Level Of Medication Adherence Research Articles

Assessment of Medication Adherence in Hypertensive Patients among Warangal Population

Background: Hypertension is the most common disease in India where 1 in 4 people suffering with it. In order to achieve the intended therapeutic outcomes, medication adherence is essential. Patients with hypertension must adhere to their disease by taking their prescriptions on time, following their diet, and making other lifestyle modifications. This study aims to assess medication adherence in Warangal population among hypertensive patients with comorbidities, social habits, medication use etc. Aims: The aim of the study is to assess the level of medication adherence and to investigate predictors of medication adherence and controlled hypertension in patients and to identify the factors enhancing medication adherence. The secondary aim is to describe the extent and type of medication used in patient population in Warangal. Study Design: An Observational, retrospective and cross - sectional study was employed to assess the predictors and level of medication adherence in hypertensive patients. Place and Duration of Study: Department of Cardiology, Sri Sri Cardiac Centre and Bhageerath Cardiac Care Centre, Hanamkonda, Warangal. The study was conducted from October 2022 to April 2023 for about a duration of 7 months. Methodology: This study includes 300 Hypertensive patients (Male - 169, Female 131) of age range between 20-90 years with various comorbidities like diabetes mellitus, coronary artery disease, hypothyroidism, dyslipidemia, COPD. We also included various sociodemographic factors like Gender, Age, Literacy, Income status, Alcohol consumption, Smoking status, Marital status, Controlled and Uncontrolled hypertension, usage of various drugs and Duration of hypertension. We observed Medication Adherence by using MMAS 8 scale. Results: Low levels of medication adherence among female patients (41%), educated patients (58%) compared to other groups because of awareness about their condition. Low adherence is noted in patients with low-income status ( 9.6% ), High adherence in nonsmokers (73.3%) and non-alcoholic (60.6%) compared to smokers (10.6%) and alcoholics (12.6%) and high adherence is reported in married (85%) category as compared to unmarried (2.6%), Patients with low comorbidities reported high adherence compared to patients with low comorbidities. High medication adherence is reported in uncontrolled blood pressure (50.3%) and in patients with \(\le\) year (24.6%) and 2-6 years (28%) of duration of hypertension. High adherence is noted with 2 combination therapy (23.6%), most of the participants are adherent to Telmisartan+ Metoprolol (25.2%) followed by Telmisartan+ hydrochlorothiazide (19.3%). According to MMAS-8 scale most of the patients reported (Q1) and (Q6), 91.3% of our study population were adherent to their medication, 7% were moderately adherent and 1.6% were low adherent to their medication. Conclusion: 91.3% of Medication adherence is noted in hypertensive patients in Warangal population. 8.6% of Medication Non-Adherence is noted and various factors for nonadherence were reported by patients. However various methods and apps should be developed to overcome the Medication Non-Adherence.

Characterization of CKD illness representation profiles using patient-level factors.

Illness perceptions are the unique perspective individuals have on their illness, based on their context and experiences, and are associated with patient outcomes including coping and adherence. The purpose of this study was to explore characteristics that may be driving membership in illness perceptions cluster groups for adults with chronic kidney disease (CKD). This study was conducted within the multicenter longitudinal Chronic Renal Insufficiency Cohort (CRIC) Study. Cross-sectional data were collected and combined with CRIC data. Illness perceptions were measured using the Revised Illness Perception Questionnaire. Clustering analysis was conducted in R, and bivariate analysis including linear regression was performed in STATA 16. The sample (n = 197) had a mean age of 68, was 52% women, 53% non-White, and mean estimated glomerular filtration rate (eGFR) 56 ml/min/1.73 m2. Three cluster groups were identified, labeled as "Disengaged" (n = 20), "Well-Resourced" (n = 108), and "Distressed" (n = 69). The "Disengaged" group was characterized by low CKD knowledge, many recent hospitalization days, and the lowest perceived CKD burden. The "Well-Resourced" group was characterized by the highest levels of education, CKD knowledge, optimism, and medication adherence. The "Distressed" group was characterized by the highest levels of depression scores, comorbidity burden, CKD burden, CKD symptoms, and lowest optimism. Group membership significantly predicted the number of hospitalization days in adjusted analyses. Illness perceptions groups are associated with number of hospitalization days but are independent of many patient characteristics. Illness perceptions data could be used to tailor care for specific patients at risk for poor health outcomes.

