Adherence Monitoring Research Articles

Systematic review of the effects of patient errors using inhaled delivery systems on clinical outcomes in COPD

BackgroundErrors using inhaled delivery systems for COPD are common and it is assumed that these lead to worse clinical outcomes. Previous systematic reviews have included patients with both asthma and...

Self-management practices among diabetic patients during the COVID 19 pandemic: Systematic review

Introduction: Self-management is crucial in diabetes care and assessing its impact during the COVID-19 pandemic is vital. This systematic review examines the pandemic's influence on self-management practices among diabetic patients. Methods: We conducted searches in PubMed, Cochrane Library, and Science Direct from December 2019 to June 2021. Included studies evaluated the effect of COVID-19 on self-management practices in diabetic patients. After removing duplicates, two independent reviewers conducted title and abstract reviews, followed by full-text screening, in accordance with PRISMA guidelines. Results: Of 1083 records, nine studies were included, comprising 5279 patients with sample sizes ranging from 52 to 1510. During the pandemic, most self-management practices remained relatively stable. Improvements were observed in dietary control (1% to 82.6%), self-blood glucose monitoring (11.3% to 47.1%), medication adherence (8.1% to 18.4%), weight management (19% to 40.9%), and physical activity (1% to 25.7%). Notably, physical activity showed a decrease (19% to 69.1%) during the pandemic. Conclusion: Compared to the pre-pandemic period, dietary control exhibited the most significant improvement, while physical activity demonstrated the least increase. Medication adherence and self-blood glucose monitoring were relatively better than other self-management practices. It is imperative to enhance self-management practices in diabetic patients during similar pandemics.

Development of Wearable Devices for Collecting Digital Rehabilitation/Fitness Data from Lower Limbs.

Lower extremity exercises are considered a standard and necessary treatment for rehabilitation and a well-rounded fitness routine, which builds strength, flexibility, and balance. The efficacy of rehabilitation programs hinges on meticulous monitoring of both adherence to home exercise routines and the quality of performance. However, in a home environment, patients often tend to inaccurately report the number of exercises performed and overlook the correctness of their rehabilitation motions, lacking quantifiable and systematic standards, thus impeding the recovery process. To address these challenges, there is a crucial need for a lightweight, unbiased, cost-effective, and objective wearable motion capture (Mocap) system designed for monitoring and evaluating home-based rehabilitation/fitness programs. This paper focuses on the development of such a system to gather exercise data into usable metrics. Five radio frequency (RF) inertial measurement unit (IMU) devices (RF-IMUs) were developed and strategically placed on calves, thighs, and abdomens. A two-layer long short-term memory (LSTM) model was used for fitness activity recognition (FAR) with an average accuracy of 97.4%. An intelligent smartphone algorithm was developed to track motion, recognize activity, and calculate key exercise variables in real time for squat, high knees, and lunge exercises. Additionally, a 3D avatar on the smartphone App allows users to observe and track their progress in real time or by replaying their exercise motions. A dynamic time warping (DTW) algorithm was also integrated into the system for scoring the similarity in two motions. The system's adaptability shows promise for applications in medical rehabilitation and sports.

Evaluating the Safety and Efficacy of Sodium-Glucose Co-transporter2 Inhibitors in Subjects with Prediabetes: A Protocol for a Randomized Controlled Trial.

