Purpose : To assess the feasibility of using automated text parsing to screen physician notes in the electronic health record (EHR) to identify glaucoma patients with poor medication compliance. Methods : For recruitment to a larger study assessing the impact of a glaucoma coaching program on medication adherence, we used an automated EHR pull to identify patients who received ophthalmic care at the University of Michigan, had a diagnosis of glaucoma, were ≥40 years old, and took ≥1 glaucoma medication. A manual chart review was performed to exclude those deceased, or with severe mental illness or cognitive impairment. A research associate called patients and, if interested, assessed their medication adherence with two validated instruments, the Chang Scale and the Morisky Medication Adherence Scale. In tandem, we used the Electronic Medical Record Search Engine (EMERSE), a text parsing tool that abstracts data from the text section of the EHR to search for the terms noncompliant and ...

This service works with community pharmacists, community services and social care to provide support and solutions for patients and their carers and is delivered in patients own homes where possible. Patients taking four or more prescribed medications are targeted, along with vulnerable patients, and vulnerable, hard to reach patients with long term conditions and complex high risk patients recently discharged from hospital.. The technician-based service delivers a comprehensive medication compliance review service for older people and people with multiple long-term conditions in the Nottingham City registered population.. A particular focus of the service are patients aged 65 and over who are within two weeks of discharge from hospital; elderly or housebound patients on four or more medications and adults with one or more long-term conditions identified as having specific compliance or concordance problems.. ...

The results of this study suggest that a daily intake of 120 mg NOPE and 105 mg of EGCG for 4-weeks, can enhance compliance to a low caloric diet, total mood score, feelings of fatigue, and confusion, but does not alter body mass or body fat to any greater magnitude than placebo. However, these benefits were not maintained by week 8 of the study, where only feelings of tension were reduced in comparison to placebo. These findings contrast with Rondanelli et al.,[17] in which sustained compliance and improvements in feelings of satiety, and severity of binge eating were observed for 8-weeks of study duration.. It is possible that the method used to determine dietary compliance may have contributed to the differences between the studies. In the present investigation, compliance was defined as the ability to maintain the recommended low caloric diet. Rondonelli and colleagues defined compliance in terms of drop-out rate[17]. This may not entirely capture compliance, as approximately 72% of the ...

Measurement of treatment compliance using a medical device for glaucoma patients associated with intraocular pressure control: a survey Jean-Philippe Nordmann1, Christophe Baudouin1, Jean-Paul Renard2, Philippe Denis3, Antoine Lafuma4, Caroline Laurendeau4, Viviane Jeanbat4, Gilles Berdeaux5,61Hôpital des Quinzes-Vingt, Paris, France; 2Hôpital du Val de Grâce, Paris, France; 3Hôpital Edouard Herriot, Lyon, France; 4Cemka, Bourg-la-Reine, France; 5Alcon France, Rueil-Malmaison, France; 6Conservatoire National des Arts et Métiers, Paris, FranceObjective: To identify and characterize treatment compliance profiles of glaucoma patients and evaluate the association with intraocular pressure (IOP).Methods: A computerized device (Travalert®) that recorded daily instillation times and eye-drop counts was given for 3 months. Patients were declared compliant when at least 2 drops were instilled per day. Compliance rates were calculated for weekdays and weekends, separately, over

A system and method for controlling patient access to an entertainment program to encourage a patient to comply with a treatment plan. The method includes the step of collecting compliance data from the patient. In one embodiment, the compliance data includes measurements of a physiological condition of the patient as well as patient answers to compliance questions. The method further includes the step of comparing the compliance data to evaluation criteria selected by a healthcare provider to determine if the patient is in compliance with the treatment plan. If the patient is in compliance, access is granted to the entertainment program. If the patient is not in compliance, access to the entertainment program is restricted. In the preferred embodiment, the method includes the additional steps of transmitting and displaying the patients compliance data and compliance status to the healthcare provider.

Results Between 1 January 2012 and 31 December 2014, a total of 6074 patients were treated for chlamydia and 425 for gonorrhoea in Estonia. Among all prescriptions, 48.6% were non-compliant with gonorrhoea treatment guidelines and 3.8% for chlamydia. Non-compliant antibiotic treatment for gonorrhoea was associated with patient gender (female (adjusted OR (AOR)) 3.0, 95% CI 1.6 to 5.9), region (east AOR 3.3, 95% CI 1.3 to 8.2; west AOR 6.5, 95% CI 2.2 to 19.7) and prescribing physician specialty (general healthcare doctors: AOR 5.6, 95% CI 2.3 to 13.8; gynaecologists: AOR 5.9, 95% CI 2.8 to 12.4). Non-compliant antibiotic treatment for chlamydia was associated with younger patient age (15-24 AOR 0.5, 95% CI 0.4 to 0.7), region (north AOR 1.9, 95% CI 1.4 to 2.6; west AOR 2.3, 95% CI 1.5 to 3.4) and multiple treatment episodes (AOR 2.7, 95% CI 2.1 to 3.9). Approximately 14% of prescriptions were multiple treatments for the same patient for the same infection over the 3-year period (6.1% for ...

