scholarly journals Evaluation and improvement of adherence to medication

2021 ◽  
Vol 64 (2) ◽  
pp. 130-136
Author(s):  
Won Kyung Lee ◽  
Joongyub Lee
Keyword(s):  
Information Technology ◽  
Medication Adherence ◽  
Healthcare Providers ◽  
Poor Adherence ◽  
Improve Medication Adherence ◽  
Medical Expenses ◽  
Adherence To Medication ◽  
Innovative Methods ◽  
Increased Risk ◽  
All Diseases

Medication adherence refers to the extent to which a patient takes medication according to prescription. In many cases, adherence to medication is defined as the proportion of prescribed drugs taken as prescribed over a certain period. However, there is no satisfactory level of adherence that can be applied uniformly to all diseases and medications. Patients with poor adherence experience worsening of conditions, complications, and increased risk for death, which increases medical expenses. Therefore, to improve medication adherence, healthcare providers should try to identify poor adherence, adjust prescriptions to optimize treatment according to the patient’s lifestyle, and educate patients to help them understand the value of medical treatment and the effects of adherence. The most practical way to identify poor adherence during clinical visits is by asking patients about their medication adherence in a non-judgmental manner. Reducing the number of doses is more effective than reducing the number of tablets to increase compliance. It is necessary to adopt innovative methods based on information technology in our healthcare system because of the labor-intensive nature of educational intervention to improve adherence.

Psychosocial Treatments for Bipolar Disorder

2007 ◽  
pp. 309-322 ◽  
Author(s):  
David J. Miklowitz ◽  
W. Edward Craighead
Keyword(s):  
Bipolar Disorder ◽  
Medication Adherence ◽  
Treatment Period ◽  
Pharmacological Treatment ◽  
Psychosocial Interventions ◽  
Improve Medication Adherence ◽  
Coping With Stress ◽  
Adherence To Medication ◽  
Bipolar Patients

Whereas pharmacological interventions remain the primary treatment for bipolar disorder, adjunctive psychosocial interventions have the potential to increase adherence to medication regimens, decrease hospitalizations and relapses, improve quality of life, and enhance mechanisms for coping with stress. Controlled studies have established that individual, family, and group psychoeducation, designed to provide information to bipolar patients and their families about the disorder, its pharmacological treatment, and the treatments’ side effects, leads to lower rates of recurrence and greater adherence to pharmacological treatment among bipolar patients. Type 1 and 2 studies have evaluated cognitive behavioral therapy (CBT) as an ancillary treatment. These studies indicate that CBT is associated with better medication adherence and significantly fewer recurrences and/or rehospitalizations. One Type 1 study has evaluated the effectiveness of IPSRT (interpersonal and social rhythm therapy) for bipolar disorder. IPSRT demonstrated its greatest symptomatic effects during a maintenance treatment period, especially if bipolar patients had been successful in stabilizing their daily and nightly routines during an acute treatment period. Finally, four Type 1 studies in adult and pediatric patients have shown that marital/ family therapy may be effectively combined with pharmacotherapy to reduce recurrences and improve medication adherence and family functioning.

scholarly journals Adherence to antihypertensive medications in patients attending public hospitals in Kano State, Nigeria

2020 ◽  
Vol 12 (1) ◽  
pp. 395-400
Author(s):  
Umar Idris Ibrahim ◽  
Shafiu Mohammed ◽  
Abdulkadir Umar Zezi ◽  
Basira Kankia Lawal
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Antihypertensive Medication ◽  
Public Hospitals ◽  
Poor Adherence ◽  
Chronic Medical Condition ◽  
Public Healthcare ◽  
Good Adherence ◽  
Adherence To Medication ◽  
Arterial Blood

