Determinants Of Medication Adherence Research Articles

Determinants of medication adherence among elderly with high blood pressure living in deprived areas.

The current study was conducted to determine the impact of health literacy and factors related to adherence to drug treatment, using the model proposed by the World Health Organization, in older adults with hypertension residing in informal settlements in Hamadan. This cross-sectional study was conducted on 405 patients in Hamadan city, located in the western part of Iran. Data were collected using an interviewer-administered questionnaire that included the 5-dimensional model proposed by the World Health Organization, Health Literacy for Iranian Adults, and Morisky Medication Adherence Scale-8. A two-stage sampling procedure was used to select patients from 14 comprehensive health service centers and health bases. The data were analyzed using SPSS v.24. The study found that medication adherence was suboptimal in 63% of the participants. Additionally, 87.5% of patients had inadequate or insufficient health literacy. Factors related to medication adherence included age (odds ratio (OR) = 1.07), annual income (OR = 0.17), duration of hypertension (OR = 7.33), health literacy (OR = 1.03), self-reported health status (P < 0.05), and regular medication use (P < 0.008). The results of this study indicate that more than half of the older adults in the study had suboptimal medication adherence and insufficient health literacy. The study also found that various factors, such as socioeconomic status, disease and treatment-related factors, and patient-related factors, influence medication adherence among older adults.

Knowledge, Awareness, and Determinants of Medication Adherence in Hypertensive Patients: A Hospital-Based Cross-sectional Study in North India

ABSTRACT Background: Knowledge and awareness studies reveal the basic information of the community and the misconceptions in relation to practices of a disease. The identification of such factors is important as they directly influence the health care-related interventions. Hypertension is one of the emerging noncommunicable diseases (NCDs) globally. So, we conducted this study to assess the status of our community regarding hypertension. Materials and Methods: The study was conducted on 300 hypertensive patients to assess the knowledge and awareness by a hypertension fact questionnaire. Medication adherence was assessed in the same group of patients by Hill–Bone scale—a uniform scale used worldwide. Results: Our study revealed a greater number of females with hypertension as compared to males and a maximum number of patients being in the age-group of 61–70 years and belonging to rural areas. Most of the patients had a secondary education as a highest educational qualification with only 10% of patients being postgraduates. A fair number of patients had a good knowledge and awareness about their disease, and most of the respondents accounted forgetfulness as a main reason for nonadherence to therapy over other reasons. Conclusion: Our population has good knowledge and awareness about their disease despite not having very good educational qualifications, and we need to strengthen our healthcare programs for even more greater dissemination of information.

Determinants of medication adherence and impact of mobile telephony, pillbox interventions on compliance and glycemic control among patients with type 2 diabetes

Abstract Background: Medication adherence has been linked to improved glycemic control, fewer complications from diabetes, fewer hospitalizations, reduced health care expenses, and a decreased mortality rate. The medication adherence pattern, reason, and factors associated with poor medication adherence among patients living with type 2 diabetes mellitus were determined, and the impact of two interventions to improve medication adherence was assessed. Materials and Methods: The medication adherence patterns of 240 people living with diabetes were determined using the Morisky Green Levine Medication Adherence Scale-4 and categorized into low, medium, and high adherence patterns. Patients with poor medication adherence (low and medium pattern) scores were randomized into short message service (SMS) and pillbox interventions, and the impact of Interventions on compliance and glycemic control was determined. Results: Results demonstrate that 3% of patients living with type 2 diabetes have low, 43% medium, and 54% have high medication adherence patterns. The most common reason cited for non-adherence was (88%) followed by lack of finance (5%) and multiple medications (4%). A positive association of injectable dosage forms, number of drugs, and treatment modalities with adherence was found. SMS and pillbox intervention improved medication adherence among individuals with diabetes who had poor adherence, which translated into good glycemic control. Conclusions: The improvement in drug compliance and glycemic control was found to be equivocal among the SMS and pillbox intervention groups. The inclusion of interventions into the institutional education program and counseling by health care workers will motivate patients to adopt these interventions to improve drug compliance and glycemic control.

