Influence Treatment Adherence Research Articles

CTNI-40. PSYCHOLOGICAL DOMAINS CORRELATE WITH ADHERENCE IN TTFIELDS TREATMENT OF GLIOBLASTOMA

Abstract INTRODUCTION Adherence is critical to the success of the treatment with Tumor Treating Fields (TTFields) for Glioblastoma Multiforme (GBM). Previously found factors influencing treatment adherence in general are social support, belief in the efficacy of treatment, communication with physicians, anxiety, and depression. We propose those five factors predict adherence to TTFields treatment since, to our knowledge, no systematic data exists for this treatment. METHODS We conducted a longitudinal study and included 25 patients with newly diagnosed GBM who received treatment with TTFields. Participants were invited to take part in six structured interviews, each four weeks apart, during their treatment with TTFields, assessing the five factors expected to influence treatment adherence over time. RESULTS We found a significant impact of communication, anxiety, and depression on treatment adherence with TTFields. Furthermore, also the time point during treatment (days of treatment) was significantly related to adherence. Better physician communication and a higher level of anxiety were associated with higher adherence and higher depression with less adherence. A higher belief in efficacy showed a trend toward significantly improving treatment adherence. When results were separately compared for early, middle, and later 90-day treatment phases, factors seemed to be differentially influential, with belief in efficacy being significantly relevant in the first, efficacy, communication, and anxiety in the second, and depression in the third phase of treatment with TTFields. CONCLUSIONS Our findings not only confirm the predictive role of psychosocial factors in treatment adherence but also provide specific targets for psychological interventions. This suggests that by addressing these factors, healthcare providers can potentially increase treatment adherence among GBM patients. Moreover, our results indicate that these interventions may be most effective when tailored to the specific phase of treatment, offering a practical approach for healthcare providers.

Treatment Adherence and Factors Influencing It in End-Stage Renal Disease Patients on Maintenance Hemodialysis: A Study From a Tertiary Care Hospital in North India.

Background Chronic kidney disease (CKD) has become a significant global health concern, making its effective management crucial. Patients with end-stage renal disease (ESRD) often require multiple medications, restriction of fluid and diet intake, and maintenance hemodialysis (HD) to manage their condition, which together makes it difficult to maintain adherence to treatment. This study aimed to evaluate the prevalence of treatment adherence among ESRD patients and to identify influencing factors, addressing the lack of such data from Northern India. Methods This cross-sectional study was conducted at a tertiary care hospital in Northern India. ESRD patients on maintenance HD for at least three months were recruited from the outpatient and dialysis units of the hospital. Patients were interviewed using a validated and reliable tool, the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ). The primary objective was to assess the prevalence of treatment adherence among ESRD patients on HD who presented to the hospital, and the secondary objective was to evaluate various factors influencing treatment adherence among these patients. Results A total of 199 patients were enrolled, with a mean age ± standard deviation of 44.34 ± 13.7 years. Among the patients, 51.76% (n = 103) demonstrated good adherence (adherence score >1000), 41.71% (n = 83) showed moderate adherence (adherence score 700-999), and 6.53% (n = 13) exhibited poor adherence (adherence score <700). A significant association was found between adherence scores and patients' perception of treatment regimens (p < 0.0001 for each of the four treatment adherence domains, namely, HD, medication, fluid restriction, and diet restriction) and between adherence scores and the frequency of counseling by medical professionals (p = 0.106, 0.037, 0.014, and 0.002 for HD, medication, fluid restriction, and diet restriction, respectively). Individuals with graduate-level education or higher exhibited significantly better adherence scores than those with education levels below graduation (p = 0.044). However, age, sex, marital status, area of residence, employment status, mode of transportation, and the presence of family members accompanying patients to HD sessions were not significantly associated with treatment adherence. Conclusion Approximately half of the study population exhibited moderate-to-poor adherence, emphasizing the need for substantial improvement in adherence levels. These findings suggest that more frequent and effective counseling is necessary, as low adherence scores were significantly associated with infrequent counseling and poor patients' perceptions of the importance of treatment regimens.

