adherence monitoring
Recently Published Documents


TOTAL DOCUMENTS

208
(FIVE YEARS 96)

H-INDEX

22
(FIVE YEARS 5)

Healthcare ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 116
Author(s):  
Martin K. Msukwa ◽  
Munyaradzi P. Mapingure ◽  
Jennifer M. Zech ◽  
Tsitsi B. Masvawure ◽  
Joanne E. Mantell ◽  
...  

As Zimbabwe expands tuberculosis preventive treatment (TPT) for people living with HIV (PLHIV), the Ministry of Health and Child Care is considering making TPT more accessible to PLHIV via less-intensive differentiated service delivery models such as Community ART Refill Groups (CARGs). We designed a study to assess the feasibility and acceptability of integrating TPT into CARGs among key stakeholders, including CARG members, in Zimbabwe. We conducted 45 key informant interviews (KII) with policy makers, implementers, and CARG leaders; 16 focus group discussions (FGD) with 136 PLHIV in CARGs; and structured observations of 8 CARG meetings. KII and FGD were conducted in English and Shona. CARG observations were conducted using a structured checklist and time-motion data capture. Ninety six percent of participants supported TPT integration into CARGs and preferred multi-month TPT dispensing aligned with ART dispensing schedules. Participants noted that the existing CARG support systems could be used for TB symptom screening and TPT adherence monitoring/support. Other perceived advantages included convenience for PLHIV and decreased health facility provider workloads. Participants expressed concerns about possible medication stockouts and limited knowledge about TPT among CARG leaders but were confident that CARGs could effectively provide community-based TPT education, adherence monitoring/support, and TB symptom screening provided that CARG leaders received appropriate training and supervision. These results are consistent with findings from pilot projects in other African countries that are scaling up both differentiated service delivery for HIV and TPT and suggest that designing contextually appropriate approaches to integrating TPT into less-intensive HIV treatment models is an effective way to reach people who are established on ART but who may have missed out on access to TPT.


Author(s):  
Becky Siu Yin Li ◽  
Carmen Wing Han Chan ◽  
Minjie Li ◽  
Irene Kit Yee Wong ◽  
Yvonne Hoi Un Yu

<b><i>Introduction:</i></b> Behavioral and psychological symptoms of dementia (BPSD) is the most prominent and distressing manifestation for older persons with dementia (PWD) and caregivers. Aromatherapy has demonstrated its effectiveness in managing BPSD in various studies. However, previous studies and systematic reviews have obtained inconsistent findings, and a review of qualitative studies is yet to be conducted. <b><i>Method:</i></b> A mixed-methods systematic review with a convergent segregated approach was performed to evaluate the effectiveness of aromatherapy in improving the BPSD and quality of life (QoL) of PWD and in relieving the distress and burden of caregivers, as well as its safety for PWD. Both published and unpublished quantitative and qualitative studies written in English and Chinese between January 1996 and December 2020 were retrieved from 28 databases, including MEDLINE, EMBASE, and Web of Science, based on the prespecified criteria. The methodological quality was assessed by using critical appraisal tools from the Joanna Briggs Institute. Quantitative synthesis, qualitative synthesis, and integration of quantitative and qualitative evidence were performed. <b><i>Results:</i></b> A total of 12 randomized controlled trials, 10 quasi-experimental studies, and 2 qualitative studies were included in the review. Some inconsistent findings regarding the effectiveness of aromatherapy in reducing the severity of BPSD were observed. Some studies reported that aromatherapy significantly improved the QoL of PWD and relieved the distress and burden of caregivers, promoted a positive experience among caregivers, and had very low adverse effects on PWD (with aromatherapy inhalation reporting no adverse effects). <b><i>Conclusion:</i></b> Aromatherapy, especially in the inhalation approach, could be a potentially safe and effective strategy for managing BPSD. However, more structuralized and comparable studies with sufficient sample size, adherence monitoring, and sound theoretical basis could be conducted to obtain conclusive findings.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 230-230
Author(s):  
Gilles Einstein ◽  
Daniel Morrow ◽  
Jeannie Lee ◽  
Wendy Rogers ◽  
Tracy Mitzner ◽  
...  

Abstract Discovering a composite of measures of executive function/working memory predicted everyday medication adherence among older adults, led to the development of a behavioral intervention, the Multifaceted Prospective Memory Intervention (MPMI) to improve hypertension medication adherence. The intervention resulted in a 35% improvement in adherence compared to an active education and attention control condition. However, adherence slowly declined over an additional five months of adherence monitoring without the presence of interventionists in the home. We proposed that the use of technology might help individuals maintain the prospective memory strategies, resulting in sustained adherence. An interdisciplinary team was formed to translate the behavioral intervention to technology, resulting in the first version of the MEDSReM system. In this presentation we describe the evolution of the project, from the components of the successful MPMI to the design and initial testing of MEDSReM. These efforts provide general insights about translating interventions into technology tools.


