
Lawrence Yusupoff ◽  
...  

Results are presented from a randomized controlled trial indicating which psychotic symptoms respond to cognitive behaviour therapy. The aim of the study was to investigate whether different types of psychotic symptoms are more or less responsive to cognitive-behaviour therapy compared to treatment received by control groups. Seventy-two patients suffering from chronic schizophrenia who experienced persistent positive psychotic symptoms were assessed at baseline and randomized to either cognitive-behaviour therapy and routine care, supportive counselling and routine care, or routine care alone and were re-assessed after 3 months of treatment (post-treatment). Independent and blind assessment of outcome indicated delusions significantly improved with both cognitive behaviour therapy and supportive counselling compared to routine care. Hallucinations significantly decreased with cognitive-behaviour therapy compared to supportive counselling. There was no difference in the percentage change of hallucinations compared to delusions in patients treated by cognitive behaviour therapy. There was little change in measures of affective symptoms but there was no evidence that a reduction in positive symptoms was associated with an increase in depres sion. In fact, a reduction in positive symptoms was positively correlated with a reduction in depression. There were significant differences in the reductions in thought disorder and negative symptoms with an advantage of cognitive-behaviour therapy compared to routine care.


2018 ◽  
Vol 6 (2) ◽  
pp. 82
Author(s):  
Ni Kadek Sutini ◽  
Ni Wayan Septarini ◽  
I Made Ady Wirawan ◽  
Anak Agung Sagung Sawitri

Background and purpose: Hypertension is a major risk factor for stroke. Despite efforts to control hypertension with pharmacological and non-pharmacological therapies, the prevalence of and death from stroke is reported to be increasing. This study aims to determine the association of hypertension self-management with the incidence of stroke in patients with hypertension.Methods: A case-control study was conducted involving 44 patients suffering from hypertension and who had suffered a stroke as a case, as well as 44 patients with hypertension and no stroke as a control. Data on self-management of diet, physical activity, stress mitigation efforts, alcohol consumption, and medication adherence were collected using self administered questionnaire. Data on the diagnosis of hypertension, stroke and history of comorbidities were obtained from the patient's medical records. Multivariatee analysis using logistic regression was employed to assess the association between hypertension self-management with the incidence of stroke in patients with hypertension.Results: Characteristics of cases and controls did not differ in education, marital and socioeconomic status, but differed in age and employment. Multivariate analysis showed that there were three components of hypertension self-management associated with the incidence of stroke, namely poor adherence to medication (AOR=7.28; 95%CI: 2.19-24.17), poor self-management of stress (AOR=5.45; 95%CI: 1.56-18.99), and poor management of self-regulated diet (AOR=5.28; 95%CI: 1.31-21.32).Conclusions: Medication adherence, diet and stress management are the three main components of self-management that are associated with stroke events among hypertension patients. Efforts to increase medication adherence, diet and stress management should be enhanced.


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