Prediabetes is a state of subclinical glycemic impairment, bridging normal glucose tolerance and diabetes. Globally, over 30% of individuals exhibit prediabetic conditions, with a significant proportion progressing to diabetes. Prediabetes augments risks of various diseases including cardiovascular and kidney disease. While interventions like lifestyle changes have shown promise in diabetes prevention, their long-term sustainability is challenging. Alternative pharmacological treatments, such as acarbose and metformin, have demonstrated efficacy in certain populations. Sodium-glucose co-transporter2 inhibitors, a novel class of glucose-lowering agents, have shown potential benefits for heart and kidney health in patients with diabetes. This research aims to evaluate the effectiveness and safety of dapagliflozin in individuals with prediabetes, elucidating its potential role in diabetes prevention strategies. This prospective trial is being conducted at Peking University Third Hospital. A total of 240 participants with prediabetes will be enrolled and randomly divided into two groups: one receiving dapagliflozin (10mg/day) with lifestyle education, and the other with lifestyle education alone over a 12-week duration (with male/female = 1:1 in each group). Anthropometric, clinical and laboratory tests, including body mass index, waist circumference, fasting blood glucose, oral glucose tolerance test, insulin, lipid profile, liver and kidney function, sperm quality, will be conducted at the onset and conclusion of the trial. For adherence monitoring, participants will receive phone follow-ups at week4 and week8. The primary outcome is the change in 2-h plasma glucose during an oral glucose tolerance test over the study duration. Secondary outcomes encompass changes in various health metrics, including body mass index, lipid profiles, and liver function. The proposed study is set to refine diabetes prevention strategies on the basis of its potential benefits observed in patients with diabetes. This will be the first randomized controlled trial to evaluate the safety and effectiveness of sodium-glucose co-transporter2 inhibitors compared with lifestyle education for individuals with prediabetes. ClinicalTrials.gov identifier NCT05914857 (registered 24 July 2023).

Towards clinical adherence monitoring of oral endocrine breast cancer therapies by LC-HRMS—method development, validation, comparison of four sample matrices, and proof of concept

Oral endocrine therapies (OET) for breast cancer treatment need to be taken over a long period of time and are associated with considerable side effects. Therefore, adherence to OET is an important issue and of high clinical significance for breast cancer patients’ caregivers. We hypothesized that a new bioanalytical strategy based on liquid chromatography and high-resolution mass spectrometry might be suitable for unbiased adherence monitoring (AM) of OET. Four different biomatrices (plasma, urine, finger prick blood by volumetric absorptive microsampling (VAMS), oral fluid (OF)) were evaluated regarding their suitability for AM of the OET abemaciclib, anastrozole, exemestane, letrozole, palbociclib, ribociclib, tamoxifen, and endoxifen. An analytical method was developed and validated according to international recommendations. The analytical procedures were successfully validated in all sample matrices for most analytes, even meeting requirements for therapeutic drug monitoring. Chromatographic separation of analytes was achieved in less than 10 min and limits of quantification ranged from 1 to 1000 ng/mL. The analysis of 25 matching patient samples showed that AM of OET is possible using all four matrices with the exception of, e.g., letrozole and exemestane in OF. We were able to show that unbiased bioanalytical AM of OET was possible using different biomatrices with distinct restrictions. Sample collection of VAMS was difficult in most cases due to circulatory restraints and peripheral neuropathy in fingers and OF sampling was hampered by dry mouth syndrome in some cases. Although parent compounds could be detected in most of the urine samples, metabolites should be included when analyzing urine or OF. Plasma is currently the most suitable matrix due to available reference concentrations.Graphical

HIV Preexposure Prophylaxis With Emtricitabine and Tenofovir Disoproxil Fumarate Among Cisgender Women

