Factors Influencing Medication Adherence Research Articles

Factors affecting medication adherence in patients using oral chemotherapy: A descriptive study.

The utilization of oral chemotherapy agents for cancer treatment has witnessed a steady rise in recent years. The pivotal determinant for the success of oral chemotherapy lies in the adherence of cancer patients to the prescribed treatment. This study aims to explore oral chemotherapy adherence and identify factors influencing medication adherence among cancer patients. A total of 103 cancer patients participated in this descriptive study. Data were collected using the Oral Chemotherapy Adherence Scale, the Turkish Translation of the Beliefs about Medicines Questionnaire (BMQ-T) and The Functional Living Index-Cancer. Of the participants, 66% reported good adherence to oral chemotherapy. Key findings indicate that access to health services (β = -1.473, p = 0.009), cancer stage (β = -1.570, p = 0.015) and the BMQ-T subscale of General Overuse (β = .696, p = 0.041) were independent predictors of medication adherence. The study observed medication non-adherence in one-third of patients undergoing oral chemotherapy. Primary contributors to non-adherence included difficulties in accessing health services, advanced cancer stage and the belief that drugs are over-recommended by doctors. These results underscore the need for a heightened focus on preventable factors, such as improving access to health services and addressing beliefs about drug overuse, to enhance medication adherence in patients receiving oral chemotherapy.

Levels of adherence to treatment, illness perception and acceptance of illness in patients with coronary artery disease - descriptive and correlational study

BackgroundUnderstanding the disease and its acceptance significantly influence adherence to prescribed medications, a critical aspect in managing coronary artery disease (CAD). This study is designed to explore the multifaceted factors influencing medication adherence specifically in CAD patients. Of particular interest is investigating the interconnectedness between medication adherence, the perception of illness, and the level of acceptance of the illness itself among these individuals.MethodsThis cross-sectional study involved 280 confirmed CAD patients who were selected through a convenience sampling method adhering to predefined inclusion criteria. The study was conducted between March and September 2023. Three primary parameters—medication adherence, illness perception, and acceptance of illness—were evaluated using standardized tools: The Morisky Medication Adherence Scale-8, Illness Perception Questionnaire-Brief, and Acceptance of Illness Scale. Statistical analyses using SPSS (version 25) were used to analyze the data.ResultsPatients had moderate illness perception (51.82 ± 7.58) and low acceptance to illness (16.98 ± 4.75), and 61.8 of them adhered to their medication regimen. A positive relationship between acceptance of illness and medication adherence (r = 0.435, p-value < 0.01) was found. Level of education, type of drug and marital status had significantly impact on medication adherence, and gender, level of education, intention to stop drug and marital status were associated with acceptance of illness (p < 0.05).ConclusionThese results underscore the pivotal role of medication adherence in CAD management. Future interventions should target improving illness perception and acceptance of illness among CAD patients to enhance their overall adherence to prescribed medications and ultimately improve disease management.

Factors Influencing Medication Adherence in Patients Undergoing Hemodialysis

Purpose: This study aimed to investigate medication regimen complexity, social support, and beliefs about medicine as factors related to medication adherence, with the eventual goal of targeting these factors to improve medication adherence in patients undergoing hemodialysis.Methods: This study included 143 patients undergoing hemodialysis (hospitalized or outpatients) from two hospitals located in Daegu city. Data were collected from January 11 to March 31, 2023, using self-reported questionnaires, including the Morisky Medication Adherence Scale (MMAS-8), medication regimen complexity index, multidimensional scale of perceived social support, and beliefs about medicine. The collected data were analyzed using descriptive tests, the independent t-test, one-way analysis of variance, Pearson’s correlation coefficients, and hierarchical multiple regression via SPSS for Windows version 25.0.Results: Based on the MMAS-8 scores, the prevalence of medication nonadherence was determined to be 53.8%. In hierarchical regression analysis, the factors affecting medication adherence included beliefs about medicine (β=.34, &lt;i&gt;p&lt;/i&gt;&lt;.001) and social support (β=.30, &lt;i&gt;p&lt;/i&gt;&lt;.001). The total explanatory power of the regression model was 44% (F=16.83, &lt;i&gt;p&lt;/i&gt;&lt;.001).Conclusion: Social support and beliefs about medicine can be effective strategies for positively changing medication adherence in patients undergoing hemodialysis. It is essential to establish nursing intervention programs to increase social support and modify beliefs about medicine in patients undergoing hemodialysis.

