High Levels Of Medication Adherence Research Articles

Medication Adherence Among Hypertensive Patients in Kurdistan Region of Iraq: An Observational Follow-Up Study

Background: Adherence to medications is a main concern to hypertension control and incidence of CVD complications. This study aimed to measure the level of medication adherence of hypertensive patients after one month follow-up. Methods: An observational one-month follow-up study was conducted in 93 hypertensive patients in Kurdistan Region. Results: Patients’ mean age was 55.03 (25-85 years). The mean value of the MARS score of adherences was 7.68 out of 10. The mean values of dimensions of adherence were 3.20 of 4 (medication adherence behavior), 2.92 of 4 (attitude toward taking medication), and 1.55 of 2 (negative side effects and attitudes to medication). We found that the males, single and married, urban, those with no chronic disease, and those with higher levels of education were more likely to adhere to medication. The patients with shorter disease duration and treatment had higher adherence scores. The patients with no experience of the medication side effects had higher levels of medication adherence (8.80 vs. 7.00; P<0.0001) and patients who took fewer tablets/day. Conclusions: We observed high-adherence level among hypertensive patients. Prolong disease duration, long treatment duration, increase number of tablets/days, and increase number of comorbidities may significantly decrease the medication adherence rate.

Results of a randomized, double-blind, placebo-controlled trial of lorcaserin in cocaine use disorder

BackgroundCocaine use disorder (CUD) is a major public health problem for which there is no approved pharmacotherapy. The primary purpose of this study was to evaluate the ability of lorcaserin, a 5-hydroxytryptamine2 C (5-HT2 C) receptor agonist, to facilitate abstinence in individuals seeking treatment for CUD. MethodsThis was a 12-site, randomized, parallel arm study with a 13-week Treatment Phase that included a 1-week, single-blind run-in period when all participants received twice daily 15mg acetazolamide capsules (a medication adherence marker), followed by randomization to either twice daily 10mg lorcaserin or placebo capsules for the remaining 12 weeks. Pre-randomization data were utilized in an enrichment strategy aimed at achieving high levels of medication adherence and low placebo response rates in a subgroup of participants that qualified for the “efficacy population.” For lorcaserin vs. placebo, the primary efficacy endpoint was the proportion of participants in the efficacy population achieving abstinence during the last three weeks of treatment, as evidenced by self-report of no cocaine use, confirmed by urine testing. Results: Within the efficacy population, 1.1% of 91 participants receiving lorcaserin and 4.3% of 92 receiving placebo achieved abstinence during the last 3 weeks of treatment. Among all randomized participants, 2.5% of 118 receiving lorcaserin and 5.6% of 124 receiving placebo achieved similar abstinence. Study participants receiving lorcaserin exhibited significantly greater reductions in body weight and BMI, indicating that medication adherence was sufficient to produce a pharmacological effect. Conclusions: Twice daily 10mg lorcaserin failed to demonstrate efficacy in the treatment of CUD.

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.

Dyspepsia - The Indian perspective: A cross sectional study on demographics and treatment patterns of Dyspepsia from across India (Power 1.0 study).

