Level Of Adherence Research Articles

Factors Influencing Adherence to Hazardous Waste Management Policy Frameworks among Health Workers in Private Hospitals in Nairobi County – Kenya

Purpose: This study, therefore, sought to investigate the factors influencing the adherence to hazardous waste management guidelines among healthcare workers in private hospitals in Nairobi County. The specific objectives of the study included; determining the level of adherence to proper HCWM practices among health workers, identifying the individual related factors that influence adherence to proper HCWM practices among health workers, and identifying the health facility-related (institutional) factors that influence adherence to proper HCWM practices in 4 selected hospitals in Nairobi County Kenya. From the population of 900 healthcare workers from 4 levels 4 facilities, random sampling was applied to identify the 90 respondents. Methodology: Data analysis and reporting was done using appropriate quantitative methods. Findings: The findings from this study show that the level of adherence to hazardous waste management policies among healthcare workers in private level four hospitals in Nairobi County is low. Despite the high level of awareness by the health workers on the important measures of collection, segregation, treatment, transportation and disposal of waste, the level of performance on the same is low. This is greatly attributable to negligence and unfavorable attitude towards healthcare waste management practices among healthcare workers. Unique contribution to theory, policy and practice: Based on the study findings, we would recommend the improvement of hazardous waste management efficiency.

Assessment of the Level of Adherence to Hazardous Waste Management Policy Frameworks among Health Workers in Private Hospitals in Nairobi County - Kenya

Purpose: This study, therefore, sought to assess the level of adherence to hazardous waste management guidelines among healthcare workers in private hospitals in Nairobi County. From the population of 900 healthcare workers from 4 levels 4 facilities, random sampling was applied to identify the 90 respondents. Methodology: Data analysis and reporting was done using appropriate quantitative methods. Findings: The findings from this study show that the level of adherence to hazardous waste management policies among healthcare workers in private level four hospitals in Nairobi County is low. Despite the high level of awareness by the health workers on the important measures of collection, segregation, treatment, transportation and disposal of waste, the level of performance on the same is low. This is greatly attributable to negligence and unfavorable attitude towards healthcare waste management practices among healthcare workers. Unique contribution to theory, policy and practice: Based on the study findings, we would recommend the improvement of adherence of hazardous waste management efficiency.

Institutional Factors Influencing Adherence to Hazardous Waste Management Policy Frameworks among Health Workers in Private Hospitals in Nairobi County – Kenya

Purpose: This study, therefore, sought to investigate the institutional factors influencing the adherence to hazardous waste management guidelines among healthcare workers in 4 selected hospitals in Nairobi County Kenya private hospitals in Nairobi County. From the population of 900 healthcare workers from 4 levels 4 facilities, random sampling was applied to identify the 90 respondents. Methodology: Data analysis and reporting was done using appropriate quantitative methods. Findings: The findings from this study show that the level of adherence to hazardous waste management policies among healthcare workers in private level four hospitals in Nairobi County is low. Despite the high level of awareness by the health workers on the important measures of collection, segregation, treatment, transportation and disposal of waste, the level of performance on the same is low. This is greatly attributable to negligence and unfavorable attitude towards healthcare waste management practices among healthcare workers. Unique contribution to theory, policy and practice: Based on the study findings, we would recommend the improvement of hazardous waste management efficiency.

Assessment of attitude and knowledge of infection control practices amongst UG dental students in Uttarakhand towards immunocompromised patients undergoing treatment - A questionnaire based study

This study aimed to assess the attitude and knowledge of infection control practices amongst undergraduate (UG) dental students in Uttarakhand towards immunocompromised patients undergoing dental treatment. The objective was to evaluate the level of awareness and adherence to infection control protocols among UG dental students in Uttarakhand and to identify any gaps in knowledge or attitude towards treating immunocompromised patients. A questionnaire-based survey was conducted, comprising questions related to infection control practices and attitudes towards treating immunocompromised patients. The survey was distributed to 300 UG dental students across multiple dental colleges in Uttarakhand. Data collected were analyzed using statistical methods to identify trends and assess knowledge levels. The results revealed varying levels of awareness and adherence to infection control practices among UG dental students. While a majority demonstrated adequate knowledge, there were notable gaps in understanding specific protocols related to treating immunocompromised patients. Additionally, attitudes towards such patients varied, with some students expressing hesitation or uncertainty in providing treatment. This study underscores the importance of ongoing education and training in infection control practices among dental students, particularly concerning the treatment of immunocompromised patients. Addressing knowledge gaps and fostering a positive attitude towards providing care for this vulnerable population is essential to ensure optimal patient outcomes and minimize the risk of infection transmission.