Adherence to Medications of Hypertension among Hypertensive Patients of Majmaah City of Saudi Arabia

Objectives: To assess engagement in heart-healthy lifestyle practices and adherence to antihypertensive medications with knowledge of hypertension, for more effective blood pressure control. Methodology: It was a cross-sectional study involving adults of more than 18 years diagnosed with hypertension as study participants. Total sample size was 381. Assessment of medication adherence, and responses were calculated using Malaysian Medicine Adherence Score 8 (MALMAS 8) scale. The scoring system utilized in the MALMAS questionnaire, aligned with the MMAS-8, aids in categorizing participants based on their medication adherence levels. Data were collected using a pre-tested, self-administered questionnaire. The data were analysed using the statistical software for social sciences (SPSS26). Results: The prevalence of hypertension among the selected study participants was found to be 71%. High level of adherence was found in 33% of the participants. The medication adherence of the patient was significantly associated with gender (p<0.05). 27% of the study participants belong to the age group of 25-40 years. Around 63% of the females were having high adherence and this association was found to be statistically significant, (p value < 0.05.). There was no statistically significant association between participants’ adherence to the age group they belong, marital status, educational level and their occupation. Conclusion: In conclusion, this cross-sectional study highlights the difficulty in adhering to treatment plans, with forgetfulness and trouble taking medications ranking as the biggest obstacles. Interestingly, adherence was higher in females than in males. Nevertheless, no statistically significant correlation was observed between medication adherence and other demographic variables, including age, income level, occupation, marital status, education, or occupation

Social support and medication adherence among adult myasthenia gravis patients in China: the mediating role of mental health and self-efficacy

BackgroundMyasthenia gravis (MG), a rare chronic neuromuscular disorder, is characterized by progressive physical decline and requires long-term pharmacological treatment. Due to the decline of physical and social abilities, MG patients are in great need of social support, including tangible and emotional support. This study aims to examine the association between social support and medication adherence and the possible mediating effects of mental health and self-efficacy among MG patients.MethodsA cross-sectional analysis of a nationwide MG registry was conducted on 865 patients under oral medication treatment in China between June and July 2022. Validated scales were used to measure the respondent’s mental distress (Four-item Patient Health Questionnaire), social support (Modified Medical Outcomes Study Social Support Scale), self-efficacy for medication use (Self-efficacy for Appropriate Medication Use Scale), and medication adherence (Morisky Medication Adherence Scale, MMAS).ResultsThe association between social support and medication adherence and possible mediating effects of mental distress and self-efficacy were tested by structural equation model, with significant demographic and disease-related factors adjusted. The respondents showed a very low level of medication adherence (71.2% poor adherence; 1.4% high adherence; mean MMAS = 4.65). The level of social support was positively associated with medication adherence, and such association was fully mediated by two indirect pathways: through self-efficacy (β = 0.07, proportion mediated = 63.8%); and through mental distress and then self-efficacy (β = 0.01, proportion mediated = 6.7%).ConclusionProvision of social support and interventions on mental health with emphasis on improving self-efficacy for medication use may effectively improve medication adherence among MG patients.

Adherence patterns, risk factors and complications among patients with tuberculosis: a cross-sectional study at Nsawam Government Hospital

BackgroundTuberculosis (TB) is the ninth leading cause of death worldwide, and the leading cause of death from a single infectious agent prior to COVID-19 pandemic. TB substantially affects adults during...

Relationship Between Medication Adherence and Blood Sugar Levels Among Diabetes Mellitus Outpatients

Diabetes Mellitus (DM) is a disease with progressively increasing prevalence every year and often leads to complications when not properly managed. Control or success of treatment is influenced by adherence of patients to the treatment process. This study aimed to analyze relationship between medication adherence and fasting glucose levels among DM outpatients. A correlation study was conducted using a cross-sectional approach on a sample of 300 respondents selected by probability sampling technique from the entire population. The instrument used was the MMAS-8 Test (Morisky Scale Medication Adherence Scales-8) and examination of fasting sugar levels. Meanwhile, data analysis was conducted with the Spearman Rho test. The results showed that the highest treatment adherence was in the moderate category by 130 (43.3%) and a decrease in fasting sugar levels was observed among 230 (76.7%) respondents. A significant relationship was found between medication adherence and fasting glucose levels with a p-value = <0.001 and r: -0.597. Based on the results, there was a negative relationship between medication adherence and fasting blood sugar. The higher medication adherence, the better the fasting sugar levels in DM outpatients.

