Determinants Of Treatment Adherence Research Articles

Determinants of Treatment Adherence and Health Outcomes in Patients With Type 2 Diabetes and Hypertension in a Low-Income Urban Agglomerate in Delhi, India: A Qualitative Study.

Background Diabetes and hypertension (HTN) are increasing threats to global public health.Despite evidence of effective management of diabetes and HTN bymedications that help in the prevention and reducing mortality of the disease, a large proportion of people either remain undiagnosed or untreated, especially in low-resource countries.This study wasconducted to explore the patient treatment pathway and their health-seeking behavior in a low-income urban area. Methodology We conducted 45 in-depth interviews of adult patients affected by type 2 diabetes mellitus (DM) and/or HTN on treatment for at least two years and attended the weeklyclinic catering to an urban resettlement colonyin the Northeast district of Delhi. Interviews were conducted and transcribed into Hindi and translated into English. Dataanalysis was done using Microsoft Excel. The patient treatment pathways were mapped, and their health-seeking behavior, treatment adherence, and experiences were described. Results Most patients reported taking treatment from the government primary health facilitiesdue to optimal healthcare accessibility as the prescribed drugs for DM/HTN control were available free of cost at these healthcare facilities. Those who visited private facilities thought of shorter waiting times and the quality of drugs. Patients also had little knowledge of complications of diabetes and hypertensive disorders. Nearly 25% of patients had poor adherence to the medications, and lifestyle modification was rarely practiced by patients although they were aware of the same. Conclusions Expanding the role of community health workers or volunteers in providing information on noncommunicable diseases might help improvepatient treatment pathways to care.

Determinants Of Treatment Adherence In Drug-Sensitive Tuberculosis Patients During The Covid-19 Pandemic

Background: During the COVID-19 pandemic in Surakarta, there were patients who were absent, failed, and dropped out of treatment. This study aims to analyze factors associated with treatment adherence of drug-sensitive tuberculosis patients (TB-SO) during the COVID-19 pandemic at the Surakarta City Public Health Center.
 Methods: This research method combines quantitative research with cross-sectional research. A sample of 105 patients from 10 Public Health Center (Puskesmas) in Surakarta City was obtained using a total population sampling based on inclusion and exclusion criteria. This research was conducted from April to June 2022. The research instrument used was a questionnaire, and the data was analyzed univariate and bivariate with the chi-square.
 Results: This study showed that more patients were adherere (79%) than non-adherent (21%). Factors related to treatment adherence were the role of health professionals (p = 0.045) and Treatment Supervisors (Pengawas Menelan Obat/PMO) support (p = 0.035).
 Conclusion: The role of health workers and the support provided by the PMO to patients related to adherence to treatment for TB-SO patients Therefore, it is expected that health professionals need to keep a good relationship with patients through personal counseling and need to provide socialization to PMOs.

Determinants of Treatment Adherence Among Patients Living With Noncommunicable Diseases: A Mixed-Method Study in a Rural Area of West Bengal.

The multisectoral impact of the COVID-19 pandemic can impair treatment adherence of patients with noncommunicable diseases (NCDs). This mixed-method study, conducted from November 2020 to January 2021, assessed the quantum of their treatment adherence and its determinants in rural West Bengal. Quantitative data were collected from 213 NCD patients while qualitative exploration for barriers of treatment adherence was conducted as 6 in-depth Interviews. Treatment adherence was assessed by “Medication Compliance Questionnaire” and “Adherence to Healthy Lifestyle and Follow-up Advice” Questionnaire. A total of 39.4% were nonadherent to medications while 67.1% had nonadherence to healthy lifestyle and follow-up advice. Significant predictors associated with nonadherence were increasing age, female gender, lower socioeconomic status, decreasing patient empowerment, and decreasing trust in the medical profession. Economic crisis, fear of contagion, and nonavailability of investigation facilities were some new emerging barriers in addition to preexisting barriers of treatment adherence. Therefore, measures for improving patient empowerment and patient–provider relationship by motivation and counseling, taking proper care of vulnerable patients affected by the pandemic, and correcting deficiencies at the health-system level should be given utmost priority.

