A Framework for Studying Patterns of Effective Medication Adherence

2013 ◽  
Vol 5 (4) ◽  
pp. 1-12 ◽  
Author(s):  
Upkar Varshney ◽  
Neetu Singh
Keyword(s):  
Medication Adherence ◽  
Mobile Applications ◽  
Medication Management ◽  
Mobile Technologies ◽  
Medication Regimen ◽  
Adherence Level ◽  
Dose Time ◽  
Medication Systems ◽  
Low Levels ◽  
Effective Medication

Medication adherence has been studied extensively in the healthcare literature. Most of the studies focus on improving medication adherence using interventions, including those based on wireless and mobile technologies, and measure average medication adherence level. This is useful in differentiating between patients with high and low levels of adherence. In practice, the same average medication adherence could be achieved by patients with widely different adherence patterns. In this paper, the authors propose that in addition to average medication adherence level, the patterns of adherence should also be studied. The patterns of adherence can be obtained using wireless medication systems and set of actions/decisions can be communicated to these systems or mobile applications for medication management. The authors present a framework, some metrics including Effective Medication Adherence, and results related to the patterns of adherence. Their results show that pattern of adherence has significant impact on the effective medication adherence. Also, higher levels of effective adherence can be achieved for more flexible medication regimen, such as those with higher values of maximum inter-dose time. It is also possible for a patient with lower average adherence but a desirable pattern of adherence to have higher effective medication adherence than a patient with higher average adherence with less desirable pattern.

scholarly journals Barriers to medication adherence in a rural-urban dual economy: a multi-stakeholder qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jacqueline Xu ◽  
Mengxi Zhao ◽  
Athina Vrosgou ◽  
Natalie Chin Wen Yu ◽  
Chelsea Liu ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Secondary Prevention ◽  
Medication Management ◽  
Healthcare Providers ◽  
Multiple Perspectives ◽  
Medication Regimen ◽  
Middle Income ◽  
Middle Income Countries ◽  
Beijing China ◽  
Low And Middle Income

Abstract Background One of the most cost-effective treatments for secondary prevention of stroke and other non-communicable diseases is a long-term medication regimen. However, the complexities of medication adherence extend far beyond individual behavior change, particularly in low- and middle-income countries. The purpose of this study was to examine stakeholder perspectives on barriers to medication adherence for stroke patients in Beijing, China, identifying opportunities to improve care and policy in resource-constrained settings. Methods We conducted a qualitative, phenomenological analysis of data obtained from 36 individuals. Participants were patients; caregivers; healthcare providers; and representatives from industry and government, purposively selected to synthesize multiple perspectives on medication management and adherence for stroke secondary prevention in Beijing, China. Data was analyzed by thematic analysis across iterative coding cycles. Results Four major themes characterized barriers on medication adherence, across stakeholders and geographies: limitations driven by individual patient knowledge / attitudes; lack of patient-provider interaction time; lack of coordination across the stratified health system; and lack of affordability driven by high overall costs and limited insurance policies. Conclusions These barriers to medication management and adherence suggest opportunities for policy reform and local practice changes, particularly for multi-tiered health systems. Findings from this study in Beijing, China could be explored for applicability in other low- and middle-income countries with urban centers serving large geographic regions.

Developing and Validating a M-Governance Framework Adoption Model of a University for Communication Services to Its Affiliated Institutions

2017 ◽  
Vol 7 (7) ◽  
pp. 484
Author(s):  
E. Ramganesh ◽  
E. Kirubakaran ◽  
D. Ravindran ◽  
R. Gobi
Keyword(s):  
Technology Acceptance ◽  
Technology Acceptance Model ◽  
Public Service ◽  
Mobile Applications ◽  
Communication Technologies ◽  
Mobile Technologies ◽  
Communication Services ◽  
Governance Framework ◽  
Social And Economic Development ◽  
Acceptance Model

The m-Governance framework of auniversity aims to utilize the massive reach of mobile phones and harness the potential of mobile applications to enable easy and round the-clock access to the services of its affiliated institutions.  In the current mobile age there is need for transforming e-governance services to m-Governance as m-Governance is not a replacement for e-Governance rather it complements e-Governance. With this unparalleled advancement of mobile communication technologies, universities are turning to m-governance to realize the value of mobile technologies for responsive governance and measurable improvements to academic, social and economic development, public service delivery, operational efficiencies and active stakeholder engagement. In this context the present study, aims to develop and validate a m-governance framework of a university by extending Technology Acceptance Model (TAM) with its prime stakeholders so called the Heads of the affiliated institutions. A survey instrument was developed based on the framework and it was administered with 20 Heads of the affiliated Institutions. The results also showed that the Heads of the affiliated Institutions expressed their favorableness towards m-governance adoption.

scholarly journals Benefit of a pharmacist-led intervention for medication management of renal transplant patients: a controlled before-and-after study

