This is the first study to assess the economic consequences of initial medication non-adherence and among the first to estimate the economic consequences of a medication non-adherence event in almost an entire population. Big data provide high representativeness, which increases the validity of the results.. Regarding limitations in the database registries, it was not possible to assess differences in hospital admissions and interventions between adherent and non-adherent patients. These costs have been shown to be higher in patients who display post-initiation medication non-adherence.6,7 Furthermore, it was not possible to evaluate the clinical impact of non-adherence and, as mentioned above, only the short-term impact of non-adherence to chronic medication could be evaluated. In the future, clinical indicators should be searched in the database for specific diseases and economic models constructed to evaluate the long-term consequences of initial medication non-adherence.. Another database ...
Of the many factors that contribute to poor medication adherence among the chronically ill, the portion of drug costs borne by patients appears to be central. Pitney Bowes is one of a handful of large employers and insurers that have begun experimenting with reduced copays for essential medications. In 2007, the company reduced or eliminated cost-sharing for medications used to treat coronary artery disease and osteoporosis, with the goal of improving employees medication adherence and health outcomes. This project will examine Pitney Bowes claims data to determine the impact that reduced copayments have had on medication adherence, clinical outcomes, health care utilization, and costs. The findings will aid employers, private insurers, the Medicare program, and policymakers in crafting changes to the structure of health benefits that lead to increased use of prescription drugs known to be effective for managing chronic disease.. ...
Background: Parsimonious self-report tools predicting pharmacy refill in patients with uncontrolled blood pressure could facilitate hypertension management in the elderly. We developed and evaluated a short self-report tool to predict low adherence via pharmacy refill in older patients with uncontrolled hypertension.. Methods: Cross-sectional analyses of survey and administrative data from the Cohort Study of Medication Adherence among Older Adults (CoSMO) were conducted on 394 adults with uncontrolled blood pressure. We considered 164 self-reported candidate items for development of a prediction rule for low (,0.8) vs. high (≥0.8) medication possession ratio (MPR) from pharmacy refill data. Risk prediction models were evaluated using best subsets analyses, and the final model was chosen based on clinical relevance and model parsimony. Bootstrap simulations assessed internal validation. The performance of the final model was compared to the 8-item Morisky Medication Adherence Scale (MMAS-8) ...
Abstract Medication Adherence in Adult Patients with Bipolar Disorder: An Integrative Literature Review Objective: To examine factors contributing to nonadherence in BD and methods for directly addressing these in an effect to offer providers information that can be used to assist clients. Methods: A review of the literature from 2012 to 2017 was conducted using a computerized search using Cumulative Index to Nursing and Health Literature (CINAHL) and PsycInfo. Results: Ten studies were identified as meeting the inclusion criteria. The resulting studies evenly discussed the reasons for medication non-adherence as well as treatment strategies aimed at improving adherence. Conclusion: The major findings of this study are two-fold, with one aspect determining effective strategies aimed at improving medication non-adherence in BD patients, while the other determines the reasons behind medication non-adherence. A significant portion of the research attributed non-adherence to substance abuse. Another
OBJECTIVE: The objective of this study was to investigate the effect of a multidisciplinary program on anxiety, depression, medication adherence, and quality of life in patients with epilepsy in eastern China.. METHODS: A cohort of 184 patients with epilepsy from the epilepsy clinic of a tertiary hospital in eastern China completed this program, out of which 92 were randomized into the intervention group and 92 the control group. Patients in both groups received standard antiepileptic drugs (AEDs), while those of the intervention group received an additional 12-month multidisciplinary program developed by a group of the epileptologist, pharmacist, psychiatrist, and epilepsy specialist nurse. Patients were assessed both before and after the 12-month period. The Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), and the eight-item Morisky Medication Adherence Scale (MMAS-8) were used to assess the severity of depression, anxiety, and medication adherence, respectively, along with ...