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 ...

Physical activity reduces the risk for disease, improves overall health, and quality of life. Group exercise classes are large contributors for meeting physical activity recommendations. Improving long-term adherence to group exercise classes is essential in order to receive health and fitness benefits. Many contributing factors affect adherence rates including the role of the instructor. The instructor has great influence over the decision to return to a group exercise class. It is important to find out what qualities and characteristics are preferred among those who take classes to increase long-term adherence. Another important factor relating to adherence is body type, appearance and attractiveness of the instructor. These factors have been influential in other areas including performance enhancement consulting, counseling, teacher ratings, and willingness to accept health advice. However, little research has been done to determine if body type, appearance and attractiveness influence adherence to

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 ...

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.. ...

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.

TY - JOUR. T1 - Super learner analysis of electronic adherence data improves viral prediction and may provide strategies for selective HIV RNA monitoring. AU - Petersen, Maya L.. AU - LeDell, Erin. AU - Schwab, Joshua. AU - Sarovar, Varada. AU - Gross, Robert. AU - Reynolds, Nancy. AU - Haberer, Jessica E.. AU - Goggin, Kathy. AU - Golin, Carol. AU - Arnsten, Julia. AU - Rosen, Marc I.. AU - Remien, Robert H.. AU - Etoori, David. AU - Wilson, Ira B.. AU - Simoni, Jane M.. AU - Erlen, Judith A.. AU - Van Der Laan, Mark J.. AU - Liu, Honghu. AU - Bangsberg, David R.. PY - 2015/5/1. Y1 - 2015/5/1. N2 - Objective: Regular HIV RNA testing for all HIV-positive patients on antiretroviral therapy (ART) is expensive and has low yield since most tests are undetectable. Selective testing of those at higher risk of failure may improve efficiency. We investigated whether a novel analysis of adherence data could correctly classify virological failure and potentially inform a selective testing strategy. ...

A course of treatment with checkpoint inhibitors Yervoy (ipilimumab) and Opdivo (nivolumab) for patients with unresectable or metastatic melanoma is every 3 weeks for a total of four doses. Almost forty percent of patients receiving this combined regimen discontinue treatment because of immune-related adverse events. Toxicities that contribute to early discontinuation of the 4-dose combined checkpoint regimen include diarrhea, colitis, elevated liver enzymes. Systemic steroids are the most frequently used immunosuppressive therapy for the management of adverse events on checkpoint inhibitors. Limiting the course of therapy and administering immunosuppressive therapy to manage toxicities on combined checkpoint inhibition, however, could abrogate the desired anti-cancer effects.. Does discontinuation of combined checkpoint inhibition therapy negatively affect efficacy?. Researchers at Sloan Kettering performed a pooled analysis of patients participating in the Phase II CheckMate 069 and Phase III ...

A higher prescription co-payment, especially among older women, is associated with the early discontinuation and incomplete use of adjuvant aromatase inhibitor therapy, a life-saving therapy for women with hormone-sensitive, early-stage breast cancer, research shows.

Homework assignments that patient work with between sessions is a key component in both face-to-face and Internet-based Cognitive Behavior Therapy (CBT). However, adherence to assignments is often low and it is largely unclear what factors predict or affect treatment adherence, and in the end, treatment outcomes. The overall aim of this thesis was to investigate if treatment presentation and therapist support can affect adherence and treatment outcome in internet-based CBT, whether adherence can be predicted by motivation variables and to compare differences in face-to-face and online conditions in this regard.. A randomized controlled trial with a brief online relaxation program for people with stress and anxiety symptoms was conducted (n = 162). Participants in the enhanced support conditions completed a larger proportion of the online treatment but adherence was not affected by enhanced treatment presentation (Study I). Participants reported reduced symptoms of stress and anxiety after the ...

Angelina Juwita Wibowo1 , Herlyani Khosama2 , Junita Maja Pertiwi3. (2020). Living in Urban Areas, Low Education, Cognitive Function, and Medication Adherence Are Factors Related to Major Depression among Epilepsy Patients in Manado, Indonesia. Indian Journal of Public Health Research & Development, 11(10), 199-202. https://doi.org/10.37506/ijphrd. ...

