General Medication Adherence Scale Research Articles

Association of Anxiety and Depressive Symptoms and Treatment Adherence Among Patients With Type 2 Diabetes Mellitus in Jazan, Saudi Arabia: A Cross-Sectional Study.

Diabetes mellitus is a serious public health concern. It is associated with many psychological problems, such as depression, anxiety, and eating disorders. These co-morbidities are associated with improper adherence to treatment, self-care, poor glycemic control, more complications, and worse outcomes. This study aimed to measure the level of medication adherence among type 2 diabetics in Jazan, Saudi Arabia, and to find its association with their psychological status (specifically, depression and anxiety).A cross-sectional descriptive design was used among adults with type 2 diabetes at the Diabetes and Endocrinology Center in Jazan, Saudi Arabia. The estimated sample size was 480 patients.The General Medication Adherence Scale and Patient Health Questionnaire-4 (PHQ-4) were used as tools to achieve the study objectives. A total of 449 diabetic patients completed the survey (93.5% response rate). Patients with poor, low, and partial adherence account for 337 (75%) of patients and only 112 (25%) have good and high medication adherence. Employment and duration of illness were highly significant with a positive relationship to treatment adherence (p = 0.010 and 0.000, respectively). On the other hand, age and disease duration had a significant relationship with psychological disorders (p = 0.029and 0.002, respectively).Of the patients,64 (14.3%) had high scores on the PHQ-4, with depressive symptoms in 46 (10.24%) and anxiety symptoms in 75 (16.7%). Correlation analysis reveals that there is a highly significant negative correlation between psychological disorders and adherence to medications (r = -0.288, p = 0.000). A negative correlation between psychological disorders and adherence to medications was found. The findings indicate the importance of psychological support for diabetic patients for better treatment adherence.

Depression, and Drug Adherence in Type 2 Diabetes Mellitus in Primary Care in the Kingdom of Bahrain

Depression stands out as the predominant risk factor among Type 2 diabetes (T2DM) patients. Depression and its association with drug adherence in T2DM patients are lacking in Bahrain. The current study aimed to examine the association depression in relation to drug adherence in T2DM in primary care centers in the Kingdom of Bahrain. This was a cross-sectional study that enrolled 455 people with T2DM. Data on demographics, risk behavior, and diabetes details were noted. Measuring tools such as patient health questionnaire (PHQ-9) to measure depression severity, and General Medication Adherence Scale (GMAS) were used to assess medical adherence respectively. Categorical variables and continuous variables were presented in a frequency table and mean ± SD/ Median (Min, Max) respectively. The data was analyzed using SPSS 24.0 software. The statistical significance threshold was set at p=0.05. The study involved participants with an average age of 54.5 ± 11.5 (M±SD) years. The frequency of depression based on PHQ-9 and medical adherence as per GMAS among T2DM patients was 30.5% and 79.1% respectively. There was a significant association between the prevalence of depression and adherence (x2 =25.03; P=0.001). Age (r=-0.121; P= 0.010), education (r=-0.096; P=0.040), family income (r=-0.101; P=0.031), physical activity (r=-0.193; P=0.001), and self-rated diabetes control within the last visit (r=-0.200; P=0.001) were significantly negatively correlated with PHQ – 9 scale. Likewise, age (r=-0.231; p=0.001), education (r=-0.123; p=0.008), nationality (r=-0.185; p=0.001), physical activity (r=-0.108; p=0.021), and self-rated diabetes control within the last visit (r=-0.139; p=0.003) were significantly negatively correlated with the GMAS scale. Our findings suggest that medical adherence is linked to depression. Age, height, education, family income, physical activity, and self-rated diabetes control in the previous visit are all important factors that are correlated to depression and drug adherence.