Assessment of Medication Adherence in Hypertensive Patients among Warangal Population

Background: Hypertension is the most common disease in India where 1 in 4 people suffering with it. In order to achieve the intended therapeutic outcomes, medication adherence is essential. Patients with hypertension must adhere to their disease by taking their prescriptions on time, following their diet, and making other lifestyle modifications. This study aims to assess medication adherence in Warangal population among hypertensive patients with comorbidities, social habits, medication use etc. Aims: The aim of the study is to assess the level of medication adherence and to investigate predictors of medication adherence and controlled hypertension in patients and to identify the factors enhancing medication adherence. The secondary aim is to describe the extent and type of medication used in patient population in Warangal. Study Design: An Observational, retrospective and cross - sectional study was employed to assess the predictors and level of medication adherence in hypertensive patients. Place and Duration of Study: Department of Cardiology, Sri Sri Cardiac Centre and Bhageerath Cardiac Care Centre, Hanamkonda, Warangal. The study was conducted from October 2022 to April 2023 for about a duration of 7 months. Methodology: This study includes 300 Hypertensive patients (Male - 169, Female 131) of age range between 20-90 years with various comorbidities like diabetes mellitus, coronary artery disease, hypothyroidism, dyslipidemia, COPD. We also included various sociodemographic factors like Gender, Age, Literacy, Income status, Alcohol consumption, Smoking status, Marital status, Controlled and Uncontrolled hypertension, usage of various drugs and Duration of hypertension. We observed Medication Adherence by using MMAS 8 scale. Results: Low levels of medication adherence among female patients (41%), educated patients (58%) compared to other groups because of awareness about their condition. Low adherence is noted in patients with low-income status ( 9.6% ), High adherence in nonsmokers (73.3%) and non-alcoholic (60.6%) compared to smokers (10.6%) and alcoholics (12.6%) and high adherence is reported in married (85%) category as compared to unmarried (2.6%), Patients with low comorbidities reported high adherence compared to patients with low comorbidities. High medication adherence is reported in uncontrolled blood pressure (50.3%) and in patients with \(\le\) year (24.6%) and 2-6 years (28%) of duration of hypertension. High adherence is noted with 2 combination therapy (23.6%), most of the participants are adherent to Telmisartan+ Metoprolol (25.2%) followed by Telmisartan+ hydrochlorothiazide (19.3%). According to MMAS-8 scale most of the patients reported (Q1) and (Q6), 91.3% of our study population were adherent to their medication, 7% were moderately adherent and 1.6% were low adherent to their medication. Conclusion: 91.3% of Medication adherence is noted in hypertensive patients in Warangal population. 8.6% of Medication Non-Adherence is noted and various factors for nonadherence were reported by patients. However various methods and apps should be developed to overcome the Medication Non-Adherence.

Adherence to COVID-19 preventive measures among residents in selected townships, Yangon Region, Myanmar: a community-based cross-sectional study

BackgroundTo fight the current coronavirus disease (COVID-19) pandemic, many countries have implemented various mitigation measures to contain the spread of the disease. By engaging with health service providers, the community’s participation in adherence to preventive measures is certainly required in the implementation of COVID-19 mitigation strategies. Therefore, this study aimed to assess the level of adherence to COVID-19 preventive measures and its associated factors among the residents, Yangon Region, Myanmar.MethodsA community-based cross-sectional study was carried out among 636 residents in Yangon Region, Myanmar, from October to December 2021. A multistage non-probability sampling method, purposively selected for three townships in Yangon Region and convenience sampling for 212 participants from each township, was applied and the data were collected by face-to-face interviews using structured and pretested questionnaires. Data were entered, coded, and analyzed using IBM SPSS version 25.0. Simple and multiple logistic regression analysis were performed to identify the significant variables of adherence to COVID-19 preventive measures.ResultsAs a level of adherence to COVID-19 preventive measures, the proportion of residents who had good adherence was 39.3% (95% CI 35.5–43.2%), moderate adherence was 37.6% (95% CI 33.8–41.5%), and poor adherence was 23.1% (95% CI 19.9–26.6%). The age group of 31–40 years (AOR: 3.13, 95% CI 1.62–6.05), 30 years and younger (AOR: 3.22, 95% CI 1.75–5.92), Burmese ethnicity (AOR: 2.52, 95% CI 1.44–4.39), own business (AOR: 3.19, 95% CI 1.15–8.87), high school education level and below (AOR: 1.64, 95% CI 1.02–2.69), less than 280.90 USD of monthly family income (AOR: 1.51, 95% CI 1.01–2.29), low knowledge about COVID-19 (AOR: 1.90, 95% CI 1.26–2.88) were significantly associated with poor adherence to COVID-19 preventive measures.ConclusionsIn this study, nearly one-fourth of the residents were experiencing poor adherence to COVID-19 preventive measures. Therefore, building up the risk communication through the community using widely used mainstream media, the continuation of disease surveillance and announcement of updated information or advice for the public to increase awareness towards COVID-19, and enforcement to follow the recommended directions and regulations of health institutions are vital to consider for improving the adherence to preventive measures against COVID-19 among the residents.