Hypertension is a chronic medical condition characterized by an elevated arterial blood pressure with increasing prevalence in developing countries including Nigeria. One of the integral elements in management of hypertension is adherence to medication and life-style modification. This study aimed to assess adherence level for anti-hypertensive medications among adult hypertensive patients attending public hospitals in Kano State, Nigeria. The study was a cross sectional prospective survey involving 600 patients from six public healthcare facilities selected by multistage sampling technique. Adherence status was assessed using Morisky medication adherence scale. Sociodemographic data and other factors that may influence adherence to hypertension medications were evaluated. Out of the 598 patients that participated in the study, only 178 (29.8%) have their BP controlled based on JNC8. Three hundred and thirty two (55.5%) out of 598 patients have good adherence, while 266 (45.5%) have poor adherence. Of the 178 patients who had good BP control, 120 (67.5%) have good adherence while 58 (32.5%) have poor adherence. BP control was significantly higher in those that adhered to antihypertensive medication compared with non-adhering patients (χ2 = 14.526; df = 1; p-value = < 0.001). Additionally, Chi-square test showed significant association between number of antihypertensives and blood pressure control. (χ2=37.556, df=3, p<0.001). The study established that 55.5% of the respondents have good adherence to their antihypertensive medication while 29.8% had their BP controlled. Adherence and number of antihypertensive medication a patient is taking were found to have significant relationship with BP control. Keywords: Medication, adherence, hypertension, antihypertensive

scholarly journals Improving medication adherence among kidney transplant recipients: Findings from other industries, patient engagement, and behavioral economics—A scoping review

2016 ◽  
Vol 4 ◽  
pp. 205031211562502 ◽  
Author(s):  
Shelley R Oberlin ◽  
Stephen T Parente ◽  
Timothy L Pruett
Keyword(s):  
Medication Adherence ◽  
Kidney Transplant ◽  
Scoping Review ◽  
Patient Engagement ◽  
Collaborative Partnerships ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Improve Medication Adherence ◽  
Increased Risk ◽  
The Right

The immune system is a powerful barrier to successful organ transplantation, but one that has been routinely thwarted through modern pharmacotherapeutics. Despite the benefits of immunosuppressive therapy, medication non-adherence leads to an increased risk of graft rejection, higher hospital utilization and costs, and poor outcomes. We conduct a scoping review following Arksey and O’Malley’s five-stage framework methodology to identify established or novel interventions that could be applied to kidney transplant recipients to improve medication adherence. As the desired outcome is a behavior (taking a pill), we assess three areas: behavioral-focused interventions in other industries, patient engagement theories, and behavioral economic principles. Search strategies included mining business, social sciences, and medical literature with additional guidance from six consultative interviews. Our review suggests that no intervention stands out as superior or likely to be more effective than any other intervention; yet promising strategies and interventions were identified across all three areas examined. Based on our findings, we believe there are five strategies that transplant centers and other organizations can implement to improve medication adherence: (1) Build a foundation of trust; (2) Employ multiple interventions; (3) Stratify the population; (4) Develop collaborative partnerships; and (5) Embed medication adherence into the organization’s culture. The effectiveness of these interventions will need to be investigated further, but we believe they are a step in the right direction for organizations to consider in their efforts to improve medication adherence.

Medication Adherence in Older Patients With Dementia: A Systematic Literature Review

2017 ◽  
Vol 31 (3) ◽  
pp. 322-334 ◽  
Author(s):  
Najwan El-Saifi ◽  
Wendy Moyle ◽  
Cindy Jones ◽  
Haitham Tuffaha
Keyword(s):  
Medication Adherence ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Older Patients ◽  
Cochrane Library ◽  
Future Research ◽  
Improve Medication Adherence ◽  
Related Factors ◽  
Medication Discontinuation ◽  
Increased Risk

Background: Older patients with dementia are often unable to take their medications as prescribed due to cognitive and physical impairment. Objectives: To review the evidence on medication adherence in older patients with dementia in terms of the level of adherence, outcomes, contributing factors, and available interventions. Methods: A systematic literature review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searched databases included CINAHL, Cochrane Library, DARE, MEDLINE, and PubMed. Results: Eighteen studies reported levels of medication adherence or discontinuation and related factors. Medication adherence ranged from 17% to 42%, and medication discontinuation before the end of treatment ranged from 37% to 80%. Nonadherence was associated with an increased risk of hospitalization or death, while increasing age, choice of medication, use of concomitant medications, and medicines’ costs were reported to decrease medication adherence. Telehealth home monitoring and treatment modification were the only interventions reported in the literature to improve medication adherence in this population. Conclusion: Older patients with dementia have a low level of medication adherence. Future research should focus on the development and implementation of interventions to help older patients with dementia and their caregivers make better use of medications.