Odds On Compliance has appointed former New Jersey Division of Gaming Enforcement Lab Chief, Eric Weiss, as its new Vice President of Technical Compliance.

In the present study, 10.6% patients did not comply to the treatment. Overall compliance rate was 89.4%. Alcaide Megias et al4 (1999) found compliance rate of 91.8%. Similarly, Smirnoff et al5 (1998) reported 85% overall compliance with DOTS treatment. Sunil Bhat et al6 (1998) reported adherence to treatment to the extent of 80%.. It is evident from the study that patients falling in 35-44 years age group are more non-compliant (25.4%) to the treatment followed by the patients aged above 45 years (18.1%) and the patients in age group 15-24 years were least (3.5%) non-compliant. Since 25.4% of these patients (35-44 years) were found to be non-complaint and the reason for this may be that in majority of these cases, patient was only economically active person in the family and hence could not spare time to visit DOTS clinic on a regular basis. Menzis D et al7 (1996) found that older subjects were less compliant.. The present study shows that non-compliance to treatment was equally prevalent among ...

Poor medication compliance in chronic diseases in a well-known public health problem. Pharmacists play a key role in optimizing medication use in patients with chronic conditions.

Novocure has announced results from a retrospective post-hoc analysis of its phase 3 pivotal EF-14 trial data showing that increased compliance with Optune predicted increased survival in glioblastoma (GBM) patients. Results were highlighted in an oral presentation at the 22nd Annual Meeting of the Society for Neuro-Oncology (SNO) in San Francisco.. The analysis showed that an Optune compliance threshold as low as 50 percent correlated with significantly improved outcomes in patients treated with Optune together with temozolomide compared to patients treated with temozolomide alone. The results also demonstrated that the greater patients compliance with Optune, the better their outcomes.. Patients who used Optune more than 90 percent of the time (n=43) had the greatest chance of survival: a median survival of 24.9 months from randomization and a five-year survival of 29.3 percent. The median time from diagnosis to randomization was 3.8 months for patients treated with Optune together with ...

The RFID system enables the hospital to know when discharged patients fail to comply with their prescription regimen, or when side effects occur. - Page 1

See the accompanying comic strip about Jake Gallant! Allow me to introduce you to Jake, a Gallant Asthmatic. After spending the day at his friends cabin, and as he was getting ready to go out and par

Discussion. The aim of this study was to identify the relevant characteristics that might have been associated with non-adherence to treatment, in a group of patients who presented poor adherence to HAART. During the time period of the study, 898 (64.4%) men and 497 (35.6%) women were treated at the HUPES outpatient clinic. It is noteworthy that more women (33 subjects, 70% of sample) showed poor adherence to HAART. This result is consistent with a study developed in Belo Horizonte, MG, that confirmed poorer adherence among women.23 Likewise, another multicentric study developed by the AIDS Clinical Trials Group in the United States, Puerto Rico and Italy24 reported women as having a greater risk of virologic failure due to poor adherence. Nevertheless, there are other recent studies that did not find a relationship between gender and levels of adherence.25,26 Moreover, a systematic review on differences of adherence according to gender found a marginally significant difference of lower ...

THOUSAND OAKS, Calif., March 23, 2011 /PRNewswire/ -- Treatment With Prolia® (denosumab) Associated With Significantly Greater Adherence, Compliance and...

Thats one of the questions raised by a new study on patient adherence rates by the nations top independent pharmacy organization. In its first National Report Card on Adherence, the National Community Pharmacists Association gives U.S. adults ages 40 and older only a so-so grade of C+ overall, and says 1-in-7 of those medication users rate an F. Millions of adults ages 40 and older with chronic conditions are departing from doctors instructions in taking their medications - skipping, missing or forgetting whether theyve taken doses, failing to fill or refill prescriptions, under- or over-dosing, or taking medication prescribed for a different condition or to a different person, NCPA reported.. Factors like the out-of-pocket cost of a prescription and the patients age - older patients tend to adhere more to their drug therapy than do younger ones - play a big part in adherence rates. And of course patients tend to skip their meds if they dont want to deal with the side effects, or if they ...

Objective: To assess medication adherence among patients with chronic diseases.. Methods: This was a prospective observational study carried out over period of one year in mysuru city. The subjects who meet study criteria were enrolled in this research study. The enrolled subjects were administered with simplified medication adherence questionnaire. The criteria to establish adherent and non-adherent were calculated as per simplified medication adherence questionnaire directions.. Results: The gender distribution of this research study was reflected with male accountable for 45.63 % followed by female 54.36%. Asper simplified medication adherence questionnaire88% were adherent and remaining 12% were non-adherent in this research study.. Conclusion: Patients with good adherence in this research study showed that they have good literacy status as well as better awareness about the existing medical condition and more consciousness may be there among these patients, what will be going to happen if ...