Dyspepsia includes a spectrum of symptoms ranging from epigastric pain and early satiety to postprandial fullness. The worldwide prevalence of dyspepsia is 20-30%. It is slightly higher in the Western population and occurs more frequently among women. While the precise prevalence of dyspepsia in India is not available, different studies estimate that it affects 7.6-49% of the Indian population. Through our current study, we wanted to understand the demographics, clinical profile, patient presentation, and management in India. We also wanted to document the pattern of use of proton pump inhibitors (PPI) and patient satisfaction with PPIs in Indian patients with dyspepsia. This pan-India, multi-centric, cross-sectional, questionnaire-based, noninterventional, observational study was conducted between February and October 2021 in patients >18 years of age with a clinical diagnosis of any form of dyspepsia. Descriptive statistics were used for categorical variables, and between-group comparisons were made using Fischer's exact test, with p < 0.05 denoting statistical significance. A total of 3,739 patients from across 29 states of India participated in the study. Most of the patients were male (70.8%) and were from urban areas (56.8%). The highest percentage of patients were aged 31-40 (33.8%), and most patients (60.2%) had dyspepsia for a duration of 6-12 months. Patients with functional dyspepsia (FD) (78.5%) were significantly higher compared to organic dyspepsia (OD) (21.5%) (p < 0.001). The most frequent presenting symptoms were epigastric pain, nausea, vomiting, and heartburn. A quarter (25.6%) of the dyspepsia patients were associated with various comorbid conditions, of which diabetes mellitus, hypertension, and irritable bowel syndrome are the most common ones. A total of 619 patients in the study were on concomitant medications, of which the most common were antidiabetic drugs (271/619, 43.8%). Rabeprazole was the most frequently used PPI (2467/3739, 66.0%) among the study participants. The patient satisfaction analysis showed that, overall, patients were satisfied with PPIs, as most patients (~80%) agreed to almost all questions. The analysis for individual PPIs showed the highest "agree" responses in the rabeprazole group for almost all questions (12 of 13). Around 86.4% of patients on rabeprazole agreed with "immediate relief from acidity," 84.9% for "gives me complete relief," and 85.9% for "relief from nighttime acidity symptoms." Our study involving over 3,700 Indian patients with Dyspepsia adds to the growing knowledge of dyspepsia in India. Dyspepsia is more prevalent in males and in the 31-50 age group. FD is the most common form. Overall, patients were satisfied with PPIs in dyspepsia management in India. Patients on rabeprazole showed higher levels of medication adherence, satisfaction with symptom relief, convenience of therapy, and safety compared to patients on other PPIs. Against the backdrop of a paucity of reliable data about dyspepsia in India, our study results provide valuable insights into Dyspepsia and its management in an Indian setting.

Experience of Patients With Rheumatoid Arthritis: A Qualitative Study of a Nurse-Led Clinic.

Rheumatoid arthritis (RA) is an extremely prevalent chronic inflammatory rheumatic disease. This study explores the experiences of patients with RA under nurse-led care, the roles that nurses play, and the outcomes achieved when applying the patient-centered care (PCC) approach. A purposive sample of 12 participants who had been diagnosed with RA for at least 1 year were recruited from a nurse-led rheumatology clinic. They were also receiving treatment with disease-modifying antirheumatic drugs. All of the participants reported high levels of satisfaction with the care they received in the nurse-led clinic, along with high levels of medication adherence. The nurses were highly accessible to the participants, and they regularly communicated information regarding their symptoms, medication, and treatment management. These findings illustrate the importance of the holistic care that nurses provide to their patients, as the participants agreed that nurse-led services could have a wider outreach in hospitals and the community.

LEVEL OF MEDICATION ADHERENCE IN HYPERTENSIVE PATIENTS

Background: Hypertension (high blood pressure) is when the pressure in your blood vessels is too high (140/90 mmHg or higher). It is common but can be serious if not treated. A patient with hypertension who receives a treatment, implements a diet program, and carries out activities must comply with the recommendations of health workers.
 Objective: To find out the level of medication adherence in hypertensive patients at Selokerto Village.
 Method: This study was a quntitative study with a cross-sectional approach. The research sample was 100 people with hypertension at Selokerto Village and they were taken by total sampling method.
 Result: The results of this study were 63 (63%) respondents with a high level of medication adherence and 37 (37%) respondents with a moderate level of medication adherence.
 Conclusion: The level of medication adherence in Selokerto Village was dominantly good medication adherence.
 Recommendation: For further research, researchers are expected to examine the factors associated with medication adherence.

SPUR: A Patient-Reported Medication Adherence Model as a Predictor of Admission and Early Readmission in Patients Living with Type 2 Diabetes.