Exploring Barriers to Medication Adherence Among African American Emerging Adults With Uncontrolled Asthma

2021 ◽  
pp. 109019812110013
Author(s):  
Karen Kolmodin MacDonell ◽  
Rhonda Dailey ◽  
Wanda Gibson-Scipio ◽  
Bo Wang ◽  
Veronica Dinaj-Koci ◽  
...  
Keyword(s):  
African American ◽  
Medication Adherence ◽  
Emerging Adults ◽  
Asthma Control ◽  
Text Messaging ◽  
Persistent Asthma ◽  
Poor Adherence ◽  
Daily Diaries ◽  
Asthma Symptoms ◽  
Adherence To Medication

African American emerging adults (age 18–29 years) tend to have poor asthma outcomes, possibly due to poor adherence to medication. Few studies have explored barriers to controller adherence in this population. This study utilized electronic daily diaries to assess barriers to adherence and asthma symptoms among 141 African American emerging adults with uncontrolled persistent asthma and poor adherence. Participants reported symptoms M = 3.43 days (of 7 days). They reported unintentional (e.g., forgetting) and intentional (e.g., choosing not to take) barriers to adherence, but forgetting, being too busy, and sleeping through a dose were the most common. Significant correlations were found between symptoms and barriers, as well as asthma control and medication adherence in the expected directions. Asthma symptoms and number of barriers were significant predictors of asthma control. Existing intervention strategies such as text-messaging may prove effective to address these barriers, but measuring and addressing adherence remains complex.

Role of Medication Beliefs on Medication Adherence in Hypertensive Middle Eastern Refugees and Migrants in Australia

2020 ◽  
Author(s):  
Wejdan Shahin ◽  
Gerard A. Kennedy ◽  
Wendell Cockshaw ◽  
Ieva Stupans
Keyword(s):  
Medication Adherence ◽  
Middle Eastern ◽  
Multiple Mediation ◽  
Improve Medication Adherence ◽  
Medication Beliefs ◽  
Migration Status ◽  
Adherence To Medication ◽  
Modifiable Factors ◽  
The Relationship

Abstract BackgroundAdherence to medication is essential in some patients for achieving treatment control in hypertension. Medication beliefs is one of the personal modifiable factors that has been recognised to influence medication adherence in different populations. However, there is no published research to confirm the relationship between medication beliefs and medication adherence in Middle Eastern refugees and migrants in Australia. These two different groups may develop different beliefs about their medications that lead to different medication taking behaviours. Understanding the possible differences in beliefs may have a significant impact on enhancing medication adherence in these groups.Design320 Middle Eastern refugees and migrants with hypertension were approached via various social groups in Australia and asked to complete Arabic versions of the Beliefs about Medicine Questionnaire (BMQ) and the Medication Adherence Questionnaire. BMQ scores (necessity and concerns scales) were classified as "accepting", "indifferent", "ambivalent" or "skeptical". Multiple mediation modelling was applied to examine the role of necessity and concerns scales as mediators between migration status and medication adherence.ResultsThere were significant associations between medication adherence and medication beliefs scores (necessity and concerns scales) (p = 0.0001). Necessity, and concern were mediators in the relationship between migration status and medication adherence. Significant differences were found between refugees and migrants for medication adherence and medication beliefs. Refugees were likely to have less necessity, and more concern beliefs than migrants. They were also less likely to adhere to medications. Almost 30% of refugees could be classified as skeptical and 40% as ambivalent. In contrast, 50% of migrants had accepting beliefs, and around 35% held ambivalent beliefs. Refugees and migrants with “accepting” beliefs reported the highest adherence to medication and those holding “skeptical” beliefs reported the lowest adherence.ConclusionMedication beliefs are potentially modifiable and are reasonable targets for clinical interventions designed to improve medication adherence. Understanding these beliefs and the likely differences between refugees and migrants is crucial to provide specific and targeted advice to each group independently in order to improve medication adherence and overall health.