This study is testing a theory-based HIV treatment adherence intervention delivered by cell phone to patients in urban and rural areas. Adherence to antiretroviral (ART) medications is necessary to achieve HIV suppression and non-adherence can lead to treatment resistant genetic variants of HIV. People living with HIV/AIDS often experience difficulty sustaining high-levels of treatment adherence. Most factors that interfere with adherence are unanticipated and occur between clinical visits, including depression, side effects, substance use, and lapses in pharmacy refill. We will conduct a randomized clinical trial to test a cell phone-delivered theory-based medication adherence counseling intervention. The intervention is grounded in Self-Regulation Model and utilizes unannounced pill counts to monitor adherence and guide corrective feedback within the counseling context. Using pill count adherence information for counseling allows providers to detect and correct patient non-adherence within a ...
This study is testing a theory-based HIV treatment adherence intervention delivered by cell phone to patients in urban and rural areas. Adherence to antiretroviral (ART) medications is necessary to achieve HIV suppression and non-adherence can lead to treatment resistant genetic variants of HIV. People living with HIV/AIDS often experience difficulty sustaining high-levels of treatment adherence. Most factors that interfere with adherence are unanticipated and occur between clinical visits, including depression, side effects, substance use, and lapses in pharmacy refill. We will conduct a randomized clinical trial to test a cell phone-delivered theory-based medication adherence counseling intervention. The intervention is grounded in Self-Regulation Model and utilizes unannounced pill counts to monitor adherence and guide corrective feedback within the counseling context. Using pill count adherence information for counseling allows providers to detect and correct patient non-adherence within a ...
TY - JOUR. T1 - The Effect of Partner Serostatus and Relationship Duration on HIV Medication Adherence. AU - Mitzel, Luke D.. AU - Vanderdrift, Laura. AU - Ioerger, Michael. AU - Vanable, Peter A. PY - 2018/1/1. Y1 - 2018/1/1. N2 - High adherence rates to antiretroviral medications are necessary for people living with HIV/AIDS. The current study focuses on relationship-level predictors of HIV medication adherence by testing whether adherence rates differ by dyadic serostatus (seroconcordant vs. serodiscordant couples) among individuals with HIV in romantic relationships. Results showed a significant interaction between dyadic serostatus and relationship duration on adherence, such that individuals in long-term serodiscordant relationships reported better adherence than short-term serodiscordant relationships or seroconcordant partners in long-term relationships. Future research is needed to understand what relationship dynamics explain differences in adherence rates based on dyadic ...
Hypertension is a challenging public health problem with a huge burden in the developing countries. Non-adherence to antihypertensive treatment is a big obstacle in blood pressure (BP) control and favours disease progression to complications. Our objectives were to determine the rate of non-adherence to antihypertensive pharmacotherapy, investigate factors associated with non-adherence, and to assess the association between non-adherence and BP control in the Buea Health District (BHD), Cameroon. A community-based cross-sectional study using stratified cluster sampling was conducted in the BHD from November 2013 - March 2014. Eligible consenting adult participants had their BP measured and classified using the Joint National Committee VII criteria. The Morisky medication adherence scale was used to assess adherence to BP lowering medication. Multivariable logistic regression models were used to predict non-adherence. One hundred and eighty-three participants were recruited with mean age of 55.9 years.
Background: Non-adherence to medications is a major concern among patients with type 2 diabetes mellitus (T2DM). Failure to achieve positive health-related outcomes could be associated with non-adherence. Medication non-adherence is considered a socio-behavioral problem, thus using a behavioral model such as the transtheoretical model (TTM) could improve it. Objective: The primary objectives of this study were: (1) to determine the TTMs Stages of Change (SOC) and medication adherence scores of patients with T2DM in a primary health care setting in Qatar; (2) to determine the relationship between these two variables; and (3) to determine whether SOC could predict medication adherence whilst controlling for confounding factors. The secondary objectives were to assess the relationship: (1) between SOC and glycated hemoglobin (HbA1c); and (2) between medication adherence and HbA1c in the same population. Method: The study was conducted in the non-communicable disease clinic. Non-Qatari patients ...