Determinants of Treatment Adherence among Patients with Severe Mental Disorders at the Kedungmundu Primary Health Center in Semarang City

Background: Treatment adherence among patients with severe mental disorders is needed to avoid drop-outs, relapses, and shackling. Kedungmundu Primary Health Center in Semarang City is known to have a low treatment adherence to patients with severe mental disorders. This study aimed to determine the factors associated with treatment adherence among patients with severe mental disorders.Methods: A quantitative study with a cross-sectional approach. The samples were 73 patients with severe mental disorders at The Kedungmundu Primary Health Center. Data were collected using questionnaires and analyzed using frequency distribution analysis and Spearman Rank Correlation Test.Results: The results indicated that knowledge (p = 0,000; r = 0,715), attitudes (p = 0,000; r = 0,839), family support (p = 0,000; r = 0,427), assessment of health workers (p = 0,000; r = 0,456), and the need for health services (p = 0,000; r = 0,716) have a positive correlation with treatment adherence among severe mental disorders patients.Conclusion: Kedungmundu Primary Health Center is suggested to provide psychoeducation to patients and families, improve the implementation of mental health programs, and empower mental health cadres.

Determinants of Treatment Adherence among Patients with Severe Mental Disorders at the Kedungmundu Primary Health Center in Semarang City

Background: Treatment adherence among patients with severe mental disorders is needed to avoid drop-outs, relapses, and shackling. Kedungmundu Primary Health Center in Semarang City is known to have a low treatment adherence to patients with severe mental disorders. This study aimed to determine the factors associated with treatment adherence among patients with severe mental disorders.Methods: A quantitative study with a cross-sectional approach. The samples were 73 patients with severe mental disorders at The Kedungmundu Primary Health Center. Data were collected using questionnaires and analyzed using frequency distribution analysis and Spearman Rank Correlation Test.Results: The results indicated that knowledge (p = 0,000; r = 0,715), attitudes (p = 0,000; r = 0,839), family support (p = 0,000; r = 0,427), assessment of health workers (p = 0,000; r = 0,456), and the need for health services (p = 0,000; r = 0,716) have a positive correlation with treatment adherence among severe mental disorders patients.Conclusion: Kedungmundu Primary Health Center is suggested to provide psychoeducation to patients and families, improve the implementation of mental health programs, and empower mental health cadres.

Determinants of Treatment Adherence and Retention in Care among HIV Positive Pregnant and Breastfeeding Women in a Rural District in Zimbabwe

Determinants of Treatment Adherence and Retention in Care among HIV Positive Pregnant and Breastfeeding Women in a Rural District in Zimbabwe

Outcomes and Determinants of Treatment Adherence among HIV Patients on Art: Evidence from a Retrospective Cohort Study in Selected Clinics in Windhoek, Namibia

Outcomes and Determinants of Treatment Adherence among HIV Patients on Art: Evidence from a Retrospective Cohort Study in Selected Clinics in Windhoek, Namibia

Determinants of treatment adherence among women with osteoporosis: A qualitative study in Iran

Determinants of treatment adherence among women with osteoporosis: A qualitative study in Iran

Determinants of treatment adherence among the patients receiving treatment in the ART centre of a tertiary hospital in Kolkata, West Bengal, India

Background: WHO recommended adherence of 95% or more to antiretroviral therapy for better outcome in terms of general well-being and decreased chance of drug resistance. This study was conducted with the objective of describing the factors associated with adherence pattern to ongoing ART regimens in adults with HIV/AIDS in R. G. Kar Medical College and Hospital (RGKMCH), a tertiary hospital in Kolkata, West Bengal, India.Methods: An observational, descriptive cross-sectional study was conducted on the adults receiving treatment at the ART centre of R. G. Kar Medical College, Kolkata. Patients above 15 years of age, who received at least one year of treatment before the day of the interview, comprise the study population. Sample size was 279. We tried to find out any association between adherence level and factors like socio-demographic profile, treatment profile, lifestyle pattern etc. applying bivariate analysis, Chi square test, multiple logistic regressions. Data were analyzed using IBM SPSS (version 20).Results: Different factors like employment status, monthly income, language of communication, addiction, following advice on food and water intake, side effects from ART were found to be statistically associated with level of adherence among the subjects.Conclusions: Emphasis should be given on thorough counseling of the people with HIV/AIDS so as to motivate them to take medication as advised and to maintain adequate adherence level of therapy improving their general well-being.

Sociocultural determinants of treatment adherence in bipolar disorders: a review of recent trends

Non-adherence to medication or treatment is one of the greatest challenges in psychiatry, especially among persons with bipolar disorders. Non-adherence is multi-factorial. Studying sociocultural f...

