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Results for “Medication Adherence”

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At least 145 records · Page 8Linked to original sources

PubMed2005

Gender differences among HIV-positive methadone maintenance patients enrolled in a medication adherence trial.

This study examined baseline gender differences among HIV-positive methadone maintenance outpatients currently prescribed antiretroviral medications. Participants were enrolled in a larger clinical trial, which included a 4-week observation period using electronic monitors to track medication adherence. Contrary to previous literature, no significant differences were detected between men (n = 42) and women (n = 36) on medication adherence or depression. Both groups showed remarkably poor adherence during baseline (M = 56% of doses taken on time), high overall prevalence of depression (47%) and illicit cocaine use (47%). Women reported significantly more medication side effects (M = 21.4 vs. 14.9), higher severity of ASI psychiatric problems (M = 0.50 vs. 0.40), and lower SF-36 health-related quality of life in physical (M = 42.1 vs. 63.3) and emotional functioning (M = 26.9 vs. 58.9) than men. Women tested positive for opioids at higher rates than men (53% vs. 29%, respectively), whereas men were more likely to be positive for benzodiazepines than women (26% vs. 6%, respectively). Findings suggest that gender differences between male and female methadone maintenance patients have relevance to treatment providers. Extensive assessment, specialized medical care and mental health services may be warranted in the treatment of HIV-positive female drug abusers.

Adult↗

PubMed2005

Using outpatient prescription claims to evaluate medication adherence in an acute myocardial infarction population.

We have previously shown that using computerized alerts and academic detailing results in significant improvement in physician adherence to secondary prevention guidelines for acute myocardial infarction. However, information about patient medication adherence after hospital discharge was not previously available. Using electronic outpatient prescription claims data, medication adherence for a coronary artery disease population is described.

Ambulatory Care↗

PubMed2004

Electronic monitoring and counseling to improve medication adherence.

Electronic caps, pill caps that record the date and time of pill bottle opening provide an objective measure of adherence to prescribed medication. A promising intervention to improve adherence, cue-dose training, involves reviewing patients' pill cap-generated reports concerning their medication-taking and offering individualized recommendations for remembering to take medications at specific times of day. In this preliminary study, 79 patients prescribed the antihyperglycemic medication metformin had adherence assessed during a 4-week baseline period. Adherence, defined as proportion of prescribed doses taken within a predetermined 4-h window, was measured using electronic MEMS caps. Those who had less than 80% baseline adherence (n = 33) were randomly assigned to either receive 4 months of cue-dose training (n = 16) or to a control group (n = 17). Cue-dose training was associated with significantly better adherence to metformin (mean improvement of 15%). The effects of cue-dose training on adherence to other antihyperglycemic medication did not reach statistical significance. Glycosylated hemoglobin (a measure of blood sugar control) did not differ between groups. Data from nine patients who reviewed pill cap-generated data with their primary care providers suggested that both patients and providers found the discussion moderately helpful and not at all uncomfortable.

Cues↗

PubMed2006

Executive function, working memory, and medication adherence among older adults.

The purpose of this study was to investigate the association between cognitive processes and medication adherence among community-dwelling older adults. Ninety-five participants (M = 78 years) completed a battery of cognitive assessments including measures of executive function, working memory, cued recall, and recognition memory. Medication adherence was examined over 8 weeks for one prescribed medicine by use of an electronic medication-monitoring cap. In a simultaneous regression, the composite of executive function and working memory tasks was the only significant predictor (beta =.44, p <.01). Findings suggest that assessments of executive function and working memory can be used to identify community-dwelling older adults who may be at risk for failure to take medicines as prescribed.

Aged↗

PubMed2004

Identification of medication-adherence barriers and strategies to increase adherence in recipients of renal transplants.

One hundred randomly selected renal transplant centers (RTCs) were surveyed concerning barriers to medication adherence by recipents of renal transplants (RTRs). Responders were asked to list factors that they believe decrease RTRs' medication adherence. Survey responses were used to develop another survey, which was mailed to a different set of 100 RTCs. Barriers identified included issues concerning the particular medication prescribed, patient knowledge and comprehension concerning how to take the medication, patients' desire or motivation to take the medication, patient-health care professional relationship, and the ability of the caregiver to deliver optimum care. Barriers that received at least a 75% agreement were given to a multidisciplinary focus group, who developed strategies to circumvent the barriers. Strategies addressing barriers are discussed.