Although the medication adherence of patients with glaucoma differs between reports, depending on the study patients and the methods of measurement, it is known to be low because glaucoma typically has no clear symptoms until it develops enough to reach its last stages.1 Therefore, an increase in medication adherence is regarded as an important factor for the better management of glaucoma. In this multicentre study, we aimed to investigate which factors influence medication adherence among patients with glaucoma in South Korea.. According to our results, the medication adherence rate of the patients with glaucoma in South Korea was 90.6±17.8%, and patients with ,80% medication adherence (non-adherent patients) made up about 30% of the study population. Hence, medication adherence of patients with glaucoma in South Korea appears to be relatively good when compared with that in foreign countries as reported to be 15%-58%.5 And, it could be partially explained by the relatively good insurance ...
Factors affecting adherence/compliance among patients diagnosed with unipolar depression in a General Hospital in Kolkata. Dr Sohini Banerjee, Dr Sayanti Ghosh, Dr Raviprasad Verma. Background. Non-adherence with psychotropic medication is a common phenomenon globally. However, adherence to anti-depressant medication in subjects diagnosed as unipolar depression requires methodical study. Limited evidence in this regard is available from India. This study aimed to assess the correlation of non-adherence to prescribed treatment among patients suffering from unipolar depression.. Method. A cross-sectional study was conducted in the Psychiatric Out Patient department (OPD) of R G Kar Medical College and Hospital in Kolkata. The Morisky Medication Adherence Scale (MMAS) was used and a questionnaire was designed by the principal investigator and was administered to the patients to explore correlation of non-adherence.. Results. A total of 239 { 63 men (26.4%), 176 women (73.6%) } patients with ...
TY - JOUR. T1 - Antihypertensive medication adherence in cancer survivors and its affecting factors. T2 - Results of a Korean population-based study. AU - Shin, Dong Wook. AU - Park, Jong Hyock. AU - Park, Jae Hyun. AU - Park, Eun Cheol. AU - Kim, So Young. AU - Kim, Sung Gyeong. AU - Choi, Jin Young. PY - 2010/2. Y1 - 2010/2. N2 - Purpose: Cancer survivors have been reported to receive less care for other conditions than the general population; however, it is not clear whether patients behavior also contribute to this. The present study was performed to examine cancer survivors adherence to antihypertensive medication and factors associated with it, compared to the general population. Methods: We used pharmacy claims and enrollment data from the National Health Insurance, which covers 97% of the Korean population. In total, 2,455,193 subjects, including 12,636 (0.5%) cancer survivors, who were prescribed antihypertensive medications during the calendar year 2004 were identified. A cumulative ...
Antipsychotic medications are a cornerstone of treatment and recovery for people with schizophrenia. However, many people have difficulty adhering to prescribed treatments and the average rate of non-adherence for schizophrenia is 50%. Failure to take medication is the most important risk factor leading to relapse and can result in a fivefold increase in the rate of relapse. An Australian study of 81 service users looked into the factors behind medication omission, including the participants levels of insight into their condition and their experience and feelings of stigma as a consequence of their mental illness. Most participants had insight into their illness and were aware of the stigma attached to it. Around 70% of them had experienced annoying side effects while nearly half admitted alcohol consumption. About a fifth admitted they had missed taking medication in the previous week. A younger age, the perception of negative side effects and lack of access to a psychiatrist all made it less ...
Medication adherence usually refers to whether patients take their medications as prescribed (eg, twice daily), as well as whether they continue to take a prescribed medication. Medication nonadherence is a growing concern to clinicians, healthcare systems, and other stakeholders (eg, payers) because of mounting evidence that it is prevalent and associated with adverse outcomes and higher costs of care. To date, measurement of patient medication adherence and use of interventions to improve adherence are rare in routine clinical practice. The goals of the present report are to address (1) different methods of measuring adherence, (2) the prevalence of medication nonadherence, (3) the association between nonadherence and outcomes, (4) the reasons for nonadherence, and finally, (5) interventions to improve medication adherence.. ...