Medication Adherence of Older Adults with Hypertension: A Systematic Review.

Hypertension (HTN) significantly increases the risk of stroke and heart disease, which are the leading causes of death and disability globally, particularly among older adults. Antihypertensive medication is a proven treatment for blood pressure control and preventing complications. However, medication adherence rates in older adults with HTN are low. In this review, we systematically identified factors influencing medication adherence in older adults with HTN. We applied the PRISMA guidelines and conducted systematic searches on PubMed, MEDLINE, and Google Scholar in July 2022 to identify preliminary studies reporting factors influencing medication adherence among older adults with HTN. The convergent integrated analysis framework suggested by the Joanna Briggs Institute for systematic reviews was adopted for data synthesis. Initially, 448 articles were identified, and after title and abstract screening, 16 articles qualified for full-text review. During this phase, three articles were excluded for reporting on irrelevant populations or focusing on issues beyond the review's aim, leaving thirteen studies in the final review. After data synthesis, fifteen themes were extracted from the key findings of the included studies. The most prevalent themes included the number of medications used (53.9%, n=7 studies), financial status (38.5%, n=5), sex (38.5%, n=5), age (30.1%, n=4), duration of disease (23.1%, n=3), comorbidities (23.1%, n=3), and health compliance (23.1%, n=3). Other themes, such as education, health literacy, health belief, medication belief, perception of illness, patient-physician relationship, self-efficacy, and social support, were also identified. The findings of this review highlight critical areas for developing innovative, evidence-based programs to improve medication adherence in hypertensive older adults. Insights from this review can contribute to improving medication adherence and preventing future health complications.

Assessing the Adherence to Antidiabetic Medications Among Patients Diagnosed With Type 2 Diabetes Mellitus in Ajman, UAE.

Background Medication adherence plays a vital role in managing blood sugar levels and preventing complications in individuals with diabetes. Patient adherence to antidiabetic medications and the factors associated with medication adherence were assessed. Objectives To assess the medication adherence among patients suffering from type 2 diabetes mellitus. To determine the various factors influencing medication adherence. Methods This cross-sectional study was conducted on patients with type 2 diabetes who were visiting the Internal Medicine Department of Thumbay University Hospital in the United Arab Emirates. A questionnaire was used to gather information about the medication adherence of a group of chosen consecutive patients. IBM SPSS Statistics for Windows, Version 27 (Released 2020; IBM Corp., Armonk, New York) was used for data analysis. A two-sided P-value <0.05 was regarded as significant when using the chi-square test to investigate the relationships between categorical variables. Results A total of 204 patients participated in the study: 112 (54.90%) males and 92 (45.09%) females. The mean age of the patients was 49 years. The adherence rates among males and females were 91% and 90%, respectively. Some of the common reasons for non-adherence to antidiabetic medications in our study included forgetfulness, unpleasant side effects, the use of multiple drugs, and long treatment duration. Conclusion Our study highlighted important factors associated with patients' non-adherence to their antidiabetic medications. Future research on methods to increase adherence rates should be taken into consideration.

Factors Influencing the Medication Adherence in Adults With Attention-Deficit/Hyperactivity Disorder (ADHD) and Its Impact on Healthcare Utilization

Objective: This study aims to investigate the factors influencing medication adherence among adults with Attention-Deficit/Hyperactivity Disorder (ADHD) and impact of central nervous system stimulants (CNS) adherence on healthcare utilization (HCU). Methods: This was a cross-sectional study using Medical Expenditure Panel Survey 2013 to 2019, with participants (≥18 years of age) with ADHD and had at least one CNS prescription. Multivariate logistic and linear regression were utilized to evaluate the medication adherence and its impact on HCU, respectively. Result: Total 798 (10,718,005 weighted) ADHD patients, were mostly White (81%), aged between 18 and 25 (35%), and non-adherent to CNS (65%). The use of extended-release medications (OR = 1.51 [1.03, 2.23]) and new users (OR = 3.46 [2.12, 5.63], p ≤ .05) were positively associated with medication adherence. The adherent group utilized more outpatient visits (0.04 vs. 0.46) and prescription refills (18.38 vs. 31.25) compared to non-adherent. Conclusion: Our findings can be applied to improve the medication adherence, patient education, and optimize intervention for adults with ADHD.