Assessment of Patients’ Information towards Diabetic Self-Management in Mosul City

Background: Diabetes self-management which includes a holistic lifestyle, medication adherence, and self-monitoring glucose levels, allows individuals with diabetes to maintain optimal, tailored glycemic control. The aims of the study to assess the patient’s information about diabetic self-management. Methodology: A study design that was descriptive was used in Al-Wafaa primary health care center for diabetes and endocrinology in Mosul city. Purposive sampling technique used to select (383) male and female patients with diabetic type II who aged 20 years or more. Data were collected through a face-to-face interview from period 20 November 2023 until February 15, 2024. The study used developed diabetic self-management scale to assess patients’ information. Results: the study found the patient’s information about diabetic self-management were good except the information about blood glucose monitoring was inadequate It appeared that most of the answers were mean rank (I don’t know), (9.25), followed by the correct answers (7.75) and finally the incorrect answers (2.5). Conclusion & recommendation: The researcher concluded that the patient’s information about diabetic self-management were good except the information about blood glucose monitoring was inadequate. Diabetic patients should be encouraged to understand diabetes self-management and adhere to all medical recommendations and guidelines from the doctor and health educator, especially adherence to treatment and self-monitoring of blood sugar.

Role of a National Health Service Electronic Prescriptions Database in the Detection of Prescribing and Dispensing Issues and Adherence Evaluation of Direct Oral Anticoagulants.

Anticoagulation therapy plays a crucial role in the management of atrial fibrillation (AF) by significantly reducing the risk of stroke. Direct oral anticoagulants (DOAC) became preferred over warfarin due to their superior safety and efficacy profile. Assessing adherence to anticoagulation therapy is necessary in clinical practice for optimising patient outcomes and treatment efficacy, thus emphasising its significance. A retrospective study utilised the Latvian National Health Service reimbursement prescriptions database, covering prescriptions for AF and flutter from January 2012 to December 2022. The proportion of days covered method was selected for adherence assessment, categorising it into three groups: (1) below 80%, (2) between 80% and 90%, and (3) above 90%. A total of 1,646,648 prescriptions were analysed. Dabigatran prescriptions started declining after 2020, coinciding with a decrease in warfarin prescriptions since 2018. The total adherence levels to DOAC therapy were 69.4%. Only 44.2% of users achieved an adherence level exceeding 80%. The rate of paper prescriptions decreased from 98.5% in 2017 to 1.3% in 2022. Additionally, the utilisation of international non-proprietary names reached 79.7% in 2022. Specifically, 16.7% of patients selected a single pharmacy, whereas 27.7% visited one or two pharmacies. Meanwhile, other patients obtained medicines from multiple pharmacies. The total adherence level to DOAC therapy is evaluated as low and there was no significant difference in age, gender, or "switcher" status among adherence groups. Physicians' prescribing habits have changed over a decade.

Leo program, a short multi-family skill-based psychoeducational program for caregivers of relatives living with a severe mental disorder: a retrospective pilot study.