Poor medication adherence (MA) is linked to an increased likelihood of hospital admission. Early interventions to address MA may reduce this risk and associated health-care costs. This study aimed to evaluate a holistic Patient Reported Outcome Measure (PROM) of MA, known as SPUR, as a predictor of general admission and early readmission in patients living with Type 2 Diabetes. An observational study design was used to assess data collected over a 12-month period including 6-month retrospective and 6-month prospective monitoring of the number of admissions and early readmissions (admissions occurring within 30 days of discharge) across the cohort. Patients (n = 200) were recruited from a large South London NHS Trust. Covariates of interest included: age, ethnicity, gender, level of education, income, the number of medicines and medical conditions, and a Covid-19 diagnosis. A Poisson or negative binomial model was employed for count outcomes, with the exponentiated coefficient indicating incident ratios (IR) [95% CI]. For binary outcomes (Coefficient, [95% CI]), a logistic regression model was developed. Higher SPUR scores (increased adherence) were significantly associated with a lower number of admissions (IR = 0.98, [0.96, 1.00]). The number of medical conditions (IR = 1.07, [1.01, 1.13]), age ≥80 years (IR = 5.18, [1.01, 26.55]), a positive Covid-19 diagnosis during follow-up (IR = 1.83, [1.11, 3.02]) and GCSE education (IR = 2.11, [1.15,3.87]) were factors associated with a greater risk of admission. When modelled as a binary variable, only the SPUR score (-0.051, [-0.094, -0.007]) was significantly predictive of an early readmission, with patients reporting higher SPUR scores being less likely to experience an early readmission. Higher levels of MA, as determined by SPUR, were significantly associated with a lower risk of general admissions and early readmissions among patients living with Type 2 Diabetes.

Adherence to Acromegaly Treatment and Analysis of the Related Factors-A Real-World Study in Bulgaria.

The purpose was to assess the level of medication adherence (MA) and related factors among individuals with acromegaly. The secondary goal was to assess the quality of life of patients and whether and how it correlates with the level of adherence. A prospective one-year study was conducted among patients with acromegaly diagnosed, treated, and monitored in the reference center for rare endocrine diseases in Bulgaria in 2021. Clinical data, patients reported outcomes, and health economics data were collected to define the predictors of non-adherence to medicines. Medication adherence level was assessed through a free Morisky-Green 4-item questionnaire. A total of 179 patients with acromegaly were observed. Approximately 62% were female, 50% were between 41 and 60 years, and the mean age at diagnosis was 40.4 years. The response rate to the questionnaires was 53% (n = 95; mean age 53.5 years, 73% female and 26% male). Patients with high levels of MA reported higher median values for the 36-Item Short Form Health Survey (SF-36) in comparison with those with low levels: 65.5 vs. 48.5 (p = 0.017). Similar results for EQ-5D-3L (3-level EuroQol 5D version) values and the level of MA were found: 0.656 vs. 0.796 (p = 0.0123). A low level of adherence was revealed in 34.7% of the patients, with no difference among different age groups. A significant positive determinant for adherence was years lived with acromegaly (OR = 5.625, 95% CI 1.7401-18.1832, p = 0.0039), as shorter duration was related to higher odds for high level of adherence. The current study demonstrates the importance of MA assessment for patients with acromegaly in Bulgaria. The medication adherence to the prescribed therapy among the observed group of patients with acromegaly varied as the percentage of adherent patients was around 65%. Still, there are low-adherent patients, and the responsible factors should be further investigated.

Medication adherence and its impact on glycemic control in type 2 diabetes mellitus patients with comorbidity: A multicenter cross-sectional study in Northwest Ethiopia.

Medication nonadherence in patients with chronic diseases, particularly in type 2 diabetes mellitus (T2DM) with comorbidity, has continued to be the cause of treatment failure. The current study assessed medication adherence and its impact on glycemic control in T2DM patients with comorbidity. An institutional-based multicenter cross-sectional study was conducted among T2DM patients with comorbidity at the selected hospitals in Northwest Ethiopia. Medication adherence was measured using a structured questionnaire of the General Medication Adherence Scale (GMAS). A logistic regression model was used to identify predictors of the level of medication adherence and glycemic control. P < 0.05 at 95% confidence interval (CI) was statistically significant. A total of 403 samples were included in the final study. This study showed that more than three-fourths (76.9%) of the participants were under a low level of medication adherence. Source of medication cost coverage [AOR = 10.593, 95% CI (2.628-41.835; P = 0.003], monthly income (P < 0.00), self-monitoring of blood glucose (SMBG) practice [AOR = 0.266, 95% CI (0.117-0.604); P = 0.002], number of medications [AOR = 0.068, 95% CI (0.004-0.813); P = 0.014] and medical conditions [AOR = 0.307, 95% CI (0.026-0.437); P = 0.018] were found to be significant predictors of medication adherence. Significantly, majority (74.7%) of participants had poor levels of glycemic control. Patients who had a high level of medication adherence [AOR = 0.003, 95% CI (0.000-0.113); P = 0.002] were found less likely to have poor glycemic control compared with patients who were low adherent to their medications. The current study concluded that medication adherence was low and significantly associated with poor glycemic control. Number of medical conditions and medications were found to be associated with medication adherence. Management interventions of T2DM patients with comorbidity should focus on the improvement of medication adherence.

