Medication Adherence In Individuals Research Articles

Behavioral Nudging With Generative AI for Content Development in SMS Health Care Interventions: Case Study.

Brief message interventions have demonstrated immense promise in health care, yet the development of these messages has suffered from a dearth of transparency and a scarcity of publicly accessible data sets. Moreover, the researcher-driven content creation process has raised resource allocation issues, necessitating a more efficient and transparent approach to content development. This research sets out to address the challenges of content development for SMS interventions by showcasing the use of generative artificial intelligence (AI) as a tool for content creation, transparently explaining the prompt design and content generation process, and providing the largest publicly available data set of brief messages and source code for future replication of our process. Leveraging the pretrained large language model GPT-3.5 (OpenAI), we generate a collection of messages in the context of medication adherence for individuals with type 2 diabetes using evidence-derived behavior change techniques identified in a prior systematic review. We create an attributed prompt designed to adhere to content (readability and tone) and SMS (character count and encoder type) standards while encouraging message variability to reflect differences in behavior change techniques. We deliver the most extensive repository of brief messages for a singular health care intervention and the first library of messages crafted with generative AI. In total, our method yields a data set comprising 1150 messages, with 89.91% (n=1034) meeting character length requirements and 80.7% (n=928) meeting readability requirements. Furthermore, our analysis reveals that all messages exhibit diversity comparable to an existing publicly available data set created under the same theoretical framework for a similar setting. This research provides a novel approach to content creation for health care interventions using state-of-the-art generative AI tools. Future research is needed to assess the generated content for ethical, safety, and research standards, as well as to determine whether the intervention is successful in improving the target behaviors.

Impact of sociodemographic factors and depression on medication adherence in schizophrenia: Cross sectional study in Morocco

BackgroundMedication non-adherence in schizophrenia is a major cause of relapse and hospitalization, presenting a significant challenge for clinicians. This study was conducted to estimate the prevalence of medication non-adherence and identify the impact of depression, as well as other factors, on medication adherence in individuals with schizophrenia. MethodsThis was a cross-sectional study conducted among individuals with schizophrenia, both outpatients and inpatients. Data on sociodemographic, clinical, and therapeutic factors were collected using a dedicated questionnaire. Medication adherence and depression were assessed using two validated scales, the Medication Adherence Rating Scale (MARS) and the Calgary Depression Scale for Schizophrenia (CDSS), respectively. ResultsAmong the 305 participants included in this study, 21.3 % had poor medication adherence according to the MARS scores. The logistic regression model showed that only work and depression were significant predictors of poor medication adherence in individuals with schizophrenia. ConclusionThe results of this study highlight a less explored factor that can influence medication adherence in individuals with schizophrenia, namely, depression. This underpins the importance of treating the non-psychotic dimensions of schizophrenia in the recovery process. However, further studies are needed to better characterize the pathways of medication adherence in schizophrenia.

Assessing the impact of telephone call intervention on medication adherence in individuals with mental health disorders: A longitudinal study in a tertiary facility in Volta Region

Medication adherence strategies that are successful, suitable and economical are vital to the treatment outcome of persons living with mental illness. Mobile-phone-based intervention is one such strategy and is particularly critical to reducing medication non-adherence, especially in mental health disorders. This study aimed to assess the impact of telephone adherence counselling on medication adherence in persons with mental health disorders. A longitudinal study was conducted on study participants who were randomly assigned to control and intervention groups over three months. Both groups received standard medication adherence counselling for the first month and then baseline adherence levels were determined using the medication adherence rating scale (MARS). The control group received standard medication adherence counselling at the psychiatric clinic whilst the intervention group received additional telephone calls made to each member of the intervention group once a week for a total of 8 times over 2 months. Of the patients who were screened for potential participation, 149 participants passed and 87 participants participated making a response rate of 58.40 %. The t-test conducted on the participants after the first (Month 2) and second (Month 3) on those with Telephone Call Intervention inferred significant statistical differences (p < 0.001). MARS Scores appreciated in the intervention group compared to the control group in Month 2 (1.64) and Month 3 (1.79). A positive impact of Telephone Call Interventions on medication adherence was achieved. This intervention can be a medication adherence strategy to supplement the standard medication adherence counselling which could improve treatment outcomes.