Caring for a relative with a severe mental disorder (SMD) is associated with high levels of burden and poor physical and mental health. There is a dire need for family psychoeducational programs that can be provided as early as possible. This manuscript describes the pilot testing of "Leo" a motivational-based psychoeducational program for caregivers of individuals with a SMD. The Leo program aims to provide caregivers with skills to best support their relative and to adopt self-care behaviors. We retrospectively analyzed medical records of caregivers who enrolled in a short, multi-family, skill-based psychoeducational program, consisting of eight 3-hour sessions over 8 weeks. Outcomes of interest included: i) adherence to the program, ii) satisfaction and perceived usefulness, and iii) pre-post changes in self-reported levels of depression (CES-D), burden (ZBI), and skills (10 Likert-scaled items). A network analysis was used to investigate the relationships between pre-post changes in self-evaluated skills and pre-post changes in burden and depression levels. Over the 91 enrolled participants, 87 (95.6%) completed the program attending at least 5/8 sessions, 80.5% attending all sessions. Seventy-six caregivers fulfilled the questionnaires at baseline and after the program, and were included in the analysis. Although there was no evidence for significant change in self-reported depression levels (Cohen's d=0.19, p=0.210), burden scores and all evaluated skills were improved post-intervention, with medium to strong effect size (Cohen's ds from 0.47 to 0.87; p<0.001). Network output indicated that increased self-evaluated competence in 5 skills were associated with a global improvement in caregivers' burden and/or depression scores. Post-intervention, 89.7% of caregivers were "very satisfied" and 82.1% found the program "extremely useful". This pilot retrospective study shows high levels of satisfaction, perceived usefulness, and adherence to "Leo", a short, multi-family, skill-based psychoeducational program with promising results in improving caregivers' burden, self-evaluated competence in coping with caregiving demands and in self-care behaviors. This study provides preliminary insights into the mechanisms by which family psychoeducation might alleviate burden of care. A larger-scaled, controlled, randomized study with follow-up assessments is warranted to determine how burden, depression, and skills, as well as their inter-relationships, evolve over time.

Characterization of CKD illness representation profiles using patient-level factors.

Illness perceptions are the unique perspective individuals have on their illness, based on their context and experiences, and are associated with patient outcomes including coping and adherence. The purpose of this study was to explore characteristics that may be driving membership in illness perceptions cluster groups for adults with chronic kidney disease (CKD). This study was conducted within the multicenter longitudinal Chronic Renal Insufficiency Cohort (CRIC) Study. Cross-sectional data were collected and combined with CRIC data. Illness perceptions were measured using the Revised Illness Perception Questionnaire. Clustering analysis was conducted in R, and bivariate analysis including linear regression was performed in STATA 16. The sample (n = 197) had a mean age of 68, was 52% women, 53% non-White, and mean estimated glomerular filtration rate (eGFR) 56 ml/min/1.73 m2. Three cluster groups were identified, labeled as "Disengaged" (n = 20), "Well-Resourced" (n = 108), and "Distressed" (n = 69). The "Disengaged" group was characterized by low CKD knowledge, many recent hospitalization days, and the lowest perceived CKD burden. The "Well-Resourced" group was characterized by the highest levels of education, CKD knowledge, optimism, and medication adherence. The "Distressed" group was characterized by the highest levels of depression scores, comorbidity burden, CKD burden, CKD symptoms, and lowest optimism. Group membership significantly predicted the number of hospitalization days in adjusted analyses. Illness perceptions groups are associated with number of hospitalization days but are independent of many patient characteristics. Illness perceptions data could be used to tailor care for specific patients at risk for poor health outcomes.

Remote monitoring of the course of bronchial asthma in children

Aim: to evaluate the eff ectiveness and satisfaction of patients with bronchial asthma (BA) using the remote monitoring software product “ASTMATEST”. Materials and methods. A specialized website “ASTMATEST” — ww.asthmatest.ru was developed for conducting remote and timely telemonitoring of the health status of patients with verifi ed BA. An open prospective comparative study was conducted at the pediatric department of the City Children’s Clinical Hospital in Ufa from November 2022 till April 2023. The study included 2 groups of patients, similar in age and demographic indicators: the main group consisted of 38 (57.8 %) children whose parents agreed to use the information system of the website “ASTMATEST” in combination with its traditional methods, the control group included 34 (43.2 %) children whose parents refused to use the software product due to various reasons. The effectiveness of remote monitoring was analyzed by comparing the morning and evening peak flow meter readings, symptom control report data. Satisfaction with the work and use of the remote monitoring technology of the website “ASTMATEST” by patients with BA and their parents was assessed through a sociological survey using questionnaires. Results. In the main study group, the proportion of patients with severe BA decreased to 18.42 % due to an increase in the proportion of patients with mild (up to 34.21 %) and moderate (47.37 %) severity of BA. In the control group, the proportion of patients with mild BA decreased to 40.74 %, due to an increase in the proportion of patients with moderate (up to 44.44 %) and severe (14.82 %) severity. Conclusion. During the survey of patients in the main group using a specially designed questionnaire, it was found that the majority of patients and their parents/legal representatives are willing to continue using the developed software product to assess the level of disease control and adherence to doctor’s recommendations and prescriptions.

