Incidence Of Nonadherence Research Articles

Medication-related burden and its association with medication adherence among elderly tuberculosis patients in Guizhou, China: a cross-sectional study.

Tuberculosis (TB) morbidity and mortality are significantly increasing in the elderly worldwide. Their optimal health outcomes are hampered by medication related burden (MRB) and poor treatment adherence. Understanding th e MRB status from patients' perspectives and its association with adherence among elderly TB patients will help achieve the End TB targets. Thus, we aimed to identify the incidence of MRB and nonadherence among elderly TB patients in Guizhou, and determine their association. A cross-sectional study was conducted in three prefectures with high TB notifications in Guizhou in 2022. The data were collected via face-to-face structured interviews. MRB was measured using the Living with Medicines Questionnaire version 3 (LMQ-3), which consists of eight domains. Nonadherence was assessed by treatment interruption, which was defined as any interruption lasting at least 1day at any time within the last 3months. A binary unconditional logistic regression model was used to determine the association between variables. Of the 405 elderly TB patients enrolled, 49.4% and 42.7% of the respondents perceived suffering from moderate and high MRB, respectively. The incidence of nonadherence among patients was 33.6%. Patients with higher scores in domain 2 (practical difficulties) [OR adj = 1.19; 95% CI (1.11-1.28)] and domain 4 (side effects burden of prescribed medications) [OR adj = 1.16; 95% CI (1.06-1.27)] were more likely to experience nonadherence. But, patients with higher scores in domain 8 (control/autonomy of medicine use) [OR adj = 0.70; 95% CI (0.61, 0.81)] were more likely to occur adherence. Patients with a high education level [OR adj = 0.29; 95% CI (0.08, 0.92)] had a decreased risk of nonadherence, but those with a living expense from a retirement salary [OR adj = 2.55; 95% CI (1.16, 5.71)] had an increased risk of nonadherence. The incidence of MRB and medication nonadherence is high among elderly TB patients in Guizhou. The significant associations between the three domains of MRB and nonadherence highlight that measuring MRB in multiple dimensions using the LMQ-3 in elderly TB patients could assist clinicians in providing patient-centered care, and multifaceted interventions targeting the identified problems should be implemented to reduce MRB and nonadherence among elderly TB patients in Guizhou.

Oft veltir lítil þúfa þungu hlassi: Sjálfræðisréttur skjólstæðinga, vanlíðan vegna frávika og traust innan heilbrigðisþjónustu

Traust skjólstæðinga gagnvart heilbrigðisstéttum og heilbrigðisstofnunum er forsenda gæða innan heilbrigðisþjónustu. Traust snýr að tiltrú sjúklings um að hagsmunir hans séu hafðir að leiðarljósi og vanmáttur hans sé ekki misnotaður. Almennt vænta sjúklingar þess að sjálfræði þeirra sé virt, en í því felst að sjúklingi sé gert kleift að taka sjálfstæðar ákvarðanir varðandi meðferðir og inngrip. Erlendar rannsóknir hafa hins vegar sýnt að frávik frá rétti sjúklinga til sjálfræðis eru nokkuð algeng innan heilbrigðisþjónustu. Markmið rannsóknarinnar var að varpa ljósi á hvað ákvarði traust til heilbrigðisþjónustu. Í því skyni var kannað hvort upplifun af atvikum sem snúa að frávikum frá rétti til sjálfræðis sé líkleg til að draga úr trausti skjólstæðinga innan heilbrigðisþjónustu. Í rannsókninni var sjónum sérstaklega beint að skjólstæðingum Kvennadeildar Landspítalans. Notast var við rafrænt hentugleikaúrtak þar sem skilyrði fyrir þátttöku var reynsla af þjónustu Kvennadeildar. Niðurstöðurnar sýndu að þeir skjólstæðingar sem hafa upplifað frávik frá rétti til sjálfræðis bera minna traust til heilbrigðisstarfsfólks og hafa meira vantraust gagnvart Landspítalanum heldur en þeir sem ekki hafa upplifað slík atvik. Jafnframt sýndu niðurstöðurnar að vanlíðan vegna fráviks frá rétti til sjálfræðis ýti undir vantraust gagnvart Landspítalanum en að það traust sem skjólstæðingar bera til lækna, hjúkrunarfræðinga og ljósmæðra geti spornað við myndun slíks vantrausts. Niðurstöðurnar gefa því tilefni til að ætla að góð samskipti og upplýsingagjöf til sjúklinga, þannig að þeir skynji að hagsmuna þeirra sé gætt og réttur þeirra virtur, sé líkleg til að ýta undir traust til heilbrigðisþjónustu. Aukið traust er líklegt til að stuðla að auknum gæðum, draga úr kostnaði og auka virði heilbrigðisþjónustu.