Material and Methods. : SS was measured using a social support inventory previously validated in Chile. Self-Rated Health was assessed with a single non-comparative general question; adherence to medication was assessed using the four-item Morisky medication adherence scale. Blood glucose and blood pressure control were also assessed. A logistic regression was performed to estimate Prevalence Odds Ratio (POR) and Robust Poisson method to estimate the Prevalence Ratio (PR). ...
Objective: Nonadherence to prescribed antipsychotic medications places patients with schizophrenia at a greatly increased risk of illness exacerbation and rehospitalization. Identification of risk factors for nonadherence is an initial step toward designing effective interventions. This article reviews recent literature on the prevalence of and risk factors for medication nonadherence in patients with schizophrenia. Data Sources: We searched the MEDLINE/HealthSTAR and PsycINFO databases using combinations of the keywords risk factor(s), adherence, compliance, antipsychotic, neuroleptic, schizophrenia, and psychosis for articles published since 1980 that identified risk factors for medication nonadherence in schizophrenia patients. We included reports that (1) were published in English and (2) specifically examined risk factors for medication nonadherence. Thirty-nine articles met our selection criteria. Data Synthesis: Among the 10 reports that met a strict set of study inclusion criteria, we ...
The New York Times has described American's nonadherence to prescribed medications as an "out-of-control epidemic that costs more and affects more…
BACKGROUND/OBJECTIVE: The AIDS Clinical Trials Group (ACTG) Adherence Questionnaire is used extensively, but investigators frequently only use the first item of the questionnaire (4-day recall).. DESIGN/METHODS: A secondary analysis was conducted to (1) estimate the validity and reliability of each of the 5 scale items and (2) compare the approach commonly used to summarize adherence data collected with the instrument (average 4-day recall) with alternate approaches derived using principal component (PC) analysis and the full questionnaire. We hypothesized that an estimate of adherence taking all items of the questionnaire into account would provide a stronger measure of adherence.. RESULTS: Logistic regression analyses showed that the first PC identified (PC1) was significantly correlated with plasma HIV RNA outcome (P , 0.0001 for ACTG 370 data and P = 0.006 for ACTG 398 data) and correlated with plasma HIV RNA better than average 4-day recall. An adherence index formulated using weights of ...
Prescription refill online. Request a medication refill online for Walgreens, Walmart, CVS, Rite Aid and Costco prescription refills.
Despite increased awareness, poor adherence to treatments for chronic diseases remains a global problem. Adherence issues are common in patients taking antihypertensive therapy and associated with increased risks of coronary and cerebrovascular events. Whilst there has been a gradual trend towards improved control of hypertension, the number of patients with blood pressure values above goal has remained constant. This has both personal and economic consequences. Medication adherence is a multifaceted issue and consists of three components: initiation, implementation and persistence. A combination of methods is recommended to measure adherence, with electronic monitoring and drug measurement being the most accurate. Pill burden, resulting from free combinations of blood pressure lowering treatments, makes the daily routine of medication taking complex, which can be a barrier to optimal adherence. Single-pill fixed-dose combinations simplify the habit of medication taking and improve medication adherence.
Background: Myocardial infarction (MI) is one of the leading causes of death. Along with lifestyle factors, poor medication adherence is one of the causes. This study was planned to find out the level of adherence in post-MI patients and its related factors. Objectives: Monitoring medication adherence in patients of MI attending cardiac outpatient department and to reveal causes of nonadherence to drug therapy in them. Methods: One hundred and one newly diagnosed MI patients were included in the study. Data collected were patient characteristics, habits, comorbidities, and drugs prescribed. Morisky 8 item scale was used to find out the medication adherence at the end of 1 st and 6 th month of cardiac event. Data were analyzed using McNemar test, Chi-square test, and logistic regression analysis. Results: Most common preventive cardiovascular drugs given were aspirin, clopidogrel, and statins, 98%, 88.1%, and 90%, respectively. Medication adherence at 6 th month post-MI was significantly ...