An Example of Defining Patient Compliance: 10.4018/978-1-61520-723-7.ch009: This case examines the issue of compliance by patients at the University of Louisville School of Dentistry (ULSD). The focus is defining compliance and

We assessed the validity of TEXAS to record COPD exacerbations in prospective clinical studies, and compared its detection rate, compliance and patient preference with conventional recording methods (weekly paper diary cards and medical record review). The validity of TEXAS was high, independent of the exacerbation definition used. Detection rates and patients compliance in providing exacerbation-related information differed significantly between the recording strategies, but were highest with TEXAS. Patient preference did not differ significantly between TEXAS and the paper diary cards.. When assessing the validity of any instrument, deciding on the gold standard (i.e. the generally accepted method to measure the outcome) is crucial [27]. TEXAS was developed to record exacerbations based on common definition criteria, such as symptom changes or events [8]. Consequently, we used as our gold standard the information on worsening of symptoms, use of oral medication and/or use of healthcare ...

Stream of alert notifications. The case of Cameron Washington, 31, shows that troubling issues existed with the system.. Washington now is charged with raping two women - one while armed with a gun, the other while armed with a knife - and the attempted rape of another woman in November while enrolled in the intensive-supervision program.. His electronic monitor generated a steady, ongoing stream of alert notifications following his release from prison after serving a sentence for attempted burglary and trespassing. The day he was hooked up to his electronic monitor in September, he disappeared from his motel. Officials, for the most part, responded by continually calling the motels front desk - more than 70 telephone calls in all - even after they confirmed he was no longer staying there.. More than a month after he left the motel, officials noted he needed a new electronic monitor since the state was switching vendors, but they didnt know where he was. Nothing in the parole documents the ...

For a range of chronic immune-mediated inflammatory diseases, patients beliefs and concerns can influence how well they adhere to drug therapy, new research shows.

While the majority of patients may benefit from physical therapy, less than 15% on average are given prescriptions for PT, noted Oberlander. Many ignore their injury until it becomes debilitating or rely on medications to alleviate pain. In some cases, patients would actually prefer to undergo surgery to relieve their suffering.. To learn more about how telerehab works, view this short video: http://bit.ly/2DaNfdp. Oberlander explained that two primary reasons people dont seek physical therapy are cost and convenience.. In my sports medicine practice I saw a significant gap with conventional rehabilitation, he noted. Patients were paying more, not completing their PT treatment plans and were relying more on pain medicines.. Oberlander said that reduction in reimbursements have pushed the burden of paying for physical therapy to the patient. Out-of-pocket costs today can range between $60 to $175 per session. Additionally, work, family life and other life pressures have also infringed on ...

The VT was not perfectly delivered in the normal condition by 3 ventilators: Hamilton T1, Medumat, and Osiris 3. All the others had a , 5% average VT error. But the Hamilton T1 was unable to deliver an accurate VT of 300 mL in the low compliance and resistance condition, although the manufacturer claims that it can be used for pediatric patients. The delivered VT was too high (430 mL instead of 300 mL). Pediatric patients usually have high compliance and need low VT (, 300 mL).. With VT preset at 6 mL/kg of predicted body weight, a 17% VT error represents an error of 1 mL/kg.9 Thus, the VT error range can be 1-3 mL/kg with the ventilators we tested. The clinical implication of this finding is unclear. In ARDS patients, for example, setting an accurate VT is crucial, to avoid alveolar damage, despite the most recent studies on VT in ARDS that found no mortality difference between 7 mL/kg and 10 mL/kg.10-12 Clearly, transport ventilators are not designed or usually used to ventilate patients with ...

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.. ...

In this large diverse cohort with structured follow-up for hypertension at clinics that received audit and feedback similar to current best practices for chronic disease management [23, 24], we found that clinical and demographic participant characteristics remained associated with both visit and medication adherence. While these associations are not large enough to aid clinical decision-making for individual patients, they could significantly affect reimbursement in systems that reward improved adherence. Similarly, these differences could have important implications for designing and powering RCTs. Moreover, while clinic characteristics impact both medication and visit adherence, the ability of larger, more structured clinics (e.g., VAMC, university, or group practices) to achieve better visit adherence did not translate into improved medication adherence. Indeed, better visit adherence was not associated with improved medication adherence at the participant level, suggesting that closer ...