“Take the tablet or don’t take the tablet?”—A qualitative study of patients’ experiences of self-administering anti-cancer medications related to adherence and managing side effects

PurposeMedication non-adherence is a well-recognised problem in cancer care, negatively impacting health outcomes and healthcare resources. Patient-related factors influencing medication adherence (MA) are complicated and interrelated. There is a need for qualitative research to better understand their underlying interaction processes and patients’ needs to facilitate the development of effective patient-tailored complex interventions. This study aimed to explore experiences, perceptions, and needs relating to MA and side effect management of patients who are self-administering anti-cancer treatment.MethodsSemi-structured audio-recorded interviews with patients who have haematological cancer were conducted. A comparative, iterative, and predominantly inductive thematic analysis approach was employed.ResultsTwenty-five patients from a specialist cancer hospital were interviewed. While self-administering cancer medications at home, patients’ motivation to adhere was affected by cancer-related physical reactions, fears, cancer literacy and beliefs, and healthcare professional (HCP) and informal support. Patients desired need for regular follow-ups from respectful, encouraging, informative, responsive, and consistent HCPs as part of routine care. Motivated patients can develop high adherence and side effect self-management over time, especially when being supported by HCPs and informal networks.ConclusionPatients with cancer need varied support to medically adhere to and manage side effects at home. HCPs should adapt their practices to meet the patients’ expectations to further support them during treatment. We propose a multi-dimensional and technology- and theory-based intervention, which incorporates regular HCP consultations providing tailored education and support to facilitate and maintain patient MA and side effect self-management.

Determinan Kepatuhan Minum Obat Gagal Jantung

This study aims to determine the factors influencing medication adherence in heart failure patients at Persahabatan Hospital. The research method used is observational analytics with a cross-sectional study approach using a retrospective system. The results showed that the characteristics of respondents who adhered to taking medication were 78 people (56.1%). Factors that are significantly related to medication adherence are anxiety and family support, and the most dominant variable is the Anxiety variable (p-value: 0.018., OR: 3.157., 95%CI 1.220 – 8.171). In conclusion, the more optimal the family support received by the respondent, the better their compliance with treatment. The more the respondent does not experience anxiety, the more obedient the respondent is in taking medication.&#x0D;  &#x0D; Keywords: Determinants of Compliance with Medication, Heart Failure.

Factors influencing adherence to non-communicable disease medication in India: secondary analysis of cross-sectional data from WHO - SAGE2.

Background: Non-communicable diseases (NCDs) are a leading cause of death globally and disproportionately affect those in low- and middle-income countries lower-middle-income countries. Poor medication adherence among patients with NCDs is prevalent in India due to lack of initiation, missed dosing or cessation of treatment, and represents a growing healthcare and financial burden. Objective: This study aimed to identify factors influencing medication adherence in adults with NCDs in India. Methods: We performed a cross-sectional study, conducting secondary data analysis on the second wave of the World Health Organisation's 'Study on global AGEing and adult health (SAGE)', a survey that collected data from predominantly older adults across India. Bivariate analysis and multivariate logistic regression modelling were conducted to specifically interrogate the reasons for lack of initiation and cessation of treatment. Reporting of this study was informed by the STROBE guidelines. Results: The average medication adherence rate was 51% across 2,840 patients with one or more NCDs, reflecting non-initiation and lack of persistence of treatment. The strongest factor significantly predicting non-adherence to medication across these components was multimorbidity (odds ratio 0.47, 95% CI 0.40-0.56). Tobacco use (OR = 0.76, CI 0.59-0.98) and never having attended school (OR = 0.75, CI 0.62-0.92) were significantly associated with poor medication adherence (p < 0.05) while rural living (OR = 0.70, CI 0.48-1.02), feelings of anxiety (OR = 0.84, CI 0.66-1.08) and feelings of depression (OR = 0.90, CI 0.70-1.16) were factors lacking statistically significant association with medication adherence on multivariate analysis. Older age (OR = 2.02, CI 1.51-2.71) was significantly associated with improved medication adherence whilst there was a weak association between increased wealth and improved medication use. Limitations: The SAGE2 survey did not capture whether patients were taking their medication doses according to prescribed instructions-as a result our findings may under-estimate the true prevalence of medication non-adherence. Conclusion: Our analysis provides evidence that poor medication adherence in India is multifactorial, with distinct socioeconomic and health-system factors interacting to influence patient decision making. Future large-scale surveys interrogating adherence should assess all components of adherence specifically, whilst public health interventions to improve medication adherence should focus on barriers that may exist due to multimorbidity, comorbid depression and anxiety, and low educational status.