Determinants of Medication Adherence in Patients Following Presentation With Acute Coronary Syndrome (ACS)

Determinants of Medication Adherence in Patients Following Presentation With Acute Coronary Syndrome (ACS)

A systematic review on the determinants of medication adherence in older adults with hypertension

Introduction. Medication adherence is a key element in controlling blood pressure when lifestyle modifications fail to achieved blood pressure targets. The degenerative process challenges the ability to adhere to medication in older adults. Objective. This research aimed to systematically investigate the predictor of medication in older patients with hypertension. Materials and Methods. A systematic searching strategy in six databases, such as Science Direct, PubMed, Proquest, SAGE, and Emerald was applied in this study. Studies after 2012 were included in this research, and then followed Preferred Reporting Items for Systematic Reviews. Results. Of 887 studies identified, 12 were included in the data synthesis. Self-management, health literacy about hypertension and antihypertensive agent, cognitive function (memory), belief, and subjective life expectancy were identified as determinants of medication adherence in older adults with hypertension. Memory functions are the strongest determinant in medication adherence among the elderly. Conclusions. Interventions increasing memory ability, such as strategies for remembering, rewarding, and reinforcement, are needed in the population of elderly with hypertension.

Prevalence and determinants of medication adherence among patients taking antihypertensive medications in Africa: A systematic review and meta-analysis 2010-2021.

This study synthesized the prevalence and determinants of hypertension medication adherence. Systematic review and meta-analysis through systematic search in PUBMED, EMBASE, CINAHL, Cochrane library and Google Scholar, from 2010 to 2021. Screening was conducted and reported according to PRISMA criteria, and ten studies identified according to predetermined criteria. The studies were evaluated using the Mixed Method Appraisal Tool. Analysis was done using the narrative synthesis method. Prevalence data were examined using random effects meta-analysis in Comprehensive Meta-Analysis version 3. The overall prevalence of medication adherence was 34.1%, and determinants of medication adherence were the ability to attain hypertension control; hypertension knowledge; and treatment-related factors including belief of the drug efficacy, having commodities, sociocultural and financial-related factors. It is imperative to develop, test and use a comprehensive hypertension medication adherence tool that is culturally congruent to Africa.

Determinants of Medication Adherence among Jordanian Patients with End Stage Kidney Disease

Background End stage kidney disease (ESKD) requires complex medical management. To ensure the success of management plan, patient’s adherence to medication is fundamental. However, adherence to medication is challenging for patients with ESKD. Objective This study aimed to describe adherence to medication and to identify demographic and clinical determinants in Jordanian patients with ESKD. Methods Cross-sectional correlational design was performed using a sample of 188 patients with ESKD who attended haemodialysis units in five hospitals in Amman between March and June 2021. Medication adherence was measured using Morisky Medication Adherence Scale (MMAS). Results The mean age of the participants was 50.9 years (SD=15.64), more than half of the participants were males 109 (58.0%) and were non-smokers 115 (61.2%). The mean score of the MMAS was 5.18 (SD=2.024) which indicates high prevalence of inadequate adherence to medication. Younger age, longer duration on hemodialysis, and higher number of medications were risk factors for inadequate adherence to medication among patients with ESKD. Conclusion ESKD patients who are younger in age, have longer duration on hemodialysis, and have higher number of medications should be targeted as they have medication adherence challenges. Those patients should be taken into consideration when planning and developing interventions to enhance medication adherence in patients with ESKD.