Psychosocial factors influencing treatment adherence in Brazilian gay men living with HIV

Context and Aim: Adherence to antiretroviral treatment (ART) among men who have sex with men (MSM) living with HIV poses a public health challenge. Although studies in developed countries emphasize the role of psychosocial factors in ART adherence, there is limited research on this association among Brazilian MSM living with HIV. This study examined the impact of depression, anxiety, internalized homonegativity, and HIV-related stigma on ART adherence in a sample of this population. Method: A cross-sectional study recruited 43 MSM living with HIV (Mage = 34.93, SD = 7.90) through social media. Instruments included sociodemographic and clinical questionnaires, the Questionnaire for Assessment of Adherence to Antiretroviral Treatment, the Beck Depression Scale, the Trait-State Anxiety Inventory, the Internalized Homophobia Scale, and the HIV Stigmatization Scale. Results: Twelve participants (27.9%) showed inadequate ART adherence, and 18 (41.8%) reported signs and symptoms of depression at clinical level. Depression was negatively and moderately correlated with ART adherence. HIV-related stigma was positively and moderately correlated with depression, trait anxiety, and homonegativity. Depression significantly impacted ART adherence, explaining 13.4% of the variance. Conclusions: Our results highlight the need for regular depression screening and affirmative interventions to support MSM living with HIV, addressing stigma, and promoting adherence to ART.

Social Support and Adherence to Treatment Regimens among Patients Undergoing Hemodialysis

Background/Objectives: Following recommended treatment plans is essential to the success of the treatment. In hemodialysis, adherence to the treatment regimen remains a challenge in many healthcare settings. Many factors, including the patient’s level of social support, influence treatment adherence, but few studies have addressed these relationships. Methods: A correlational cross-sectional design was used to assess the relationship between perceived social support and adherence to treatment regimens among patients undergoing hemodialysis. Self-reported surveys were used to collect data. Results: One hundred and twenty-one hemodialysis patients were recruited from two dialysis centers. Overall, 45.5% of participants demonstrated good adherence, 47.9% had moderate adherence, and 6.6% had poor adherence. Specifically, 76% of participants consistently took their prescribed medications, 75% regularly attended hemodialysis sessions, 67.8% adhered to dietary restrictions, and 62% followed fluid-intake guidelines. Perceived social support was reported as highest from family members (89.3%), followed by significant others (62.8%) and friends (49.6%). There were significant correlations between perceived social support and overall adherence to treatments among hemodialysis patients. Conclusions: This study provides evidence for positive relationships between perceived social support and adherence to treatment regimens among hemodialysis patients. It is recommended that professional caregivers intervene with clients and their families, prepare recreational and educational programs for patients undergoing hemodialysis, and inspire other researchers to suggest different social support models and approaches.

Predictive role of spiritual health, resilience, and mental well-being in treatment adherence among hemodialysis patients

BackgroundEnd-stage renal disease (ESRD) causes numerous physical and psychological problems in patients, so that they must adhere to their treatment regimen to recover their disease, alleviate these problems, and increase their lifespan. The present study aimed to determine the predictive role of spiritual health, resilience, and mental well-being in treatment adherence among hemodialysis patients.MethodsThis correlational cross-sectional study investigated some variables related to treatment adherence in 184 patients undergoing hemodialysis referred to two dialysis centers in Kerman, southeastern Iran. A census method was used to select the participants and data were collected using socio-demographic characteristics questionnaire, Adherence to Treatment Questionnaire (ATQ), Conner-Davidson Resilience Scale, Reef Psychological well-being Questionnaire, and Spiritual Well-Being Scale (SWBS).ResultsThe overall treatment adherence score was 155.42 ± 27.98 and we found a positive significant correlation between spiritual health, resilience, psychological well-being, and treatment adherence (p < 0.001). The mean scores of resilience, spiritual health and psychological well-being were 70.59 ± 17.02, 90.09 ± 12.01, and 77.88 ± 11.72, respectively. Spiritual health, psychological well-being, resilience, gender and marital status predicted 54% of the variance of treatment adherence, with psychological well-being being the best predictor (p < 0.001).ConclusionsSpiritual health, psychological well-being, and resilience are factors that influence treatment adherence of the patients undergoing hemodialysis, with psychological well-being having the greatest contribution to improving patient’s treatment adherence. Interventions effective in improving psychological well-being, spiritual health and resilience can improve treatment adherence of patients undergoing hemodialysis. Healthcare workers must pay more attention to the factors affecting treatment adherence of patients undergoing hemodialysis.

