Experiences of Persons Living Schizophrenia in Ghana

Living with a chronic condition such as schizophrenia comes with significant challenges. Yet, there is little data on the experiences of people living with schizophrenia in Ghana. This study explored the experiences of persons living with schizophrenia in the Cape Coast Metropolis of Ghana. The study adopted a descriptive phenomenological approach using purposive sampling technique to select nine (9) persons living with schizophrenia for the study. Data was collected using face-to-face in-depth interviews. Interviews were taped, transcribed verbatim, and analysed following Colaizzi’s (1978) descriptive phenomenological data analysis approach. The study revealed that people with schizophrenia maintained their Activities of Daily Living such as washing, sweeping, maintenance of personal and environmental hygiene, so long as they were in their lucid interval. Study participants valued supportive relationship with family members, mental health practitioners, religious institutions and the social networks. Participants reported stigma and lack of job opportunities as some of the major challenges they faced. Non adherence to medication and stigmatization were perceived as common cause of relapse by participants.

Perception of pharmacological prevention and subsequent non-adherence to medication in patients with ischaemic heart disease: a population-based cohort study

ObjectiveA patient-focused approach is advocated to embody risk of non-adherence to medication and subsequent adverse clinical outcomes following ischaemic heart disease (IHD). This study aimed to explore how patient perceived information on pharmacological prevention was associated with subsequent non-adherence to medication (measured by non-initiation, non-implementation and non-persistence) in patients with incident IHD.DesignCohort study.SettingDenmark.ParticipantsRegister-based cohort of 829 patients with incident IHD in 2013.MeasuresPerception covered whether patients’ experienced being adequately informed about their pharmacological prevention. Information on such was obtained from a survey and divided into ‘Well informed’, ‘Moderately informed’ and ‘Poorly informed’. Information on baseline characteristics, and reimbursed prescriptions of medication (antiplatelets, statins, ACE-inhibitors/angiotensin receptor blockers and β-blockers) during follow-up were obtained by linkage to nationwide public registers. Non-initiation and non-implementation of medication, measured as proportion of days covered, were analysed by Poisson regression. Non-persistence to medication, measured as risk of discontinuation, was analysed by multivariable Cox proportional hazard regression.Primary and secondary outcome measuresNon-implementation and non-persistence to medication up to 365 days of follow-up were primary outcomes. Secondary outcomes included non-initiation as well as non-implementation and non-persistence to medication at 180 days of follow-up.ResultsA dose–response association was in general found between perception of pharmacological prevention and risk of non-implementation and non-persistence. For example, the hazard of non-persistence to antiplatelets was 1.18 (95% CI 0.71 to 1.96) times higher for patients reporting 'Moderately informed' and 1.89 (95% CI 1.10 to 3.25) times higher for patients reporting 'Poorly informed', compared with patients reporting 'Well informed of perception of pharmacological prevention' up to 365 days of follow-up.ConclusionLower levels of perception of pharmacological prevention were associated with subsequent non-implementation and non-persistence to medication in patients with incident IHD.

Health Literacy of Newly-Admitted Cancer Patients in Vietnam: Difficulties Understanding Treatment Options and Processing Health-Related Information

Having a good understanding of cancer patients’ health literacy in the early stage of diagnosis can help to implement strategies to improve the management process and overall health outcomes. The study aims to describe health literacy and its association with socio-demographic characteristics among newly admitted cancer patients. A cross-sectional study was conducted on 262 newly admitted patients of a cancer hospital in Vietnam using the Vietnamese version of the HLS-SF12 questionnaire. Descriptive analytics and regression analysis were used to describe health literacy and examine associated factors. Older age, lower level of education, and living in rural areas were associated with lower health literacy while there was no significant relationship between gender and health literacy among newly admitted cancer patients. Many newly admitted patients, especially the older patients have difficulties understanding the different treatment options (54%) and evaluating the reliability of health information on the internet (43%). During the early stage of treatment, strategies should be implemented with regards to patients’ health literacy, to properly educate patients and their caregivers to improve communication, adherence to medication, lifestyle, and overall better quality of life and treatment outcome.