Determinants of medication adherence in people with epilepsy: A multicenter, cross-sectional survey

ObjectivesPoor medication adherence in people with epilepsy (PwE) increases mortality, hospitalization, and poor quality of life, representing a critical challenge for clinicians. Several demographic, clinical, and neuropsychological factors were singularly found associated with medication adherence in several studies, but the literature lacks a comprehensive study simultaneously assessing all these variables. MethodsWe performed a multicenter and cross-sectional study using online questionnaires with the following clinical scales: Morisky Medication Adherence Scale (MMAS-8), Quality of Life in Epilepsy Inventory 31 (QoLIE-31), Beck Depression Inventory-II (BDI-II), Generalized Anxiety Disorder-7 (GAD-7) and 14-item Resilience scale (RES14) in a population of 200 PwE. We used the ANOVA test and Spearman’s correlation to evaluate the relationship between medication adherence and demographic, clinical (seizure frequency, number of anti-seizure medications), and neuropsychological characteristics. We trained separate machine learning models (logistic regression, random forest, support vector machine) to classify patients with medium–high adherence (MMAS-8 ≥ 6) and poor adherence (MMAS-8 < 6) and to identify the main features that influence adherence. ResultsWomen were more adherent to medication (p-value = 0.035). Morisky Medication Adherence Scale -8 showed a direct correlation with RES14 (p-value = 0.001) and age (p-value = 0.001), while was inversely correlated with BDI-II (p-value = 0.001) and GAD-7 (p-value = 0.001). In our model, the variables mostly predicting treatment adherence were QoLIE-31 subitems, followed by age, resilience, anxiety, years of school, and disease duration. ConclusionOur study confirms that gender, age, and neuropsychological traits are relevant factors in predicting medication adherence to PwE. Furthermore, our data provided the first evidence that machine learning on multidimensional self-report questionnaires could help to develop a decisional support system in outpatient epilepsy clinics.

Prevalence and Determinants of Medication Adherence in Patients with Multi-morbidities attending General Outpatient Clinics in Secondary Health Care Facilities in Kaduna State

Background: Multi-morbidity is a global public health issue which requires medication adherence to aid in the management. Poor adherence could lead to reduced quality of life, and mortality. This study was carried out to determine the prevalence and determinants of medication adherence among patients attending the general outpatient clinics in secondary health facilities in Kaduna State.&#x0D; Methods: This was a hospital-based cross-sectional study carried out among 119 patients attending the general outpatient clinics in secondary health facilities in Kaduna State. Respondents were selected via multistage sampling technique. Data was obtained from the respondents using a pre-tested interviewer-administered questionnaire. Medication adherence was assessed with eight-item Morisky Medication Adherence Scale (MMAS-8). Data was analysed using IBM SPSS Statistics version 23. Statistical significance was set at a p-value of &lt;0.05.&#x0D; Results: Seventy-four (62.2%) of the respondents were aged at least sixty years. The mean age of respondents was 60.3±13.6 years. Seventy-six (63.7%) of the respondents had low medication adherence. The older age (≥60 years) of the respondents (AOR=6.19, 95%CI=1.42-4.81, p=0.001), lack of education (AOR=5.74, 95%CI=1.39-3.42, p&lt;0.001), out-of-pocket spending (AOR=5.29, 95%CI=1.41-3.53, p&lt;0.001), low monthly income (AOR=3.39, 95%CI=1.53-4.81, p=0.004) and taking over 4 medications (AOR=8.25, 95%CI=1.26-5.13, p=0.002) were found to be predictors of low medication adherence.&#x0D; Conclusion: The finding of low adherence among majority of the respondents highlights the fact that achieving desired health outcomes will be a challenge. Improving this situation would require government interventions which are focused on social drivers of health as well as improving healthcare financing.

Impacts of two behavior change interventions on determinants of medication adherence: process evaluation applying the health action process approach and habit theory alongside a randomized controlled trial.