Medication Adherence Among Geriatric Patients with Chronic Diseases in Riyadh, Saudi Arabia.

BackgroundMedication non-adherence is a common and significant public health problem, especially among the geriatric population. This study’s objective was to measure medication adherence and associated factors among geriatric patients with chronic diseases.MethodsA cross-sectional study targeted outpatient geriatrics who suffer from chronic diseases at King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia. Telephone interviews were utilized to collect data from participants using a structured questionnaire and the GMAS validated instrument scale (General Medication Adherence Scale) intended to measure important determinants impacting adherence: patient behaviour, cost, comorbidity, and pill burden.ResultsA total of 422 patients were assessed for medication adherence. The Mean overall score for GMAS was 29.9±3.1 out of 33. (64.9%) of the patients had a high level of medication adherence. The patients had a high adherence on the domain of patient behavior related non-adherence (PBNA) (13.5±1.9) out of 15, a high adherence on the domain of additional disease and pill burden (ADPB) (11.2±1.4) out of 12, and good to high adherence on the cost-related non-adherence (CRNA) (5.25±1.1) out of 6.ConclusionThe geriatric population with chronic diseases in our study had a good level of adherence to medication if compared with other international figures. To promote better medication adherence, patients must have a good understanding of their disease and strong beliefs about the medications prescribed.

Family Social Support Perceptions and Medication Adherence among Elderly Diabetics in a Tertiary Health Institution in Lagos, Nigeria

Background: The perception of family support is pivotal in improving the health and wellbeing of elderly individuals through adherence to medication especially among diabetics. This study investigated the relationship between perceptions of family social and medication adherence among elderly diabetic patients attending the outpatient clinics of the Lagos University Teaching Hospital (LUTH). Methodology: This was a cross sectional, hospital-based study carried out among 199 randomly selected elderly diabetic patients receiving care in LUTH. Data including sociodemographic information, medication use, and procurement were obtained using an interviewer-administered semi-structured questionnaire. Perceived family social support was assessed and scored using the Perceived Social Support from Family Scale (PSS-Fa) and categorized as ‘strong’ (scores ≥ 11), ‘weak’ (scores 7-10) and ‘none’(scores≤6) while medication adherence was measured using the Morisky medication adherence scale (MMS-8). Medication adherence was rated high (score = 8), medium (scores= 6–7) and low (scores≤5). Association between perceived support and medication adherence was investigated by Chi-square test. Level of significance was p-value&lt;0.05. Results: The mean age of the participants was 68.6 ± 6.7 years. The proportion of the participants who had strong, weak and no perceived family support were 92.5%, 3.5% and 4.0% respectively. Over two-thirds of participants (72.9%) reported family as responsible for providing funds to procure their medications while almost a quarter (23.6%) bought their medications by themselves. Only 2 (1.0%) participants relied on medical insurance to procure their medications. Almost half (49.7%) of them had high levels of medication adherence. Significant association existed between perceived family social support and medication adherence (ꭓ2 = 7.626; p-value = 0.027). Conclusion: Most participants had strong perceived family social support which was significantly associated with medication adherence. We recommend the routine assessment of family social support when dealing with geriatric patients as can improve medication adherence and ultimately better outcome of care

Efficacy and safety of Chinese herbal medicine Qirui Weishu capsule in treating chronic non-atrophic gastritis: A multicentre, double-blind, randomized controlled clinical trial