Adherence to Antipsychotics among Patients with Schizophrenia at Selected Tertiary Level Hospitals

Background: Schizophrenia is a severe mental disorder where nonadherence is present in patients so that relapse, rehospitalization and treatment resistant can occur. Objectives: To identify the level of adherence to antipsychotics among patients with schizophrenia and to find its association with socio-demographic variables. Materials and method: A descriptive, cross-sectional study design was used for the study. 422 samples were collected using the purposive sampling technique Data was collected by the face-to-face interview technique during March, April, and May 2023. Questionnaire related to Socio-demographic information, standard valid tool Drug Attitude Inventory (DAI-10) was used as instrument. Data were analyzed using descriptive and inferential statistics with SPSS version 20. Results: The mean age of the respondents was 41.02, ±12.77. More than half52 (12.3%) of respondents were taking antipsychotics for more than 15 years. Majority of respondents 342 (81.0%) were taking atypical types of antipsychotics. Only 220 (52.1%) of respondents has moderate level of adherence towards antipsychotic medicine. Significant association was found between duration of illness and adherence level where p=0.006. There is mean difference found p=&lt;0.001 from nonadherent group to moderate adherent and adherent group and from moderate adherent-to-adherent group. Conclusion: Nonadherence was found important factor low Quality of life among schizophrenia patient. Implementation of community mental health program is necessary to reduce treatment gap and decrease nonadherence. It is essential to improve adherence on antipsychotic for better quality of life among schizophrenia patient.

Understanding Knowledge and Behaviors Related To the Covid-19 Epidemic in Medical Students in Morocco

Introduction: The coronavirus (COVID-19) pandemic is accompanied with increasing morbidity and mortality and has impacted the lives of people worldwide. Health care personnel including medical school students are at high risk of exposure and transmission of the coronavirus. Our aim is to study the knowledge and behavior of medical students in Morocco towards COVID-19 to have protection for themselves, their work colleagues. Methods: Cross-sectional and descriptive-analytical study in November 2021 among medical students, conducted by a self-administered questionnaire, stratified sampling on years of study was performed. Results: 300 students responded with a 75% response rate, with a mean age of 21.3 ± 1.4 years. The majority 189 (63%) were female, about 207(69 %) of the respondents had good knowledge (GK) and 174 (60%) had good behaviors (GB) using a point varying of 8 to 10 out of 10 and using a point varying of 40 to 60 out of 60 in each case. To combat the COVID-19 pandemic, 76.7% of the study participants improved their regular hand washing, and 94.7% of them used a face mask since the outbreak; There was a significant difference between hand washing with soap and water and COVID infection (p value = 0.002). The prevalence of anti-coronavirus vaccination was 87.7% (95 % CI 83.4, 90.9). Conclusion: Medical students showed a satisfactory level of knowledge and adherence to the recommendations for protection against COVID-19 and they must also be prepared with medical awareness, an appropriate attitude and good precautionary measures In the event of an emergency

Feasibility of a Telephone-Delivered Group Meditation Intervention for Chronically Ill Socially Isolated Older Adults

ABSTRACT Objectives This pilot study assessed the feasibility of a group-based telephone-delivered meditation intervention to reduce social isolation in older adults. It included weekly training sessions and daily practices of loving-kindness meditation in small groups via telephone conferences for six weeks and an extended group meditation practice for another six weeks. Methods Community-living older adults (age 60+) with multiple chronic conditions and experiencing social isolation were recruited. Each participant was assessed at the pretest, posttest, and follow-up (6 and 12 weeks after pretest). Outcome measures included social interaction, loneliness, and depressive symptoms. Open-ended questions were asked in the posttest and follow-up. Results Sixteen individuals enrolled, and fourteen completed the program (87.5% retention). Completers showed high levels of adherence (95% attendance to training) and acceptability and a statistically significant increase in social interaction at follow-up. Qualitative data suggest that participants experienced changes in emotion regulation, motivation and confidence, and sense of belonging. Conclusions A group-based telephone-delivered meditation intervention targeting chronically ill older adults who experience social isolation is technically feasible, very acceptable, and potentially beneficial to them. Clinical Implications Older adults enjoy learning meditation. Telephone conferencing is a low-cost tool for engaging socially isolated older adults in social interactions and group meditation.