Adult↗

PubMed2006

Current world literature.

Explore the source record for details and available documents.

Animals↗

PubMed2026

A Standardized Nursing-Led Protocol Integrated Pain, Sleep, Medication Adherence, and Symptom Management in Postherpetic Neuralgia.

Postherpetic neuralgia (PHN) is a persistent neuropathic pain condition after herpes zoster that frequently coexists with sleep disturbance, medication-related problems, and fluctuating symptoms. This study evaluated whether a standardized nursing-led protocol could improve multidimensional short-term outcomes beyond usual care. In this prospective, parallel-group randomized controlled trial, 128 adults with PHN were allocated 1:1 to usual care or usual care plus an eight-week protocol integrating structured pain assessment, sleep monitoring, medication-adherence support, and rule-based digital symptom monitoring. The primary outcome was the between-group difference in change in Numeric Rating Scale (NRS) pain score from baseline to Week 8. Secondary outcomes included Pittsburgh Sleep Quality Index (PSQI), MMAS-8 medication adherence, symptom burden, pain-related nocturnal awakenings, breakthrough pain, rescue analgesic use, adverse events, rule-based alerts, and nursing satisfaction. Week-8 data were available for 116 participants (57 usual care; 59 protocol). Mean NRS scores decreased from 7.19 ± 1.08 to 4.82 ± 1.53 in the usual-care group and from 7.28 ± 1.05 to 3.24 ± 1.28 in the protocol group. An NRS reduction of at least 2 points occurred in 49.1% and 76.3% of participants, respectively. The protocol group also showed larger improvements in PSQI, MMAS-8, symptom burden, and nocturnal awakenings, with fewer breakthrough-pain episodes and less rescue-analgesic use. These findings support further evaluation of the standardized nursing-led protocol in preregistered multicenter trials with intention-to-treat analyses and longer follow-up.

Humans↗

PubMed2026

Mobile health apps improve Health-Related Quality of Life in Type 2 Diabetes Mellitus by enhancing medication adherence: A multicentre randomised controlled trial with mediation analysis.

AIMS: This study evaluated whether a gamified mHealth application (CareAide®) improves Health-Related Quality of Life (HRQoL) in Type 2 Diabetes Mellitus (T2DM) and whether this effect is mediated by medication adherence. METHODS: Prespecified secondary analysis of the T2DM cohort from a 6-month multicentre RCT (NCT06068309; N = 663; three Malaysian hospitals). Participants were randomised 1:1 to standard care or CareAide®. Adherence (MMAS-8), EQ-5D-5L utility (Malaysian value set), and AQoL-6D were assessed at baseline and 6 months. Simple mediation analysis (PROCESS Model 4; 5000 bootstraps) adjusted for baseline HRQoL. RESULTS: CareAide® significantly predicted higher MMAS-8 scores (mean difference +1.756; d = 1.638; p < 0.001). Higher MMAS-8 scores significantly predicted improved AQoL-6D utility (b = 0.024; p < 0.001). The direct effect on AQoL-6D was non-significant (p = 0.248). Bootstrapped indirect effect confirmed full mediation via AQoL-6D (0.042; 95% CI [0.024, 0.060]). A sensitivity analysis adjusting for baseline HbA1c confirmed full mediation (indirect = 0.034; 95% CI [0.015, 0.052]; n = 563). EQ-5D-5L utility showed a significant direct between-group difference at 6 months (p = 0.012) but did not operate as a mediation outcome. CONCLUSIONS: Medication adherence fully mediates the AQoL-6D HRQoL benefit of a gamified mHealth intervention in T2DM, as confirmed by both the primary and HbA1c-adjusted sensitivity analyses. These findings support integration of behaviourally informed digital adjuncts into routine primary diabetes care.