Health literacy in older adults: The newest vital sign and its relation to cognition and healthy lifestyle behaviors

Health literacy tends to decrease with age, and lower health literacy has been associated with lower levels of physical function, mental health, and medication adherence. The present study examined health literacy in relation to cognition in a sample of community-dwelling older adults. The study also examined the impact of health literacy on engagement in healthy aging lifestyle behaviors. Participants included 128 older adults (age: M = 72.07, SD = 6.71; education: M = 16.34, SD = 2.56; 74% female) who completed a health literacy measure (Newest Vital Sign; NVS), a lifestyle behavior questionnaire (Healthy Aging Activity Engagement scale; HAAE), and several neuropsychological tests. The cognitive domains assessed included memory, executive function, and attention/working memory. Two variables were computed from the NVS to represent the health literacy factors of document and numeracy literacy; these factors demonstrated a small correlation (r = .18). Results revealed that attention/working memory, executive function, and memory were all significantly related to numeracy literacy and overall health literacy. Only memory was significantly related to document literacy. After accounting for age, education, and cognition, a hierarchical regression revealed that health literacy significantly predicted engagement in healthy aging lifestyle behaviors. Multiple cognitive abilities are necessary for searching, finding, and processing information to make health-related decisions. Health literacy accounted for a significant amount of variance in older adults’ engagement in everyday lifestyle behaviors. Health literacy skills may be an area of focus for intervention efforts to improve brain health in older adults.

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

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

Targeted Coaching to Improve Osteoporosis Therapy Adherence: A Single Arm Variation of the C-STOP Study.

In this pre-planned variation of the Comparing Strategies Targeting Osteoporosis to Prevent Fractures After an Upper Extremity Fracture (C-STOP) trial, we investigated whether adherence-specific coaching by the case manager (CM) further improved the adherence and persistence rates compared to those seen in the C-STOP trial. We conducted a prospective observational cohort study of community-dwelling adults 50 years or older who suffered an upper-extremity fracture and were not previously treated with osteoporosis medications, to assess whether a well-trained CM can partner with patients to improve adherence to and persistence with oral bisphosphonate intake. The primary outcome was adherence (taking > 80% of prescribed doses) to oral bisphosphonate intake at 12 months after study enrollment. Secondary outcomes included primary adherence to and 12-month persistence with oral bisphosphonate and calcium and vitamin D supplement intake at 12 months. The study cohort consisted of 84 participants, of which 30 were prescribed an oral bisphosphonate. Twenty-two (73.3%) started treatment within 3 months. The adherence rate at 12 months was 77.3%. The persistence rate at 12 months was 95.5%. Of those not prescribed an oral bisphosphonate, 62.8% were taking supplemental calcium and 93.0% were taking supplemental vitamin D at 12 months. Depression was a significant predictor of 12-month non-adherence (adjusted odds ratio, 9.8; 95% confidence interval, 1.2-81.5). Adherence-specific coaching by a CM did not further improve the level of medication adherence achieved in the original C-STOP study. Importantly, these results can inform adherence in future intervention studies.

Penatalaksanaan Gangguan Afektif Bipolar Episode Kini Depresif Berat tanpa Gejala Psikotik melalui Pendekatan Kedokteran Keluarga

Bipolar disorder is a group of affective or mood disorders characterized by depressive and manic or hypomanic periods. The prevalence of bipolar disorder is estimated to be around 10-15 per 100,000 individuals annually in the human population, with higher rates in women, which can reach up to 30 per 100,000. Comprehensive management with a family medicine approach is necessary to improve the quality of life of patients. Service activities are conducted using counseling/support for patients with bipolar affective disorder experiencing severe depressive episodes without psychotic symptoms, reviewed through self-report, collateral history, mental status examination, home visits, and secondary data obtained from patient medical records with the application of a holistic and comprehensive family medicine approach. The goal of counseling/support for patients is to increase disease awareness and improve the patient's quality of life. The results of service activities show better understanding of the disease by patients and medication adherence levels that impact therapy success. Holistic management with a family medicine approach is necessary to identify problems in various aspects and support therapy success as well as improve patient quality of life.