Assessment of Wearable Device Adherence for Monitoring Physical Activity in Older Adults: Pilot Cohort Study.

Physical activity has emerged as a modifiable behavioral factor to improve cognitive function. However, research on adherence to remote monitoring of physical activity in older adults is limited. This study aimed to assess adherence to remote monitoring of physical activity in older adults within a pilot cohort from objective user data, providing insights for the scalability of such monitoring approaches in larger, more comprehensive future studies. This study included 22 participants from the Boston University Alzheimer's Disease Research Center Clinical Core. These participants opted into wearing the Verisense watch as part of their everyday routine during 14-day intervals every 3 months. Eighteen continuous physical activity measures were assessed. Adherence was quantified daily and cumulatively across the follow-up period. The coefficient of variation was used as a key metric to assess data consistency across participants over multiple days. Day-to-day variability was estimated by calculating intraclass correlation coefficients using a 2-way random-effects model for the baseline, second, and third days. Adherence to the study on a daily basis outperformed cumulative adherence levels. The median proportion of adherence days (wearing time surpassed 90% of the day) stood at 92.1%, with an IQR spanning from 86.9% to 98.4%. However, at the cumulative level, 32% (7/22) of participants in this study exhibited lower adherence, with the device worn on fewer than 4 days within the requested initial 14-day period. Five physical activity measures have high variability for some participants. Consistent activity data for 4 physical activity measures might be attainable with just a 3-day period of device use. This study revealed that while older adults generally showed high daily adherence to the wearable device, consistent usage across consecutive days proved difficult. These findings underline the effectiveness of wearables in monitoring physical activity in older populations and emphasize the ongoing necessity to simplify usage protocols and enhance user engagement to guarantee the collection of precise and comprehensive data.

Treatment adherence among patients with pulmonary tuberculosis in Jolo

This study assessed the level of treatment adherence among pulmonary tuberculosis patients at the Rural Health Unit-Jolo in terms of disease awareness, health care support, and family support. With 33 samples taken through non-probability sampling method via purposive sampling, and with the use of weighted mean, standard deviation, t-test for independent samples, One-way ANOVA, and Pearson’s r, this study reveals the following findings:1) Of the 100 respondents, mostly are male, married within the age range of 30 years old &amp; below, and with high school of education; 2) On the average, patients at Rural Health Unit-Jolo are perceived to have moderate adherence to treatment of Pulmonary Tuberculosis; 3) Generally, unlike age and civil status, variables such as gender and educational attainment do not significantly mediate in ways how respondents assessed the levels of treatment adherence of Pulmonary Tuberculosis patient at Rural Health Unit-Jolo; 4) Generally, the group of respondents who assessed the level of treatment adherence of Pulmonary Tuberculosis patient at Rural Health Unit-Jolo, in the context of disease awareness as Moderate Adherent is mostly probably the same group of respondents who assessed the level of treatment adherence of Pulmonary Tuberculosis patient at Rural Health Unit-Jolo, in the context of disease awareness in contexts of Family Support and Healthcare Support as Moderate Adherent, respectively; and 5) This study seems to support Health Belief Model (HBM) by Edward C. Green and Elaine Murphy (2020) elucidates the cognitive processes influencing nurses’ behaviors in the context of infection control.

Adherence to Congestive Heart Failure Guidelines and Outcome in the Middle East.

