scholarly journals Factors associated with health literacy and medication adherence in the elderly patients with chronic kidney diseases

2021 ◽  
Vol 8 (2) ◽  
pp. 106
Author(s):  
EhteramSadat Ilali ◽  
Fatemeh Lohrasbi ◽  
NouraddinMousavi Nasab ◽  
Tahereh Yaghoubi
Keyword(s):  
Medication Adherence ◽  
Health Literacy ◽  
Elderly Patients ◽  
Kidney Diseases ◽  
The Elderly ◽  
Chronic Kidney Diseases ◽  
Factors Associated

scholarly journals Assessment of Knowledge and reasons for Medication non-Adherence in Ambulatory Elderly Patients with Hypertension and Diabetes Mellitus in a Geriatric Centre in Nigeria

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i4-i4
Author(s):  
W Akande-Sholabi ◽  
D E Ogini ◽  
L Adebusoye ◽  
T Fakeye
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Medication Adherence ◽  
Side Effects ◽  
Elderly Patients ◽  
Older Patients ◽  
The Elderly ◽  
Good Knowledge ◽  
Factors Associated ◽  
Adherence To Medication

Abstract Introduction Hypertension and type 2 Diabetes mellitus are global health disorders afflicting millions of elderly patients worldwide with an ever-increasing incidence and prevalence. Non-adherence to medications affects the quality and length of life, and has been associated with negative health outcomes and increasing healthcare costs especially in the elderly [1]. Few empirical data exist on the knowledge and medication adherence among elderly patients in sub-Saharan Africa countries. Aim This study aimed to assess the knowledge, medication adherence, and the factors associated with patient’s knowledge on diabetes mellitus and hypertension. Methods A cross-sectional study of 423 elderly patients aged ≥60 years diagnosed with hypertension and diabetes mellitus, selected consecutively at the Geriatric centre in the University College Teaching Hospital, Ibadan was carried out between October 2019 and January 2020. Socio-demographic information, knowledge of the indication of the medications, possible side effects, and details of medication adherence level with reasons for non-adherence were obtained using interviewer-administered semi-structured questionnaire. Bivariate and multivariate analyses were carried out using SPSS 23. Alpha was set at 0.05. Results The mean age (±SD) of the older patients was 69.6 ± 6.4 years and 253 (59.8%) were females. About three-quarter of participants (320; 75.7%) were retired. Majority of the elderly (381; 90.1%) were hypertensive, while 270 (63.8 %) were diabetic, and 85 (20.1%) had multimorbidity of both hypertension and diabetes mellitus. Patients that were non-adherent with their medication were 138 (32.6%). The most common reasons reported for non-adherence included patient slept off (41; 56.6%), pre-occupation (24; 33.1%) and unavailability of medications (12; 16.6%). Thirty-seven (8.7%) participants intentionally missed doses, out of which 22 (59.5%) reported pill burden as its reason for medication non-adherence. All patients 423 (100.0%) knew the indication for their medications and 20 (4.7%) experienced medication-related side effects. Overall, 299 (70.6%) and 309 (73.0%) of patients with hypertension and diabetes mellitus showed good knowledge about their conditions. Adherence to medication was associated with good knowledge in hypertensive patients (p=0.002), while being male (p=0.002), age-group of 60–69 (p=0.001) and poor adherence (p=0.001) were associated with good knowledge in diabetes mellitus patients. Conclusion We found non-adherence was mainly as a result of patients’ behaviors, attitude, and unavailability of medications which could be the cause of low medication adherence among the elderly patients. A systematic review on factors associated with medication adherence in older patients reported medication review aimed at simplifying regimens and educating patients about their treatment as intervention to improve adherence [2]. Thus, we recommend educational intervention among the elderly patients. The elderly patients demonstrated good knowledge about their conditions and medication. However, the relatively good knowledge did not appear to have significant impact on patient’s adherence to medication. Improvement in medication adherence through interdisciplinary approach may improve clinical outcomes. References 1. Marengoni A, Monaco A, Costa E, Cherubini A et al. Strategies to Improve Medication Adherence in Older Persons: Consensus Statement from the Senior Italia Federanziani Advisory Board. Drugs Aging. 2016. DOI 10.1007/s40266-016-0387-9. 2. Smaje A, Weston-Clark M, Raj R, Orlu M, Davis D, Rawle M. Factors associated medication adherence in older patients: A systematic review. Aging Medicine. DOI:10.1002/agm2.12045.

scholarly journals Investigating Factors Associated with Depressive Symptoms of Chronic Kidney Diseases in China with Type 2 Diabetes