Investigating the level of medication adherence and subjective recovery in patients diagnosed with schizophrenia

Background & Aim: Low compliance with medication in patients with schizophrenia may negatively affect the quality of life and subjective recovery. The objective was to analyze the association between medical adherence and subjective recovery in individuals diagnosed with schizophrenia.
 Methods & Materials: This descriptive and correlational research was conducted between July and August 2023. 120 patients registered with a Schizophrenia Relatives Association in Türkiye were included in the study using simple random sampling. Demographic questionnaire, Medication Adherence Report Scale, and Subjective Recovery Assessment Scale were used in the study. Percentage, mean, t-test in independent groups, one-way ANOVA, and Pearson correlation coefficient were used to data analysis in SPSS 25.
 Results: Medication Adherence and Subjective Recovery mean scores were 22.85±3.57 and 61.82±15.37 respectively. It was revealed that there is a positive and statistically significant relationship between Medication Adherence and Subjective Recovery scores (r=0.269, p<0.01). As well as between age and Medication Adherence Report Scale (r=0.215, p<0.05). The subjective recovery level was significantly lower in smokers compared to non-smokers (p<0.05).
 Conclusion: Subjective recovery levels of psychiatric patients can be increased by monitoring their medication adherence levels. Supportive interventions (giving motivational talks for medication use, following up with patients by phone or home visit, etc.) should be implemented for those who do not adhere to their medication regimen.

Adherence to disease-modifying therapies among patients with multiple sclerosis in Bulgaria – A real world study

Introduction: The purpose was to assess the level of medication adherence (MA) and related factors among individuals with multiple sclerosis (MS) in Bulgaria. Materials and methods: A prospective one-year study was conducted among 54 patients with MS diagnosed, treated, and monitored in Clinic of Neurology, University Hospital “Alexandrovska”, Sofia in 2022/2023. Clinical data, patients reported outcomes, patients’ characteristics such as age, gender and reduced work capacity, and other data were collected to define the predictors of non-adherence to medicines. MA level was assessed through a free Morisky–Green 4-item questionnaire. Results: Мost of the observed patients were rated with high and moderate adherence to MS therapy (n = 44; 81.48%). The remaining 18.52% of the patients with poor adherence to therapy were women. There was no statistical basis for asserting differences in adherence levels among the various factors considered. Conclusion: The current study demonstrates the importance of MA assessment and provides insights into MA among patients with MS in Bulgaria. Still, there are low-adherent patients, and the responsible factors should be further investigated.

Patient activation and medication adherence in adults

BackgroundPatients’ level of medication adherence provides conflicting results in its relationship to patient activation. Multiple factors may be contributing to these mixed results. ObjectivesThe primary purpose was to assess the association of patient activation to medication adherence in adults with chronic health conditions and low health literacy (HL). Secondary objectives were to determine whether age, education, gender, and race were associated with activation. MethodsParticipants completed self-report questionnaires regarding chronic disease self-management. Patient activation was measured using Hibbard’s Patient Activation Measure (PAM). Self-report of medication adherence was determined using the Gonzalez-Lu adherence questionnaire. Block regressions first assessed the relation of demographic variables and education to adherence and then the added relation of patient activation in a second model. ResultsThe analyses included 301 participants (mean age 58 years; 53% female; mean chronic conditions of 6.6). Some of the most common chronic conditions included hypertension (60%), arthritis (51%), depression (49%), and hyperlipidemia (43%). The relation of older age to greater medication adherence was significant (P < 0.05) in both models. The addition of PAM was significantly related to better adherence (P < 0.001) and also increased the R squared value from 0.04 to 0.09. This change resulted in a moderate effect size (d = 0.50). ConclusionEvaluating patient activation at baseline may predict those more likely to be medication adherent in patients with low HL.

Asthma and rhinitis control in adolescents and young adults: A real-world MASK-air study.

In allergic rhinitis and asthma, adolescents and young adult patients are likely to differ from older patients. We compared adolescents, young adults and adults on symptoms, control levels, and medication adherence. In a cross-sectional study (2015-2022), we assessed European users of the MASK-air mHealth app of three age groups: adolescents (13-18 years), young adults (18-26 years), and adults (>26 years). We compared them on their reported rhinitis and asthma symptoms, use and adherence to rhinitis and asthma treatment and app adherence. Allergy symptoms and control were assessed by means of visual analogue scales (VASs) on rhinitis or asthma, the combined symptom-medication score (CSMS), and the electronic daily control score for asthma (e-DASTHMA). We built multivariable regression models to compare symptoms or medication accounting for potential differences in demographic characteristics and baseline severity. We assessed 965 adolescent users (15,252 days), 4595 young adults (58,161 days), and 15,154 adult users (258,796 days). Users of all three age groups displayed similar app adherence. In multivariable models, age groups were not found to significantly differ in their adherence to rhinitis or asthma medication. These models also found that adolescents reported lower VAS on global allergy, ocular, and asthma symptoms (as well as lower CSMS) than young adults and adults. Adolescents reported a better rhinitis and asthma control than young adults and adults, even though similar medication adherence levels were observed across age groups. These results pave the way for future studies on understanding how adolescents control their allergic diseases.