Author(s):  
Anna M Hu ◽  
Marc J Pepin ◽  
Mohamed G Hashem ◽  
Rachel B Britt ◽  
Sara R Britnell ◽  
...  

Abstract Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose To describe the development of a pilot specialty medication clinical dashboard targeting tumor necrosis factor (TNF)-α inhibitor therapy. Summary This was a quality improvement project conducted between August 2019 and April 2020. The dashboard was designed with collaboration between clinical pharmacists and specialty providers in rheumatology, gastroenterology, and dermatology. Data was queried from the Veterans Affairs Corporate Data Warehouse. Patients with an active prescription or intravenous order for a TNF-α inhibitor were included. Dashboard flag criteria focused on TNF-α inhibitor safety and adherence monitoring. Flag results from the dashboard were characterized from data captured at a single time point. For 431 patients on TNF-α inhibitor treatment at the institution, 304 flags corresponding to 223 unique patients (51.7%) were identified on the dashboard: 3% of patients had a new infection, 9% had overdue monitoring laboratory tests, 5% had a critical laboratory result, 2% were on 2 biologic agents, 27% were overdue for a refill, 6% had an emergency department visit, and 2% had an inpatient admission. No patients were flagged for heart failure exacerbation or new malignancy. Seventeen percent of patients were prescribed high-dose etanercept or adalimumab, representing a potential annual cost savings of $302,497 if 50% of these patients had their dose successfully reduced to labeled dosing. Opportunities for pharmacist intervention utilizing the dashboard were identified and characterized through chart review of flagged patients. Conclusion Pharmacists have the opportunity to improve safety and adherence for TNF-α inhibitor therapy through use of a specialty medication clinical dashboard. The dashboard should be used in conjunction with collaborative practice protocols.


2021 ◽  
Author(s):  
Madilyn Mason ◽  
Youmin Cho ◽  
Jessica Rayo ◽  
Yang Gong ◽  
Marcelline Harris ◽  
...  

BACKGROUND Accurately measuring and monitoring patient medication adherence is a global challenge due to the absence of “gold standard” methods for adherence measurement. Recent attentions have turned towards the adoption of technologies for medication adherence monitoring as they provide the opportunity for continuous tracking of individual medication adherence behavior. Yet, current medication adherence monitoring technologies vary by their technical features and methods of adherence data capture, leading to differences in their respective advantages and limitations. Overall, there is a lack of appropriate criteria to guide the assessment of medication adherence monitoring technologies for optimal adoption and utilization. OBJECTIVE This study aimed to provide a concise overview and summary of current medication adherence monitoring technologies and propose a set of technology assessment criteria to aid in the development and adoption of these technologies. METHODS A literature search was conducted on PubMed, Scopus, CINAHL, and ProQuest Technology Collection (January 2010-June 2021) using the combination of keywords "medication adherence," "measurement technology," and "monitoring technology". The selection focused on studies related to medication adherence monitoring technology and its development and use. The technological features, methods of adherence data capture, and potential advantages and limitations of identified technology applications were extracted. Common, recurring elements were synthesized as potential technology assessment criteria. RESULTS Among 3865 articles retrieved, 98 remained for final review, which reported a variety of technology applications for monitoring medication adherence, including electronic pill bottles/boxes, ingestible sensors, electronic medication management systems, blister pack technology, patient self-report technology, video-based technology, and motion-sensor technology. The most commonly reported technologies included electronic pill bottles, electronic pillboxes, and ingestible sensors. Twenty-eight technology assessment criteria were identified and organized into five categories: Development Information, Technology Features, Medication Adherence Data Collection & Management, Feasibility & Implementation, and Acceptability and Usability. CONCLUSIONS This study summarized the technical features, data capture methods, and various advantages and limitations of medication adherence monitoring technology reported in the literature and proposed criteria for assessing medication adherence monitoring technologies. This collection of assessment criteria may be a useful tool to guide the development and selection of relevant technology, facilitating the optimal adoption and effective use of technology to improve medication adherence outcomes. Future studies are suggested to further validate the medication adherence monitoring technology assessment criteria and construct an appropriate technology evaluation framework.