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Xu Wang ◽  
Biyu Shen ◽  
Xun Zhuang ◽  
Xueqin Wang ◽  
Weiqun Weng
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Regression Analysis ◽  
Depressive Symptoms ◽  
Kidney Diseases ◽  
Chronic Kidney Diseases ◽  
Factors Associated

Aim.To assess the depressive symptoms status of chronic kidney diseases in Nantong, China, with type 2 diabetes and to identify factors associated with depressive symptoms.Methods.In this cross-sectional analytic study, 210 type 2 diabetic patients were recruited from the Second Affiliated Hospital of Nantong University. Depressive symptoms were assessed with the depression subscale of the Hospital Anxiety and Depression Scale (HAD-D). The quality of life was measured with the RAND 36-Item Health Survey (SF-36). And the independent risk factors of depressive symptoms were assessed by using a stepwise forward model of logistic regression analysis.Results.The mean age of the study subjects was 57.66 years (SD: 11.68). Approximately 21.4% of subjects reported depressive symptoms (n=45). Forward stepwise logistic regression analysis showed that female gender (P=0.010), hypertension (P=0.022), Stage IV (P=0.003), and Stage V (P<0.001) were significant risk factors for depressive symptoms. The quality of life of individuals with HAD-D score <11 was significantly better compared with individuals with HAD-D score ≥ 11.Conclusions.These results indicate that clinicians should be aware that female patients with chronic kidney diseases with T2DM in their late stage with hypertension are at a marked increased risk of depressive symptoms. Providing optimal care for the psychological health of this population is vital.

Factors Associated With Health Literacy and Medication Adherence in an Urban Community

2019 ◽  
Vol 34 (9) ◽  
pp. 604-612
Author(s):  
Salome Bwayo Weaver ◽  
Mary Maneno ◽  
Prince Chijioke ◽  
Debbynie Barsh ◽  
Rachel Mayaka
Keyword(s):  
High School ◽  
Medication Adherence ◽  
Health Literacy ◽  
School Health ◽  
Education Level ◽  
School Level ◽  
High School Level ◽  
Factors Associated ◽  
Health Literacy Level ◽  
Literacy Level

OBJECTIVE: The primary objective of this study is to determine factors associated with health literacy and medication adherence in an urban community. DESIGN: A cross-sectional study was conducted to assess factors associated with health literacy and medication adherence. Participants were recruited from October 2012 to April 2013. SETTING: Ambulatory care clinic and senior wellness center. PARTICIPANTS: Participants were eligible if they were older than 18 years of age and had received care at the ambulatory clinic or obtained services at the senior wellness center. INTERVENTIONS: REALM survey and the Morisky 8-Item Medication Adherence Questionnaire. MAIN OUTCOME MEASURES: The two outcomes evaluated in this study were health literacy and medication adherence. RESULTS: A total of 51 participants were enrolled in the study. Twenty-seven (53%) of the participants were noted to be nonadherent to their medications. Twenty (74%) of these participants read below the high school level, and the remaining 7 (26%) read above a high school level. Study findings showed that both education level and comorbidities status were associated with health literacy. Participants who had a below high school education level had greater odds of having a below high school health literacy level (odds ratio [OR] = 7.500, 95% confidence interval [CI] 1.482-37.949). Participants who had two or more comorbidities had greater odds of having a below high school health literacy level (OR = 24.889, 95% CI 2.698-229.610). CONCLUSION: Our study results found associations between both comorbidities and education with health literacy.

Effects of Pharmaceutical Pictograms on Medication Adherence in Elderly Patients with Chronic Diseases at Primary Health Care Center in Hat Yai, Songkhla

2021 ◽  
Vol 104 (3) ◽  
pp. 482-488
Keyword(s):  
Medication Adherence ◽  
Elderly Patients ◽  
Chronic Diseases ◽  
Care Center ◽  
The Elderly ◽  
Control Group ◽  
Health Care Center ◽  
Primary Health ◽  
Pill Counts ◽  
Experimental Group

Objective: To compare drug adherence with or without pharmaceutical pictograms in the elderly with chronic diseases. Materials and Methods: The present study was a randomized controlled trial conducted between April 2019 and June 2019 at a primary health care center in Hat Yai, Songkhla, Thailand. The elderly patients with chronic diseases were randomly allocated to the experimental group (n=25) and the control group (n=25). The experimental group received pictogram labels, text labels, and verbal information on the consumption of medications from the pharmacist. The control group received text labels and verbal information from the pharmacist. Both groups received follow-up home visits two weeks later. Results: The present study results showed that medication adherence using pill counts in the experimental group was significantly higher than in the control group. The median medication adherence scores from pill counts was (interquartile range, IQR) 100 (100, 100) versus 95.56 (90.25, 100), respectively, p=0.011. The medication adherence with the medication taking behavior measure for Thai patients (MTB-Thai) significantly increased in the experimental group (100.0%) compared with the control group (45.8%) (p=0.0002). Conclusion: The present study showed that medication adherence is greatly improved when the medication instruction is supplemented with pictograms. Therefore, medication should include pictograms on labels to better convey medical instructions to elderly patients with chronic diseases. Keywords: Pharmaceutical pictograms, Medication adherence, Chronic disease, Elderly patients

scholarly journals Clinical and Pathological Analysis of 4910 Patients Who Received Renal Biopsies at a Single Center in Northeast China