Ethnopharmacological relevanceQiruiWeishu capsule is an herbal preparation from a herbal formula prescribed by an experienced doctor at Guang'anmen Hospital of China Academy of Chinese Medical Sciences. It has been used clinically for more than 30 years. Abdominal pain, distension, and nausea are common symptoms of chronic non-atrophic gastritis with erosion dampness and heat stasis syndrome, and this herbal medicine has been used to treat them. Aim of the studyTo verify the clinical efficacy and safety of QiruiWeishu capsule in the treatment of chronic non-atrophic gastritis with damp-heat stasis syndrome. Materials and methodsThis study was a multicenter randomized double-blind clinical trial with positive herbal drug SanjiuWeitai capsule as control and superiority test of main efficacy. A total of 477 subjects with chronic non-atrophic gastritis with erosion diagnosed by gastroscopy and pathological biopsy were randomly divided into QiruiWeishu capsule and SanjiuWeitai groups respectively in a ratio of 3:1. During the trial, subjects were required to complete medication for 28 days. The primary outcome was the disappearance rate of epigastric pain from baseline to 4weeks. At baseline, treatment at 1, 2, and 4 weeks, and follow-up at 8 and 16 weeks, the epigastric pain and traditional Chinese medicine (TCM) symptom scores were evaluated; gastroscopy, histopathology, and the helicobacter pylori test were evaluated at baseline and after 4 weeks of treatment. The safety assessment included blood routine, liver and kidney function, coagulation of laboratory tests, and electrocardiogram (ECG). ResultsBoth groups of subjects had a high level of medication adherence (defined as treatment completion for over 80%) (346/357, 96.9% in Qirui Weishu group vs 118/120, 98.3% in Sanjiu Weitai group; p > 0.05). The QiruiWeishu capsule was significantly better than SanjiuWeitai capsule in disappearance rate of epigastric pain (64.2%, 229/357vs 46.7%, 56/120; p < 0.001)，especially subgroupsubjects with moderate epigastric pain (65.0%, 89/137 vs 30.4%, 14/46; p < 0.001), grade1 erythema (67.7%, 149/220 vs 51.9%, 42/81; p = 0.011) and grade 2 erythema (57.6%, 70/121 vs37.1%, 13/35; p = 0.050) of gastroscopy, grade 2 erosion (66.7%, 118/177 vs43.9%, 25/57; p = 0.002) of gastroscopy and Helicobacter pylori negative (65.4%, 155/237 vs 42.7%, 35/82; p < 0.001) at baseline. For the scores of TCM symptoms in QiruiWeishu group were significantly lower than those in SanjiuWeitai group after 28 days of treatment (p = 0.002). The number and incidence of adverse events related to the trial drug were 14/355 (3.9%) in QiruiWeishu group, 6/118 (5.1%) in SanjiuWeitai group (p > 0.05). No serious adverse reactions occurred in the two groups. According to laboratory tests and ECG, there was no discernible effect on heart, liver, kidney, or blood coagulation function. ConclusionQirui Weishu capsule appears to be more effective in terms of symptoms than the SanjiuWeitai capsule, and its use is both safe and effective for the treatment of chronic non-atrophic gastritis. A further randomized, double-blind, placebo-control trial is warranted to verify its benefit.

ALTERNATIVE COMPLEMENTARY SERVICES OF SAPONIN TOWARDS REDUCTION OF FASTING BLOOD SUGAR LEVELS AND 2 HOURS POST PRANDIAL IN TYPE II DIABETES MELLITUS PATIENTS

Background - Diabetes mellitus (DM) is a metabolic disorder disease characterized by hyperglycemia. DM disease control aims to reduce mortality and morbidity, prevent complications and improve the quality of life of DM patients. DM treatment is carried out in a lifetime, requires large costs, causes mild to dangerous side effects, and requires a high level of medication adherence. Therefore, it is necessary to conduct an intervention that is cheap, easy to obtain and minimal risk.&#x0D; Objective - To prove that the administration of saponins has an effect on reducing fasting blood sugar levels and 2 hours post prandial in patients with type 2 DM.&#x0D; Methods - From 37,195 journals accessed full text, 18 journals were obtained from the screening results that met the inclusion criteria for a systematic literature review with the design used in this study used a randomized control trial design, quasi-experimental, and pre-clinical trial published in the 2015-2020 range. The subject of this study is related to saponins, fasting blood glucose, 2 hours pp in patients with type 2 diabetes.&#x0D; Results - Giving saponins to aloe vera plants with doses in the range of 300-500 mg/day is more effective in reducing fasting blood sugar levels with p value= 0.000 and effect size 1.42 (very strong) compared to other plants. Meanwhile, the saponin content in cherry plants with a dose of 15 grams was more effective in reducing fasting blood sugar levels 2 hours post prandial in patients with type 2 diabetes mellitus compared to other plants with p value= 0.000 and effect size 2.85 (very strong).&#x0D; Conclusion - Based on the results of the analysis of the research subjects, that the saponin intervention was very effective in reducing fasting blood sugar levels and 2 hours of PP.