Investigating the mechanisms of behavior change interventions provides a more fulsome understanding of how and why interventions work (or don't work). We assessed mechanisms of two interventions (mailouts alone, and mailouts plus telephone support, informed by the Health Action Process Approach (HAPA) and Habit Theory), designed to increase medication adherence after myocardial infarction. We conducted a process evaluation alongside a pragmatic trial. Medication adherence was assessed via self-report at 12-months in the trial, and participants in all trial groups were invited to contemporaneously complete an additional questionnaire assessing targeted mechanisms (HAPA constructs and automaticity). We used multiple regression-based mediation models to investigate indirect effects. Of 589 respondents, 497 were analyzed (92 excluded due to missing data). Mailouts plus telephone support had statistically significant but small effects on intention, social support, action planning, coping planning, and automaticity. There were no indirect effects of interventions on medication adherence via these constructs. Therefore, while this intervention led to changes in proposed mechanisms, these changes were not great enough to lead to behavior change. Refinements (and subsequent evaluation) of the interventions are warranted, and our findings indicate that this could involve offering more intensive support to form plans and identify cues for taking medications, in addition to providing physical supports to encourage self-monitoring, feedback, and habit formation. Trial registration: ClinicalTrials.gov: NCT02382731.

Supporting People With Type 2 Diabetes in the Effective Use of Their Medicine Through Mobile Health Technology Integrated With Clinical Care to Reduce Cardiovascular Risk: Protocol for an Effectiveness and Cost-effectiveness Randomized Controlled Trial.

BackgroundType 2 diabetes is a common lifelong condition that affects over 400 million people worldwide. The use of effective medications and active self-management can reduce the risk of serious complications. However, people often have concerns when starting new medications and face difficulties in taking their medications regularly. Support provided by brief messages delivered through mobile phone–based SMS text messages can be effective in some long-term conditions. We have identified promising behavior change techniques (BCTs) to promote medication adherence in this population via a systematic review and developed SMS text messages that target these BCTs. Feasibility work has shown that these messages have fidelity to intended BCTs, are acceptable to patients, and are successful in changing the intended determinants of medication adherence. We now plan to test this intervention on a larger scale in a clinical trial.ObjectiveThe aim of this trial is to determine the effectiveness and cost-effectiveness of this intervention for reducing cardiovascular risk in people with type 2 diabetes by comparing it with usual care.MethodsThe trial will be a 12-month, multicenter, individually randomized controlled trial in primary care and will recruit adults (aged ≥35 years) with type 2 diabetes in England. Consenting participants will be randomized to receive short SMS text messages intended to affect a change in medication adherence 3 to 4 times per week in addition to usual care. The aim is to test the effectiveness and cost-effectiveness of the intervention when it is added to usual care. The primary clinical outcome will be a composite cardiovascular risk measure. Data including patient-reported measures will be collected at baseline, at 13 and 26 weeks, and at the end of the 12-month follow-up period. With 958 participants (479 in each group), the trial is powered at 92.5% to detect a 4–percentage point difference in cardiovascular risk. The analysis will follow a prespecified plan. A nested quantitative and qualitative process analysis will be used to examine the putative mechanisms of behavior change and wider contextual influences. A health economic analysis will be used to assess the cost-effectiveness of the intervention.ResultsThe trial has completed the recruitment phase and is in the follow-up phase. The publication of results is anticipated in 2024.ConclusionsThis trial will provide evidence regarding the effectiveness and cost-effectiveness of this intervention for people with type 2 diabetes.Trial RegistrationISRCTN Registry ISRCTN15952379; https://www.isrctn.com/ISRCTN15952379International Registered Report Identifier (IRRID)DERR1-10.2196/32918

Exploring of Determinants Factors of Anti-Diabetic Medication Adherence in Several Regions of Asia - A Systematic Review.