This resource discusses how neurological complications of progressive HIV-1 infection remain a common cause of morbidity even during widespread use of antiretroviral therapy (ART). It addresses how long-term resistance to ART, drug compliance, untoward drug side effects, a myriad of opportunistic infection, depression and other psychiatric disease manifestations, concomitant drug abuse, neuropathies, and an inability to clear viral reservoirs, explain, in large measure, disease progression and immune deterioration. It then covers the association with a number of psychiatric, muscle, nerve, infectious, as well as cognitive, behavioral, and motor disturbances seen in infected people, with a focus on the neurological complications, molecular and viral disease processes, cellular factors influencing viral replication therapeutic challenges, and the changing epidemiological patterns of disease. Less ...

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 ...

South Africa has the highest HIV prevalence and supports the largest antiretroviral therapy (ART) programme globally. With the introduction of a test and treat policy, ensuring long term optimal adherence to ART (≥95%) is essential for successful patient and public health outcomes. The aim of this study was to assess long-term ART adherence to inform best practices for chronic HIV care. Long-term ART adherence was retrospectively analysed over a median duration of 5 years (interquartile range [IQR]: 5.3-6.5) in patients initially enrolled in a randomised controlled trial assessing tuberculosis and HIV treatment integration and subsequently followed post-trial in an observational cohort study in Durban, South Africa. The association between baseline patient characteristics and adherence over time was estimated using generalized estimating equations (GEE). Adherence was assessed using pharmacy pill counts conducted at each study visit and compared to 6 monthly viral load measurements. A Kaplan Meier

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.. ...

Patients’ compliance with different administration routes for allergen immunotherapy in Germany Anne-Marie Egert-Schmidt, Jan-Marcel Kolbe, Sabine Mussler, Susanne Thum-Oltmer Allergopharma GmbH & Co. KG, Reinbek, Germany Background: Allergen immunotherapy (AIT) is the practice of administering gradually increasing quantities of an allergen extract to an allergic subject to ameliorate the symptoms associated with the subsequent exposure to the causative allergen. It is the only treatment that may alter the natural course of allergic diseases. According to AIT guidelines and summary of product characteristics (SmPCs), the treatment should be carried out for at least 3 years. It is controversially discussed whether subcutaneous or sublingual administration routes cause higher patients’ compliance.Methods: German sales data for different preparations of the allergen manufacturer Allergopharma GmbH & Co. KG were retrospectively evaluated for 5 consecutive years, based on

The players with high compliance completed twice as many injury prevention sessions as the players with intermediate compliance (1.5 vs 0.7 sessions per week). Interestingly, the preventive effect of The 11+ therefore increased with the rate of use, at least when conducted more than 1.5 times per week on average. No studies have similarly compared the risk of injury in players and teams with high, intermediate and low compliance with an intervention to prevent injuries. However, similar indications of exposure-response relationships have been found previously.28 Furthermore, a post hoc analysis showed that compared with the controls,33 players with high compliance experienced a 45% reduction in the overall risk of injury (data not shown), that is, an even greater effect than when compared with intervention players with intermediate and low compliance.. Overall, the intervention players completed 0.8 injury prevention sessions each week on average, less than the recommendation of at least two ...

Medication non-adherence has a significant impact on patients morbidity and mortality. Behavioral interventions have been developed to improve medication adherence. Adherence research requires an understanding about the best methodology to conduct studies especially when assessing interventions. Adherence studies include various designs such as: randomized controlled clinical trials, observational, and quasi-experimental studies. The Medication Adherence and Persistence Special Interest Group will develop good research practice recommendations for the conduct of medication adherence and treatment persistence research studies and will provide insight, through systematic reviews of the medication adherence literature, on interventions that improve medication adherence.. ...

Ensuring adherence to chemotherapy is important to prevent disease progression, prolong survival and sustain good quality of life. Capecitabine is a complex chemotherapeutic agent with many side effects that might affect patient adherence to treatment. This cross sectional study aimed to determine adherence to capecitabine and its contributing factors among cancer outpatients in Malaysia. One hundred and thirteen patients on single regime capecitabine were recruited from Hospital Sultan Ismail and Hospital Kuala Lumpur from October 2013 to March 2014. Adherence was determined based on adherence score using validated Medication Compliance Questionnaire. Patient socio-demographics, disease, and treatment characteristics were obtained from medical records. Satisfaction score was measured using the validated Patient Satisfaction with Healthcare questionnaire. The mean adherence score was 96.1% (standard deviation: 3.29%). The significant contributing factors of adherence to capecitabine were Malay ...