scholarly journals Improving drug adherence in osteoporosis: an update on more recent studies

2018 ◽  
Vol 10 (7) ◽  
pp. 141-149 ◽  
Author(s):  
Ayesha Jaleel ◽  
Kenneth G. Saag ◽  
Maria I. Danila
Keyword(s):  
Medication Adherence ◽  
Healthcare System ◽  
Behavioral Interventions ◽  
Osteoporosis Treatment ◽  
Fracture Liaison Service ◽  
Patient Counseling ◽  
Improve Medication Adherence ◽  
Need For Treatment ◽  
Increased Risk ◽  
Osteoporosis Care

Similar to other chronic diseases such as diabetes and hypertension, osteoporosis has struggled with suboptimal medication adherence, resulting in an increased risk of fractures and all-cause mortality. The goal of this narrative review was to summarize interventions to improve medication adherence in osteoporosis. Because past reviews of this topic covered published literature through 2013, we conducted our literature search to include the period between January 2012 and November 2017. We identified 10 studies evaluating healthcare system and patient interventions aimed at improving osteoporosis treatment adherence, including three fracture liaison service (FLS) programs, one pharmacist-delivered counseling program, and six patient-directed interventions consisting of three coaching or counseling programs and three interventions using reminder prompts. Four out of the six patient-directed interventions did not lead to significant improvements in outcomes, suggesting that patient-directed interventions may have limited success in this setting. The healthcare system interventions that evaluated FLS programs and pharmacist-directed tailored counseling were effective at improving medication adherence; however, the studies were not randomized, they were costly, resource intensive and effective in countries with more centralized healthcare, possibly limiting their generalizability. In conclusion, while healthcare system interventions such as FLS, and pharmacist-delivered counseling appeared to be successful in improving osteoporosis medication adherence in some settings, behavioral interventions including patient counseling and reminder prompts for medication utilization were not, perhaps due to patient perceptions regarding osteoporosis consequences and need for treatment. Thus, these patient attributes may define patients ‘at high risk’ for poor adherence and developing intervention approaches to enhance patient knowledge and understanding of osteoporosis and its consequences may improve the perception of the need for treatment, optimize osteoporosis care and thereby improve overall outcomes of patients with osteoporosis. We hope that the knowledge gained through our review will help inform the design of further programs aimed at optimizing osteoporosis care.

scholarly journals Barriers to medication adherence for rural patients with mental disorders in eastern China: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoyun Chai ◽  
Ying Liu ◽  
Zhuxin Mao ◽  
Shunping Li
Keyword(s):  
Medication Adherence ◽  
Mental Disorders ◽  
Qualitative Study ◽  
Rural Areas ◽  
Service Providers ◽  
Eastern China ◽  
Healthcare Providers ◽  
Family Members ◽  
Improve Medication Adherence ◽  
Rural Patients

Abstract Background Mental disorders are destructive and usually require long-term medication, but non-adherence of medication is highly prevalent in patients with mental disorders. Previous studies relating to medication non-adherence were mainly quantitative. Meanwhile, there have been even fewer studies conducted in rural areas in China that focused on patients’ medication non-adherence. This study aims to explore the barriers to medication adherence for rural patients with mental disorders in China from the perspectives of patients, patients’ family members and healthcare providers. Methods A qualitative study was carried out in the rural areas of four towns within Shandong Province in eastern China. The study adheres to COREQ guidelines. Semi-structured in-depth interviews were conducted with 11 patients, 21 family members and 8 primary mental health service providers. Results Thematic analysis generated five major themes: (1) lack of self-insight, (2) inadequate family support, (3) long treatment duration and side effects of drugs, (4) poor economic conditions, and (5) the perceived stigma of illness. Conclusion These findings may be useful for policymakers and planners to improve medication adherence and decrease the recurrence rate of mental disorders in China.