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Ping Nie ◽  
Rui Chen ◽  
Manyu Luo ◽  
Changqing Dong ◽  
Liangmei Chen ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Northeast China ◽  
Kidney Diseases ◽  
Systemic Vasculitis ◽  
The Elderly ◽  
B Virus ◽  
Renal Biopsies ◽  
Interstitial Nephropathy ◽  
Schonlein Purpura ◽  
Over Time

Purpose. To identify the epidemiology and pathological types of kidney diseases and their changes during the past decade, in a population from Northeast China. Methods. We retrospectively analysed clinical and renal pathological data from 4910 patients who received renal biopsies in the Second Hospital of Jilin University from 2008 to 2017. Results. Males received more renal biopsies than females (p < 0.001). The average age (p < 0.001) and percentage of elderly patients (p < 0.001) increased over time. The pathological types were primary glomerulonephritis (PGN, 73.2%), secondary glomerulonephritis (SGN, 23.7%), tubular-interstitial nephropathy (TIN, 2.8%), and hereditary nephropathy (HN, 0.3%). The most common forms of PGN were membranous nephropathy (MN, 37.2%) and IgA nephropathy (IgAN, 29.9%). Over time, the prevalence of IgAN decreased, but the prevalence of MN increased. MN was more common in middle-aged and elderly patients, but IgAN was most common in young adults. Analysis of SGN data indicated that lupus nephritis (LN, 34.0%), Henoch-Schönlein purpura glomerulonephritis (HSPN, 17.9%), and diabetic nephropathy (DN, 11.7%) were the most common forms. Over time, the prevalence of DN (p = 0.003), hypertension-associated renal damage (p = 0.005), and systemic vasculitis-associated nephritis (SVARD, p < 0.001) increased, but the prevalence of HSPN (p < 0.001) and hepatitis B virus-associated glomerulonephritis (HBV-GN, p = 0.001) decreased. Nephrotic syndrome was the main clinical manifestation of PGN. Conclusion. From 2008 to 2017, renal biopsies were increasingly performed in the elderly. There were notable changes in the epidemiology and pathological types of kidney disease among renal biopsy patients at our centre.

P6260ACS-group 75+: real clinical practice

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Kruchinova ◽  
S A Raff
Keyword(s):  
Elderly Patients ◽  
The Elderly ◽  
Clear Trend ◽  
Factors Associated ◽  
Coronary Syndrome ◽  
Non Invasive ◽  
Frequent Use ◽  
Receive Treatment ◽  
Common Manifestation ◽  
Real Clinical Practice

Abstract Purpose to evaluate the features of treatment and outcomes in elderly patients with acute coronary syndrome. Methods The elderly group comprised 2385 (28.9%) patients ≥75 years of the 8249 patients enrolled in the KRACS registry. Results When comparing patients of different ages, it was shown that among the elderly, dyspnoea was the most common manifestation of ACS, 9% vs 4% (p=0.015), they were less often hospitalized in “invasive” hospitals - 36% vs 49% (p=0.003), At admission, they often had the class Killip ≥ II - 36% vs 17% (p<0.001), a high risk for the GRASE-68% vs 30% (p<0.001). In addition, in elderly patients significantly lowered levels of Hb and increased creatinine were detected more often. Drug treatment of elderly patients was characterized by less frequent use of ticagrelor - 3% vs 21% (p<0.001), LMWH or fondaparinux - 4% vs 12% (p=0.004). Thrombolytic therapy in STEMI in the elderly was more often streptokinase - 30% vs 18% (p=0.04), less often - tissue activator plasminogen - 2% vs 10% (p=0.03). The frequency of performing any invasive interventions for any type of ACS in elderly patients was significantly lower - 16.7% vs 46.3% (p<0.0001), and the incidence of fatal outcomes during hospitalization for any type of ACS was significantly higher - 16, 0% vs 6.1% (p<0.0001). When assessing the incidence of fatalities in different facilities, it was found that STEMI, patients ≥75 years old hospitalized in “invasive” hospitals died significantly less frequently than when they got into “non-invasive” hospitals - 15.6% vs 50.0% (p=0.013). At the same time, among patients <75 years hospital mortality in “invasive” and “non-invasive” hospitals was not significantly different - 14.7% vs 9.9% (p=0.50). There was also a clear trend towards a higher incidence of deaths among elderly patients who were left without PCI, compared with those who had been intervened. In patients <75 years, this trend was absent. Conclusion thus, the results obtained indicate that elderly patients, with a higher risk and worse outcomes, receive treatment that is less consistent with the requirements of modern guidelines for the treatment of ACS. Important factors associated with better outcomes in elderly patients is their hospitalization in “invasive” hospitals and the implementation of PCI.