Effectiveness of clinical pharmacist intervention on medication adherence in patients with chronic obstructive pulmonary disease - A randomized controlled study

ObjectivesIn patients with chronic obstructive pulmonary disease (COPD), non-adherence remains challenging to achieve optimal disease control. Our study aimed to determine the impact of pharmacist-led educational interventions on COPD management, focusing mainly on medication adherence. MethodsWe conducted a 1-month open-labeled, randomized, controlled study at Ba Ria Hospital, Vietnam. COPD outpatients were randomly assigned to the intervention group or control group. Pharmacist-delivered education emphasized medication adherence, disease, and medication knowledge. The primary outcome was the between-group difference in medication adherence after the intervention, as assessed by the general medication adherence scale (GMAS). ResultsOf 181 recruited patients, 180 completed the follow-up. After the intervention, the results indicated a significant improvement in medication adherence rate between the two groups (90.1% vs. 66.3%, p < 0.001). Patient behavior was the most common barrier to non-adherence but was effectively reduced at the endpoint. The Modified Medical Research Council (mMRC) scale of dyspnea and inhalation technique also improved significantly in intervention patients. ConclusionsPharmacist intervention can considerably improve medication adherence and knowledge of COPD patients. Practice implicationsThis study promotes the value of clinical pharmacists in patient education to achieve better adherence and enhance population health, especially in resource-limited nations like Vietnam.

Uncontrolled Hypertension, Treatment, and Predictors among Hypertensive Out-Patients Attending Primary Health Facilities in Johannesburg, South Africa.

Hypertension is a poorly controlled risk factor for cardiovascular disease in South Africa, particularly among patients receiving care in the public sector who are mostly from low socioeconomic backgrounds. This cross-sectional study investigated uncontrolled hypertension, treatment, and predictors among hypertensive out-patients attending primary health care facilities in Johannesburg, South Africa. The WHO STEPwise approach to the surveillance of non-communicable diseases was used to collect data, including sociodemographic and lifestyle factors, health status, and measurements for anthropometry and blood pressure along with self-reported adherence to treatment, estimated through the general medication adherence scale. Uncontrolled hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg in diagnosed patients receiving anti-hypertensive treatment. Overweight and obesity were defined as a body mass index ≥25 and ≥30 kg/m2, respectively. Logistic regression models were used to assess the predictors of uncontrolled hypertension. Four hundred (n = 400) hypertensive out-patients (mean age: 50 ± 8 years) participated in this study, with most living in poor sociodemographic environments. The prevalence rate of uncontrolled hypertension was 57%. Obesity (62% vs. 42%, p ≤ 0.0001), salt consumption (90% vs. 55%, p ≤ 0.0001), alcohol intake (42% vs. 19%, p ≤ 0.0001), a smoking habit (23% vs. 4%, p ≤ 0.0001), alternative medicine use (51% vs. 40%, p = 0.043), and comorbidities (64% vs. 36%, p ≤ 0.0001) were higher in the uncontrolled group than the controlled group, whereas the prevalence of physical activity (38% vs. 15%, p ≤ 0.0001) was high in the controlled group vs. the uncontrolled. Overall, 85% of the patients moderately adhered to treatment, only 2% exhibited high adherence, and 13% demonstrated low adherence; over half of the patients received tri-therapy treatment. The predictors of uncontrolled hypertension are a number of prescribed antihypertensive therapies [adjusted odds ration = 2.39; 95% confidence interval: 1.48-3.87], treatment adherence [0.46; 0.21-0.97], salt consumption [28.35; 7.87-102.04], physical activity [0.22; 0.13-0.37], current alcohol use [2.10; 1.22-3.61], and current cigarette smoking [4.79; 1.88-12.18]. The high prevalence of uncontrolled hypertension in this study suggests a need to optimize prescriptions, adherence to BP-lowering medications, and lifestyle modifications. The management of comorbidities such as diabetes could offer considerable benefits in controlling blood pressure.

Measurement of medication adherence among type II diabetes patients attending primary healthcare facilities in Morocco.