Osteoporosis is a chronic condition that is characterized by the disruption in the balance of bone metabolism. Loss of bone mass leaves bones more fragile and susceptible to fractures. There are effective medicines available to treat osteoporosis and strengthen bones. It has been established in clinical trials that treatment with these medicines has to last for at least three years for them to be effective. Unfortunately all patients do not take their medicines as instructed by their doctor. The rate to which patients follow instructions is referred to as medication adherence. Medication non-adherence is the number one reason why patients do not achieve the health benefits from medicines hoped for. With osteoporosis medicines it is regarded as sufficient when a patient takes at least 80% of the prescribed doses for the concentration of medicine in blood to be high enough and for the drug to be effective. The current thesis studied the utilization of drugs, adherence to osteoporosis medicines and ...
New in the 2011 Edition: This all-new follow-up to the best-selling 2010 edition contains comparative 2010-over-2011 data on key activities, as well as new data on the emerging role and responsibilities of the community pharmacist in medication adherence efforts. Medication adherence efforts figure prominently into many key initiatives rolled out from healthcare reform from care transition management, where insufficient education and errors can lead to non-adherence, to accountable care organizations and patient-centered medical homes, where provider reimbursement and rewards are closely tied to patient compliance, satisfaction, clinical outcomes and appropriate use of healthcare services. This 50-page resource provides all-new metrics and measures on current and planned medication adherence programs as well as program elements, lessons learned, challenges and benefits and early returns from successful medication adherence initiatives. This exclusive report analyzes the responses of 162 ...
New in the 2011 Edition: This all-new follow-up to the best-selling 2010 edition contains comparative 2010-over-2011 data on key activities, as well as new data on the emerging role and responsibilities of the community pharmacist in medication adherence efforts. Medication adherence efforts figure prominently into many key initiatives rolled out from healthcare reform from care transition management, where insufficient education and errors can lead to non-adherence, to accountable care organizations and patient-centered medical homes, where provider reimbursement and rewards are closely tied to patient compliance, satisfaction, clinical outcomes and appropriate use of healthcare services. This 50-page resource provides all-new metrics and measures on current and planned medication adherence programs as well as program elements, lessons learned, challenges and benefits and early returns from successful medication adherence initiatives. This exclusive report analyzes the responses of 162 ...
People who are depressed are less likely to adhere to medications for their chronic health problems than patients who are not depressed, putting them at increased risk of poor health, according to a new RAND Corporation study.
Persistence rates were similar through the first 60 days of therapy. The mandatory mail cohort had a notable drop in persistence by day 90 (63.3% vs. 56.3%, p < 0.001), with a more pronounced drop among those without previous mail-service pharmacy use (50.5%). Median medication possession ratio (49.2% vs. 57.4%) and optimal adherence (33.6% vs. 36.1) were also lower. In the multivariable models, mandatory mail participants were less likely to achieve optimal adherence overall (odds ratio [OR], 0.70; 95% confidence interval [CI], 0.67-0.74) and in the metformin (OR, 0.55), sulfonylurea (OR, 0.72), ACE inhibitor (OR, 0.74), ARB (OR, 0.69), and statin (OR, 0.69) classes. Participants with no prior use of mail-service pharmacy had significantly lower odds of achieving optimal adherence in all therapeutic classes.. ...
INTRODUCTION:Adherence-enhancing interventions have been assessed in the literature, however heterogeneity and conflicting findings have prohibited a consensus on the most effective approach to maintain adherence over time. With the ageing population and growth of chronic conditions, evaluation of sustainable strategies to improve and maintain medication adherence long term is paramount. We aimed to determine the comparative effectiveness of interventions for improving medication adherence over time among adults with any clinical condition. MATERIALS AND METHODS:Meta-analyses evaluating interventions to improve medication adherence were searched in PubMed in January 2019 and reviewed for primary studies. Experimental studies with a comparison group assessing an intervention to enhance medication adherence in adult patients with reported adherence outcomes were included. Two authors extracted data for study characteristics, interventions and adherence outcomes. Interventions were categorized into ...