scholarly journals Social Support of Parents on Medication Adherence to Tuberculosis Patients in Children

2021 ◽  
Vol 5 (5) ◽  
pp. 153-155
Author(s):  
Farida Wahyu Ningtyias ◽  
Iken Nafikadini ◽  
Afif Hamdalah ◽  
Wahyu Muldayani
Keyword(s):  
Social Support ◽  
Medication Adherence ◽  
Emotional Support ◽  
Group Discussion ◽  
Instrumental Support ◽  
Patient Support ◽  
Research Focus ◽  
Tuberculosis Patients ◽  
Adherence To Medication ◽  
All Diseases

Adherence to taking this medication is needed in all diseases, especially TB disease, because this disease requires extra supervision in its treatment. Adherence to medication behavior is basically influenced by several factors, one of which is social support from those closest to the patient. Support can be obtained from the patient's family (father and mother), who always monitor the progress of patients. The 4 basic forms of social support, namely emotional support, instrumental support, informative support and reward support. This was qualitative research. Focus group discussion with 12 informants used for collected data. Results of this research showed that parents gave social supports i.g emotional support, instrumental support, informative support and reward support which related with medication adherence. Keywords: social support; parents; medication adherence; tuberculosis; children

scholarly journals Diabetes Distress, Medication Taking, Glycaemic Control and Self-Management: Comparing a Minority Migrant Group With Mainstream Society

2021 ◽  
Author(s):  
Hamzah Alzubaidi ◽  
Catarina Samorinha ◽  
Hana Sulieman ◽  
Kevin Mc Namara ◽  
Colette Browning
Keyword(s):  
Medication Adherence ◽  
Glycaemic Control ◽  
Healthcare Providers ◽  
Vulnerable Groups ◽  
Self Management ◽  
Diabetes Distress ◽  
Linear Regression Models ◽  
Improve Medication Adherence ◽  
English Speaking ◽  
Arabic Speaking

Abstract Background Diabetes distress (DD) has broad-ranging effects on type 2 diabetes (T2DM) management and outcomes. DD research is scarce among ethnic minority groups, particularly Arabic-speaking immigrant communities. To improve outcomes for these vulnerable groups, healthcare providers, including pharmacists, need to understand modifiable predictors of DD. Objective To assess and compare DD and its association with medication-taking behaviours, glycaemic control, self-management, and psychosocial factors among first-generation Arabic-speaking immigrants and English-speaking patients of Anglo-Celtic background with diabetes, and determine DD predictors. Setting: Various healthcare settings in Australia. Method: A multicentre cross-sectional study was conducted. Adults with T2DM completed a survey comprised of validated tools. Glycated haemoglobin, blood pressure, and lipid profile were gathered from medical records. Multiple linear regression models were computed to assess the DD predictors. Main outcome measure: Diabetes distress level. Results Data was analysed for 696 participants: 56.3% Arabic-speaking immigrants and 43.7% English-speaking patients. Compared with English-speaking patients, Arabic-speaking immigrants had higher DD, lower medication adherence, worse self-management and glycaemic control, and poorer health and clinical profile. The regression analysis demonstrated that higher DD in Arabic-speaking immigrants was associated with cost-related medication underuse and lower adherence to exercise, younger age, lower education level, unemployment, lower self-efficacy, and inadequate glycaemic control. Whereas among English-speaking patients, higher DD was associated with both cost- and non-cost-related underuse of medication and lower dietary adherence. Conclusion Results provided new insights to guide healthcare providers on reducing the apparent excess burden of DD among Arabic-speaking immigrants and potentially improve medication adherence, glycaemic control, and self-management.

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