Humans↗

PubMed2006

HIV medication adherence. The intersection of biomedical, behavioral, and social science research and clinical practice.

The unique nature of the HIV/AIDS epidemic and the needs of people living with HIV disease have required the expertise of clinicians and biomedical, clinical, behavioral, and social scientists. The successes achieved in the past 25 years are the collective product of committed individuals from within all these disciplines. This is particularly true in HIV care and therapeutics and, specifically, in medication adherence, where biologic, clinical, behavioral, and social issues converge and each has been critically important in achieving the stunning therapeutic benefit for individuals and populations with HIV disease. There has been growing acceptance and success of interdisciplinary collaboration to address HIV medication adherence in the past 2 decades. Nevertheless, there remain real and perceived impediments obstructing collaboration among biomedical, behavioral, and social scientists and important differences between all these research domains and clinical practice. Differences in training and expertise, perceived mission, orientation, culture, and personal and professional skills can thwart meaningful collaboration or be used synergistically to move understanding and improvement of HIV medication adherence forward. This article explores these relations and differences from the perspective of an HIV clinician and clinical researcher with a background in biology and an inclination toward behavioral and social science and suggests some approaches for their resolution.

Anti-HIV Agents↗

PubMed2005

Oral medication adherence in pediatric inflammatory bowel disease.

The purpose of this study was to examine reports of adherence to oral medications, parent-child concordance in reports of adherence, and factors associated with poor adherence in adolescents with inflammatory bowel disease (IBD). Participants were 50 children with IBD 11 to 17 years of age and their parents. Parents completed an adherence interview and the Child Behavior Checklist, Family Assessment Device, and demographics questionnaires. Separately, adolescents completed the adherence interview and the Piers Harris Self-Concept Scale, Children's Depression Inventory, and Coping Strategies Inventory questionnaires. The treating gastroenterologists of participating children completed the Pediatric Crohn's Disease Activity Index during a clinic visit within a week of completion of the questionnaires. Mean parent- and child-reported adherence scores fell between the "most of the time" and "always" categories, although perfect adherence was low. Among IBD-specific medications (5-ASAs, immunomodulators, steroids), 48% of children and 38% of parents reported being always adherent to all medications. Parent-child concordance was high. Family dysfunction and poor child coping strategies were associated with worse adherence. The correlation between more behavioral/emotional problems and lower adherence approached significance. Adherence should be monitored in families that lack appropriate child discipline and in children who cope by simply wishing stressors would go away. Because these issues are associated with poor adherence, it has been suggested that psychotherapy addressing these areas may contribute to improved adherence.

Adaptation, Psychological↗

PubMed2005

Family asthma management routines: connections to medical adherence and quality of life.

OBJECTIVES: To develop a reliable measure of asthma management routines and examine its association with health care utilization, medical adherence, and quality of life. STUDY DESIGN: Families (n = 153) with a child with asthma, drawn from two sites, participated in the study. Parents completed the Asthma Routines Questionnaire, Adherence to Clinical Trials interview, Functional Severity of Asthma Questionnaire, and Caregiver Quality of Life. Children completed the Pediatric Quality of Life. Electronic monitoring of medication use over a period of 12 months was available for children at one study site. RESULTS: A principal component factor analysis revealed two dimensions to the Asthma Routines Questionnaire: Medication Routines and Routine Burden. Medication Routines were related to medical adherence and to health care utilization. Routine Burden was related to caregiver and child quality of life. CONCLUSIONS: The Asthma Routine Questionnaire holds promise as a reliable assessment of family practices related to medication use. The emotional burden of daily care can be distinguished from medication use, which is more closely linked to adherence issues. Targeted questions during regular care may reveal family routine practices amenable to intervention.

Anti-Asthmatic Agents↗

PubMedDate not supplied

Medication adherence: a key factor in effective management of rosacea.

Rosacea is a chronic condition associated with relapses. Unsuccessful treatment is predicated, in part, on suboptimal adherence with the medication regimen. Motivating long-term compliance remains a challenge. The literature on adherence with rosacea medication is scant, but data from other diseases suggest that a multifactorial approach combining nonpharmacologic and adherence-enhancing pharmacologic interventions appears to offer the greatest success. The variety of topical metronidazole formulations that are relatively well tolerated and convenient to administer has been a notable advance in rosacea management. The dermatologist, by emphasizing the importance of adherence with therapy, can do much to facilitate this most critical behavior.