Despite the availability of many new treatment options for type 2 diabetes, the proportion of patients achieving the HbA1c target , 7.0% remains around 50%. We put forward the hypothesis that the unchanged HbA1c results, observed in the last decade in type 2 diabetes patients, are also a consequence of medication nonadherence and clinical inertia. Poor medication-taking behavior is usually defined as medication nonadherence and is responsible for uncontrolled hemoglobin A1c level in 23% of cases. Medication nonadherence may also affect clinical outcomes, as diabetic patients with good adherence (≥80%) had a significant 10% lower rate of hospitalization events and a significant 28% lower rate of all-cause mortality when compared with patients with poor adherence (,80 ...
Methods We used data on late middle age individuals (51-64 years) from the longitudinal US-based Health and Retirement Study (N=19 281) to examine the relationship between negative wealth shock and short-term outcomes that serve as markers of the pathways from wealth shock to health: elevated depressive symptoms, as a marker of the stress pathway and cost-related medication non-adherence (CRN), as a marker of the consumption pathway. Negative wealth shock was considered to be a loss of total net worth of 75% or more. ...
Women from Islamic and African cultures who have vaginal yeast infections may prefer oral drugs to vaginally inserted medications. Latin Americans expect
There are large differences in non-recurring health care spending (which includes overnight hospital stays, outpatient surgery, home health care, nursing home stays, and other services) between older singles and older couples, and these differences increase with age. For those 85 and above, singles and couples on average spent $13,355 and $8,530, respectively, on these services during the two-year period of the study ...
In this session of Beyond the Data carrying forward ideas discussed at CDCs Public Health Grand Rounds, Dr. Phoebe Thorpe and Dr. Larry Garber expand on the reasons for medication non-adherence by patients, and priority considerations for helping reduce this risk.
In HIV-infected persons, good adherence to antiretroviral therapy (ART) is essential for successful treatment outcomes. Patients worries before starting ART may affect their ART adherence and treatment outcomes. Between 2004 and 2009, HIV-infected individuals in a prospective cohort study in rural Uganda were assessed for ART eligibility. A counsellor explained the ART eligibility criteria, adherence and side effects, and recorded the patients worries related to ART. Every quarter, patients who initiated ART had clinical, immunological (CD4 cell counts) and virological (viral loads) assessments, and data were collected on ART adherence using patients self-reports and pill counts. We describe the patients worries and examine their association with ART adherence, and immunological and virological outcomes. We assessed 421 patients, 271 (64%) were females, 318 (76%) were aged 30 years and above and 315 (75%) were eligible for ART. 277 (66%) reported any worry, and the proportions were similar by sex,
Skills-based medication training program for patients with schizophrenic disorders: a rater-blind randomized controlled trial Uwe B Schirmer,1 Tilman Steinert,1,2 Erich Flammer,1,2 Raoul Borbé1,2 1Centre for Psychiatry South-Wuerttemberg, Ravensburg, Germany; 2Ulm University, Department Psychiatry I, Ravensburg, Germany Background: The long-term course of schizophrenia is often characterized by relapses, induced by poor medication adherence. Early nonadherence after discharge is frequent. Objective: To evaluate a skills-based inpatient training program for medication intake. Methods: We developed a manual-based inpatient medication training program to be carried out by nurses and focusing on practical skills enabling autonomous intake of medication. Medication adherence was measured by three different methods: pill count, determination of serum levels, and self-assessment by the patient. The raters were blinded. Results: Four weeks after discharge, 98% of the patients in the
Importance Forgetfulness is a major contributor to nonadherence to chronic disease medications and could be addressed with medication reminder devices.Objective To compare the effect of 3 low-cost reminder devices on medication adherence.Design, Setting, and Participants This 4-arm, block-randomized clinical trial involved 53 480 enrollees of CVS Caremark, a pharmacy benefit manager, across the United States. Eligible participants were aged 18 to 64 years and taking 1 to 3 oral medications for long-term use. Participants had to be suboptimally adherent to all of their prescribed therapies (with a medication possession ratio of 30% to 80%) in the 12 months before randomization. Participants were stratified on the basis of the medications they were using at randomization: medications for cardiovascular or other nondepression chronic conditions (the chronic disease stratum) and antidepressants (the antidepressant stratum). In each stratum, randomization occurred within blocks defined by whether all ...