Background: The aim of this study was to assess medication adherence among Moroccan patients with type 2 diabetes. Methods: To achieve this objective, a quantitative cross-sectional study was conducted among patients with type 2 diabetes in Morocco. The General Medication Adherence Scale (GMAS) was used to measure medication adherence in this target population. The study received ethical approval from the Moroccan Association for Research and Ethics. Results: A total of 284 patients were included in the study. Among them, 90.30% of type 2 diabetes patients demonstrated high adherence to their medication treatment, while 5.30% were considered to have moderate adherence and only 4.40% showed partial adherence. However, when the cumulative evaluation of medication adherence towards antidiabetic drugs was conducted, the results confirmed an adherence rate of approximately 95.78%. Conclusions: The study's findings revealed a high level of medication adherence among type 2 diabetes patients. To sustain these encouraging results, it will be crucial to maintain and value the efforts made by healthcare professionals involved in the care of these patients.

General medication adherence scale in patients with chronic illnesses: Persian translation and psychometric evaluation.

This study was conducted with the aim of determining the validity and reliability of the Persian version of "General Medication Adherence Scale (GMAS)" in chronic patients in Iran. The study was conducted among patients with chronic diseases in five hospitals of Iran. In this study, after cultural validation, using the steps of Content, Response Reaction, and Internal structure evaluations, the research sample was increased to 150 individuals for exploratory factor analysis (EFA) and 313 chronic patients for confirmatory factor analysis (CFA) to confirm the construct validity. Cronbach's alpha coefficient was used to assess internal consistency, and test-retest method was used to evaluate the reliability of the tool. The results of EFA and CFA confirmed the tool with three factors and 11 items. The R2 index in the above model was estimated at 0.99, indicating that 99% of the variation in medication adherence scores in research units was explained by GMAS with 11 items. The main indices of the model in factor analysis were all above 0.9, indicating a good fit for the model. Overall, the study results showed that the Persian version of GMAS has acceptable and practical characteristics for evaluating medication adherence, and it can be used as a valid tool in various related fields.

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.

Translation and validation of the Sindhi version of the general medication adherence scale in patients with chronic diseases.

Background: There is no medication adherence scale available in Sindhi language currently. Hence, the Sindhi speaking population will either use a translator or provide their medical history in another language for documentation of medical conditions. This poses a challenge in monitoring and evaluating adherence to medications within this linguistic community. Aim: The aim of this study was to translate and validate the Sindhi version of the General Medication Adherence Scale (GMAS-S) in patients with chronic diseases. Methods: This was a cross-sectional study of 4 months duration and was conducted in out-patient department of a university affiliated hospital in Karachi, Pakistan. All adults with chronic diseases, who were on long-term medications, and able to read and understand Sindhi language were invited. Convenience sampling was employed and a questionnaire consisting of demographic questions and the Sindhi version of GMAS was used. The translation of the scale was carried out. Confirmatory factor analysis (CFA) was conducted, and a structural equation model (SEM) was developed. Fit indices, namely, goodness of fit index (GFI), adjusted goodness of fit index (AGFI), Tucker Lewis index (TLI), comparative fit index (CFI), and root mean square error of approximation (RMSEA) were reported. Reliability was assessed using Cronbach's alpha (α), intraclass correlation coefficient (ICC), corrected item-to-total correlation (ITC) and item deletion. Data were analysed through IBM SPSS version 23 and IBM AMOS version 25. The study obtained ethical clearance. Results: A total of 150 responses were analysed. The reliability of the Sindhi version of GMAS was (α) = 0.696. The intraclass correlation coefficient (ICC) was reported at 0.696 (95% CI: 0.618-0.763). The values for the fit indices were as follows: χ2/df = 1.84, GFI = 0.918, TLI = 0.920, CFI = 0.942, AGFI = 0.864, and RMSEA = 0.075. All values except AGFI were in the acceptable ranges and indicated good fitness. Most participants (80.7%) appeared non-adherent to their medications. Conclusion: The results of the study demonstrate that the Sindhi version of the GMAS is a valid and reliable scale to measure adherence in Sindhi speaking persons with chronic diseases.