Algorithms↗

PubMed2006

Medication adherence and persistence as the cornerstone of effective antihypertensive therapy.

Achieving optimal outcomes in the treatment of hypertension--a prevalent and largely asymptomatic disease--necessitates that patients take their medications not only properly (medication adherence) but also continue to do so throughout long-term treatment (persistence). However, poor medication-taking behavior is a major problem among patients with hypertension, and has been identified as one of the main causes of failure to achieve adequate control of blood pressure (BP). In turn, patients with hypertension who have uncontrolled BP as a result of their poor medication-taking behavior remain at risk for serious morbidity and mortality (eg, stroke, myocardial infarction, and kidney failure), thereby accounting for a significant cost burden through avoidable hospital admissions, premature deaths, work absenteeism, and reduced productivity. Improving medication-taking behavior during antihypertensive therapy therefore represents an important potential source of health and economic improvement. Whereas many factors may contribute to poor medication-taking behavior, the complexity of dosage regimens and the side effect profiles of drugs probably have the greatest therapy-related influence. Central to any strategy aimed at improving outcomes for patients with hypertension, therefore, are efficacious antihypertensive agents that facilitate good medication-taking behavior through simplified dosing and placebo-like tolerability, along with the development of programs to detect poor medication adherence and to support long-term medication persistence in daily practice.

Antihypertensive Agents↗

PubMed2006

Association of medication adherence with workplace productivity and health-related quality of life in patients with asthma.

OBJECTIVE: Examine the association of medication adherence with workplace productivity and health-related quality of life (HRQL) in asthma patients. METHODS: Adult patients with asthma in a state health insurance program identified from medical claims (July 2001-June 2003) were mailed a three-part survey to measure HRQL (St. George's Respiratory Questionnaire), workplace productivity (Workplace Productivity Short Inventory), and self-reported medication adherence (Morisky Scale). RESULTS: The symptoms domain had the worst HRQL scores, followed by the activity and impacts domains; 39% of the participants reported themselves as "high" adherent, whereas 19% were "medium," and 42% were "low" adherent. Asthma resulted in productivity losses of 597 +/- 1,024 US dollars (absenteeism) and 658 +/- 1,808 US dollars (presenteeism) per enrollee per year. CONCLUSIONS: Asthma was associated with HRQL detriments and workplace productivity losses.

Absenteeism↗

PubMedDate not supplied

Antihypertensive medication adherence and blood pressure control in patients with psychotic disorders compared to persons without psychiatric illness.

The authors compared antihypertensive medication adherence and blood pressure control among middle-aged and older outpatients with schizophrenia and related those with psychotic disorders versus persons without any psychiatric illness. A total of 178 subjects were included in the investigation (89 patients with a psychotic disorder and 89 randomly selected, age-matched comparison subjects). Although the two groups had similar antihypertensive medication adherence, the patients with a psychotic disorder were significantly less likely to have had controlled blood pressure during the 1-year study period. The results highlight the need for clinicians to monitor closely the management of medical comorbidity in patients with schizophrenia and related disorders.

Aged↗

PubMed2003

Role of ethnicity in predicting antipsychotic medication adherence.