Incidence of Non-Adherence Within Psychiatric Patients in Prince Ali Bin Al Hussein Hospital at RMS in Jordan

Incidence of Non-Adherence Within Psychiatric Patients in Prince Ali Bin Al Hussein Hospital at RMS in Jordan

Aripiprazole Lauroxil Long-Acting Injectable: The Latest Addition to Second-Generation Long-Acting Agents.

Antipsychotics have long been the mainstay for the treatment of schizophrenia and other psychotic disorders. Long-acting injectables (LAI) of antipsychotics-provided once every two weeks to once every three months-promise to reduce the incidence of nonadherence. ARISTADA(™) (aripiprazole lauroxil; ALLAI) extended-release injectable suspension was approved by the U.S. Food and Drug Administration in October 2015 for the treatment of schizophrenia, and is the newest entrant in the LAI market. ALLAI is available as a single-use, pre-filled syringe, can be started in three different dosages, and also has the option of every six-week dosing. Treatment with oral aripiprazole is recommended for the first twenty-one days after the first ALLAI injection, which is a potential disadvantage. Adverse effects include sensitivity to extrapyramidal symptoms, especially akathisia, which is well documented in other aripiprazole preparations. There is no available data comparing ALLAI to other antipsychotics, and more head-to-head trials comparing different LAI formulations are needed. Based on the available data, ALLAI is an effective and safe option for treatment of schizophrenia. Further studies and post-marketing data will provide better understanding of this formulation.

Socioeconomic Disparities Associated with Medication Non-Adherence Following Lung Transplantation in Adult Recipients

Purpose To evaluate the impact of demographic and socioeconomic characteristics on non-adherence (NA) following lung transplantation. Methods and Materials Adult, first time, lung-only transplantations per the United Network for Organ Sharing (UNOS) database were analyzed from 10/1996-12/2006. Generalized linear models were used to determine the association between demographic/socioeconomic characteristics and early ( Results 7,284 patients were included for analysis. Early and late NA were reported in 3.1% and 8.0% of recipients, respectively. Factors associated with early NA were Medicaid insurance status at the time of transplant [adjusted odds ratio (AOR) compared to private insurance 2.19, 95% confidence interval (CI) 1.21 - 3.99, p=0.01], and black ethnicity (AOR compared to white 2.07, CI 1.05 - 4.10, p=0.04). Medicaid insurance and black ethnicity were also associated with an increased risk of late NA (AOR 2.30, CI 1.70 - 3.10, p figure 1 ] Conclusions Data from UNOS suggests that Medicaid insurance status and black ethnicity are associated with increased incidence of NA, which subsequently portends a decrease in post-transplant survival. Targeted interventions to improve medication adherence in this patient population may be warranted.

600 Impact of Non-Adherence on Outcomes after Pediatric Heart Transplantation: Analysis of Data from the Organ Procurement and Transplant Network

Non-adherence (NA) can result in serious or life-threatening illness in children following solid-organ transplantation. Little is known about the incidence of NA in a large cohort of pediatric heart transplant recipients, clinical factors associated with NA, or whether NA is associated with reduced graft survival.

Clopidogrel Adherence following Percutaneous Coronary Intervention with a Drug-Eluting Stent in a VA Medical Center

Background: Antiplatelet therapy with aspirin and a thienopyridine is the standard of care for prevention of thrombosis following coronary stent implantation. Recent evidence suggests a prolonged risk of stent thrombosis; therefore, clopidogrel therapy for at least 1 year is recommended following implantation of a drug-eluting stent. Premature discontinuation of clopidogrel is a well-recognized risk factor for stent thrombosis. Objective: To identify the rate of adherence to clopidogrel therapy among patients who have undergone percutaneous coronary intervention (PCI). Methods: We queried the central Veteran Affairs (VA) pharmacy database for each patient who underwent PCI with a drug-eluting stent between September 2004 and August 2005 at a single VA medical center. Based on pharmacy refill records, patients were considered adherent to clopidogrel if they filled more than 80% of the clopidogrel prescriptions. Results: We observed that 20.3% of patients were nonadherent to clopidogrel therapy for the course that they were assigned. Shorter duration of therapy was the only factor that predicted increased adherence. Race, polypharmacy, marital status, prior clopidogrel use, and age did not have a significant impact on adherence. Multivariable analysis did not demonstrate any other significant relationships. Conclusions: In this high-risk cohort of patients who have undergone PCI, we observed a 20% incidence of nonadherence to clopidogrel therapy. Shorter duration of therapy had a significant impact on improving rates of adherence in our analysis. This observation is of particular concern given the recent recommendations to prolong antiplatelet therapy to at least 1 year following PCI with a drug-eluting stent.

The incidence of nonadherence after organ transplant: Ensuring that our efforts at counting really count

The incidence of nonadherence after organ transplant: Ensuring that our efforts at counting really count