Validation of the Arabic version of the general medication adherence scale in patients with type 2 diabetes mellitus in Jordan.

Background: Medication adherence is a major challenge for patients with diabetes. Adherence rates are often low, and this can lead to poor glycaemic control and increased risk of complications. There are a number of tools available to measure medication adherence, but few have been validated in Arabic-speaking populations. Aim: This study aimed to validate the Arabic version of the General Medication Adherence Scale in patients with type 2 diabetes in Jordan. Methods: A cross-sectional study was conducted for 3months among patients attending diabetes mellitus outpatient clinic in Irbid, Jordan. The validation procedure included confirmatory factor analysis (CFA) and equation modelling (SEM). Fit indices, namely, goodness of fit index (GFI), Tucker Lewis index (TLI), comparative fit index (CFI), and root mean square error of approximation (RMSEA) were observed. Corrected item-total correlation (ITC) was reported. Reliability was assessed using Cronbach's alpha (α) and α value based on item deletion was also carried out. Intraclass correlation coefficient (ICC) was reported. Data were analyzed using IBM SPSS v23 and IBM AMOS v25. Results: Data from 119 participants were gathered. The mean adherence score was 27.5 (±6) ranging from 6 to 33. More than half of the patients were adherent to their therapy (n = 79, 66.4%). The reliability of the scale (n = 11) was 0.907, and ICC ranged from 0.880-0.930: 95% CI. The following values were observed in CFA; χ2 = 62.158, df = 41, χ2/df = 1.516, GFI = 0.913, AGFI = 0.860, TLI = 0.960, CFI = 0.971 and RMSEA = 0.066. A total of 10 out of 11 items had corrected ITC >0.5. The α remained between 0.89-0.92 during item deletion. Conclusion: The results obtained in this study suggest that the scale is valid and reliable in measuring adherence to medications in the studied sample of patients with diabetes. This scale can be used by clinicians in Jordan to assess adherence and may further aide in evaluating interventions to improve adherence rates in persons with type 2 diabetes.

Translation, cultural adaptation and validation of the General Medication Adherence Scale (GMAS) in moroccan patients with type-2 diabetes

BackgroundThe objective of the study was to cross-culturally adapt and validate the General Medication Adherence Scale (GMAS) in patients with type-2 diabetes in Morocco.MethodsThe study was a cross-sectional study conducted between September 12 and October 12, 2022, and included patients with type-2 diabetes from a primary health care network. To measure the different psychometric parameters of the construct, data analysis was performed using SPSS v20. The study was approved by the Moroccan Association for Research and Ethics.ResultsA total of 284 patients were included in the study; the results of the different psychometric parameters were largely acceptable. Indeed, the improvement of the goodness-of-fit of the model in relation to the independence model was evaluated by the comparative fit index (CFI), which was higher than 0.95, as well as the normalized fit index (NFI), which expresses the percentage of the general covariance between the variable demonstrated via the tested model when the null model is taken as reference and was also higher than 0.95 in this study. Additionally, the Tucker Louis Index (TLI) or Unstandardized Fit Index, which measures the increase in goodness of fit when moving from the reference model to the model under study, had a value of > 0.95. The correlations between the items were good; indeed, the Kaiser-Meyer-Olkin (KMO) index was > 0.7. The translated tool presents good internal consistency; thus, Cronbach’s α had a value of approximately 0.804 (> 0.7).ConclusionsThe version of the GMAS tool adapted to the Moroccan context has very acceptable psychometric values. This means that Moroccan researchers and health professionals can use it as an instrument to measure adherence among individuals with type-2 diabetes.