Emtricitabine and tenofovir disoproxil fumarate (F/TDF) for HIV preexposure prophylaxis (PrEP) is highly effective in cisgender men who have sex with men (MSM) when adherence is high (>4 doses/week). Real-world effectiveness and adherence with F/TDF for PrEP in cisgender women is less well characterized. To characterize the effectiveness of F/TDF for PrEP and its relationship with adherence in cisgender women. Data were pooled from 11 F/TDF PrEP postapproval studies conducted in 6 countries that included 6296 cisgender women aged 15 to 69 years conducted from 2012 to 2020. HIV incidence was evaluated according to adherence level measured objectively (tenofovir diphosphate concentration in dried blood spots or tenofovir concentration in plasma; n = 288) and subjectively (electronic pill cap monitoring, pill counts, self-report, and study-reported adherence scale; n = 2954) using group-based trajectory modeling. F/TDF prescribed orally once a day. HIV incidence was analyzed in subgroups based on adherence trajectory. HIV incidence. Of the 6296 participants, 46% were from Kenya, 28% were from South Africa, 21% were from India, 2.9% were from Uganda, 1.6% were from Botswana, and 0.8% were from the US. The mean (SD) age at PrEP initiation across all studies was 25 (7) years, with 61% of participants being younger than 25 years. The overall HIV incidence was 0.72 per 100 person-years (95% CI, 0.51-1.01; 32 incident HIV diagnoses among 6296 participants). Four distinct groups of adherence trajectories were identified: consistently daily (7 doses/week), consistently high (4-6 doses/week), high but declining (from a mean of 4-6 doses/week and then declining), and consistently low (less than 2 doses/week). None of the 498 women with consistently daily adherence acquired HIV. Only 1 of the 658 women with consistently high adherence acquired HIV (incidence rate, 0.13/100 person-years [95% CI, 0.02-0.92]). The incidence rate was 0.49 per 100 person-years (95% CI, 0.22-1.08) in the high but declining adherence group (n = 1166) and 1.27 per 100 person-years (95% CI, 0.53-3.04) in the consistently low adherence group (n = 632). In a pooled analysis of 11 postapproval studies of F/TDF for PrEP among cisgender women, overall HIV incidence was 0.72 per 100 person-years; individuals with consistently daily or consistently high adherence (4-6 doses/week) to PrEP experienced very low HIV incidence.

Adherence to medication during pregnancy in systemic autoimmune diseases: results from a prospective study.

To evaluate adherence to medication in patients with systemic autoimmune diseases (SAD), comparing pregnant and non-pregnant women. 200 patients with SAD were consecutively enrolled, 100 pregnant and 100 non-pregnant women. Each patient completed the 8-item Morisky Medication Adherence Scale (MMAS-8), one copy for hydroxychloroquine (HCQ) and one for other treatments for rheumatic disease, and Hospital Anxiety and Depression Scale (HADS). No significant differences were found in ongoing therapies between pregnant and non-pregnant women. 148 patients (74.0%) were taking HCQ and 160 (80.0%) other therapies for rheumatic disease. The mean MMAS-8 score was >6 in all groups indicating a good adherence, on average. The rate of patients with good medication adherence was higher in pregnant patients (73.9% vs. 63.3% and 76.5% vs. 64.5%, for HCQ and other therapies, respectively) although this difference was not statistically significant. Eight patients had very poor medical adherence, and all were non-pregnant women. Anxiety (15% of patients) was associated to low medication adherence for drugs other than HCQ (p=0.02), while depression (4% of patients) did not seem to have an impact on adherence. In our cohort we recorded a good adherence to prescribed medication, although adequate adherence was not achieved in about 30% of patients, confirming that non-adherence is an important issue in SAD. It is difficult to define a profile of patients at risk of poor adherence, but it appears important to implement communication and adherence monitoring strategies since strict monitoring also during pregnancy could improve medical adherence.

Prevalence and associated risk factors of hypertension among tribal population in Thrissur District: A cross-sectional study in South India

IntroductionHypertension is the major cause of premature death worldwide. There are disparities in the prevalence of hypertension across cultural groups. This study aimed to explore the prevalence, awareness, treatment and control of hypertension and the associated factors among the adult tribal population in Kerala, India. MethodsA community-based cross-sectional study was conducted among 206 adult tribal population in Thrissur district in Kerala. World Health Organization STEPS questionnaire for non-communicable disease risk factor surveillance was used. We measured blood pressure, weight and height using standard protocols. Hypertension was defined as systolic blood pressure (SBP)≥140 mmHg or diastolic blood pressure (DBP)≥90 mmHg or on medication for high blood pressure. Multivariate logistic regression was done to find out the associated factors with hypertension. ResultsThe mean age of the participants was 44.7 years (SD ± 13.9; men:30%). Around 24% of the participants did not receive any formal education. Current tobacco prevalence was 28% and alcohol consumption was 19%. Nearly 63% were physically active. Prevalence of overweight was 33%. Hypertension prevalence was 48%. Among the hypertensive participants, 59% were aware of their condition, of which 74% were under treatment, and 7.8% achieved adequate control. In the age-sex adjusted multivariate analysis, being diabetic was the highest significant factor associated with the prevalence of hypertension (OR:9.58, CI: 1.87–49.07), followed by being overweight (OR:5.48, CI: 2.49–12.03). ConclusionThis study indicates a high prevalence of hypertension and overweight among the selected tribal population. Our research highlights the importance of regular monitoring and consistent adherence to treatment for hypertension and other risk factors in this population.