2021 ◽  
Author(s):  
Migbar Sibhat ◽  
Tewodros Mulugeta ◽  
Dawit Aklilu

Abstract BackgroundWith expanding access to pediatric antiretroviral therapy, a growing amount of patients in the developing world has switched to second-line therapy, and some requiring third-line medications. A delay in switch increases mortality and risk of developing opportunistic infections. There remain limited and often conflicting estimates on the use of second-line ART in children. Thus, this study intended to determine the incidence and predictors of switching to second-line antiretroviral therapy among children.MethodsRetrospective follow up study was conducted by reviewing all charts. Data were collected by extraction tool; entered using Epi-data; cleaned and analyzed by STATA V-14. Kaplan-Meier curve, log-rank test, and life table were used for data description and adjusted hazard ratios and p-value for analysis by Cox proportional hazard regression. Any variable at P≤0.25 in the bi-variable analysis was taken to multivariate analysis and significance was declared at P≤0.05. Data were presented using texts, tables, and figures.Results and conclusionAnalysis was conducted on 424 charts with total person-time observation of 11686.1 child-months and incidence switch rate of 5.6 (95% CI 4.36-7.09) per 1000 child-month-observations. Being orphaned [AHR=2.36; 95%CI: 1.10-5.07], suboptimal ART adherence [AHR= 2.10; 95% CI: 1.12-3.92], drug toxicity [AHR= 7.05; 95% CI: 3.61-13.75], advanced recent WHO stage [AHR=2.75; 95%CI: 1.05-7.15], and initiating ART with TB co-infection [AHR=3.08; 95%CI: 1.26-7.51] were significantly associated with switch to second-line ART regimen. Moreover, long duration of ART follow up [AHR=0.75; 95% CI: 0.71-0.81] was found to be protective against switching. Hence, it is better to give priority for strengthening the focused evaluation of tuberculosis co-infection and treatment failure with continuous adherence monitoring. Further research is also needed to evaluate the effect of drug resistance.


2021 ◽  
Vol 237 ◽  
pp. 202-207
Author(s):  
Hiroyoshi Takeuchi ◽  
Marcos Sanches ◽  
Carol Borlido ◽  
Ofer Agid ◽  
Gary Remington

HIV Medicine ◽  
2021 ◽  
Author(s):  
Jose R. Castillo‐Mancilla ◽  
Nicholas Musinguzi ◽  
Stephen Asiimwe ◽  
Mark J. Siedner ◽  
Catherine Orrell ◽  
...  

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 235-235
Author(s):  
Emily Johengen ◽  
Arielle Davidson ◽  
Kathleen W. Beekman ◽  
Kelly Hecht ◽  
Emily R. Mackler

235 Background: Use of oral anticancer agents (OAAs) for cancer treatment continues to grow and creates a need for oncology practices to adapt their ambulatory infusion model of care to one that supports patients taking anti-cancer treatment at home. Historically, our practice has had success with care managers supporting infusion treatment patients. A recently published randomized trial has shown considerable benefits of dedicated pharmacist follow-up for patients taking OAAs. As a result, our practice added a dedicated oncology pharmacist to provide education and follow-up for our OAA patients. Methods: This is a single-center, retrospective evaluation of time to first follow up for patients taking OAAs pre-intervention (11/1/20 - 2/28/21) versus post-intervention (3/1/21 - 4/30/21). The intervention consists of structured symptom and adherence monitoring by a dedicated oncology pharmacist as part of our care management team for all patients prescribed an OAA. In the pre-intervention group, OAA monitoring was divided between care team members without a dedicated OAA program. The population consists of 139 patients newly started on OAAs over the 6-month period. “On-time” follow up defined by our practice is follow up that is <10 days from the OAA start date. There were 20 patients (10 per group) excluded from data analysis due to being deceased before follow-up could be assessed (n= 3), transferring oncology care elsewhere (n= 5), or never starting the OAA (n= 12). Results: Pre-intervention, initial follow up occurred via pharmacist or nurse care manager visit (n=47), provider visit (n=29), or unplanned admission (n=3). Post-intervention, all but two initial follow up visits were performed by the designated oncology pharmacist, and there were no unplanned admissions prior to first follow up. The median time to first follow up visit was 8 days (range 2 to 31 days) in the pre-intervention group (n=79) and 7 days (range 3 to 15 days) in the post-intervention group (n=40). Follow up visits occurred within 10 days of OAA initiation for 67.1% of patients in the pre-intervention group and 95% of patients in the post-intervention group (p=<0.001). Follow up occurred within 14 days of initiation for 82.3% of pre-intervention patients and 97.5% of post-intervention patients (p=0.018). Conclusions: Post-intervention assessment showed improvement in the time to follow up for patients taking OAAs. Future analyses will include outcomes, such as interventions at the time of follow-up, length on therapy, and unplanned admissions.


Sign in / Sign up

Export Citation Format

Share Document