Evaluation of Geriatric Medication Adherence using the General Medication Adherence Scale in a Primary Care Setting

Introduction: Medication non-adherence is a significant problem, especially among geriatric patients. The General Medication Adherence Scale (GMAS) is a validated tool to assess patients’ behaviour, pill burden, comorbidity, and cost. Although this tool has been tested among patients with chronic illness, less is known about the usage of GMAS in assessing adherence among geriatric patients. Aim: This study aimed to assess the level of Medication adherence and determine the factors influencing medication adherence among geriatric patients in a primary health clinic in Malaysia. Methods: This cross-sectional study involved 250 geriatric patients on follow-up in a public primary health clinic. Adherence was measured using the GMAS, a validated 11-item structured questionnaire. Both descriptive and inferential statistics were performed. Results: Half of the respondents had a high adherence while one-quarter (26.8%) showed good adherence. Female patients were more likely to adhere to their medication regime. Most of the patients had at least three illnesses and needed an average of five medicines (25.2%). Good internal consistency of the GMAS (α =0.741) was reported. Conclusion: The medication adherence rate was good among primary care geriatric patients compared to other populations in Malaysia. To promote better adherence, patients must have a good understanding of their disease and strong beliefs about the medications prescribed.

Medication Adherence, Barriers to Adherence and Treatment Satisfaction with Antiretroviral Therapy Among Adolescents Living with HIV in Lagos, Nigeria

Background: The advent of antiretroviral therapy (ART) in controlling Human Immunodeficiency Virus (HIV) disease has been quite effective in ensuring that infected people can enjoy healthy, long, and productive lives. Medication adherence is an essential part of patient care, especially among patients with HIV, as it greatly determines the effectiveness of treatment. Few studies have explored factors influencing medication adherence and treatment satisfaction among adults, with little focus on adolescents. Objectives: To assess medication adherence, treatment satisfaction and factors influencing adherence to ART medication among adolescents living with HIV in Lagos, Nigeria. Methods: This descriptive, cross-sectional study was conducted among diagnosed and registered adolescents aged 10-19 years living with HIV and receiving treatment at eight selected antiretroviral centres in Lagos state, Nigeria. A total of 203 adolescents were recruited in stages, and data were collected using an interviewer-administered semi-structured questionnaire. Results: There was a low level of adherence as only 59/203 (29.1%) of the respondents adhered to ART. Depression, perceived stigma, being away from home, side effects of drugs, pill burden, and forgetfulness were some factors identified as barriers to adherence. The respondents were most satisfied with the effectiveness of the medication and least satisfied with the side effects.   Conclusions: Medication adherence among adolescents was relatively low; the level of satisfaction with ART medication is an entity that significantly impacts adherence.

Factors Influencing Medication Adherence in Elderly Patients with Hypertension: A Single Center Study in Western China.

To develop and empirically test a conceptual model that explains the factors influencing antihypertensive medication adherence behavior in elderly patients in a city in western China. The conceptual model was based on the Theory of Planned Behavior and the Health Belief Model and was empirically tested using cross-sectional survey data from Nanchong City, a city in western China, collected between October and December 2020. Data were analyzed using structural equation modeling. Behavioral intentions were the main predictor of medication adherence behavior (path coefficient of 0.353). Perceived benefits and perceived barriers directly (path coefficient = 0.201 and -0.150, respectively), and indirectly (path coefficient = 0.118 and -0.060) through behavioral intentions, influenced medication adherence behavior. Perceived susceptibility (path coefficient = 0.390) and perceived severity (path coefficient = 0.408) influenced behavioral attitudes, which influenced behavioral intentions (path coefficient = 0.298). The conceptual model demonstrates a robust ability to predict and explain medication adherence behavior among elderly patients with hypertension, facilitating the adoption and maintenance of changes in adherence behavior and the potential for preventing disease progression and improving quality of life.