Genetic predictors of antidepressant side effects: A grouped candidate gene approach in the Genome-Based Therapeutic Drugs for Depression (GENDEP) study

The unwanted side effects associated with antidepressants are key determinants of treatment adherence in depression; propensity to experience these adverse drug reactions (ADRs) may be influenced by genetic variation. However, previous work attempting to ascertain the genetic variants involved has had limited success, in part due to the range of ADRs reported with antidepressants. ADRs reported with antidepressant treatment were categorised using their likely pharmacological basis; adrenergic, cholinergic, serotonergic and histaminergic. To identify genetic predictors of susceptibility to each group of ADRs, a candidate gene analysis was performed with data from 431 depressed patients (from a total sample size of 811 patients) enrolled in the Genome-Based Therapeutic Drugs for Depression (GENDEP) project, who were randomly allocated to receive treatment with escitalopram or nortriptyline. Data from 474 patients treated with citalopram or reboxetine in the GenPod project (total sample of 601 patients) were used for replication of significant findings. We found no significant predictors of presumed adrenergic, cholinergic and histaminergic ADRs. Putative serotonergic ADRs were significantly associated with variation in the gene encoding the serotonin 2C receptor (HTR2C, rs6644093, odds ratio (OR)=1.72, 95% confidence interval (CI)=1.31-2.25, p=7.43×10(-5)) in GENDEP. However, this finding was not replicated in GenPod. The association between serotonergic side effects and variation in the HTR2C gene in the GENDEP sample supports the hypothesis that serotonin receptor-mediated mechanisms underlie these adverse reactions, however this finding was not replicated in GenPod.

Determinants of treatment adherence among smear-positive pulmonary tuberculosis patients in Southern Ethiopia.

BackgroundDefaulting from treatment remains a challenge for most tuberculosis control programmes. It may increase the risk of drug resistance, relapse, death, and prolonged infectiousness. The aim of this study was to determine factors predicting treatment adherence among smear-positive pulmonary tuberculosis patients.Methods and FindingsA cohort of smear-positive tuberculosis patients diagnosed and registered in Hossana Hospital in southern Ethiopia from 1 September 2002 to 30 April 2004 were prospectively included. Using a structured questionnaire, potential predictor factors for defaulting from treatment were recorded at the beginning of treatment, and patients were followed up until the end of treatment. Default incidence rate was calculated and compared among preregistered risk factors. Of the 404 patients registered for treatment, 81 (20%) defaulted from treatment. A total of 91% (74 of 81) of treatment interruptions occurred during the continuation phase of treatment. On a Cox regression model, distance from home to treatment centre (hazard ratio [HR] = 2.97; p < 0.001), age > 25 y (HR = 1.71; p = 0.02), and necessity to use public transport to get to a treatment centre (HR = 1.59; p = 0.06) were found to be independently associated with defaulting from treatment.ConclusionsDefaulting due to treatment noncompletion in this study setting is high, and the main determinants appear to be factors related to physical access to a treatment centre. The continuation phase of treatment is the most crucial time for treatment interruption, and future interventions should take this factor into consideration.

Economics of antihypertensive therapy in the elderly.

Because of the high incidence of morbidity and mortality associated with hypertension in the elderly, the treatment of hypertension in this patient group must involve consideration of clinical, humanistic and economic outcomes. The most frequently used method of pharmacoeconomic analysis for antihypertensive therapy involves cost-effectiveness analysis, although several other methods are available. Current evidence reveals a trend toward cost effectiveness of antihypertensive treatment in elderly patients. However, these formal analyses are limited by the need for extrapolation of data regarding efficacy and level of risk from epidemiological and randomised trials, information which is often lacking. To incorporate economic factors into clinical decision making, other measures of economic impact should be explored. The economic impact of antihypertensive therapy is affected by the level of risk for the patient and the efficacy of the treatment. Data indicate that the risk of morbidity and mortality related to hypertension increases with age and that current antihypertensive drugs reduce this risk. When choosing an antihypertensive agent, the following parameters should be considered: acquisition cost, likelihood of adverse effects and other determinants of treatment adherence, and individual predictors of response. The economic outcomes will be maximised if prudent drug selection is supplemented by appropriate diagnostic and classification procedures and reduction of cardiovascular risk factors other than hypertension. The accumulation of data addressing the risks and benefits of therapy for the very old and the comparative efficacy of newer antihypertensive therapies will further clarify the decision-making process.