To determine the association between individual substances of abuse and antiretroviral adherence, analyses require a large sample assessed using electronic data monitoring (EDM). In this analysis, EDM data from 1,636 participants in 12 US adherence-focused studies were analyzed to determine the associations between recent use of various substances and adherence during the preceding 4 weeks. In bivariate analyses comparing adherence among patients who had used a specific substance to those who had not, adherence was significantly lower among those who had recently used cocaine, other stimulants or heroin but not among those who had used cannabis or alcohol. In multivariate analyses controlling for sociodemographics, amount of alcohol use and recent use of any alcohol, cocaine, other stimulants and heroin each was significantly negatively associated with adherence. The significant associations of cocaine, other stimulants, heroin, and alcohol use with adherence suggest that these are important ...
The relation between treatment adherence and clinical prognosis appears straightforward. Patients who consume a sufficient quantity of an effective medication should have better outcomes than those who do not. The reports by Gallagher and colleagues and others (1) describe a more complex relation: High adherence may improve prognosis even if the medication is a placebo. Recent research suggests that pill counts, the adherence measure in this study and in most clinical trials, are often manipulated by the patient and can overestimate medication consumption (2). Thus, the excellent adherence of participants in this study, 91% of whom seemed to consume ≥ 75% of their medication, may be more apparent than real. In any event, the clinical trial setting limits the generalizability of these findings to the more heterogeneous world of clinical practice. This limitation, however, does not invalidate the methods and conclusions of the study. The patients with high adherence rates in this study may also ...
The relation between treatment adherence and clinical prognosis appears straightforward. Patients who consume a sufficient quantity of an effective medication should have better outcomes than those who do not. The reports by Gallagher and colleagues and others (1) describe a more complex relation: High adherence may improve prognosis even if the medication is a placebo. Recent research suggests that pill counts, the adherence measure in this study and in most clinical trials, are often manipulated by the patient and can overestimate medication consumption (2). Thus, the excellent adherence of participants in this study, 91% of whom seemed to consume ≥ 75% of their medication, may be more apparent than real. In any event, the clinical trial setting limits the generalizability of these findings to the more heterogeneous world of clinical practice. This limitation, however, does not invalidate the methods and conclusions of the study. The patients with high adherence rates in this study may also ...
The condition-based program alerts pharmacists when patients are not adherent to their medication regimens or have a gap in care, allowing them to intervene with patients and communicate with their physicians in real time. Before this program extension, the Pharmacy Advisor program had focused on patients with diabetes or cardiovascular conditions, with more than 3.8 million interventions conducted to date. It is estimated that medication nonadherence costs the U.S. economy nearly $300 billion annually. Studies suggest that poor medication adherence is linked to chronic conditions, and that medication persistence - the length of time a patient continues to take a prescribed drug - tends to be low for those with chronic conditions. Research also suggests that the design of medically appropriate regimens for individual patients can play a role in improving costs and outcomes associated with adherence and that intervention by pharmacists can reduce gaps in care.. We are delighted to extend ...
Many patients in New Zealand dont receive the benefits from their medications due to poor medication behaviour, referred to as medication adherence. Previously, data related to medication adherence has been gathered using questionnaire surveys based on the Health Belief Model (HBM), a psychological model that attempts to explain and predict health behaviours. This research study uses big data analytics to conduct a spatial and time series analysis using new and varied sources. It will be based on the HBM and look at patients geographical information and medication history data. It will focus on cardiovascular disease, although it is expected the same findings will be able to be applied to other chronic illnesses.. ...
Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) is a global problem. Introduction of antiretroviral therapy (ART) came as a relief to people living with HIV and AIDS as it improved their quality of life. However, maintaining high adherence levels to antiretroviral treatment is still a challenge in some settings yet strict adherence to treatment instructions is critical for successful suppression of HIV. A qualitative, descriptive phenomenological research was conducted to explore factors that influence adherence to antiretroviral therapy at Beatrice Road Infectious Disease Hospital (BRIDH). Purposive homogenous sampling was done. Data was collected from twenty patients through in-depth interviews. Study findings identified five main themes that facilitate adherence and these entail knowledge on HIV and AIDS and ART, motivation to live, adherence support networks, good service delivery and factors related to ...