FACTORS ASSOCIATED WITH NON-ADHERENCE TO HEPATITIS B VIRUS ANTIVIRAL THERAPY

Objective: To assess the adherence to antivirals in Hepatitis B Virus (HBV) infected patients and to determine various social and demographic factors which can have an impact on it. Study Design: Cross- sectional study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital Rawalpindi, from Jan to Mar 2019. Methodology: Patients on oral anti-viral agents for hepatitis B virus infection were enrolled from outdoor clinics using consecutive sampling technique. Medication adherence was assessed using the 4-item Modified Morisky Score Questionnaire. Data was also collected about different variables that could potentially affect compliance, such as age, gender, education, residence, total number of pills prescribed for each day, travelling time to hospital, attendant’s company, adverse effects of treatment, presence of co-morbid conditions, patients’ knowledge regarding importance of adherence and whether they followed any particular routine in taking medicines. Results: There were 127 patients having mean age of 47.80 ± 14.54 years. Out of these, 20 (15.75%) were not adherent to treatment. Patients not following a fixed drug-dosing schedule, patients not aware of the significance of good drug compliance and residents of urban areas were more likely to have lesser compliance to treatment. Conclusion: Majority of our patients were compliant to treatment for chronic hepatitis B infection. This was more likely to be the case amongst those following a fixed drug-dosing schedule, having an awareness of significance of adherence to medication and residents of rural areas.

Kepatuhan Penggunaan Obat terhadap Profil Lipid dan Lingkar Perut pada Pasien Sindrom Metabolik di Rumah Sakit di Semarang

Metabolic syndrome is a metabolic disorder caused by a complex increase in obesity. Metabolic syndrome can be controlled by adhering to medication and a healthy lifestyle. Patient's behavior towards adherence to medication is carried out in order to achieve the goal of treatment itself. The research objective was to determine the effect of medication adherence on lipid profiles and abdominal circumference in metabolic syndrome (SM) patients at Hospital in Semarang. This research is an observational research. Data were collected using a cross sectional design. Data collection in this study was conducted in August - December 2020. This study used the chi-square test, the chi-square test for abdominal circumference obtained results of 0.254 which said there was no effect of drug adherence with the abdominal circumference value and the chi-square test. for LDL, the results were 0.046 and the results were 0.001 for triglycerides, which is said to have an effect on drug adherence to LDL levels and trglyceride levels. The conclusion in this study is that there is an effect of patient drug use adherence to LDL (Low Density Lipoprotein) and triglyceride levels, while there is no effect of patient drug use adherence to abdominal circumference values.

Study on covert administration of medications practices among persons with severe mental illness: A cross-sectional study

Background: Covert administration of medication (CoAdM) by caregivers to persons with severe mental illness (SMI) is a commonly observed medication delivery practice in India. Aims: This study aims to examine different medication delivery practices adopted by caregivers to provide care to SMI at times of medication refusal. Method: This study was conducted at the outpatient department between April 2019 and November 2019. A semi-structured questionnaire was used to interview the caregivers of persons with SMI to assess medication delivery practices. Results: A total of 300 caregivers were interviewed. CoAdM was practiced in 96 (32.0%) persons with SMI at least once during their lifetime, and other strategies used were pleading ( n = 105, 35.0%), lying ( n = 10, 3.3%), and threatening ( n = 154, 51.4%). Logistic regression showed that male gender (OR 4.75; CI 1.37–16.46), absent insight (OR 10.0; CI 2.01–47.56), and poor adherence to medication (OR 4.75; CI 1.31–16.92) were significantly associated with CoAdM in the last 1 year. Caregivers perceived significant improvement in self-care ( Z = −4.37, p < .01), interpersonal ( Z = −7.61, p < .01), work ( Z = −5.9, p < .01), family functioning ( Z = −7.82, p < .01) difficult behavior ( Z = −8.27, p < .01), and dependency ( Z = −6.34, p < .01) in persons with SMI with use of CoAdM. Conclusions: CoAdM was given to one in three persons with SMI at some point in their lives. Male gender, absent insight and poor adherence were predictive of CoAdM in the last 1 year. Caregiver perceived improvements in self-care, work, interpersonal, family functioning, problem behaviors, and dependency after CoAdM. Policies need to be evolved to serve all stakeholders while keeping these practices in mind.