Relationship between Knowledge Level about Drug-Resistant TB (TB-RO) and Medication Compliance in Pulmonary TB Patients

Introduction: Drug-resistant tuberculosis (TB RO) is still a threat in TB control and is one of the main public health problems in many countries in the world. Globally in 2019, it is estimated that 3.3% of new TB patients and 17.7% of previously treated TB patients will be drug-resistant TB patients.&#x0D; Objective: To determine the relationship between the level of knowledge about Drug-Resistant TB (TB-RO) and the level of medication adherence in pulmonary TB patients.&#x0D; Method: This type of research is quantitative research with analytical observational methods using a cross sectional approach. The population in this study was TB sufferers who were undergoing treatment at the Limboto Community Health Center, totaling 70 respondents. The research technique used accidental sampling to obtain a sample of 35 respondents. Data analysis used the Fishers exact test with the knowledge level questionnaire instrument and MMS-8.&#x0D; Results: The results showed that 29 respondents had good knowledge and were compliant with taking medication, 4 respondents had poor knowledge and were compliant with taking medication, and 2 respondents had poor knowledge and were not compliant with taking medication. The statistical test results showed that p-Value = 0.025, which means less than (α = 0.05), indicating that there is a relationship between the level of knowledge about TB-RO and adherence to taking medication.&#x0D; Conclusion: The patient's lack of knowledge about the disease and the use of drugs for therapy results in the patient's lack of understanding of the therapy being undertaken, which causes patient non-compliance in using the medication.

Digital tool assessment for the community management of patients with pulmonary tuberculosis in Yiwu city, China: evidence from real world data in 2020.

High-quality medication compliance is critical for the cure of pulmonary tuberculosis (PTB); however, the implementation of directly observed treatment (DOT) under direct interview still faces huge difficulties. Assessment of the effect of digital tool during community management has not been performed in eastern China. All drug-sensitive PTB cases notified in Yiwu city from June to December 2020 were divided into the routine group and digital tool group based on patients' willingness. The variables influencing the on-time completion level of home visits, medication adherence and treatment outcomes were estimated. A total of 599 eligible patients were enrolled, with 268 participating in the routine group and 331 using a digital tool. Most participants were men (n = 357, 59.6%), and nearly all were new cases (n = 563, 94.0%). Participants' mean age was 44.22 ± 20.32 years. There were significant differences in age, diagnostic type, and source of patients between the two groups. During the study period, the digital tool group had a higher on-time completion rate of home visits (91.5% vs. 82.5%) and medication adherence rate (94.3% vs. 89.6%) than the routine group, whereas there was no significant difference in the treatment success rate between the two groups (91.2% vs. 86.8%). Multivariate logistic regression analysis demonstrated that the digital tool group showed a more positive function in the on-time completion status of home visits, with an adjusted odds ratio of 0.41 (95% confidence interval: 0.25-0.70). Digital tools can be employed to improve the on-time completion rate of home visits in Yiwu city. Further large-scale studies that use digital tools for community management are warranted.

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&lt;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.

Investigating the Relationship between Medication Adherence Behaviors and the Achievement of Sustained Viral Load Suppression among People Living with HIV (PLHIV) on Antiretroviral Therapy (ART) in Akwa Ibom State, from 2018 - 2022

Background: Nigeria is still endemic for Human Immuno-Deficiency Virus (HIV), and currently among the top five countries with the highest burdens of HIV infection. For a successful HIV program, there should be good access to antiretroviral therapy (ART) and record of viral load suppression (VLS). This study aimed at investigating the relationship between medication adherence behavior (MAB) and sustained VLS among people living with HIV (PLHIV) receiving ART in Akwa Ibom State. Methods: This was a retrospective cohort study of the medical records of 1,763 PLHIV receiving ART services from January 2018 to December 2022, in selected ten health facilities in Akwa Ibom State. Relevant demographic, clinical, immunological, viral load (VL) information were obtained from the patients’ medical records and databases. The proportion of VLS and associated variables were then analyzed. Results: Out of the 2,550 PLHIV whose medical records were accessed, data for 1,763 PLHIV was accepted for analysis. A total of 795 (45.1%) male and 968 (54.9%) female participated in the study, with a mean age of 38.4 ± 5 years. While 23.8% (n = 420) have unsuppressed VL of &gt;1,000 copies/mL; 76.2% (n = 1,343) of participants achieved VLS of &lt;1,000 copies/mL. 90.4% (n = 1,213) of the virally suppressed participants recorded moderate to high medication adherence levels (X2 = 94.977, df = 2, p-value = 2.2 x 10-16). CD4 counts and HAART regimen have significant impact on VLS (p &lt; 0.05), while pregnancy status, TB Infection, duration on HAART, and WHO disease stage do not have significant effects on VLS (p &gt; 0.05). Conclusion: There was a strong evidence to reject the null hypothesis, which states that there is no positive association between MAB and sustained VLS among PLHIV on ART (p &lt; 0.05). The VLS rate in this study indicates a good HIV epidemic control. Good medication adherence level, high baseline CD4 count, and being on first line HAART regimen were strongly associated with VLS.