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.. ...

Written prescriptions of physical activity have increased in popularity. Such schemes have mostly been evaluated in terms of efficacy in clinical trials. This study reports on a physical activity prescription referral scheme implemented in routine primary health care (PHC) in Sweden. The aim of this study was to evaluate patients self-reported adherence to physical activity prescriptions at 3 and 12 months and to analyse different characteristics associated with adherence to these prescriptions. Prospective prescription data were obtained for the general population in 37 of 42 PHC centres in Östergötland County, during 2004. The study population consisted of 3300. The average adherence rate to the prescribed activity was 56% at 3 months and 50% at 12 months. In the multiple logistic regression models, higher adherence was associated with higher activity level at baseline and with prescriptions including home-based activities. Prescription from ordinary PHC staff yielded adherence in half of the

Results 32 patients (17 males) participated; 4 withdrew. 28 have 3-month follow-up data and, 24 have 6-month data. Average (SD) age 66.6 years, (8.3), BMI 31.8 Kg/m2 (6.7), HbA1c 7.5% (1.4%), ESS 7.9 (4.6), ODI 20.9 (14.8) and AHI 19.0(14.5). CPAP compliance was averaged over the 6 months and a median split into high and low compliers performed (, and ,2.5 h/n). At 3 months VA improved significantly in both high (p=0.009) and low compliers (p=0.001). This was only sustained at 6 months in high compliers, p=0.004. (Low compliers p=0.52). There was no significant reduction in macular oedema at either 3 or n. ...

The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format. By default, clicking on the export buttons will result in a download of the allowed maximum amount of items. To select a subset of the search results, click Selective Export button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export. After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format. ...

Treatment regimens for conditions such as hypertension and Type II diabetes require strict adherence to medical instructions. Yet, adherence among patients living with chronic medical conditions attending public health clinics is typically low. The present study sought to determine the extent to which the Theory of Planned Behaviour (TPB) was able to significantly explain variance in adherence intentions and behaviour in a sample of 117 formerly disadvantaged South Africans living with diabetes and hypertension in the Western Cape. The results showed that the linear combination of TPB variables - Attitudes, Perceived behavioural control, and Subjective norms - was able to account for 47 per cent of the variance in adherence intentions and 23 per cent of the variance in self-reported adherence behaviour. The addition of the variables Psychological distress and Social support to the two regression models, hypothesised to add predictive power to the TPB, yielded non-significant results. The ...

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 ...

Improved BP control that could result in measurable improvement in cardiovascular morbidity and mortality is a well studied outcome in the treatment of OSA patients with CPAP. At the same time, lack of compliance and adherence to prolonged use of CPAP over the course of the night is a real world problem. This study importantly shows the relevance of CPAP use and its impact on lowering BP despite only a modest adherence level, which is consistent with real world practices. On the contrary, supplemental oxygen use that had greater compliance was not associated with any beneficial BP reduction, thus challenging the earlier mechanistic studies and raising several questions regarding the alternative pathways (intrathoracic pressure changes, hypercapnia, and arousal) involved in the interaction between OSA and hypertension control. Greater nightly BP reduction despite a lower adherence level begs the question whether some CPAP use is better than no CPAP use, particularly in patients with poor ...

Patient adherence (sometimes referred to as patient compliance) is the extent to which a patients health behavior corresponds with the agreed-upon recommendations of the healthcare provider. The term patient compliance is generally synonymous with adherence but suggests that the patient played a more passive role in the healthcare professionals prescription of treatment, whereas the term adherence suggests that the patient and healthcare professional have come to an agreement on the regimen through a collaborative, shared decision-making process. Another term related to the concept of adherence is persistence (i.e., taking a medication for the recommended duration). Some patients are purposefully or intentionally nonadherent, whereas others are unintentionally nonadherent due to forgetfulness or poor understanding of the regimen. Patients may be intentionally nonadherent because of a belief that the costs of the regimen outweigh the benefits, for example. Nonadherence behaviors in medication-taking

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 ...

Strategies to Achieve Treatment Goals. Selection of Initial Combination Regimen. Several ARV regimens are recommended for use in ART-naive patients (see What to Start). Most of the recommended regimens have comparable efficacy but vary in pill burden, potential for drug interactions and/or side effects, and propensity to select for resistance mutations if ART adherence is suboptimal. Regimens should be tailored for the individual patient to enhance adherence and support long-term treatment success. Considerations when selecting an ARV regimen for an individual patient include potential side effects, patient comorbidities, possible interactions with conconcomitant medications, results of pretreatment genotypic drug-resistance testing, and regimen convenience (see Table 7).. Improving Adherence. Suboptimal adherence may result in reduced treatment response. Incomplete adherence can result from complex medication regimens; patient-related factors, such as active substance abuse, depression, or the ...