Development of Vinzons Pilot High School Online Enrollment with Student Track Identification System

The Vinzons Pilot High School is a top secondary school in the Camarines Norte province. About 6,000 students attend VPHS every year with the number seeing a steady increase. which recruited around 200 instructors and staff members. Enrolment allows around 6000 students every year which poses a concern for the student and the employees of the school. It is for that reason that the digitizing enrolment system is among the alternatives that can help to manage the large number of participants and the data to manage. The agenda on the establishment of online enrolment system coupled with student track identification for Vinzons Pilot High School was offered as an alternative for the usual manual process, and to facilitate flow and eliminate disorganization of transactions and work. The research focuses on how hand enrolling works on the side of school transactions and students' opinions about their selective track. The enrolment procedure is time-consuming and is not so efficient as manual enrolment method is used to cover multiple transactions like the updating and adding of student data, the provision of Learner Information System reports, student sectioning, assisting students to choose a specialty among others. The study requires proper data management because the study concentrates on monitoring adherence to the restrictions and assessing the manual system. In this, the proponent obtained the necessary data that would guide the development of redesigning and automating the existing process and serving students to find the right path to their career.

Understanding mother-to-child transmission of HIV among mothers engaged in HIV care in Kenya: a case report

BackgroundMother-to-child transmission of HIV, which may occur in utero, during birth, or through breastmilk, is now largely preventable with the advancement of HIV testing and treatment for women and their infants. Globally, great progress has been recorded over the years, with a 58% decline in new infections in children from 2010 to 2022. Currently, Kenya is among the countries with the highest rates of mother-to-child transmission of HIV despite consistent efforts to promote prevention of mother to child transmission strategies.MethodsThis case report presents the experiences of a woman, engaged in HIV care in Kenya, whose baby contracted HIV. The data used to describe this case come from surveys, provider notes, health records, observational notes, notes from phone call consultations, and one in-depth interview. All data sources were carefully reviewed, compared and complied to describe the timeline of events and context of the participant’s experience.ResultsWe found multiple factors which may have contributed to this case of mother-to-child transmission of HIV. Antenatal care was initiated late in pregnancy (during the third trimester), and as a result, HIV diagnosis and treatment also occurred late in pregnancy. In addition, a lack of coordination between the clinic providing antenatal care and HIV treatment, and the hospital providing labor and delivery services led to breastfeeding initiation prior to the administration of infant HIV prophylaxis medications. Finally, poor maternal adherence to HIV medications went undetected and unaddressed until it was revealed by routine viral load monitoring three months after initiating HIV treatment (more than two months postpartum).ConclusionsOur case report shows the continued need for more intensive and integrated care for mothers living with HIV and their infants including support for pregnant women newly diagnosed with HIV, coordination of perinatal and HIV care, provisions for routine monitoring of HIV medication adherence, intensive follow-up care including point of care testing for HIV exposed infants and in person breastfeeding support. Our case report contributes an important perspective especially in light of the current UNAIDS Global AIDS Strategy which recently inspired the Global Alliance to end AIDS in Children.