Modeling the economic impact of medication adherence in type 2 diabetes: a theoretical approach David S Cobden1, Louis W Niessen2, Frans FH Rutten1, W Ken Redekop11Department of Health Policy and Management, Section of Health Economics - Medical Technology Assessment (HE-MTA), Erasmus MC, Erasmus University Rotterdam, The Netherlands; 2Department of International Health, Johns Hopkins University School of Public Health, Johns Hopkins Medical Institutions, Baltimore, MD, USAAims: While strong correlations exist between medication adherence and health economic outcomes in type 2 diabetes, current economic analyses do not adequately consider them. We propose a new approach to incorporate adherence in cost-effectiveness analysis.Methods: We describe a theoretical approach to incorporating the effect of adherence when estimating the long-term costs and effectiveness of an antidiabetic medication. This approach was applied in a Markov model which includes common diabetic health states. We compared two
BACKGROUND: Not all patients with asthma adhere to their prescribed drug regimens. The Behavioral Model of Health Services Utilization, organized as predisposing, enabling, and need variables, may be useful in identifying variables related to adherent medication-taking behavior.. OBJECTIVE: To examine the relationship between predisposing, enabling, and need variables and self-reported adherence with asthma controller drugs.. METHODS: A secondary analysis was conducted from a cross-sectional study using survey and claims data obtained from adults with asthma enrolled in a managed care organization. Independent variables included predisposing (age, gender, race, years with asthma, number of comorbidities, health beliefs), enabling (income, number of metered-dose inhaler [MDI] instructors, inhaler technique, perceived physician access), and need (patient-perceived severity, symptom-derived severity, health-related quality of life). Adherence was measured using a 4 item questionnaire scored as the ...
This study demonstrates high adherence to the Wise List recommendations in the Stockholm Healthcare Region. The overall adherence rate increased steadily over time, but with variations between therapeutic areas. Additionally, the number of recommended core substances has been kept stable (around 200 substances) for the 15 years since the introduction of the Wise List, despite the number of substances with market authorisation in Sweden increasing from 1235 to 1554 in the same time period.39 A limited number of recommendations is critical to make it feasible for prescribers to choose the best therapies for their patients, keeping knowledge up to date among prescribers about the clinical pharmacology and pharmacotherapeutic characteristics of each recommended medicine.8 ,9 ,15. High adherence to the Wise List recommendations was seen across all therapeutic areas in primary and hospital care. There could be several reasons for this. We consider that the transparent development process of ...
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View this essay on Afro-Caribbeans What Works Best Adherence Intervention for. Recent improvements on prescription medications are beneficial only if patients...
Numerous studies support Skylers point. For example, in an analysis of claims data, Lau et al reported that patients nonadherent to oral diabetes medications in 2000 were at higher risk of hospitalization in 2001 (odds ratio [OR], 2.53; 95% CI, 1.38-4.64).18 In a systematic review, 7 of 8 studies (87.5%) that evaluated hospitalization with respect to diabetes medication adherence showed a statistically significant association between higher levels of adherence and decreased hospitalizations. In fact, patients with ,80% adherence may be at more than twice the risk for being hospitalized for a diabetes- or cardiovascular-disease-related event (OR, 2.53; 95% CI, 1.38-4.64); however, patients with ≥80% adherence ratios may be at a 29% decreased risk of hospitalization for any cause (OR, 0.71; 95% CI, 0.51-0.98) when adjusting for disease severity, demographics, and comorbidities.19 A retrospective cohort study of patients in the Kaiser Permanente of Colorado diabetes registry determined that ...
Electronic monitoring to measure medication adherence by patients with glaucoma documented that a sizable number of patients did not regularly use the eye drops prescribed to them.
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