2021 ◽  
Vol 12 ◽  
pp. 204062232110052
Author(s):  
Jeremy Chambord ◽  
Lionel Couzi ◽  
Pierre Merville ◽  
Karine Moreau ◽  
Fabien Xuereb ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Immunosuppressive Therapy ◽  
Medication Management ◽  
Intervention Group ◽  
Knowledge Score ◽  
Control Group ◽  
Patient Knowledge ◽  
Transplant Patients ◽  
Before And After ◽  
High Level

Aims: To assess the effect of a pharmacist-led intervention, using Barrows cards method, during the first year after renal transplantation, on patient knowledge about their treatment, medication adherence and exposure to treatment in a French cohort. Methods: We conducted a before-and-after comparative study between two groups of patients: those who benefited from a complementary pharmacist-led intervention [intervention group (IG), n = 44] versus those who did not [control group (CG), n = 48]. The pharmacist-led intervention consisted of a behavioral and educational interview at the first visit (visit 1). The intervention was assessed 4 months later at the second visit (visit 2), using the following endpoints: treatment knowledge, medication adherence [proportion of days covered (PDC) by immunosuppressive therapy] and tacrolimus exposure. Results: At visit 2, IG patients achieved a significantly higher knowledge score than CG patients (83.3% versus 72.2%, p = 0.001). We did not find any differences in treatment exposure or medication adherence; however, the intervention tended to reduce the proportion of non-adherent patients with low knowledge scores. Using the PDC by immunosuppressive therapy, we identified 10 non-adherent patients (10.9%) at visit 1 and six at visit 2. Conclusions: Our intervention showed a positive effect on patient knowledge about their treatment. However, our results did not show any improvement in overall medication adherence, which was likely to be because of the initially high level of adherence in our study population. Nevertheless, the intervention appears to have improved adherence in non-adherent patients with low knowledge scores.

scholarly journals Gamification-less: may gamification really foster civic participation? A controlled field experiment

2021 ◽  
Author(s):  
Marco Romano ◽  
Paloma Díaz ◽  
Ignacio Aedo
Keyword(s):  
Crisis Management ◽  
Mobile Applications ◽  
Civic Participation ◽  
Mobile Technologies ◽  
Design Experiment ◽  
Decision Making Process ◽  
Group Design ◽  
In The Wild ◽  
Open Issue ◽  
Smart Communities

AbstractIn the context of smart communities, it is essential an active and continuous collaboration between citizens, organizations and institutions. There are several cases where citizens may be asked to participate such as in public decision-making process by informing, voting or proposing projects or in crisis management by sharing precise and timely information with other citizens and emergency organizations. However, these opportunities do not automatically result in participatory practices sustained over time. Mobile technologies and social networks provide the substratum for supporting formal empowerment, but citizen engagement in participation processes is still an open issue. One of the techniques used to improve engagement is gamification based on the humans’ predisposition to games. So far, we still lack studies that can prove the advantage of gamified systems respect to non-gamified ones in civic participation context. In this work, we present a between-group design experiment performed in the wild using two mobile applications enabling civic participation, one gamified and the other not. Our results highlight that the gamified application generates a better user experience and civic engagement.

Exploring Older Adults’ Internalizations And Misconceptions Regarding Antihypertensive Medication Management

2021 ◽  
Vol 10 (1) ◽  
pp. 304-308
Author(s):  
Kenneth A. Blocker ◽  
Wendy A. Rogers
Keyword(s):  
Older Adults ◽  
Medication Adherence ◽  
Antihypertensive Medication ◽  
Medication Management ◽  
Illness Representation ◽  
Effective Management ◽  
Structured Interviews ◽  
Antihypertensive Medications ◽  
Hypertension Knowledge ◽  
Management Behaviors

Hypertension, or high blood pressure, is an asymptomatic cardiovascular condition common with increasing age that must be controlled with proper management behaviors, such as adherence to prescribed antihypertensive medications. Unfortunately, older adults may struggle with consistent and effective management of this medication specifically and the disease generally, which can lead to poorer health outcomes. The goal of the study was to investigate older adults’ antihypertensive medication management using the Illness Representation Model as a lens to identify potential misconceptions that may contribute to medication management. We conducted semi-structured interviews with 40 older adults regarding management routines, hypertension knowledge, perceived nonadherence contributors, and perspectives related to their illness. We identified numerous misconceptions regarding hypertension knowledge, disease severity, as well as perceived adherence performance that may contribute to challenges older adults face with maintaining antihypertensive medication adherence. Moreover, these findings inform the need for and design of effective educational tools for improving antihypertensive medication adherence.