BackgroundThe determinants of medication adherence in people with diabetes may differ between populations of an area due to social environment, cultural beliefs, socioeconomic conditions, education, and many other factors differences.ObjectiveTherefore, this study aims to explore, identify and classify the determinants of medication adherence in several Asian regions.MethodsA systematic literature review was conducted to gain insight into the determinants of medication adherence. Seven relevant databases (EBSCO, ProQuest, PubMed, ScienceDirect, Scopus, Wiley, dan Taylor and Francis) and hand searching methods were conducted from January 2011 to December 2020. Keywords were compiled based on the PICO method. The selection process used the PRISMA guidelines based on inclusion, and the quality was assessed using Crowe’s critical assessment tool. Textual summaries and a conceptual framework model of medication adherence were proposed to aid in the understanding of the factors influencing medication adherence.ResultsTwenty-six articles from countries in several Asian regions were further analyzed. Most studies on type 2 diabetes patients in India used the MMAS-8 scale, and cross-sectional study is the most frequently used research design. The medication adherence rate among diabetic patients was low to moderate. Fifty-one specific factors identified were further categorized into twenty-three subdomains and six domains. Furthermore, the determinants were classified into four categories: inconsistent factors, positively related factors, negatively related factors, and non-associated factors. In most studies, patient-related factors dominate the association with medication adherence. This domain relates to patient-specific demographics, physiological feelings, knowledge, perceptions and beliefs, comorbidities, and other factors related to the patient. Several limitations in this review need to be considered for further research.ConclusionMedication adherence to diabetic therapy is a complex phenomenon. Most determinants produced disparate findings in terms of statistical significance. The identified factors can serve various goals related to medication adherence. Policymakers and health care providers should consider patient-related factors.

Determinants of medication adherence in childhood nephrotic syndrome and associations of adherence with clinical outcomes.

Pediatric patients with nephrotic syndrome take medications long-term with significant toxicity and complex regimens, yet data on medication adherence are limited. In a multicenter observational study of patients with nephrotic syndrome, NEPTUNE (NCT01209000), we surveyed caregivers of patients <19 years old and adolescent patients on medication adherence during longitudinal follow-up beginning in June 2015. Data extraction was in October 2020. We described the proportion of nonadherent patients at first survey. Participant social and economic factors, condition-related factors, therapy-related factors, and patient-related factors were examined for relationships with nonadherence by generalized linear mixed models using the longitudinal data. In exploratory fashion, we assessed the relationship between adherence and subsequent steroid response classification by binary logistic regression and adherence with healthcare utilization by Poisson regression. A total of 225 participants completed a median of 3 surveys during follow-up (IQR, 2-5), with a total of 743 surveys. Overall, 80 (36%) reported nonadherence with medications. In adjusted analysis, older age (per 1 year; OR 1.08; 95% CI, 1.03 1.12), lower maternal educational level (≥ high school vs. < high school; OR 0.47; 95% CI 0.25 to 0.89), and increased parent and self-identification of medications barriers (per 1 point; OR 1.57; 95% CI, 1.15-2.15) were significantly associated with nonadherence. No relationship between nonadherence and subsequent frequency of healthcare utilization was observed. A trend toward increased subsequent steroid resistance classification was seen with nonadherence, though not statistically significant. Medication nonadherence is common in pediatric nephrotic syndrome. Investigations into the use of surveys in the clinic setting to identify at-risk patients and ways to support families over time are needed. A higher resolution version of the Graphical abstract is available as Supplementary information.

Dterminants of medication adherence in Moroccan schzophrenic patients

Abstract Introduction Schizophrenia is a psychiatric condition in which patient adherence is a key issue in its management. Objectives To estimate the prevalence and determine the factors associated with medication adherence in patients with schizophrenia. Methods This was a cross-sectional study conducted at the psychiatry department of the CHU IBN Rochd of Casablanca among schizophrenic patients followed from May 2019 to January 2020. The sample size was calculated apriori and the measurement of therapeutic compliance and Insight (patients' perception of the disorders related to their pathology) was made thanks to the Medication Adherence Rating Scale (MARS) and the Birchwood insight scale (BIS) respectively. Socio-demographic data and data on the management of schizophrenia were also collected. Statistical analyses were performed with RStudio software and the multivariate analysis method of logistic regression was used. The threshold of significance was set at 5%. Results A total of 370 were collected, the median age was 31 years and the most represented class was the over 28 years (26.25%). The female gender represented 28% and the majority was single (72%). Substance abuse was 68.8%, 46% were on dual therapy and 43.2% of patients were on regular follow-up. The prevalence of therapeutic compliance was 25.6% and 30.3% were aware of their pathology. The determinants of medication adherence in the schizophrenic patients included in the final model were: regularity of follow-up (p &amp;lt; 0.001), insight (p &amp;lt; 0.001), number of medications (p = 0.011), history of substance use (p = 0.008), place of residence (p = 0.082). Conclusions Therapeutic compliance was low, the knowledge of the factors associated with therapeutic compliance in schizophrenia allows us to put forward hypotheses in order to improve the management of patients. Key messages Patient adherence to treatment is important in the management of Schizophrenia. Therapeutic compliance is poor.