Healthcare Concern: The High Rate of Diabetes in Southeastern Nigeria

Diabetes mellitus is an escalating public health crisis globally, and its impact is profoundly felt in Southeastern Nigeria, where the prevalence of diabetes stands at approximately 24%, significantly higher than both national and global averages. This review examines the epidemiology, risk factors, health impacts, and management challenges associated with diabetes in this region. Key contributors to the high diabetes rates in Southeastern Nigeria include genetic predispositions, rapid urbanization, lifestyle changes, and socioeconomic disparities. The health implications of diabetes are severe, encompassing complications such as neuropathy, nephropathy, and cardiovascular disease, which lead to a diminished quality of life and increased mortality. Challenges in managing diabetes are compounded by inadequate healthcare infrastructure, limited access to specialized care, and cultural factors influencing treatment adherence. Effective strategies for diabetes management in Southeastern Nigeria require comprehensive public health interventions, enhanced healthcare infrastructure, and culturally tailored educational programs. Future research should focus on filling gaps in epidemiological data, understanding rural healthcare barriers, and evaluating the effectiveness of targeted interventions. A collaborative approach involving government, healthcare providers, and communities is crucial for mitigating the diabetes burden and improving health outcomes in the region. Keywords: Diabetes mellitus, Southeastern Nigeria, epidemiology, risk factors, healthcare challenges, public health interventions.

Patient-reported outcomes and treatment adherence in type 2 diabetes using natural language processing: Wave 8 of the Observational International Diabetes Management Practices Study.

We analyzed patient-reported outcomes of people with type 2 diabetes to better understand perceptions and experiences contributing to treatment adherence. In the ongoing International Diabetes Management Practices Study, we collected patient-reported outcomes data from structured questionnaires (chronic treatment acceptance questionnaire and Diabetes Self-Management Questionnaire) and free-text answers to open-ended questions to assess perceptions of treatment value and side-effects, as well as barriers to, and enablers for, adherence and self-management. Free-text answers were analyzed by natural language processing. In 2018-2020, we recruited 2,475 patients with type 2 diabetes (43.3% insulin-treated, glycated hemoglobin (HbA1c) 8.0 ± 1.8%; 30.9% with HbA1c <7%) from 13 countries across Africa, the Middle East, Europe, Latin America and Asia. Mean ± standard deviation scores of chronic treatment acceptance questionnaire (acceptance of medication, rated out of 100) and Diabetes Self-Management Questionnaire (self-management, rated out of 10) were 87.8 ± 24.5 and 3.3 ± 0.9, respectively. Based on free-text analysis and coded responses, one in three patients reported treatment non-adherence. Overall, although most patients accepted treatment values and side-effects, self-management was suboptimal. Treatment duration, regimen complexity and disruption of daily routines were major barriers to adherence, whereas habit formation was a key enabler. Treatment-adherent patients were older (60 ± 11.6 vs 55 ± 11.7 years, P < 0.001), and more likely to have longer disease duration (12 ± 8.6 vs 10 ± 7.7 years, P < 0.001), exposure to diabetes education (73.1% vs 67.8%, P < 0.05), lower HbA1c (7.9 ± 1.8% vs 8.3 ± 1.9%, P < 0.001) and attainment of HbA1c <7% (29.7% vs 23.3%, P < 0.01). Patient perceptions/experiences influence treatment adherence and self-management. Patient-centered education and support programs that consider patient-reported outcomes aimed at promoting empowerment and developing new routines might improve glycemic control.

Predictors of quality of life (QOL) and treatment adherence among children with nephrotic syndrome.