Medication Adherence in Inflammatory Bowel Disease

Inflammatory bowel disease is a chronic idiopathic inflammatory condition with intestinal and extra-intestinal features. The key component of treating inflammatory bowel disease is medication. Patients, however, often don't take their medication as directed. Medication adherence is the act of taking a patient's prescribed medications as directed. Average medication non-adherence rates for chronic diseases are 50% in developed nations, and they are even lower in developing nations. Measuring medication adherence can be done in a variety of ways, including direct and indirect methods, each with advantages and disadvantages. The factors influencing medication adherence are multifactorial. Cost, Psychosocial-related and medication-related factors were more important determinants of adherence compared with demographic or clinical variables which will be looked at in this review. Additionally, this review talks about the negative clinical effects of non-adherence to drug therapy. Finally, this review explores different intervention strategies to improve adherence to medications. Keywords: [Inflammatory bowel disease, Medication adherence, Medication non adherence]

Comparing Medication Non-adherence in Cardiovascular Disease Patients at Public and Private Hospitals in Peshawar: A Cross-Sectional Study of Prevalence and Contributing Factors.

Introduction The incidence of cardiovascular diseases continues to increase, becoming one of the leading causes of mortality globally. The proper use of medication can greatly reduce the death rate by slowing the progression of the disease. Yet, many patients struggle with following their medication regimen due to various reasons. Effective treatment management relies on patients'self-care and understanding of their illness and medications, which can impact their adherence to taking their prescribed drugs.The objective of the study was to determine the prevalence of medication non-compliance among patients in two public and private tertiary care hospitals in Peshawarand to identify the factors that contribute to this behavior. Material and methods A comparative cross-sectional study design was employed for the research. The study was conducted at Hayatabad Medical Complex and Rehman Medical Institute in Peshawar, as these two hospitals provide care for a significant proportion of cardiovascular disease patients in the area. To assess adherence, a quantitative scale was devised with scores of 8 considered high adherence, scores between 6 and 7 considered medium adherence, and scores below 6 considered low adherence. The factors impacting medication non-adherence were analyzed using a self-administered questionnaire, which was developed following a preliminary study conducted at both hospitals. Results In total, 168 eligible patients from the two hospitals were given the questionnaire. Out of these patients, 107 (63.7%) were male, and 61 (36.3%) were female, with ages ranging from 19 to 84 and a mean age of 55.33. The level of medication adherence was calculated among the participants, with 20.2% reporting high adherence, 22.6% reporting medium adherence, and 57.1% reporting low adherence. The results showed that monthly income (p = 0.006), the presence of co-morbidities (p = 0.002), and the fear of addiction to medication (p = 0.048) were the main factors influencing medication adherence. In regression analysis with high adherence as the reference category and a 95% confidence interval, hospital affiliation was found to be significantly associated with adherence levels. Conclusions The study found that medication adherence among cardiovascular disease patients in private tertiary care hospitals is generally high. However, the level of adherence was seen to be impacted by the patient's monthly income. In light of this, the government should implement programs to reduce the cost of healthcare provision and increase affordability for patients.

Factors influencing medication adherence in multi-ethnic Asian patients with chronic diseases in Singapore: A qualitative study.

Background: Poor medication adherence can lead to adverse health outcomes and increased healthcare costs. Although reasons for medication adherence have been widely studied, less is explored about factors affecting medication adherence for patients in non-Western healthcare setting and from Asian cultures. This study aimed to explore cultural perspectives on factors influencing medication adherence among patients with chronic diseases in a multi-ethnic Asian healthcare setting. Methods: We conducted a qualitative study involving in-depth interviews with patients with chronic conditions purposively recruited from a community hospital in Singapore until data saturation was achieved. A total of 25 patients participated in this study. Interviews were transcribed and thematically analyzed. Themes were subsequently mapped into the World Health Organization (WHO) Framework of Medication Adherence. Results: Participants commonly perceived that sides effects (therapy-related dimension), poor understanding of medication (patient-related dimension), limited knowledge of condition (patient-related dimension), forgetfulness (patient-related dimension) and language issues within a multi-ethnic healthcare context (healthcare team and system-related dimension) as the main factors contributing to medication adherence. Importantly, medication adherence was influenced by cultural beliefs such as the notion of modern medicines as harms and fatalistic orientations towards escalation of doses and polypharmacy (patient-related dimension). Participants made various suggestions to foster adherence, including improved patient-physician communication, enhanced care coordination across providers, use of language familiar to patients, patient education and empowerment on the benefits of medication and medication adjustment. Conclusion: A wide range of factors influenced medication adherence, with therapy- and patient-related dimensions more pronounced compared to other dimensions. Findings demonstrated the importance of cultural beliefs that may influence medication adherence. Future efforts to improve medication adherence should consider a person-centered approach to foster more positive health expectations and self-efficacy on medication adherence, supplemented with routine reviews, development of pictograms and cultural competence training for healthcare professionals.