THE IMPACT OF MEDICATION REGIMEN COMPLEXITY ON ADHERENCE TO LONG-TERM THERAPIES

Objective: Adherence is a multifactorial phenomenon. Medication-related factors have long been the focus of attention. However, the results are inconsistent. Methods: In a cross-sectional questionnaire-based study of outpatients, we assessed 180 patients suffering from chronic conditions. The objective of this study is to determine the impact of medication regimen complexity on adherence to long-term drug therapies. Results: 91.66% of patients receiving more than four drugs had good or high adherence. 80.94% of patients on thrice a day (or more) drug administration had good or high adherence. 91.66% of patients receiving drug therapy for more than 5 years had good or high adherence. In all other groups, the adherence was low. The adherence was significantly (p&lt;0.05) and positively (rs=0.792 and 0.846) correlated to the frequency of drug administration and duration of treatment. Adherence was positively correlated to the number of drugs per day (rs=0.668) but the relationships were not statistically significant (p=0.102). All the correlations were large. Conclusions: We found adherence positively correlated with medication regimen complexity. An improved understanding of the determinants of medication adherence is needed. Keywords: Medication regimen complexity, Adherence, Long-term therapy, Chronic disease

Prevalence and Determinants of Medication Adherence among Patients with HIV/AIDS in Southern Vietnam.

This study was conducted to determine the prevalence and determinants of medication adherence among patients with HIV/AIDS in southern Vietnam. Methods: A cross-sectional study was conducted in a hospital in southern Vietnam from June to December 2019 on patients who began antiretroviral therapy (ART) for at least 6 months. Using a designed questionnaire, patients were considered adherent if they took correct medicines with right doses, on time and properly with food and beverage and had follow-up visits as scheduled. Multivariable logistic regression was used to identify determinants of adherence. Key findings: A total of 350 patients (from 861 medical records) were eligible for the study. The majority of patients were male (62.9%), and the dominant age group (≥35 years old) accounted for 53.7% of patients. Sexual intercourse was the primary route of transmission of HIV (95.1%). The proportions of participants who took the correct medicine and at a proper dose were 98.3% and 86.3%, respectively. In total, 94.9% of participants took medicine appropriately in combination with food and beverage, and 75.7% of participants were strictly adherent to ART. The factors marital status (odds ratio (OR) = 2.54; 95%CI = 1.51–4.28), being away from home (OR = 1.7; 95%CI = 1.03–2.78), substance abuse (OR = 2.7; 95%CI = 1.44–5.05), general knowledge about ART (OR = 2.75; 95%CI = 1.67–4.53), stopping medication after improvement (OR = 4.16; 95%CI = 2.29–7.56) and self-assessment of therapy adherence (OR = 9.83; 95%CI = 5.44–17.77) were significantly associated with patients’ adherence. Conclusions: Three-quarters of patients were adherent to ART. Researchers should consider these determinants of adherence in developing interventions in further studies.