Medication adherence and its influencing factors in community-dwelling older adults with chronic illnesses in a rural area

Background &amp; Aim: Older adults with chronic diseases are usually required to manage multiple medications and complex medication regimens. Medication adherence is crucial in older adults which is increasingly being recognized due to its potential to impact healthcare utilization and treatment efficacy. The current study aimed to assess medication adherence and its influencing factors in community-dwelling older adults with chronic illnesses in rural areas. ‎&#x0D; Methods &amp; Materials: A cross-sectional study design was used to achieve the study aim. The study sample was composed of 310 older patients from a rural area in Sharkia Governorate, Egypt. Medication adherence was assessed by the Arabic version of the General Medication Adherence Scale. Association between medication adherence and older patients' characteristics was identified through the Chi-square test, Pearson's correlation coefficient, and Logistic regression.&#x0D; Results: Among 310 older patients, 84.8% of them were non-adherent to their medications. Significant relationships were found between medication adherence and age, gender, educational level, marital status, and monthly income. Aging less than 70 years, female gender, sufficient income, fewer illnesses, and medication number were significant predictors for medication adherence.&#x0D; Conclusion: The current study findings revealed that most rural older adults with chronic illnesses were non-adherent to their medications, with many influencing factors such as age, gender, educational level, monthly income, and illnesses and medication number. So, the study recommends the importance of developing strategies to improve medication adherence in community-dwelling older adults in rural areas.

Brief cognitive behavior therapy for stigmatization, depression, quality of life, social support and adherence to treatment among patients with HIV/AIDS: a randomized control trial

ObjectiveIndividuals living with HIV/AIDs are at a high risk of many problems like depression, stigma, quality of life, decreased adherence to treatment, and lack of social support. The present study aimed to investigate the impact of brief-cognitive behavior therapy (B-CBT) on reducing depression and stigma and improving treatment adherence, quality of life, and social support among patients with HIV/AIDS attending antiretroviral therapy (ART).Materials and methodsThis randomized clinical trial was conducted at ART Clinic in the Tehsil Headquarters Hospital Shahkot Nankana Sahib from July 2021 to October 2021. After baseline screening, 126 patients met the eligibility criteria and 63 were allocated to the experimental group (EXPg = 63) and 63 to waitlist-control group (WLCg = 63). Participants’ age range was from 20 to 55 years. Participants who were taking ART treatment were enrolled for the CBT treatment. Before this, all the participants completed a baseline assessment to ensure a level of severity and diagnosis. A total of eight CBT based therapeutic sessions were conducted individually with EXPg. To assess the outcomes among patients receiving ART, we used Demographic form, Patient health questionnaire, HIV stigma scale, General medication adherence scale, Multidimensional scale of perceived social support, and WHOQOL BREF scale.ResultsFindings suggest that B-CBT significantly reduced the level of depression (i.e. F (1, 78) = 101.38, p < .000, η2 = .599), and social stigma (i.e. F (1, 78) = 208.47, p < .000, η2 = .787) among patients with HIV/AIDS. Furthermore, CBT substantially improved the level of adherence to treatment (i.e. F(1,78) = 24.75, p < .000, η2 = .503), social support (i.e. F (1, 78) = 128.33, p < .000, η2 = .606), and quality of life (i.e. F (1, 78) = 373.39, p < .000, η2 = .837) among patients with HIV/AIDS. Significant mean difference M(SD) on PHQ at post-analysis in the EXPg vs. WLCg was seen 1.22(0.47) vs. 2.30(0.68) and similarly, on MPSS at a post-analysis in the EXPg vs. WLCg 2.85(0.36) vs. 1.70(0.51) which indicates sound therapeutic outcomes.ConclusionsCognitive behavioral therapy effectively decreases the level of depression and stigma and enhances the level of social support, quality of life, and adherence to treatment among HIV/AIDS patients. It is concluded that cognitive behavior therapy is an effective treatment approach for patients with HIV/AIDS.Trial registrationThai clinical trial registry (i.e. TCTR = TCTR20210702002).