Therapeutic impact of an intervention associating pharmacist counseling and the use of a mobile health application for type 2 diabetes patients

Background and objectives: Diabetes represents a real public health problem, due to its constantly increasing prevalence and many complications. Prevalence of type 2 diabetes is high in Belgium (estimated at over 8%, 1 patient out of 3 being unaware of their diagnosis). Management based on a change of lifestyle and the adoption of health-promoting behaviors, complemented if necessary by drug treatment, prevents complications, improves the patient's quality of life, and reduces mortality. It is essential to implement multidisciplinary patient support, in which the pharmacist can participate through pharmaceutical care, but also through the implementation of educational sessions promoting the involvement of the diabetic patient in the management of his or her health. Research suggests that the use of mobile technologies combined with health coaching can help patients with their daily life and disease management. This study, a collaboration between ULiège, Multipharma and Comunicare, aims at exploring the benefits of the use of mobile technologies combined with health coaching by the community pharmacist for type 2 diabetes patients. The intervention aimed to reinforce the patient's willingness to actively participate in the management of their disease and to adopt favorable health behaviors, in order to increase their level of therapeutic adherence.&#x0D; Intervention and methods: This interventional study combined educational intervention and coaching sessions by the community pharmacist with the daily use of a mobile health application provided by Comunicare. This was a quantitative study established over a period of six months with three data collection periods (before, during and after the intervention). Primary outcomes (HbA1c and MARS-5 score), related to the level of medication adherence, and secondary outcomes (HDL cholesterol, LDL cholesterol, systolic and diastolic blood pressure, BMI and waist circumference), considered as cardiovascular risk factors, were analyzed.&#x0D; Results: The baseline sample consisted of 66 patients, 50 of whom completed the study. Statistical analyses did not show an improvement in the level of medication adherence. However, significant results were observed for systolic blood pressure and waist circumference (both improving). All the other outcomes, including HbA1c, changed positively or stabilized between the beginning and end of the study.&#x0D; Conclusion: This study showed that counseling by the community pharmacist, combined with the use of a mobile health application, can achieve the therapeutic intent of physician-initiated therapy and have a positive impact on the management of the type 2 diabetic patients as well as on outcomes considered as cardiovascular risk factors.

Assessment of Patient Related Factors Associated with Medication Adherence in type II Diabetes Mellitus

Poor and insufficient glycaemia management in people with Type 2 diabetes mellitus (DM) is a major public health issue that hastens the onset of diabetes related complications. Poor medication adherence among type2 diabetes mellitus patients is associated with inadequate glycaemia control, increased hospitalization, increase the risk of complications, increased mortality and morbidity. The main objectives of the study was to assess patient related factors associated with medication adherence and assess knowledge about diabetes and related complications among type II diabetes mellitus patients visiting an out-patient clinic, Bangalore. Data was entered and analyzed by using Microsoft excel and SPSS 22 version 29.0. It was found that, mean age of the study subjects was 49.89 years, majority of the subjects were male, of the respondents 30 (51.7%), 19 (32.75%) and 9 (15.5%) had good, average and poor level of diabetic knowledge respectively. 34 (59%) and 24 (41%) were adherent and non-adherent respectively. In this study, factors like male gender, having higher income, high socio-economic levels, following diabetic diet, maintaining physical activity on a regular basis, good knowledge about the disease and having stronger beliefs about medicines and their use were highly adherent to anti-diabetic medications indicating high medication adherence levels. Healthcare professionals such as pharmacists should implement effective health education interventions required to improve diabetes knowledge and beliefs regarding the disease and medications for better management of the disease which thereby results in improved quality of life, in addition medication compliance ensures a strategic diabetic management and