Advancing affordable IoT solutions in smart homes to enhance independence and autonomy of the elderly

There is a growing trend among elderly people to live alone and this trend is expected to increase in the future. Social isolation and limited support can have a negative impact on the physical and mental well-being of older adults. The increasing life expectancy and expanding geriatric population necessitate the development of innovative solutions to support their health, independence, and autonomy. This article addresses the key challenges and issues confronting the elderly and analyzes various IoT technologies and solutions proposed to enhance their lives. Smart home technologies improve the quality of life and enable older adults to live independently in their own homes while their adult children are at work. This article presents a smart home model for the elderly in Kazakhstan, based on their needs, concerns, and financial capabilities. The proposed prototype will be developed using an accessible, open-source intelligent system that includes health monitoring, medication adherence monitoring, alerting family members in case of falls or deteriorating health indicators, and video surveillance. Another advantage of this system is the automation of processes such as automatic lighting control, voice command functionality, home security, and climate control. Preliminary testing of the hardware model shows promising results, with plans for continuous improvement and evaluation as it is deployed. Key criteria for its implementation include affordability, accessibility, and feasibility. Based on Kazakhstan’s unique socio-cultural and economic context, this paper proposes a sophisticated smart home model tailored to the specific needs and financial capabilities of elderly Kazakhs.

Approach to difficult-to-treat asthma in childhood: a narrative review.

Asthma is a major chronic disease affecting children, and children with difficult-to-treat asthma account for a disproportionate share of resource utilisation and healthcare costs. This review presents a comprehensive and up-to-date overview of the treatment strategies in difficult-to-treat paediatric asthma. Mimickers of asthma must first be ruled out, and the diagnosis confirmed with objective tests whenever possible. The effect of comorbid conditions such as obesity, smoking, other atopic conditions and psychosocial factors on asthma control and severity should be considered. Treatment can then be optimised by implementing personalised strategies, including the use of appropriate drug delivery devices and adherence monitoring. Biologics can be an alternative treatment option for selected patients but should not be a substitute for addressing poor adherence. Many patients with difficult-to-treat asthma may not have severe asthma, and the physician should work with patients and families to achieve good asthma control via an individualised approach.

More than metrics: The role of socio-environmental factors in determining the success of athlete monitoring

ABSTRACT The perceived value of athlete monitoring systems (AMS) has recently been questioned. Poor perceptions of AMS are important, because where practitioners lack confidence in monitoring their ability to influence programming, and performance is likely diminished. To address this, researchers have primarily sought to improve factors related to monitoring metrics, e.g., validity rather than socio-environmental factors, e.g., buy-in. Seventy-five practitioners (response rate: n = 30) working with Olympic and Paralympic athletes were invited to take part in a survey about their perceptions of AMS value. Fifty-two per cent (n = 13) was confident in the sensitivity of their athlete self-report measures, but only 64% (n = 16), indicated their monitoring was underpinned by scientific evidence. A scientific base was associated with improved athlete feedback (r S (23) = 0.487, p =0.014*) and feedback correlated with athlete monitoring adherence (r S (22) = 0.675, p = <0.001**). If athletes did not complete their monitoring, 52% (n = 13) of respondents felt performance might be compromised. However, most respondents 56% (n = 14), had worked with internationally successful athlete(s) who did not complete their monitoring. While AMS can be a useful tool to aid performance optimisation, its potential value is not always realised. Addressing socio-environmental factors alongside metric-factors may improve AMS efficacy.

Formative Perceptions of a Digital Pill System to Measure Adherence to Heart Failure Pharmacotherapy: Mixed Methods Study.