Any significant changes in the growth and development of any aspect of life will ultimately affect the health-related quality of life (HRQOL) of children with nephrotic syndrome. Various factors can influence treatment adherence, which can promote or decline the child's quality of life (QOL). Objective: To assess the quality of life and adherence to treatment regimen and to identify the predictors of QOL and adherence to treatment regimen among children with nephrotic syndrome. A cross-sectional study was conducted among 59 children with nephrotic syndrome who attended the Paediatric Department of AIIMS, Bhubaneswar, using the PedsQL 4.0 generic core scale to assess the quality of life and adherence response scale. Both descriptive and inferential statistics were performed using the SPSS 20 version. The overall QOL median score was 93.48, with an IQR of 18.48, which indicated good QOL. A median score of treatment adherence was 16 with IQR 5, which indicated that the overall treatment adherence was good. Type of nephrotic syndrome (P = 0.014), developmental stage (P = 0.018), education of mother (P = 0.026), and occupation of mother (P = 0.026) were the variables predicted QOL. Duration of disease (P = 0.006) and duration of therapy (P = 0.005) significantly predicted treatment adherence. Children need continuous reinforcement on treatment adherence strategies to attain and maintain good QOL so that it can help to reduce the disease severity. Controlling the predictors that influence the QOL and treatment adherence has to be counseled among the parents so that their adherence can be sustained throughout the disease process to maintain good QOL.

Religion and mental health: an Eastern Mediterranean region perspective.

In the last decade, spirituality gained increasing recognition, with an individualized approach to the significance of symptoms and the purpose of treatment. Many psychiatrists started adopting the term "biopsychosocial-spiritual" management. Modern psychological therapies have drawn from the principles of ancient Eastern traditions. However, the spiritual beliefs within Islam and their impact on mental well-being have yet to be studied sufficiently. The Eastern Mediterranean region is largely Muslim and shares similar cultural beliefs. This paper explores some of these beliefs and their impact on perceptions of mental health and help-seeking behavior. The paper will focus primarily on the religious ideologies, the concepts of punishment and reward from Allah (God) in the context of the high stigma associated with mental illness in the region, and the knowledge, attitudes, and perceptions toward people with mental illness. We will explore cultural beliefs in possession, evil eye, and black magic and how they influence treatment adherence. Traditional and faith healers remain very popular in this part of the world and are often the first line of treatment for people presenting with mental illness. Suicide and self-harming are particularly sensitive areas due to their religious implications in life and death, as well as the afterlife. Despite the global interest in the Eastern Mediterranean region, there still is a shortage of research on the intercultural aspects of this region, especially regarding mental health assessments. In this regard, we will explore some published literature from Qatar and draw comparisons with regional findings.

Prevalence of and Factors Associated with Treatment Burden and Medication Adherence Among Primary Care Patients with Multimorbidity in Jeddah, Saudi Arabia: A Cross-Sectional Study.

Multimorbidity, the coexistence of multiple chronic conditions, presents significant challenges in treatment management and medication adherence. This study investigates the burden of multimorbidity and factors influencing treatment adherence among primary care patients in Jeddah, Saudi Arabia. A cross-sectional study was conducted from November to December 2023, including 422 participants selected via stratified random sampling from 12 primary healthcare centers in Jeddah. Participants were adults aged 18 years or older with two or more confirmed long-term medical conditions. The Multimorbidity Treatment Burden Questionnaire (MTBQ) and General Medication Adherence Scale (GMAS) were used to measure treatment burden and medication adherence, respectively. Demographic variables were assessed for their influence on these outcomes. High treatment burden was reported by 55% of participants, while 21% reported medium burden, 15% experienced low burden and 9% no burden. Medication adherence was partial in 69% of participants, with 13% reporting high adherence, 13% good adherence, and 5% poor adherence. Statistically significant differences in MTBQ scores were observed based on marital status, education level, residence, occupation, and income. GMAS scores varied statistically significantly with marital status, education level, residence, occupation, income, and previous self-care education session attendance and MTBQ scores, with those having high burden reporting the lowest adherence scores. Demographic factors, including marital status, education level, residence, occupation, and income, significantly influence multimorbidity treatment burden and medication adherence. A higher treatment burden was associated with lower adherence. Targeted interventions addressing these factors could improve treatment outcomes for patients with multiple chronic conditions.

Adherence to Supervised and Unsupervised Exercise Programmes in Ageing Population with Intermittent Claudication: A Randomized Controlled Trial.