Clinical correlates of medication adherence in individuals with bipolar disorder and comorbid hypertension.

Individuals with bipolar disorder (BD) have high rates of suboptimal medication adherence, medical illness, and premature mortality, largely from cardiovascular causes. This analysis examined the association between adherence to antihypertensive and BD medications and clinical symptoms in patients with BD and comorbid hypertension (HTN) from an ongoing trial to optimize adherence. Inclusion criteria were a BD diagnosis, treatment with antihypertensives, adherence challenges, and poorly controlled HTN. Adherence was measured via self-report using the Tablets Routine Questionnaire and using eCAP, an electronic pillcap which captures openings. Average systolic blood pressure (SBP) was calculated from 12 readings over 1week. The Montgomery-Asberg Depression Rating Scale (MADRS) and the Brief Psychiatric Rating Scale (BPRS) assessed BD symptoms. A total of 83 participants with BD and HTN were included. Adherence to BD and antihypertensive medications were positively correlated. eCAP openings showed more missed doses than self-reported antihypertensive adherence. BD medication adherence was positively correlated with BPRS at baseline; antihypertensive adherence was negatively correlated with SBP at screening. Antihypertensive adherence improved and SBP decreased between screening and baseline. Adherence levels fluctuated over time and differed based on measurement method in people with comorbid BD and HTN. Self-reported BD adherence was positively related to global psychiatric symptoms and antihypertensive adherence was related to better SBP control. Monitoring both medication and blood pressure led to change in self-reported adherence. BD symptom severity may indicate poor adherence in patients with BD and should be considered in treatment planning.

Racial Comparison of the Pharmacokinetics and Safety of Fixed-dose Combination of Dapagliflozin/Sitagliptin in Western and Korean Healthy Adults

PurposeWe evaluated the pharmacokinetics, safety, and tolerability of a fixed-dose combination (FDC) of dapagliflozin/sitagliptin versus individual component (IC) tablets in healthy Western and Korean participants. The combination of these antihyperglycemic drugs provides efficient glucose control, and the use of FDC has generally been shown to improve medication adherence in individuals with type 2 diabetes mellitus (T2DM). MethodsTwo randomized, open-label, two-period, two-treatment, single-dose, single-center, crossover bioequivalence studies conducted on healthy fasted German participants (aged 18–55 years; Western study) and South Korean participants (aged 19–55 years; Korean study) were included. In both studies, pharmacokinetic parameters (maximum [peak] plasma concentration [Cmax], area under the plasma concentration–time curve from zero to the last quantifiable concentration [AUClast], and area under the plasma concentration–time curve from zero to infinity [AUCinf]) were used to assess the bioequivalence of 10 mg dapagliflozin/100 mg sitagliptin FDC (Treatment A) with their ICs (Treatment B) under fasted conditions. Safety and tolerability were assessed throughout the study. FindingsForty-six healthy participants (male, 60.9%; mean age, 39.5 years; mean body mass index [BMI], 23.9 kg/m2) were randomized in the Western study, and 51 healthy participants (male, 100.0%; mean age, 24.6 years; mean BMI, 23.9 kg/m2) were randomized in the Korean study. In both studies, the participants were randomized 1:1 into treatment sequence AB and treatment sequence BA. Dapagliflozin/sitagliptin FDC was bioequivalent to IC tablets in both Western and Korean studies, as the 90% confidence interval of the FDC to IC ratios of the geometric least-squares means of the pharmacokinetic parameters for both dapagliflozin and sitagliptin was within the 0.8000–1.2500 bioequivalence criterion limit. The observed differences in pharmacokinetic parameters, such as Cmax, AUClast, and AUCinf, between the Western and Korean studies were not clinically meaningful. Dapagliflozin/sitagliptin FDC and their ICs were well tolerated, with no serious adverse events reported in any of the study populations. ImplicationsThe 10 mg dapagliflozin/100 mg sitagliptin FDC and IC formulations were bioequivalent in fasted healthy Western and Korean participants, with no new safety concerns identified, thus offering a useful alternative for patients currently receiving individual medications as part of their treatment regimen. Clinical trial registrationWestern study (clinicaltrials.gov: NCT05266404) and Korean study (clinicaltrials.gov: NCT05453786).