Strategies to Achieve Treatment Goals. Selection of Initial Combination Regimen. Several ARV regimens are recommended for use in ART-naive patients (see What to Start). Most of the recommended regimens have comparable efficacy but vary in pill burden, potential for drug interactions and/or side effects, and propensity to select for resistance mutations if ART adherence is suboptimal. Regimens should be tailored for the individual patient to enhance adherence and support long-term treatment success. Considerations when selecting an ARV regimen for an individual patient include potential side effects, patient comorbidities, possible interactions with conconcomitant medications, results of pretreatment genotypic drug-resistance testing, and regimen convenience (see Table 7).. Improving Adherence. Suboptimal adherence may result in reduced treatment response. Incomplete adherence can result from complex medication regimens; patient-related factors, such as active substance abuse, depression, or the ...

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 ...

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 ...

In the work under this new grant, Zhous team will upgrade the system by incorporating synergistic antibiotics into a nano-sized liposome. A liposome is a spherical vesicle formed from two or more lipid bilayers. The benefits to using liposomes for inhalation therapy include controlled release of the drugs and minimized local irritation in the airways.. Clinical studies have shown that inhaling polymyxins may lead to local irritation. This irritation compromises patients compliance, often with patients quitting the therapy prematurely. Incorporating drugs into liposomes has shown to improve local side effects in the airways in some clinical studies.. Our research not only develops new inhalation therapies, but also examines the mechanism of drug-induced pulmonary side effects and tries to find out how liposomes protect the airways from such side effects. In addition, such platform may also be applied for the treatment of other lung infections including tuberculosis and viral lung infections by ...

Jason Miller, OD, shares some take-home points from his lecture, Anything New in the World of Contact Lenses. He tells AOC/EyetubeOD Editor-in-Chief Conni Koury that recent developments in lens technology can address digital eye strain. He offered tips on enhancing patients compliance and having success with daily-wear modalities.

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 ...

Because adherence to therapy is an integral part of the effective management of asthma, all international public health efforts to improve asthma outcomes should include educational strategies for both patients and health care providers that target the promotion of adherence. Regular adherence to ICS therapy is dependent on the patients acceptance that asthma is a chronic disease requiring preventive treatment. Patients must also feel that the prescribed therapy is effective in achieving the desired treatment goals and is safe for long-term use. Several studies have confirmed that the beliefs that patients hold about their asthma and the therapy prescribed for it are closely associated with the likelihood of adherence. When patients do not perceive that their asthma is chronic or that it requires preventive treatment, adherence with therapy is generally episodic.. Effective communication between patients and providers has been identified as having an important influence on patients adherence. ...

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 ...

At enrolment, half of the participants had become compliant after a brief talk by a pharmacist at the screening visit. Of the 236 patients who changed to being compliant, 14 of 117 (12%) died in the intervention group and 18 of 119 (15%) in the control group. Of the 206 who stayed non-compliant at enrolment, 11 of 102 (11%) died in the intervention group and 20 of 104 (19%) in the control group. Compliance was reassessed at the end of the two year study period in patients who survived. Fewer patients who were non-compliant at enrolment remained non-compliant at the end of the study in the intervention group than in the control group (7% (7 of 102) v 18% (19 of 104), P , 0.001). More patients who turned compliant at enrolment remained compliant in the intervention group than in the control group (81% (95 of 117) v 58% (69 of 119), P = 0.038).. Compared with the two year period before the screening visit, the increase in the use of healthcare resources was greater in the control group than in the ...

Patients with type 2 diabetes who take their oral medication only some of the time risk hospitalization. Using data from a managed care organization, researchers examined the link between nonadherence and subsequent hospitalization in 900 adult patients with type 2 diabetes. The results showed that, over a 12-month period, 28.9% of the patients were nonadherent to the antihyperglycemic regimen. The risk of hospitalization increased by >2-fold in patients with type 2 diabetes who had been nonadherent to their oral medications the year before. The investigators noted that hospitalization was a strong possibility even after considering the effect of other illnesses and the patients adherence to hypertension- and cholesterol-lowering medications. The study also showed that nonadherence to high blood pressure? and cholesterol-lowering medication, seen in 18.8% and 26.9% of the patients, respectively, was not significantly connected with an increased risk of hospitalization. (The findings were ...