Hubungan Tingkat Penerimaan diri dengan Tingkat Kepatuhan Minum Obat Pasien Lupus di Yayasan Kupu Parahita Indonesia

Lupus is a chronic autoimmune disease that can become a bio-psycho-socio-economic-culture-spiritual burden for individuals because its complex treatment and management. Self-acceptance and adherence to medication are the keys in lupus management. Purpose of this study was to determine the relationship between self-acceptance level of lupus patients and their medication adherence level. The study was designed using a correlational study with a cross sectional approach. About 92 lupus patient respondents at Kupu Parahita Indonesia Foundation who went to the Saiful Anwar Hospital Malang were selected using purposive sampling according to inclusion and exclusion criteria. Respondents were asked to fill out a modified Acceptance of Illness questionnaire to measure patient self-acceptance level and the Morisky Medication Adherence Scale 8 (MMAS-8) to assess drug adherence level. From the 92 respondents, it was found that 37% had a high level of self-acceptance, 52.2% were moderate, and 10.8% were low. Adherence medication level in 92 respondents showed 51.1% high, 38.1% moderate, and 10.8% low. Spearman test results showed a significant relationship between self-acceptance level and medication adherence level (p=0.001, r=0.355). This value indicates the strength of the weak relationship and the direction of the positive correlation between self-acceptance and medication adherence. Conclusion, the higher of self-acceptance level of lupus patients, the higher medication adherence level.

Knowledge and self-management practices among type II diabetes patients: a study in Gatundu town in Kiambu, Kenya

Background: Type-2 diabetes mellitus is recognized as a key non-communicable disease affecting over 425 million world-wide, with only half of them currently diagnosed. The most crucial risk factor for mortality associated with type-2 diabetes is poor adherence to the prescribed medication.Methods: A cohort study design was used to study 98 type 2 diabetes patients in Kiambu County. Consecutive sampling method was used. The collection of data utilized a pre-designed and piloted structured questionnaire. Quantitative data analysis was conducted using SPSS version 26.0 and correlation between the total count of the remaining diabetic medication and the blood sugar after one month follow-up was assessed. Univariate logistic regression was conducted in assessing the association between each of the predictor variables and the two main outcome variables (adherence to medication and glycemic control). A multiple logistic regression model was constructed for each of the two outcome variables.Results: 31 (31.6%) of the study subjects were between 60-69 years, 70 (71.4%) were married and 66 (67.3%) were female. In addition, 37 (37.8%) had diabetes for more than 8 years, 70.6% had hypertension and 83.7% were prescribed oral hypoglycaemic agents as initial treatment. Majority of the respondents constituting 80.7% had high adherence to prescribed diabetes medication regimen, knowledge on diabetes treatment (p=0.009) and detecting low blood sugar levels through signs and symptoms and manage (p=0.001) had significantly association with adherence to antidiabetic.Conclusions: Diabetic patients who have knowledge on diabetes and its management, those who stop alcohol and cigarette smoking and those who understand hypertension are more likely to adhere to diabetic treatment.

The Effect of Behavioral Therapy with Modeling Techniques on Changes in the Adherence of Diabetes Mellitus Patients

Diabetes Mellitus (DM) is a disease whose prevalence is not infectious increases with changes in lifestyle. If not managed properly, it will cause various complications that reduce quality of life, increase morbidity and mortality, and harm the economy. The success of DM management is strongly influenced by the patient's adherence to medication and diet. One of the interventions to improve the adherence of DM sufferers is Behavior Therapy with modeling techniques. The purpose of this study was to analyze the effect of behavioral therapy with modeling techniques on changes in adherence of DM patients. The design of this study was quasy-experimental with pretest posttest and control group, on a sample of 40 DM patients with consecutive sampling technique. The intervention was carried out in 4 sessions for 2 weeks. The results of the statistical test paired sample t-test and independent sample t-test obtained p <0.5 (0.000), which meant that there was an effect of behavioral therapy with modeling techniques on changes in adherence DM patient. Changes in compliance that occurred between before and after the intervention was 16.95 points. Modeling technique is behavioral learning through observation of a model who has successfully controlled his illness to emphasize changes in mindset, beliefs, and commitment to a person's new positive behavior. Modeling has an impact not only on imitating, but also adding or subtracting the observed behavior, so that it can be applied to obtain new behavior, leave old negative behavior, and maintain the desired behavior.