Analisis Faktor-Faktor yang Memengaruhi Kepatuhan Minum Obat pada Penderita DM Tipe 2 di Wilayah Kerja Puskesmas Muarasoma Tahun 2021

Abstract&#x0D; Background : Type 2 DM is DM with hyperglycemia due to a combination of insulin action resistance, insulin secretion and excessive or inadequate glucagon secretion. High adherence to medication is one of the factors that determine the success of the DM type 2 control process.&#x0D;  Objective : This study aimed to analyze the factors that influence adherence to taking antidiabetic drugs in the Muarasoma Health Center Work Area in 2021.&#x0D; Methods: This study is an analytical study using a cross-sectional approach which was conducted on 77 patientswith type 2 DM according to the inclusion and exclusion criteria in the working area of the Muarasoma HealthCenter. Knowledge level, medication adherence and family support were measured using the Diabetes Knowledge Quiestionnaire (DKQ-24), Morisky Medication Adherence Scale (MMAS-8) and the Hensarling Diabetes Family Support (HDFS) which have been validated.&#x0D;  Results: The factors influencing medication adherence in patients with type 2 DM were gender with p value = 0,002), education level with p value = 0,007, income with p value = 0,015, level of knowledge with p value =0,047, and family support with p value = 0,043). Factors that are not associated with medication adherence in patients with type 2 DM were DM duration with p value = 0,059 and drug regimen with p value = 0,056&#x0D; Conclusion: The factors that influence medication adherence in patients with type 2 DM at the Muarasoma Health Center are gender, level of education, level of knowledge, income, and family support.&#x0D;  &#x0D;  &#x0D;  

Illness Perception, Self-Efficacy, and Medication Adherence in Patients With Coronary Artery Disease: A Path Analysis of Conceptual Model.

Illness perception and self-efficacy in patients with coronary artery disease (CAD) may affect medication adherence, which is one of the most important challenges in disease management in this group of patients. The present study aimed to investigate the factors influencing medication adherence in CAD patients, especially the effect of illness perception and self-efficacy. This study was cross-sectional and conducted from April to September 2021. A total of 259 patients with confirmed CAD were selected by convenience sampling method based on inclusion criteria. Illness perception, self-efficacy, and medication adherence were investigated using Brief IPQ, SCSES, and MARS_10 questionnaires, respectively. The data were analyzed using the STATA software (version 14) and the regression path analysis method. Patients had moderate illness perception and high self-efficacy, and 61.8 of them adhered to their medication regimen. Greater illness perception, better self-efficacy, and higher education had a positive effect on medication adherence, and increasing age had a negative effect on it. The final path model shows a good fit of the data in the model (χ2: 0.37, df: 274, χ2/df: 0.36, CFI: 1, IFI: 0.95, TLI: 1.07, and RMSEA: 0.00). The results of the present study suggest that patients' illness perception can play an important role in predicting self-efficacy in disease management and the level of medication adherence in patients with CAD. To improve self-efficacy and medication adherence, future intervention studies should focus on the patient's illness perceptions and their improvement.

Effect of Pharmacist-Led Interventions on Medication Adherence and Glycemic Control in Type 2 Diabetic Patients: A Study from the Chinese Population.