Background: Intermittent Claudication symptomatic peripheral arterial disease (ICSPAD) is associated with reduced mobility, functional capacity, and quality of life. Physical exercise is an effective non-pharmacological intervention for the management of ICSPAD. Adherence to exercise programs is challenging, due to the nature of the disease and the complex comorbidities associated with it. This study aimed to determine adherence to three supervised physical exercise programs (a walking intervention, strength intervention, and concurrent intervention) and an unsupervised exercise program (standard advice) in individuals with ICSPAD. Methods: In this clinical trial, 122 patients were divided into four groups based on the type of exercise program they followed: standard advice, walking intervention, strength intervention, and concurrent intervention. Results: The results revealed that while the demographic characteristics were similar, the strength intervention group had a younger mean age, and the walking group had a higher prevalence of hypertension and increased usage of anti-hypertensive drugs. Adherence to physical exercise and pedometer wearing was highest in the standard advice group. Logistic regression analysis showed lower odds of adherence to exercise and pedometer wearing in the intervention groups compared to the standard advice group. Adherence did not significantly vary across ankle-brachial index categories. Furthermore, there was no significant difference in adherence between the severity levels of intermittent claudication, though mild cases tended to exhibit higher adherence. Conclusions: The results show that the standard advice from healthcare professionals positively influences treatment adherence.

Epilepsy in rural South Africa: Patient experiences and healthcare challenges.

This study investigates the prevalent issues of healthcare access and the impact of antiseizure treatments among people with epilepsy (PWE) in rural Limpopo and Mpumalanga, South Africa, where healthcare facilities and affordable treatments are often inadequate. Using a cross-sectional survey, 162 PWE were selected using multistage sampling across the provinces. Data were collected via a structured questionnaire and analyzed descriptively using SPSS v27. Most of the participants experienced seizures intermittently, with 70.6% in Limpopo and 53.3% in Mpumalanga reporting occasional episodes, whereas a significant minority in both regions-20.6% and 40%, respectively-suffered from frequent seizures. A notable portion of PWE also reported recurring side effects from antiseizure drugs, which led to consequential life disruptions, including educational dropout and unemployment. The findings underscore an urgent need for enhanced educational programs and increased awareness to improve the understanding and management of epilepsy in these underserved areas. Optimizing care for PWE requires a multifaceted approach, including evaluating healthcare accessibility, affordability, and societal beliefs influencing treatment adherence. The study advocates for government and policy interventions to mitigate the quality of life deterioration caused by epilepsy and its treatment in rural communities. In Limpopo and Mpumalanga, many individuals with epilepsy experience seizures occasionally, while a significant minority have them frequently. Numerous people also suffer recurring side effects from antiseizure medications, impacting their lives severely by causing school dropouts and job losses. This underscores the urgent need for improved education and awareness programs to manage epilepsy in these provinces effectively. The study urges government action and policy reforms to enhance care and support for people with epilepsy in rural areas, aiming to improve their quality of life.

Physical activity and treatment adherence in patients with mental disorders: a randomized controlled trial

IntroductionLack of adherence to pharmacological treatment is considered a multifactorial phenomenon, remarkably frequent in clinical practice. Non-adherence is associated with increased number of relapses, poor clinical and functional outcomes, and worsening of patient health status, with a resulting increase in healthcare costs, particularly in people with severe mental disorders (SMD). Treatment adherence rates remain extremely low, highlighting the need to develop innovative and integrated strategies; one of these is represented by the promotion of healthy lifestyle behaviours, including regular physical activity.ObjectivesThe aim of this study is to assess how the rates of treatment adherence vary in patients with SMD after receiving a psychosocial intervention, focusing on the positive relationship between treatment adherence and physical activity.MethodsLIFESTYLE is a randomized controlled trial comparing the efficacy of a structured psychosocial lifestyle intervention involving moderate physical activity exercises over a brief psychoeducational intervention. Levels of physical activity was assessed thorough the IPAQ scale, while treatment adherence was evaluated by the Morisky Medication Adherence Scale (MMAS).ResultsThe sample includes 401 patients, with a mean duration of illness was 16.3 (±17.8) years. All patients were receiving a pharmacological drug treatment; in particular, 59.6% (N=239) were treated with a second-generation antipsychotic and 54.9% (N=220) with a mood stabilizer. Our results show that moderate physical activity improves rates of treatment adherence. After 6 months, adherence to treatment increased from 35.8% at baseline to 47.6% at baseline in the experimental group, along with improvement in clinical health parameters (reduction in BMI, weight, and metabolic parameters). Another significant inverse correlation was found between adherence and quality of life (Rho di Person: -.140, p&lt;.005). Furthermore, this study indicates that having a diagnosis of major depression, a better cognitive functioning, a shorter duration of illness and contact time with the local mental health centre are factors that positively influence treatment adherence. Remarkably, treatment adherence was not influenced by symptom severity and type of pharmacological treatment.ConclusionsModerate physical activity can represent a valid strategy to increase treatment adherence in patients with SMD. Therefore, promoting physical activity exercises in our clinical practice may be associated with better outcomes. However, further studies that evaluate patients with acute mental disorders are needed.Disclosure of InterestNone Declared