Predictors of Medication Adherence among Patients with Bipolar I Disorder

The present study aimed to determine predictors of medication adherence among patients diagnosed with Bipolar I Disorder (BP-I). Another aim was to estimate differences with different marital status  in perceived social support, internalized stigmatization and medication adherence. Correlational research design was used and a sample of 103 participants was gathered using purposive sampling method. Data was collected by administering Multidimensional Scale of Perceived Social Support (MSPSS), Internalized Stigma of Mental Illness (ISMI), and General Medication Adherence Scale (GMAS). Results illustrated perceived social support (R2 = .46, F (3, 99) = 28.52, p&lt;0.001) and internalized stigmatization R2 = .49, F (8, 94) = 11.40, p&lt;0.001) to be significant predictors of medication adherence. Furthermore, it was found that married individuals with bipolar I disorder received more support [F (1, 101) = 4.08, p = .04] and were more adherent to medication [F (1, 101) = 6.35, p = .01] as compared to single individuals with bipolar I disorder. However, no significant difference was found between married and single patients in their experience of internalized stigmatization.  Present study highlights the need for awareness campaign where individuals are informed regarding the importance of their support and also the need for educational workshops for skill building in patients with Bipolar I disorder.

Effect of Pharmacist-Led Interventions on Medication Adherence among Vietnamese Patients with Asthma: A Randomized Controlled Trial.

Medication adherence in asthmatic patients enhances the effectiveness of treatments, but some studies in low and middle-income countries still show some limitations. Our study aimed to determine if pharmacist-led interventions could increase medication adherence, improve treatment effectiveness, and relieve symptom severity in outpatients with asthma. We conducted a randomized, controlled trial on 247 asthmatic outpatients (aged ≥ 16) with a 1:1 ratio randomization at the hospitalization time and repeated after 1-month discharge. The primary outcome was to detect the difference in medication adherence between groups. Adherence was assessed by the general medication adherence scale (GMAS). Data collected by questionnaire was coded and entered into SPSS_20 for statistical analysis; Results: 247 patients (123 intervention, 124 control) were enrolled (61.1% male). After intervention, the adherence rate was higher among the intervention group than the control group (94.3% vs. 82.8%, p = 0.001). Patient behavior and knowledge were enhanced in the intervention group (p < 0.05). Asthma symptoms were relieved in the intervention group (p = 0.014). Pharmacist-led interventions on adherence rate were higher with OR: 3.550, 95% CI: 1.378-9.143, p = 0.009. pharmaceutical intervention could improve medication adherence, treatment efficacy, and the outcome should not be taken for granted; further research should be carried out in this regard.

Exploration of the psychometric properties of the novel General Medication Adherence Scale (GMAS) for chronic illness patients

Objective Many related scales have been developed and applied to measure patients’ medication adherence, but the research on the psychometric characteristics of the scale still requires further studies. This study aims to provide further validation of the GMAS scale by using Rasch analysis and to make targeted recommendations for scale improvement. Methods This is a cross-sectional study using secondary data. 312 Chinese adult patients were recruited from two tertiary hospitals and one community health service center in Tianjin to complete a questionnaire containing the GMAS, from January to June 2020. Participants included to have at least one chronic condition and also have been on medication for more than 3 months, but excluded patients with major life-threatening illnesses (e.g. heart failure, cancer), cognitive impairments preventing clear expression and significant communication difficulties. Rasch analysis was used to explore the psychometric properties of the GMAS scale. Key indicators including unidimensionality, validity and reliability, differential item functioning and degree of fit with Rasch model are validated. Results After fitting the Rasch model for the first time, 56 samples poorly fitting the model were deleted. The remaining 256 samples were used for Rasch analysis. The results show that GMAS can fit the Rasch model well, which proves that the scale has favourable psychometric characteristics. But some items had differential item functioning in whether patients have comorbidities. Conclusion The GMAS was found to be useful as a screening tool for patients’ medication adherence problems reported, except some issues to be addressed for further improvement of the scale.