A new research study out of Japan published in Psychiatry Research suggests that a schizophrenic patients attitude toward drug therapy is important to predict compliance and required intervention.. The study started from the well known fact that antipsychotic noncompliance is a major reason for relapse in outpatients with schizophrenia. The scientists reported that In a 2-year follow-up study, we used the Japanese version of the Rating of Medication Influences Scale (ROMI-J) to investigate the reasons for compliance and noncompliance in outpatients with schizophrenia,. As might also be predicted, All the outpatients were followed up for 2 years. At the initial interview, the most frequent reason for compliance was relapse prevention, while the most frequent reason for noncompliance was distressed by side effects.. Sixty-four outpatients who maintained compliance during the follow-up had higher ratings of fulfillment of life goals than their noncompliant counterparts.. The authors ...

It is well established that pharmacotherapy is fundamental to disease and symptom management. Adherence to medication regimens is therefore essential for improved patient health outcomes. In reality, however, many patients experience difficulty with medication taking resulting in suboptimal adherence. Given the consequences of this pervasive problem, non-adherence is increasingly recognized as one of the leading challenges that professionals face in contemporary health care. As health-care professionals, nurses have an important role in combating this problem. This paper therefore examines the literature surrounding medication adherence for the purposes of enhancing professional knowledge and practice in this area. Specifically, the impact of poor adherence from the patients, health-care professional and health-care system perspective is detailed to highlight the significance of this issue. The underlying philosophical attributes of adherence and the interchangeable concepts of compliance and ...

High pill burden may result in poor treatment adherence, which in turn leads to inadequate glycemic control. Long-term complications increase morbidity, pre-mortality, and the burden on health care services. Reasons for nonadherence are multifactorial and difficult to identify; they include age, information, perception, duration of disease, complexity of dosing regimen, polypharmacy, psychological factors, safety, tolerability, and cost (12). Some practical approaches to improve patients adherence to medications include reducing treatment complexity by using fixed-dose combination pills, implementing regimens involving less frequent dosing, and using medications that are associated with better efficacy and fewer adverse events (13).. The number of tablets taken each day by patients with type 2 diabetes has an impact on how they subjectively perceive their disease status. In this study, the perception of patients that a high number of pills made them feel sicker is consistent with the previously ...

TY - JOUR. T1 - Behavior change theory, content and delivery of interventions to enhance adherence in chronic respiratory disease: A systematic review. AU - McCullough, Amanda R. AU - Ryan, Crístín. AU - Macindoe, Christopher. AU - Yii, Nathan. AU - Bradley, Judy M. AU - ONeill, Brenda. AU - Elborn, J. Stuart. AU - Hughes, Carmel M. N1 - Compliant in UIR; evidence uploaded to other files and UIR dates added to PURE link. PY - 2016/7/1. Y1 - 2016/7/1. N2 - Background We sought to describe the theory used to design treatment adherence interventions, the content delivered, and the mode of delivery of these interventions in chronic respiratory disease.Methods We included randomized controlled trials of adherence interventions (compared to another intervention or control) in adults with chronic respiratory disease (8 databases searched; inception until March 2015). Two reviewers screened and extracted data: post-intervention adherence (measured objectively); behavior change theory, content ...

Compliant patients are all alike; every noncompliant patient is obstinate in his or her own way. Because of this, persuading patients to make good choices is ra

Women from Islamic and African cultures who have vaginal yeast infections may prefer oral drugs to vaginally inserted medications. Latin Americans expect

The HCP5 genetic marker was not a good predictor of quitting abacavir, perhaps because the study considered stopping abacavir for any reason, not just the hypersensitivity reaction, and because people in Switzerland started getting HLA-B*5701 screening before beginning abacavir during this period. For the other four drugs, hazard ratios adjusted for other risk factors found that genetic markers independently predicted stopping efavirenz (adjusted hazard ratio [aHR] 3.10, 95% confidence interval [CI] 1.48 to 6.46, P = 2.59 x 10(-3) and atazanavir (aHR 7.31, 95% CI 2.86 to 18.72, P = 3.30 x 10(-6)). There was a strong trend toward an independent effect of genetic markers on quitting tenofovir (aHR 2.30, 95% CI 0.99 to 5.31, P = 0.052) but not lopinavir (aHR 1.42, 95% CI 0.62 to 3.25, P = 0.41 ...

Read Risk Factors for Poor Compliance with Adjuvant S-1 Chemotherapy for Gastric Cancer: A Multicenter Retrospective Study, Annals of Surgical Oncology on DeepDyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips.

There has been quite a buzz since the Department of Justice announced last year that it had appointed a compliance counselor to aid prosecutors