The impact of hope levels on treatment adherence in psychiatric patients

PurposeIn this study, aimed to determine the status of hope and treatment adherence in psychiatric patients and the relationship between the two. Material and methodThe sample of the study consisted of participants (n = 103) in a university hospital psychiatric clinic. Research data were collected using personal information form, Morisky treatment adherence scale and Herth Hope Index (HHI). Statistical analysis of the data was carried out with SPSS 22.0 program using descriptive tests, student t-test, one-way variance analysis, chi-square test and Spearman correlation analysis. ResultsThe average score of the patients' hope scale is 34.23 ± 9.59 and is above the intermediate level. 43.7 % of patients have low adherence with treatment. It was found that as patients' hope scores increased (r = −0.417) non-adherence with treatment decreased; as annual hospitalization increased non-adherence increased (r = 0.274); as the duration of disease increased score of hope (r = −0.271), non-adherence with therapy (r = 0.353) and annual hospitalization increased (r = 0.211) (p < .05). Among the patients who took part in the study, 36.9 % were diagnosed with bipolar disorder, 33.0 % with schizophrenia and other psychotic disorders, 20.4 % with depression. Patients with bipolar disorder had higher treatment non-adherence scores. It was determined that 29.1 % of the patients stopped taking medication thinking they had recovered and 28.2 % did not adhere to the treatment due to drug side effects. ConclusionThe findings underscore the crucial role of hope in influencing treatment adherence among psychiatric patients. Clinicians should consider strategies to bolster hope as a potential avenue for improving adherence rates.

Factors that influence medication adherence in women with fibromyalgia: A path analysis.

To investigate the relationships between depression symptoms, perceived stigma, disease severity, patient-provider communication and medication adherence in fibromyalgia patients. The objectives were to explore how these factors influence treatment adherence and to develop a comprehensive model illustrating their interconnections. Fibromyalgia is a chronic pain syndrome with fatigue, sleep issues and idiopathic pain. Medication adherence is limited by insufficient symptom relief, side effects and costs. Stigma further complicates fibromyalgia. Disease severity affects patient-provider communication. Associations between depression, stigma, severity, communication and adherence in fibromyalgia are unclear. A cross-sectional, correlational study. The STROBE guidelines for cross-sectional studies were followed. Participants included Hebrew-speaking participants who were members of two Facebook groups: 'Shades of Purple' and 'Fibromyalgia- Get to Know!' Between February and April 2022. They undertook evaluations using The Patient Health Questionnaire-9 to gauge depression symptoms, assessed perceived stigma, utilised The Revised Fibromyalgia Impact Questionnaire to determine disease severity, employed The Patient Reaction Assessment questionnaire for patient-provider communication, and used the 8-item Morisky Medication Adherence Scale (MMAS-8). Associations between the variables were explored using Pearson's correlations and path analyses. The study included 141 women with fibromyalgia, aged 22 to 76 years. Most reported having a stable partner (69.5%) and 75.2% had children. The treatment adherence levels were as follows: 53.2% (N = 75)-low, 33.3% (N = 47)-medium and 13.5% (N = 19)-high. Depression positively correlated with stigma. Stigma negatively correlated with patient-provider communication. Patient-provider communication positively correlated with treatment adherence. A significant negative indirect effect of depression on treatment adherence through stigma and patient-provider communication was found. Perceived stigma and patient-provider communication played a mediating role in the relationships between depression and treatment adherence among women with fibromyalgia. Addressing stigma related to fibromyalgia and effective patient-provider communication can positively influence treatment adherence. No patient or public contribution.