Medication Adherence to Psychotropic Medication and Relationship with Psychiatric Symptoms among Syrian Refugees in Turkey: A Pilot Study

Background: Due to experiencing traumatic and stressful events, refugees are at risk of having mental disorders. The refugees might need to use psychotropic agents to treat mental disorders. It is essential to understand this population’s adherence rate to psychotropic medication. Aim: This study aimed to evaluate adherence to psychotropic medication and the relationship with psychiatric symptoms among Syrian refugees in Turkey. Method: The study design was descriptive and correlational. The study was conducted with 55 Syrian refugees attending a community health center in southern Turkey. The data was collected with General Medication Adherence Scale–Arabic Version (GMAS–AR) and Brief Psychiatric Inventory (BPI). Results: 78.2% (n: 43) of the participants’ medication adherence was poor, and a significant negative and weak correlation was found at 0.01 level between GMAS–AR and BPI (r: −0.37). According to multiple linear regression analysis, the model with gender and BPI was significant, and this model explained 19% of GMAS–AR total points (p &lt; 0.001). Conclusion: Mental health professionals should test the effectiveness of psychosocial interventions that increase adherence to treatment for the cultural characteristics of societies.

Fracture liaison services combined with online home nursing care in fragility hip fracture: a comparative effectiveness pilot study.

Among potential e-health platforms, mobile internet encompasses the largest user group of mobile instant messaging software in Asia and offers strong interaction, low cost, and fast speed. The online home nursing care model prevents unnecessary hospital admissions and readmissions. This study aims to explore the effects of a fracture liaison service (FLS) model combined with online home nursing care on patients with fragility hip fracture. Patients discharged after November 2020 received FLS care combined with online home nursing care. Patients discharged from May 2020 to November 2020 received only routine discharge guidance and were classified as the control group. The Parker Mobility Score (PMS), Medical Outcomes Study 36-item short-form health survey (MOS SF-36), general medication adherence scale (GMAS), complication rate, and fall/refracture rates were used to evaluate the efficacy of the FLS combined with online home nursing care during the 52-week follow-up period. Eighty-nine patients with complete follow-up information were included in the analysis at the 52-week follow-up. The FLS combined with online home nursing care was associated with improved osteoporosis patient care, including increased medication adherence (64.58% in the control group and 90.24% in the observation group), improved mental quality of life, reduced fall/refracture rate (12.5% and 4.88%, respectively), and reduced rates of bedsores and joint stiffness; however, there was no effect on functional recovery within 1year. We recommend the combination of FLS with online home nursing care, considering the local environment, to economically and conveniently monitor patients, reduce falls and refractures, and improve care and medication adherence.

Cognitive behavior therapy for diabetes distress, depression, health anxiety, quality of life and treatment adherence among patients with type-II diabetes mellitus: a randomized control trial