BACKGROUND: Clinicians treating schizophrenia face increasingly diverse ethnic populations. Ethnic groups may have different approaches to the management of schizophrenia, which could impact antipsychotic medication adherence. OBJECTIVE: To examine the association between adherence and ethnicity or the specific medication used after controlling for other factors. METHODS: Texas Medicaid claims were retrieved for persons aged 21-65 years, diagnosed with schizophrenia or schizoaffective disorder, after initiating treatment with olanzapine (n = 1875), risperidone (n = 982), or haloperidol (n = 726) between January 1997 and August 1998. The association between ethnicity (African American, Mexican American, white) or medication and days' use of the medication in the year following initiation was assessed using multivariate linear regression. Covariates included other patient demographics, region, comorbid mental health conditions, and prior medication and healthcare resource use. RESULTS: African American and Mexican American patients were significantly less adherent than white patients (19 d less, p < 0.001 for African Americans; 18 d less, p = 0.003 for Mexican Americans). For patients of all ethnicities, olanzapine was associated with 23 more adherent days than risperidone and 55 more adherent days than haloperidol (p < 0.001 for each comparison). CONCLUSIONS: When other factors were controlled for, ethnicity was a significant predictor of medication adherence following initiation on an antipsychotic medication, and patients of all ethnicities were most adherent when taking olanzapine, less adherent when taking risperidone, and least adherent when taking haloperidol.

Adult↗

PubMed2003

Measurement, correlates, and health outcomes of medication adherence among seniors.

OBJECTIVE: To provide a comprehensive review of the literature on the measurement, correlates, and health outcomes of medication adherence among community-dwelling older adults. DATA SOURCES: Searches of MEDLINE, PubMed, and International Pharmaceutical Abstracts databases for English-language literature (1966-December 2002) were conducted using one or more of the following terms: elderly, adherence/nonadherence, compliance/noncompliance, medication/drug, methodology/measurement, and hospitalization. STUDY SELECTION AND DATA EXTRACTION: From the above search, studies of medication adherence in community-dwelling seniors were selected for review along with relevant publications from the reference lists of articles identified in the initial database search. DATA SYNTHESIS: Although several methods are available for the assessment of adherence, accurate measurement continues to be difficult. The available evidence suggests that polypharmacy and poor patient-healthcare provider relationships (including the use of multiple providers) may be major determinants of nonadherence among older persons, with the impact of most sociodemographic factors being negligible. There is little consensus regarding other determinants of nonadherence. Relatively few high-quality investigations have examined the associations between nonadherence and subsequent health outcomes. Available data provide some support for increased health risks with nonadherence. However, interventions to improve adherence have seldom demonstrated positive effects on health outcomes. CONCLUSIONS: There are few empirical data to support a simple systematic descriptor of the nonadherent patient. The inconsistencies across studies may be attributable, in part, to the inherent difficulties involved in the measurement of a behavioral risk factor such as nonadherence. Future research in this area would be strengthened by incorporation of detailed assessments of patient-reported reasons for nonadherence, the appropriateness of drug regimens, and the effect of nonadherence on health outcomes.

Activities of Daily Living↗

PubMed2007

Validity of a stage of change instrument in assessing medication adherence in indigent patients with HIV infection.

BACKGROUND: Adherence to antiretroviral therapy (ART) is vital to achieve durable suppression of viral replication. Effective mechanisms to predict adherence can be difficult to implement in clinical practice settings. Self-administered questionnaires are a practical option for assessing patient adherence but may lack validation with objective measures of adherence. OBJECTIVE: To examine the ability of a 2 item stage of change (SOC) questionnaire to predict medication adherence in indigent patients receiving ART. METHODS: Patients participating in an ongoing study to examine adherence interventions were administered a 2 item SOC instrument to assess readiness for adherence behavior. The SOC instrument was given to patients prior to beginning ART and readministered after they had received 16 weeks of treatment. Electronic monitoring was used to examine the validity of the SOC instrument to predict patient readiness for adherence behavior. RESULTS: Thirty-one patients completed the SOC questionnaire prior to beginning a new ART regimen. Most (87%) patients were male, had previously received antiretroviral therapy (77%), and had an AIDS diagnosis (77%). The SOC category determined at baseline was a poor predictor of adherence at 4 and 16 weeks; however, the SOC category determined after treatment onset (week 16) was a strong predictor of adherence at both time points (p < 0.001 for 4 and 16 weeks; one way ANOVA). CONCLUSIONS: The SOC category determined at baseline correlated poorly with subsequent medication adherence in our indigent, HIV-infected patient population. Prediction of adherence based on SOC after treatment initiation may provide a better estimate of adherence behavior. Recognition of this limitation may help clinicians more accurately interpret predicted adherence behavior from self-report instruments.

Adult↗