Factors Influencing Treatment Adherence Among Newly Diagnosed Diabetic Clients of Ledzokuku Krowor Municipal Assembly (Lekma)

The study focused on assessing compliance among newly diagnosed diabetic client in Ledzokuku Krowor Municipal Assembly (LEKMA) Hospital. A descriptive survey design was adopted and 120 diabetic patients were sampled using random sampling techniques. A self-developed questionnaire instrument was the main data collection tool and quantitative analysis was used with the aid of IBM SPSS (v.23). The study found that most of the respondents were of the view that diabetes mellitus was hereditary. It was recorded that all respondents considered hospital-based treatment as effective in treating the condition. About 90 (72.0%) were of the view that of a diabetic patient skipped a dose, he/she was to ignore that dose and wait till the time for the next dose. Moreover, 116 (92.0%) respondents shared with researcher that diabetics were supposed to avoid all fatty foods. All respondents visited the hospital facility on a monthly basis to receive medical-care. Female turn to have adhered more to their medication regimen than the males did, but it was not statistically significant (t=.047, p= .963). Age has negative relationship (r = -.123, p= 533) with their adherence to medication. It was realized that those who had secondary education adhered mostly to diabetic medications followed by tertiary education and primary education attainers respectively. There was a positive relationship (r = .050, p=0.732) between the marital status, occupational status (r = .272, p = .056) of respondents and their adherence status to taking medications. Respondents (40%) disagreed that prescribed medications were fully covered under the National Health Insurance Scheme (NHIS). All of the respondents agreed that finance was a challenge to seeking treatment and medical care for the management of DM. About 40 percent of the respondents feared about side effect of drugs. It was recommended that government should extend the NHIS to cater for DM medications. There was also the need that government subsidized the treatment cost of patients seeking for healthcare with respect to DM

The role of affective temperaments in self-care and medication adherence among individuals with bipolar disorder: a moderation analysis.

Affective temperament, defined as the fundamental predisposition from which normal affective states originate or as the constitutional core of personality, play a crucial role in mood disorders, particularly bipolar disorders. Understanding the relationship between temperaments, treatment adherence, and self-care is crucial for effective management and improved clinical results. This study aims to (1) assess the correlation between affective temperaments and treatment adherence, (2) investigate the relationship between affective temperaments and self-care abilities, (3) identify predictors of treatment adherence, and (4) explore the moderating effect of self-care on the relationship between treatment adherence and depressive temperament in individuals with bipolar disorder. A cross-sectional study was conducted with 231 individuals diagnosed with bipolar disorder (BD) type I (N=160) and type II (N=71). The participants were evaluated using the following psychometric tools: Temperament Evaluation of Memphis, Pisa, and San Diego (TEMPS) to assess affective temperaments, Personal and Social Performance Scale (PSP) to evaluate social functioning and self-care abilities, and Morisky Medication Adherence Scale (MMAS) to measure treatment adherence. The study involved statistical analyses to examine correlations, identify predictors, and explore moderating effects. The findings revealed significant correlations between affective temperaments and both treatment adherence and self-care abilities. Specifically, hyperthymic temperament was positively associated with higher treatment adherence, whereas cyclothymic and depressive temperaments were linked to lower adherence. Self-care abilities were found to mediate the relationship between depressive temperament and treatment adherence, suggesting that improved self-care can enhance adherence in individuals with depressive temperament. Affective temperaments significantly influence treatment adherence and self-care abilities in individuals with bipolar disorder. The mediating role of self-care highlights the importance of developing targeted interventions to improve self-care practices, thereby enhancing treatment adherence and overall well-being. Personalized treatment strategies based on temperament assessments could lead to better clinical outcomes and quality of life for individuals with bipolar disorder.