Multimodal Assessment of Medication Adherence Among Youth With Migraine: An Ancillary Study of the CHAMP Trial

Examine preventive medication adherence among youth with migraine. Adherence (self-report, pill count, and blood serum drug levels) was assessed as an ancillary study that utilized data from 328 CHAMP Study participants (ages 8-17). CHAMP was a multisite trial of preventive medications. Participants completed a prospective headache diary during a six-month active treatment period during which youth took amitriptyline, topiramate, or placebo pill twice daily. Self-reported medication adherence was collected via daily diary. At monthly study visits, pill count measures were captured. At trial month 3 (trial midpoint) and 6 (end of active trial), blood serum drug levels were obtained. Self-report and pill count adherence percentages were calculated for the active trial period, at each monthly study visit, and in the days prior to participants' mid-trial blood draw. Percentages of nonzero drug levels were calculated to assess blood serum drug level data. Adherence measures were compared and assessed in context of several sociodemographic factors. Multiple regression analyses investigated medication adherence as a predictor of headache outcomes. Self-report and pill count adherence rates were high (over 90%) and sustained over the course of the trial period. Serum drug level adherence rates were somewhat lower and decreased significantly (from 84% to 76%) across the trial period [t (198) = 3.23, p = .001]. Adherence measures did not predict headache days at trial end; trial midpoint serum drug levels predicted headache-related disability. Youth with migraine can demonstrate and sustain relatively high levels of medication adherence over the course of a clinical trial.

Machine Learning and Medication Adherence: Scoping Review.

This is the first scoping review to focus broadly on the topics of machine learning and medication adherence. This review aims to categorize, summarize, and analyze literature focused on using machine learning for actions related to medication adherence. PubMed, Scopus, ACM Digital Library, IEEE, and Web of Science were searched to find works that meet the inclusion criteria. After full-text review, 43 works were included in the final analysis. Information of interest was systematically charted before inclusion in the final draft. Studies were placed into natural categories for additional analysis dependent upon the combination of actions related to medication adherence. The protocol for this scoping review was created using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Publications focused on predicting medication adherence have uncovered 20 strong predictors that were significant in two or more studies. A total of 13 studies that predicted medication adherence used either self-reported questionnaires or pharmacy claims data to determine medication adherence status. In addition, 13 studies that predicted medication adherence did so using either logistic regression, artificial neural networks, random forest, or support vector machines. Of the 15 studies that predicted medication adherence, 6 reported predictor accuracy, the lowest of which was 77.6%. Of 13 monitoring systems, 12 determined medication administration using medication container sensors or sensors in consumer electronics, like smartwatches or smartphones. A total of 11 monitoring systems used logistic regression, artificial neural networks, support vector machines, or random forest algorithms to determine medication administration. The 4 systems that monitored inhaler administration reported a classification accuracy of 93.75% or higher. The 2 systems that monitored medication status in patients with Parkinson disease reported a classification accuracy of 78% or higher. A total of 3 studies monitored medication administration using only smartwatch sensors and reported a classification accuracy of 78.6% or higher. Two systems that provided context-aware medication reminders helped patients to achieve an adherence level of 92% or higher. Two conversational artificial intelligence reminder systems significantly improved adherence rates when compared against traditional reminder systems. Creation of systems that accurately predict medication adherence across multiple data sets may be possible due to predictors remaining strong across multiple studies. Higher quality measures of adherence should be adopted when possible so that prediction algorithms are based on accurate information. Currently, medication adherence can be predicted with a good level of accuracy, potentially allowing for the development of interventions aimed at preventing nonadherence. Monitoring systems that track inhaler use currently classify inhaler-related actions with an excellent level of accuracy, allowing for tracking of adherence and potentially proper inhaler technique. Systems that monitor medication states in patients with Parkinson disease can currently achieve a good level of classification accuracy and have the potential to inform medication therapy changes in the future. Medication administration monitoring systems that only use motion sensors in smartwatches can currently achieve a good level of classification accuracy but only when differentiating between a small number of possible activities. Context-aware reminder systems can help patients achieve high levels of medication adherence but are also intrusive, which may not be acceptable to users. Conversational artificial intelligence reminder systems can significantly improve adherence.