Application of the Web 2.0 Technologies Podcast and Vidcast for Formation and Development of Listening Comprehension Skill in an Extended Englishtraining Course in Eighth Grade

2021 ◽  
Vol 9 (4) ◽  
Author(s):  
Rumen Hristov
Keyword(s):  
Web 2.0 ◽  
Listening Comprehension ◽  
Mobile Technologies ◽  
Foreign Languages ◽  
Specific Method ◽  
Web 2.0 Technologies ◽  
Comprehension Skill ◽  
Comprehension Skills ◽  
Low Levels ◽  
The Web

Low levels of listening comprehension skills in English is observed in many students. As a specific method, which can both cover mobile technologies and combine them with training, is the application of technology for podcasting and vidcasting/vodkasting. Podcasts and podcasts can provide authentic, up-to-date and easily accessible material, making them extremely useful when learning foreign languages. Their application makes learning freer and independent by introducing more interesting elements; gives greater freedom and independence to participants in the lesson. Students can listen to the material on the bus or while going to the gym.

Medication Management System Design for Isolated Patient Care

2020 ◽  
Author(s):  
Samhith Kethireddy Abigail Swamidoss ◽  
Bushra Alghamdi ◽  
Ronald L. Hickman ◽  
Shanina Knighton ◽  
Miriam Pekarek ◽  
...  
Keyword(s):  
System Design ◽  
Language Processing ◽  
Management System ◽  
Classification Tree ◽  
Medication Management ◽  
Care Providers ◽  
Medication Regimen ◽  
Dynamic Framework ◽  
Medication Schedule ◽  
Number Of Patients

Abstract Independent living care for polypharmacy patients can be complicated in those situations with medications that are pro re nata (PRN, “as needed”). Such medication regimen may involve multiple dosing whereby specific drug contraindications might be easily overlooked by hospice and palliative care patients, or by those isolated and not in regular contact with care providers. The goal of this paper is to describe the development steps and current design of a system providing medication decision support for isolated patients. With an increased number of patients living alone or isolated - a situation exacerbated during the COVID19 pandemic – polypharmacy patients may be challenged when PRN (as needed) medications confound what might ordinarily be a routine medication schedule. Central to our medication management system design is the so-called “conversational agent” that when integrated with a natural language processing front- end and classification tree algorithm provide a dynamic framework for patient self-management of medications. Research on “patient need” revealed patients were more likely to embrace the system if the system were autonomous, secure, and not cloud-based.

Abstract 3016: Spirituality and Medication Adherence in Older African American Adults Diagnosed with Hypertension: A Qualitative Study

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Lisa M Lewis
Keyword(s):  
African American ◽  
Medication Adherence ◽  
Qualitative Study ◽  
Antihypertensive Medication ◽  
Demographic Data ◽  
Patient Treatment ◽  
List Type ◽  
Medication Regimen ◽  
Antihypertensive Medications ◽  
The Mean

Background : Medication adherence (ADH) is key to decreasing hypertension (HTN)-related morbidity and mortality in older African-American (AA) adults. However, older AA adults have poorer ADH to prescribed antihypertensive medications when compared to their younger and Caucasian-American counterparts. Patient beliefs and cultural concepts about their medications influence their medication ADH. An important cultural concept in this regards is spirituality, which is a significant resource in the AA community. Thus, the purpose of this qualitative study was to explore the role of spirituality in ADH to antihypertensive medications for older AA adults. Methods: Older AA adults who were members of a Program of All Inclusive Care for the Elderly (PACE) and who were (a) diagnosed with HTN; (b) prescribed at least one antihypertensive medication; (c) self-identified as African-American or Black; and (d) self-identified as spiritual completed one in-depth individual face-to-face in this qualitative descriptive study informed by grounded theory. Demographic data were also collected. Results : Twenty-one PACE members completed the study. All of the participants were female. The mean age of participants was 73 years with most completing high school (67%). The mean HTN diagnosis was16.7 years and mean number of prescriptions for antihypertensives was 3.3. Participants indicated that their spirituality was used in a collaborative process with formal health care to manage their ADH to antihypertensive medications. This process was identified as Partnering with God to Manage My Medications. Partnering with God to Manage My Medications indicated that the PACE members acknowledged personal responsibility for adhering to their antihypertensive medication regimen but used their spirituality as a resource for making decisions to remain adherent; coping with medication side effects; and increasing their self-efficacy to deal with barriers to ADH . Conclusions : Spirituality played a positive role in medication adherence for the PACE members. Incorporating individual beliefs, such as spirituality, into patient treatment for HTN may capitalize on their inner resources for medication ADH and demonstrates culturally appropriate care.

scholarly journals Content and Usability Evaluation of Medication Adherence Mobile Applications for Use in Pediatrics

2018 ◽  
Vol 44 (3) ◽  
pp. 333-342 ◽  
Author(s):  
Julia K Carmody ◽  
Lee A Denson ◽  
Kevin A Hommel
Keyword(s):  
Medication Adherence ◽  
Mobile Applications ◽  
Usability Evaluation
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