Moderating Effects of Authentic Happiness on the Relationship Between Health-seeking Behaviour and Treatment Adherence Among Patients with Hypertension

Background: Hypertension is a chronic health condition that requires consistent management and adherence to treatment. However, there is a dearth of empirical data on the psychological factors influencing treatment adherence among patients with hypertension in Nigeria. Objectives: To determine the moderating effects of authentic happiness on the relationship between health-seeking behaviour and treatment adherence among patients with hypertension. Methods: The study used a cross-sectional study design. Survey tools comprising items of the Authentic Happiness Scale, Health-seeking Behaviour Scale, Hill-bone Compliance High Blood Pressure Therapy Scale were used to obtain data from two hundred and ninety (290) patients who were selected by purposive sampling and met the study eligibility criteria. Results: Increase in health-seeking behaviour and authentic happiness showed significant effects on adherence to treatment [β1 = 0.241, t = 2.92, p = 0.004; β2 = 0.208, t = 4.80, p = 0.01 respectively]. The interaction between health-seeking behaviour and authentic happiness lacked significant effects on treatment adherence [β3 = 0.003, t = 0.032, p = 0.751]. The analysis of conditional effects revealed that the effects of health seeking behaviour on treatment adherence were significantly differentiated when happiness was low [β = 0.263, t = 2.46, p = 0.015], moderate [β = 0.241, t = 2.92, p = 0.004], or high [β = 0.219, t = 2.02, p = 0.044]. Conclusion: Health-seeking behaviour and authentic happiness are potential explanatory factors for adherence to treatment among patients with hypertension.

Identifying patient preferences for diabetes care: A protocol for implementing a discrete choice experiment in Samoa.

In Samoa, adult Type 2 diabetes prevalence has increased within the past 30 years. Patient preferences for care are factors known to influence treatment adherence and are associated with reduced disease progression and severity. However, patient preferences for diabetes care, generally, are understudied, and other patient-centered factors such as willingness-to-pay (WTP) for diabetes treatment have never been explored in this setting. Discrete Choice Experiments (DCE) are useful tools to elicit preferences and WTP for healthcare. DCEs present patients with hypothetical scenarios composed of a series of multi-alternative choice profiles made up of attributes and levels. Patients choose a profile based on which attributes and levels may be preferable for them, thereby quantifying and identifying locally relevant patient-centered preferences. This paper presents the protocol for the design, piloting, and implementation of a DCE identifying patient preferences for diabetes care, in Samoa. Using an exploratory sequential mixed methods design, formative data from a literature review and semi-structured interviews with n = 20 Samoan adults living with Type 2 diabetes was used to design a Best-Best DCE instrument. Experimental design procedures were used to reduce the number of choice-sets and balance the instrument. Following pilot testing, the DCE is being administered to n = 450 Samoan adults living with diabetes, along with associated questionnaires, and anthropometrics. Subsequently, we will also be assessing longitudinally how preferences for care change over time. Data will be analyzed using progressive mixed Rank Order Logit models. The results will identify which diabetes care attributes are important to patients (p < 0.05), examine associations between participant characteristics and preference, illuminate the trade-offs participants are willing to make, and the probability of uptake, and WTP for specific attributes and levels. The results from this study will provide integral data useful for designing and adapting efficacious diabetes intervention and treatment approaches in this setting.

A Novel Digital Educational Strategy Improves Treatment Adherence and Quality of Life in Patients with Multiple Myeloma.

Multiple myeloma, the second most common hematologic malignancy worldwide, is an aggressive disease with high morbidity and mortality rates. Although myeloma remains incurable, new treatments have improved patients' life expectancy and quality of life. However, as these therapies are administered for prolonged and often indefinite periods, their success depends on high treatment adherence and significant patient engagement. This study aimed to evaluate the impact of a novel digital educational strategy on treatment adherence, quality of life, and the development of complications in patients with newly diagnosed myeloma. To this end, a two-arm, randomized, prospective, double-blind study was conducted to compare the conventional educational approach alone or combined with the novel digital strategy. This strategy was based on some principles of the Persuasive Systems Design model and incorporated the educational recommendations of patients and caregivers. Compared to the control group that only received information through the conventional educational approach, patients randomized to the digital strategy showed significantly higher treatment adherence and quality of life, associated with increased functionality and rapid reincorporation into daily routines. The digital strategy empowered patients and caregivers to understand the disease and therapeutic options and helped patients recall treatment information and implement healthy lifestyle habits. These results support that patient-targeted educational strategies can positively influence treatment adherence and thus improve their quality of life.