Abstract 12491: Use of a Self-Care Mobile Phone Application Can Improve Patient Education and Medication Adherence in Patients With Acute Decompensated Heart Failure

Introduction: The use of digital health technologies using mobile phone health applications has increased over the last few years. We developed a mobile phone application (APP) (Aintree Heart Failure Passport APP) for heart failure (HF) patient self-education and improved medication adherence. The APP consisted of a Traffic Light System for education self-care advice, prompt for medications, reminder of appointments, educational videos as well as a mood check questionnaire. Methods: This was a pilot feasibility study in a British university hospital conducted in 2019 and 2020. We assessed self-care behaviour following the use of the Aintree Heart Failure Passport Mobile APP in a cohort of patients with acute decompensated HF. We employed the use of European Heart Failure Self-care Behaviour scale (EHFSBs), medication adherence using the Medication Adherence Report Scale (MARS-5) at 2 weeks and compared 30-day HF readmissions with annual hospital HF data. Descriptive statistics were represented as continuous variables as means with standard deviations. Categorical variables were represented with percentages and analysed using Chi-squared test. Results: 102 patients with acute decompensated HF were recruited to this pilot feasibility study. 57% were men and mean age 56 years±5.1. 55% patients had HF with reduced ejection fraction (HFrEF), 34% had HF with preserved EF (HFpEF) and 11% had HF with mid-range EF. Mean EHFSBs was 19.7±6.1and mean MARS-5 score was 23.5±1. 10/102 (10%) patients were re-hospitalised with HF compared to the annual hospital HF rehospitalisation incidence which was 19% (95/393); p=0.04. Conclusions: Results from our pilot feasibility study suggest that use of a HF self care mobile phone APP (Aintree Heart Failure Passport App) in patients with acute decompensated HF, leads to high quality self care behaviour, high levels of medication adherence and lower levels of 30-day HF re-hospitalisation. These results will need to be validated in a randomised controlled trial.

Factors related to self-care drug treatment and medication adherence of elderly people in Japan

ObjectivesThe number of home-dwelling elderly people who need drug treatment is increasing with the aging of the population. Elderly people are often suffering from various chronic diseases requiring treatment with multiple drugs, which makes self-care at home difficult. This study focused on medication adherence and aimed to identify the current state of self-care for drug treatment in home-dwelling elderly people and the factors that relate to self-care and medication. Study designCross-sectional study. MethodsMedication adherence was measured on a 12-item medication adherence scale for home-dwelling elderly people aged 65 and over who were taking medications. The present condition of medication self-care for home-dwelling elderly people was clarified in terms of medication adherence. Next, we clarified the relationship between medication adherence and other factors such as demographic and clinical characteristics, communication with doctors, and health literacy. ResultsThe average age was 73.7 (47.2% male). Functional health literacy and communicative health literacy were significantly associated with a high level of medication adherence. There was also a significant association between medication adherence and good communication with doctors. ConclusionsMedication adherence among home-dwelling elderly people was found to be related to the ability to obtain, understand, and communicate information, in addition to the basic literacy skills of health literacy. We also found that good communication with doctors was closely related to medication adherence. Our findings suggest that it is necessary to be consciously involved in promoting health literacy and communication when supporting self-care for medical treatment of home-dwelling elderly people in the future.

Clinician's perspective regarding medication adherence in patients with obstructive lung diseases and the impact of COVID-19.