ObjectiveDiabetes distress typically causes depressive symptoms; common comorbidity of diabetes unpleasantly affects patients’ medical and psychological functions. Psychotherapeutic interventions are effective treatments to treat depressive symptoms and to improve the quality of life in many chronic diseases including diabetes. The present study investigated the efficacy of cognitive behavior therapy (CBT) to treat depressive symptoms in patients with type 2 diabetes mellitus (T2DM) using experimental and waitlist control conditions.Materials and MethodsA total of 130 diagnosed patients with T2DM were taken from outdoor patients services of different hospitals in Faisalabad. Ninety patients met the eligibility criteria and were randomly assigned to experimental (n = 45) and waitlist control (n = 45) conditions. All the patients completed clinical interviews and assessment measures at pre-and post-assessment stages (16 weeks intervals). Medical consultants at the respective hospitals diagnosed the patients on the base of their medical reports and then referred those patients to us. Then we used different scales to assess primary and secondary outcomes: Diabetes Distress Scale (DDS) and Patient Health Questionnaire (PHQ) to assess primary outcomes, and a Short Health Anxiety Inventory (SHAI), a Revised Version of the Diabetes Quality of Life Questionnaire (DQLQ), and a General Medication Adherence Scale (GMAS) were used to investigate secondary outcomes. Repeated measure ANOVA was used to analyze the results.ResultsThe findings indicated that patients who received CBT got a significant reduction in their diabetes distress F(1,60) = 222.710, P < 0.001, η2 = .788), depressive symptoms F(1,60) = 94.436, P < 0.001, η2 = .611), health anxiety F(1,60) = 201.915, P < .0.001, η2 = 771), and a significant improvement in their quality of life F(1,60) = 83.352, P < 0.001, η2 = .581), treatment adherence F(1,60) = 67.579, P < 0.001, η2 = .566) and physical activity schedule F(1,60) = 164.245, P < .0.001, η2 = .736 as compared to the patients in waitlist control condition.ConclusionIt is concluded that cognitive behavior therapy is an effective and promising intervention for depressive symptoms, diabetes distress, and health anxiety which also helps the person to promote quality of life, treatment adherence and physical activity.

Effectiveness of an instructional program on patient's adherence about clopidogrel therapy post percutaneous coronary intervention

Objective: To evaluate the effectiveness of an instructional program on patient's adherence about clopidogrel therapy post percutaneous coronary intervention Methodology: Thia quasi-experimental study was carried out at Al- Nasiriyah Heart Center in Thi-Qar Governorate from 19th of May to 25th of October 2022. A non-probability (purposive) sample of 100 patients were divided into two groups; 50 patients as study and 50 as controls. We used General Medication Adherence Scale, which is composed of 11 items. Validity and reliability of the instrument are determined through a pilot study. Data were analyzed through SPSS version 24. Results: Patients in the study group showed poor level of adherence during the pre-test (84%) while they showed good and high levels of adherence during the post-test (good= 50% and high=34%). Conclusion: The instructional program was influential in enhancing patient's adherence regarding clopidogrel therapy post percutaneous coronary intervention

ADHERENCE TO ANTICOAGULANT THERAPY AND ITS AWARENESS AMONG CARDIAC PATIENTS ATTENDING CARDIAC OPD OF CHITWAN MEDICAL COLLEGE TEACHING HOSPITAL, CHITWAN

Background: Oral Anti-coagulant is widely used for the prevention and treatment of cardiac and thromboembolic diseases. As oral anticoagulant is a narrow therapeutic index medicine, it requires close monitoring to achieve effectiveness of anticoagulants therapy. Therefore, this study was conducted to assess adherence to anticoagulant therapy and its awareness among cardiac patients attending cardiac OPD of Chitwan Medical College Teaching Hospital, Chitwan. Methods: A descriptive cross-sectional study design was carried out among 91 cardiac patients attending cardiac OPD of Chitwan Medical College Teaching Hospital sample was selected by using Consecutive sampling technique. Data was collected using structured interview schedule. General medication adherence scale and self-prepared structured questionnaire of awareness of anticoagulant therapy was used.  Data was analyzed in SPSS version 20 by using descriptive and inferential statistics. Results: Out of 91 respondents 42.9% of the respondents had partial adherence while 33.0% had good adherence. Only 6% of the respondents had high adherence, 7.7% and 9.9% of the respondents had poor and low respectively. Regarding awareness of anticoagulant therapy 63.7% of the respondents had inadequate level of awareness. There was statistically significant relationship between level of awareness with educational status (0.02), having insurance (0.05) and drug duration (0.05). Conclusions: Based on this finding respondent’s awareness was found to be low on the risk effects of alcohol intake, drugs and food interaction and self-limiting of injurious activities and most identified reason for non-adherence is discontinue due to feeling well, adverse effect and progression of disease. So, clinician and nurse should design an effective instructional program about anticoagulant therapy by highlighting those limited area thus to enhance adherence and prevent life threatening complications.