Heart failure (HF) affects 6.2 million Americans and is a leading cause of hospitalization. The mainstay of the management of HF is adherence to pharmacotherapy. Despite the effectiveness of HF pharmacotherapy, effectiveness is closely linked to adherence. Measuring adherence to HF pharmacotherapy is difficult; most clinical measures use indirect strategies such as calculating pharmacy refill data or using self-report. While helpful in guiding treatment adjustments, indirect measures of adherence may miss the detection of suboptimal adherence and co-occurring structural barriers associated with nonadherence. Digital pill systems (DPSs), which use an ingestible radiofrequency emitter to directly measure medication ingestions in real-time, represent a strategy for measuring and responding to nonadherence in the context of HF pharmacotherapy. Previous work has demonstrated the feasibility of using DPSs to measure adherence in other chronic diseases, but this strategy has yet to be leveraged for individuals with HF. We aim to explore through qualitative interviews the facilitators and barriers to using DPS technology to monitor pharmacotherapy adherence among patients with HF. We conducted individual, semistructured qualitative interviews and quantitative assessments between April and August 2022. A total of 20 patients with HF who were admitted to the general medical or cardiology service at an urban quaternary care hospital participated in this study. Participants completed a qualitative interview exploring the overall acceptability of and willingness to use DPS technology for adherence monitoring and perceived barriers to DPS use. Quantitative assessments evaluated HF history, existing medication adherence strategies, and attitudes toward technology. We analyzed qualitative data using applied thematic analysis and NVivo software (QSR International). Most participants (12/20, 60%) in qualitative interviews reported a willingness to use the DPS to measure HF medication adherence. Overall, the DPS was viewed as useful for increasing accountability and reinforcing adherence behaviors. Perceived barriers included technological issues, a lack of need, additional costs, and privacy concerns. Most were open to sharing adherence data with providers to bolster clinical care and decision-making. Reminder messages following detected nonadherence were perceived as a key feature, and customization was desired. Suggested improvements are primarily related to the design and usability of the Reader (a wearable device). Overall, individuals with HF perceived the DPS to be an acceptable and useful tool for measuring medication adherence. Accurate, real-time ingestion data can guide adherence counseling to optimize adherence management and inform tailored behavioral interventions to support adherence among patients with HF.

Monitoring buprenorphine in patients on medication-assisted treatment.

Buprenorphine is used for medication-assisted treatment of opioid dependence. Monitoring of medication adherence involves testing of urine or oral fluid for the drug or its metabolite. Quantitative results using liquid chromatography tandem mass spectrometer testing defined the excretion pattern of the drug and its metabolites. Frequency distribution curves of buprenorphine and norbuprenorphine describe the expected drug concentrations of patients on this medication. Urine and oral fluid drug testing can be used to monitor adherence in this population.

Feasibility of Using a GENEActiv Accelerometer with Triaxial Acceleration and Temperature Sensors to Monitor Adherence to Shoulder Sling Wear Following Surgery.

Self-reported adherence to sling wear is unreliable due to recall bias. We aim to assess the feasibility and accuracy of quantifying sling wear and non-wear utilising slings pre-fitted with a GENEActiv accelerometer that houses triaxial acceleration and temperature sensors. Ten participants were asked to wear slings for 480 min (8 h) incorporating 180 min of non-wear time in durations varying from 5-120 min. GENEActiv devices were fitted in sutured inner sling pockets and participants logged sling donning and doffing times. An algorithm based on variability in acceleration in three axes and temperature change was developed to identify sling wear and non-wear and compared to participants' logs. There was no significant difference between algorithm detected non-wear duration (mean ± standard deviation = 172.0 ± 6.8 min/participant) and actual non-wear (179.7 ± 1.0 min/participant). Minute-by-minute agreement of sensor-detected wear and non-wear with participant reported wear was 97.3 ± 1.5% (range = 93.9-99.0), with mean sensitivity 94.3 ± 3.5% (range = 86.1-98.3) and specificity 99.1 ± 0.8% (range = 93.7-100). An algorithm based on accelerometer-assessed acceleration and temperature can accurately identify shoulder sling wear/non-wear times. This method may have potential for assessing whether sling wear adherence after shoulder surgeries have any bearing on patient functional outcomes.

Establishing consensus recommendations for long-term osteoporosis care for patients who have attended an Australian fracture liaison service: a Delphi study