scholarly journals Mediators of the association of limited English health literacy with medication non-adherence among Singaporean elderly

2020 ◽  
Vol 29 (1) ◽  
pp. 25-32
Author(s):  
Sumithra Suppiah ◽  
Yi Wen Tan ◽  
Grand H-L Cheng ◽  
Wern Ee Tang ◽  
Rahul Malhotra
Keyword(s):  
Medication Adherence ◽  
Health Literacy ◽  
Medication Use ◽  
Prescription Medication ◽  
The Elderly ◽  
P Value ◽  
Improve Medication Adherence ◽  
Written Information ◽  
Bilingual Text ◽  
Significant Mediator

Background: In Singapore, English is predominantly used on prescription medication labels (PMLs). However, many older Singaporeans cannot read English, and among those who read English, their English health literacy (EHL) proficiency varies. It is thus pertinent to examine the link between EHL and medication use outcomes in this population. The present research aims to address this question. Methods: Data from a national survey, on 1167 home-dwelling elderly on ⩾1 prescribed medication was analysed. The validated Health Literacy Test for Singapore was used to determine EHL. Medication non-adherence was self-reported. Path analysis examined the association between limited EHL and medication non-adherence and tested possible mediators. Results: Limited EHL was associated with medication non-adherence (total effect=0.35; p-value: 0.032), and ‘uncertainty in taking medications correctly due to difficulty in understanding written information on PMLs’ was a significant mediator (indirect effect=0.23, 95% confidence interval (0.12–0.39)). Conclusions: Elderly people with limited EHL were significantly more likely than those with adequate EHL to report that they were uncertain about taking medications correctly because they had difficulty understanding the information on PMLs and this misunderstanding contributed to medication non-adherence. Interventions focused on incorporating bilingual text and/or pictograms on PMLs may reduce uncertainty in taking medication correctly and improve medication adherence among the elderly.

scholarly journals Decreased B1 and B2 Lymphocytes Are Associated With Mortality in Elderly Patients With Chronic Kidney Diseases

2020 ◽  
Vol 7 ◽  
Author(s):  
Jieshan Lin ◽  
Wenfang Tang ◽  
Wei Liu ◽  
Feng Yu ◽  
Yanhua Wu ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Kidney Diseases ◽  
Chronic Kidney Diseases

scholarly journals Incidence and risk factors associated with postoperative stroke in the elderly patients undergoing hip fracture surgery

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Lili Yu ◽  
Yanbin Zhu ◽  
Wei Chen ◽  
Hui Bu ◽  
Yingze Zhang
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Hip Fractures ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
The Elderly ◽  
Individual Risk ◽  
Factors Associated ◽  
Postoperative Stroke

Abstract Objectives Stroke is one of the rare but devastating complications after hip fracture in the elderly. By far, there is still scarce data on postoperative stroke in elderly patients with hip fractures. Methods This was a retrospective study of prospectively collected data. Between October 2014 to December 2018, patients aged above 65 years who underwent operative treatment for hip fractures were included. Inpatient medical surveillance and scheduled telephone follow-up at 1, 3, 6, and 12 months after operation was conducted to identify who developed an incident stroke. Variables of interests were extracted from patients’ inpatient medical records. Univariate analysis and multivariate logistic regression analysis were used to identify the independent risk factors associated with stroke. Results During the study period, a total of 3743 patients were included, among whom 56 were found to have a stroke after operation, representing an incidence of 1.5% (95% CI, 1.1 to 1.9%). The multivariate analyses showed that advanced age (1-year increment; OR, 1.32; 95% CI, 1.08 to 1.48), history of previous stroke (OR, 4.79; 95% CI, 1.86 to 6.56), ASA III and above (OR, 2.62; 95% CI, 1.27 to 3.68), long-term use of aspirin (OR, 3.63; 95% CI, 1.41 to 4.78), and elevated RDW level (each increment of 1%, OR, 1.21; 95% CI, 1.02 to 1.36) were independently associated with postoperative stroke. Conclusions Although most are not modifiable, these risk factors help in counseling patients regarding the risk of postoperative stroke, individual risk stratification, and targeted optimization of medical conditions and should be firmly kept in treating surgeon’s mind.

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