Medication adherence among Nigerian patients with rheumatoid arthritis: a two instruments survey

Abstract Objectives Medication adherence is still a significant problem in chronic diseases management and rheumatoid arthritis (RA) is not an exception. There is very little information regarding the level and influencing factors of medication adherence among Nigerian patients with RA. This study evaluated the level and determinants of medication adherence among patients with RA in a Nigerian referral hospital. Methods Using a questionnaire based cross sectional survey, 169 patients with RA were evaluated for their medication adherence using two validated instruments namely; five-item Medication Adherence Report Scale and five-item Compliance Questionnaire for Rheumatology. The two instruments were subjected to descriptive (mean and frequencies) and mean difference (chi-square, t-test, Pearson correlation) analysis, and their reliability (Cronbach alpha) in a Nigerian setting was also established. Key findings The level of non-adherence reported in this study was high and ranged from 48.5% for the CQR to 63.9% for the Medication Adherence Report Scale questionnaires respectively. Being of a male gender, of an older age, the higher number of pills taken, better education and the duration of the disease all significantly contributed to higher adherence measures among these RA patients (P &amp;lt;0.05 for all). Both questionnaires used were correlated and reliable for use among patients with rheumatoid arthritis in Nigeria. Conclusion Findings from this study show that non adherence to medications among RA patients were high and factors such age, gender, education, pill burden could have been responsible.

Prevalence and determinants of medication adherence among patients with acute coronary syndrome in Vietnam

Prevalence and determinants of medication adherence among patients with acute coronary syndrome in Vietnam

Determinants of medication adherence among hypertensive patients using the Pender's health promotion model

BACKGROUND:Poor adherence in treatment and medication is a global issue in curing the chronic diseases such as hypertension. The present study was conducted to identify the factors related with medication adherence among hypertensive patients referred to the health centers of Borujerd based on the Pender's Health Promotion Model (HPM).MATERIALS AND METHODS:This cross-sectional study was conducted on 463 patients who were referred to the comprehensive health centers of Borujerd city by cluster sampling method in 2019. The data were collected using a questionnaire including demographic variables and Pender's HPM constructs. Data were analyzed by SPSS 18 software using Pearson correlation coefficient and linear regression.RESULTS:The mean and standard deviation of the participants' age was 63.29 ± 11.2 years. The results showed that hypertensive patients had a relatively desirable level of medication adherence behavior. Perceived barriers (β = −0.169), perceived self-efficacy (β = 0.196), activity related affect (β = 0.232), and following medication regimen (β = 0.225) were the best predictors of performing the medication adherence behavior. In total, different structures of the HPM explained 42.2% of the variation of medication adherence behavior changes.CONCLUSIONS:According to the findings, the design of educational programs using HPM is recommended to increase the medication adherence among hypertensive patients.

Adherence to Antiepileptic Regime: A Cross-sectional Survey.

Epilepsy is a treatable and curable brain disorder. However major proportion of individuals with this disease in developing countries receives no treatment because of misunderstandings of the public. Other than that, poor adherence to ordered medication is considered the primary cause of drug therapy failure in epilepsy. Nonadherence, therefore, results directly in a rise in health care costs and compromised quality of life. To assess the adherence pattern to antiepileptic regimen, among patients with epilepsy and to identify the clinical and patient-related factors associated with the adherence pattern to antiepileptic regimen. A cross-sectional survey design was used in 100 epilepsy patients. A consecutive sampling technique was used to enrol patients who meet inclusion criteria. Structured interview from a pre-tested questionnaire and medical records review was done to collect the data. Descriptive and inferential statistics were used for the analysis of data. Descriptive statistics (mean, standard deviation, frequency and percentages) were used to describe the clinical and demographic variables of study participants. The determinants of medication adherence were analyzed using Chi-Square test. Majority (71%) of patients were not adherent to antiepileptic treatment. The severity of seizure (indicated by the presence of seizure last year; P = 0.007), medication frequency (p = 0.001) and complexity of treatment (p = 0.003) were found to have a significant association with the AED adherence status. Status of adherence is significantly associated with frequency of seizure/year and positive life style (P=0.0001). As Medication adherence was observed to be low, services for adherence counselling and health educational interventions in the epilepsy clinics is recommended.