SummaryCoordinating healthcare activities between fracture liaison services (FLS) and primary care is challenging. Using a Delphi technique, we developed 34 consensus statements to support improved care coordination across this healthcare transition.PurposeEvidence supporting an optimal coordination strategy between fracture liaison services (FLS) and primary care is lacking. This study aimed to develop consensus statements to support consistency and benchmarking of clinical practice to improve coordination of care for patients transitioning from FLS to primary care following an osteoporotic fracture.MethodsA Delphi technique was used to develop consensus among a panel of experts, including FLS clinicians (medical and non-medical), general practitioners (GPs), and consumers.ResultsResults of a preparatory questionnaire (n = 33) informed the development of 34 statements for review by expert panellists over two Delphi rounds (n = 25 and n = 19, respectively). The majority of participants were from New South Wales (82%), employed as FLS clinicians (78.8%) and working in metropolitan centres (60.6%). Consensus was achieved for 24/34 statements in round one and 8/10 statements in round two. All statements concerning patient education, communication, and the GP-patient relationship achieved consensus. Expert opinions diverged in some areas of clinician roles and responsibilities and long-term monitoring and management recommendations.ConclusionWe found clear consensus among experts in many key areas of FLS integration with primary care. While experts agreed that primary care is the most appropriate setting for long-term osteoporosis care, overall confidence in primary care systems to achieve this was low. The role of (and responsibility for) adherence monitoring in a resource-limited setting remains to be defined.

Prevalence of alcohol and drug use and their impact on adherence among hospitalised TB patients in South Africa.

This cross-sectional study aimed to explore the use of alcohol and drugs and the potential impact on adherence to medication for tuberculosis. Adult patients admitted to specialised tuberculosis hospitals in South Africa were assessed for drug use, alcohol use and adherence to tuberculosis medication. A total of 175 patients participated in the study; 32% reported harmful alcohol use, and 44% reported problematic use of drugs. Participants who used drugs were four times as likely (OR = 4.11, 95% CI (1.89, 8.91)) and those using alcohol were twice as likely (OR = 2.06, 95% CI (1.02, 5.08)) to be nonadherent to medication for tuberculosis. Prevalence of harmful/hazardous use of alcohol and other drugs was high and significantly correlated with poorer medication adherence. Routine screening for and treatment of substance use in patients on treatment for tuberculosis and ongoing monitoring of adherence to medication is recommended.

Key aspects of medication adherence to oral anticancer drugs: A literature review

At least 25% of the anticancer drugs are intended for oral use, while the creation and rapid introduction of oral drugs into clinical practice is constantly growing. Between 2006 and 2021, 80 oral forms of anticancer drugs were approved. It has been shown that patients prefer oral therapy to intravenous therapy if such a replacement is possible with equal efficacy and toxicity of the drugs. This once again emphasizes that the issue of adherence to treatment with oral forms is open and relevant for study. Currently, adherence, as the main factor in achieving the best clinical outcome, has been studied from different perspectives. However, there are no structured data globally, and, accordingly, evidence-based and specific recommendations in the absence of adherence. The review includes data from studies performed over the past 10 years, studying the adherence of patients to treatment with oral anticancer drugs. The data sources for the review were the Medline, Embase, and Scopus databases. Literature analysis showed that the most important aspects in the field of adherence to treatment with oral anticancer drugs include the level of patient adherence to treatment, factors affecting non-compliance, correlation of treatment adherence and clinical outcomes in malignant neoplasms. At the same time, the article considers the impact of non-compliance on the health care system as a whole. The most reliable and up-to-date data in the study area were examined to subsequently identify measures aimed at achieving the best practice in the organization of healthcare for patients with malignant neoplasms. The research results demonstrate the variability and heterogeneity of data, the lack of unified methodological approaches. In turn, this prevents the formation of objective and reliable conclusions about adherence. To make rational strategic decisions on monitoring adherence to treatment, it is necessary to initiate large-scale studies, adopt uniform standard procedures and recommendations for assessing adherence.

Delivery Systems with an Electronic Element

Delivery systems with an electronic element can be classified as one of the last few decades' most modern and innovative pharmaceutical systems. Incorporating an electronic/digital element offers several advantages, such as the possibility of the precise timing of the drug released in the desired location of the gastrointestinal tract, collection of biometric data, or indisputable proof of the patient's adherence to therapy. Currently, it is possible to observe the development of the field in two main directions. The first one is using these systems in conjunction with the controlled release principle in absorption and general pharmacokinetic studies of new substances. The second direction is digital monitoring of therapy adherence. This brief overview briefly mentions the field's history, brings information about the two main branches, and states the essential systems of both branches and their use.