Adherence to Congestive Heart Failure with reduced Ejection Fraction (CHFrEF) guidelines is not easily attainable everywhere, particularly in countries with a high prevalence of low socioeconomic status, which includes many Middle Eastern countries. However, it is well-established that adherence to the guidelines is associated with lower mortality and morbidity rates. Our objective is to investigate the adherence to the degree of treatment guideline in CHFrEF within a patient population in the Middle East and correlate the level of compliance both fully and partially with morbidity and mortality outcomes. Methods and Statistics: We conducted a retrospective study on patients with CHFrEF in the Middle East region who were maintained on Sacubitril/Valsartan for up to 4 years (190 patients). This study included follow-up assessments for morbidity and mortality rates and their correlation with the level of adherence to guidelines. Statistical analysis was performed using IBM SPSS® 27th version. In both the partial adherence group and the full adherence group, there was a statistically significant improvement in NYHA (pretreatment and post-treatment) and Ejection fraction (pretreatment and posttreatment). This means that regardless of the level of adherence to the use of Sacubitril/Valsartan in CHFrEF, there was an overall improvement in the morbidity and mortality rates over the four years of follow-up. While we fully support the idea of achieving full CHFrEF guideline adherence, we recognize the difficulty of this task. Nevertheless, this study reinforces the notion that any degree of adherence to guideline is correlated with better morbidity and mortality rates over a long-term follow-up.

THE EFFECT OF HIGH VERSUS LOW ADHERENCE TO THE DASH DIET ON BLOOD PRESSURE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Objective: The objective of our study was to systematically review the current literature and perform a meta-analysis to evaluate the effect of the level of adherence to the DASH diet on blood pressure. Design and method: The identification of relevant studies, data extraction and critical appraisal of the included studies were performed independently by two reviewers. A random-effects model was employed to synthesize the available evidence using the standardized mean difference (SMD) as the appropriate effect size. Results: A total of 37 and 29 articles were included in the qualitative and quantitative analysis, respectively. The pooled effect for systolic blood pressure was SMD = -0.18 (95%CI: -0.32 to -0.04; I2 = 94%; PI: -0.93 to 0.57) and for diastolic blood pressure it was SMD = -0.13 (95%CI: -0.19 to -0.06; I2 = 94%; PI: -0.42 to 0.17). Conclusions: Our findings showed that greater adherence to the DASH diet has a beneficial effect on blood pressure compared to the lowest adherence. Increased compliance with DASH diet recommendations might also have a positive effect on cardiometabolic factors and overall health status. Future studies should aim to standardize the tools of adherence to the DASH diet and utilize rigorous study designs to establish a clearer understanding of the potential benefits of the level of adherence to the DASH diet in blood pressure management.

Adherence to dietary guidelines and associated factors among rural Australian cancer survivors: a cross-sectional study

PurposeThis study aimed to explore levels of adherence to dietary guidelines, and factors associated with dietary guideline adherence, among rural Australian cancer survivors.MethodsA cross-sectional study was undertaken. We recruited a convenience sample of adults with cancer who attended the chemotherapy day unit or allied health appointments at a rural hospital in Baw Baw Shire, Victoria, Australia, between August 2017 and December 2021. Dietary guideline adherence was assessed by cross-referencing participants’ responses to an adapted version of the Dietary Questionnaire for Epidemiological Studies with dietary recommendations in Australian dietary guidelines. Binary logistic regression was used to assess factors associated with dietary guideline adherence for fruits and whole red meats.ResultsThere were 107 rural cancer survivors (median age, 67 years). Dietary guideline adherence was highest for alcohol (88%) followed by whole red meats (63%), fruits (56%), processed red meats (24%), cereals/breads/grains (7%), and vegetables (4%). Relative to those aged < 65 years, 65–74-year-olds had 5.7-fold greater odds (adjusted odds ratio (aOR) = 5.74, 95% confidence interval (CI) = 1.91–17.17) of adhering to the dietary guideline for fruits. Relative to those who had completed/ceased treatment, participants who were currently receiving treatment had 78% lower odds (aOR = 0.22, 95% CI = 0.09–0.59) of adhering to the dietary guideline for fruits.ConclusionThis study contributes preliminary data on adherence to dietary guidelines and associated factors among rural Australian cancer survivors. Dietary guideline adherence varied across food groups and was mostly low, albeit not markedly worse than Australia’s national population for the fruits and vegetables groups. The mostly low adherence in our sample suggests a potential need to increase provision of dietary information, supportive care screening, and, wherever necessary, dietetics referrals, assessments, and interventions among rural cancer survivors. Larger, longitudinal studies of adherence to dietary guidelines and/or tailored, cancer-specific dietary recommendations should be undertaken in future.

Effect of an in-hospital medication self-management intervention (SelfMED) on medication adherence in polypharmacy patients postdischarge: protocol of a pre–post intervention study

IntroductionHealthcare providers usually manage medication for patients during hospitalisation, although patients are expected to self-manage their medication after discharge. A lack of self-management competencies is found to be associated with...