Medication adherence plays an important role in glycemic control in type 2 diabetes mellitus (T2DM) self-management. To analyze the factors influencing medication adherence in T2DM patients and the effect of pharmacist-led interventions, we conducted a study in Beijing, China. T2DM patients with hypoglycemic drugs for at least 6 months were enrolled. A pharmacist-led survey was conducted followed by individualized interventions for those non-adherent patients monthly within 3 months. FPG, HbA1c, and 2hPG were measured as the comprehensive glycemic control. Medication adherence was determined according to the patient's self-reported compliance with prescribed medication during the last 3 months. A total of 763 T2DM patients were included. The average age was 63.26±11.89 years, with 363 males. After pharmacist intervention, the patients with good adherence increased from 34.21% to 39.06%, while poor adherence decreased from 32.5% to 24.5% (p < 0.001). The average adherence score was a significant increase (p < 0.001) from 27.846±4.185 to 29.831±7.065. Furthermore, our study demonstrated that pharmacist-led interventions significantly increased glycemic control (FPG from 42.33% to 53.60%, p < 0.001; 2hPG from 41.68% to 48.75%, p = 0.005; HbA1c from 24.12% to 29.23%, p = 0.024). The results found that body mass index (OR 0.643, 95% CI 0.437-0.945), use of medications empirically (occasionally (OR=3.066, 95% CI 2.069-4.543); often (OR=2.984, 95% CI 1.107-8.044)), following the doctor's advice to visit (OR 2.129, 95% CI 1.079-4.202) and lifestyle compliance (OR 2.835, 95% CI 1.094-7.346) were the independent risk factors of non-adherence (p < 0.05), the area under the ROC curve was 0.716. Self-reported medication adherence and glycemic control in T2DM patients were poor which can be improved by pharmacist-led interventions. Interventions should focus on empirical medication behavior, non-adherence to lifestyle, and failure to follow the doctor's advice. The recall bias with self-reported results needs further objective data to verify.

Factors impacting medication adherence in a birth cohort at higher risk for Hepatitis C infection

Due to the high prevalence of Hepatitis C virus (HCV) infection among individuals born between 1945 and 1965, in 2012 the Centers for Disease Control and Prevention began recommending HCV screening for this birth cohort. As adherence to HCV treatment is essential for sustained virologic response, identifying factors influencing medication adherence is important. The validated Adherence to Refills and Medications Scale (ARMS) is used to study recent medication adherence in those with chronic disease. This cross-sectional pilot study assesses factors associated with reduced adherence, indicated by higher ARMS scores, among individuals in this birth cohort. To elucidate factors associated with medication adherence, measured by the ARMS score, among a birth cohort at higher risk for HCV to guide future treatment and improve adherence. Patients born between 1945 and 1965, accessing care at an academic family medicine clinic, were recruited between April and June 2019. Demographics, prior HCV diagnosis, HCV risk factors (prior imprisonment, tattoos, and intravenous drug use), depression assessment (Patient Health Questionnaire-9), adverse childhood experiences (ACEs), and ARMS scores were collected. Mean ARMS scores were compared using t tests and analysis of variance (α = 0.05), while multiple variable models were performed using linear regression. Women comprised 58% of participants (n = 76), 52% reported depression and 37% 4 or more ACEs. The mean ARMS score was 16.3 (SD = 3.43) and 10% reported prior diagnosis of HCV. In the final multiple variable model, ARMS scores were 2.3 points higher in those with mild depression (95% CI: 0.63, 4.04), 2.0 in those with at least 4 ACEs (95% CI: 0.55, 3.49), and 1.8 in those with tattoos (95% CI: 0.30, 3.28). ACEs and food insecurity were identified as confounding variables in those with moderate to severe depression. This study found medication adherence was related to depression, ACEs, tattoos, and food insecurity among patients in this birth cohort at higher risk for HCV.

Determinants of Adherence to Antihypertensives Among Elderly: A Multifactorial Concern.

The aim of the study was to assess the predictors of adherence among elderly on antihypertensives and to examine the difference in adherence among males and females. Cross-sectional survey design was adopted for the study. The data were collected from 800 patients of age 60 years and above using demographic proforma, clinical proforma and Morisky Medication Adherence Scale (MMAS-8) with due approval from the institutional ethical clearance committee and written informed consent from the participants. The findings revealed no significant difference in the non-adherence rates among males and females. Number of medications was identified as the major predictor of adherence. Awareness of factors influencing medication adherence is crucial for health professionals to provide appropriate advice for patients to maintain quality health. The findings of the study highlight the importance of nurses' role towards imparting knowledge on hypertension and emphasizing on the importance of adherence to antihypertensives among elderly.