Failure to achieve high levels of medication adherence in obstructive lung diseases is a major cause of uncontrolled disease. The purpose of this study is to reveal clinicians' opinions on the level of patient adherence and the change in adherence during the COVID-19 pandemic. A questionnaire containing multiple-choice questions about treatment adherence in patients with obstructive lung diseases was voluntarily applied to doctors working in a tertiary hospital for chest diseases. Eighty-one doctors (mean age, 37.2 years [standard deviation, 9.7 years]; 57 (70.4%) women) answered the questionnaires. Almost all clinicians participating in the study reported that they always or frequently asked patients if they adhered to treatment. Most clinicians think that in 20-50% of patients with asthma and less than 20% of patients with chronic obstructive pulmonary disease, a decrease in medication adherence appears in the first year of treatment. Most clinicians think the main reason for patients with obstructive lung diseases not adhering is patients' reluctance to be treated regularly. Regarding the impact of the COVID-19 pandemic on patients' drug adherence, 43.2% of clinicians observed that adherence increased after the start of the pandemic. Adherence to medication is not at the desired levels in patients with obstructive lung diseases. However, when faced with a serious health threat, such as the COVID-19 pandemic, patients realize the severity of their illness and begin using their treatments more regularly.

High level of medication adherence is required to lower mortality in patients with chronic hepatitis B taking entecavir: A nationwide cohort study.

It is unclear whether suboptimal adherence contributes to adverse clinical outcomes in patients with chronic hepatitis B (CHB). Moreover, there is no consensus regarding the optimal level of drug adherence. This was a population-based historical cohort study including 51975 adult CHB patients treated with entecavir (0.5mg/d orally). Data were obtained from the Korean national health insurance service claims database, which covers >99% of the entire population, between 2007 and 2015. Medication adherence was categorized as high (proportion of days covered [PDC], ≥90%; n=32089), intermediate (PDC, 80%-89%; n=10197) and low (PDC, <80%; n=9689). During a median 4.5years (maximal 9years) of follow-up in 51975 CHB patients treated with entecavir, multivariable analyses revealed that the risk of mortality/transplantation was significantly greater in the low-adherers (adjusted hazard ratio [HR], 1.38; P<.001) and intermediate-adherers (adjusted HR, 1.44; P<.001) than the high-adherers (P for trend<0.001). The risk of renal failure in the low- and intermediate-adherence groups was also significantly higher than the high-adherence group (P for trend<0.001). By contrast, the risk of hepatocellular carcinoma (HCC) was not significantly different between groups (P for trend=0.70). The higher risk of mortality/transplantation and renal failure but similar risk of HCC for low- and intermediate-adherers compared with high-adherers was consistent in inverse probability treatment weighting analysis of the entire cohort and subcohorts with or without cirrhosis. In conclusion, high medication adherence (≥90%) is required to significantly lower risk of mortality and renal failure in patients with CHB during long-term treatment with entecavir.

Feasibility of Short-Term PrEP Uptake for Men Who Have Sex With Men With Episodic Periods of Increased HIV Risk.

Pre-exposure prophylaxis (PrEP) with emtricitabine/tenofovir disoproxil fumarate is efficacious in reducing HIV acquisition. For some gay, bisexual, and other men who have sex with men (MSM), daily ongoing PrEP may be unsuitable for use as a long-term prevention strategy because of episodic risk, cost issues, or concerns about the biological consequences of medication. This study evaluated the feasibility of short-term, fixed-interval episodic PrEP (Epi-PrEP) for use among vacationing MSM. We describe the feasibility of implementing a clinic-based Epi-PrEP pilot program for 48 MSM who reported occasional condomless sex and anticipated a defined high-risk time. This was a nonrandomized naturalistic study of an observational clinical intervention. The primary outcome assessed was adherence, as measured by self-report and plasma tenofovir levels. Of 54 MSM who enrolled in the study, 48 completed the 3-month visit. The majority (93.7%) had tenofovir concentrations consistent with daily use on returning from vacation. Almost 3/4 reported condomless sex during vacation, and about 1/3 reported recreational drug use. During the 3-month follow-up, 1 participant had become HIV-infected because of a lapse in continued access to the PrEP after study. Although adverse events were common, none were serious. More than 70% of participants indicated an interest in daily ongoing PrEP use. Epi-PrEP was well tolerated by at risk MSM in this study, with high levels of medication adherence. Many participants felt the experience of initiating PrEP while on vacation could be a means for transition to long-term PrEP use.