The impact of multiple pharmacy use on medication adherence in individuals with colorectal cancer.

11041 Background: Colorectal cancer (CRC) is the third most common cancer diagnosed in the US. The pharmacological care of older and often comorbid members with CRC is a growing healthcare issue. Cancer members are prone to the unintended consequences of multiple pharmacy use, as they often receive chemotherapy and symptom-relieving agents, in addition to medications they may be taking for other comorbidities. The purpose of this study was to assess multiple pharmacy use and adherence in a cohort of individuals with CRC. Methods: Adult pharmacy benefit manager (PBM) members who had at least 2 fills of either regorafenib, encorafenib, or trifluridine + tipiracil at specialty pharmacies between 1/1/2022 and 12/31/2022 were included. Any fills must have included one of the following diagnosis codes: C18.X, C19.X, C20.X, C21.8, C78.5, C78.6, D37.4, D37.5. Members were excluded if they did not maintain continuous eligibility for the 180 days prior to initiation in the study. Specialty pharmacy type included CVS Specialty, Competitor Specialty and Competitor non-specialty. Multiple pharmacy use was defined as utilizing more than one pharmacy for medication fills. The primary outcome was adherence determined by the medication possession ratio (MPR), defined as the number of days supplied/number of days in the evaluation period; optimal adherence was defined as MPR ≥ 0.8. Continuous and categorical variables were assessed with standard statistical tests. Bivariate logistic regression models were constructed for each covariate; significant variables were included in the multivariate model. Odds ratios (OR) and 95% confidence intervals (CI) are presented; p values &lt; 0.05 were significant. Results: 891 members met all inclusion criteria; 362 (40.6%) met the definition of multiple pharmacy use. Members were on average 59.6 ± 11.2 years old and 54.3% were male. No differences in member demographics between specialty pharmacy type were found (all p &gt; 0.05). Adherence was high with 79.5% of members having a MPR ≥ 0.8. Members with multiple pharmacy use had significantly lower adherence rates (76.0% vs. 81.9%; p=0.04) and MPRs (mean ± SD) (1.06 ± 0.45 vs. 1.15 ± 0.53; p=0.011). Controlling for specialty pharmacy type, medication used, and gender, multiple pharmacy use was significantly associated with decreased likelihood of optimal adherence compared to single pharmacy use (OR [95% CI]: 0.705 [0.507-0.98]; p= 0.038). Male gender was associated with significantly higher likelihood of optimal adherence (OR [95% CI]: 1.517 [1.093-2.107]; p=0.013). Conclusions: In this study of individuals with CRC receiving regorafenib, encorafenib, or trifluridine + tipiracil, utilizing multiple pharmacies for non-CRC medications was associated with a 29.5% decreased likelihood of optimal adherence compared to those who only utilized one pharmacy. Further examinations are warranted that include other modulators of adherence.

Randomized comparison of the effects of tailored text messaging versus pillbox organizers on medication adherence of heart failure patients

BackgroundHeart failure (HF) is a major public health issue worldwide, affecting approximately 64.3 million people in 2017. Non-adherence to medication is a common and serious issue in the management of HF. However, new reminder systems utilizing mobile technology, such as text messaging, have shown promise in improving medication adherence. The purpose of this study was to compare the impact of tailored text messaging (TTM) and pillbox organizers on medication adherence in individuals with HF.MethodsA randomized controlled trial was conducted, involving 189 eligible patients with HF who were randomly assigned to either the TTM, pillbox organizer, or control group. Medication adherence was evaluated using pill counting and the Medication Adherence Rating Scale (MARS) over a period of three months and compared across the groups. The data were analyzed using Kruskal-Wallis, Analysis of Variance (ANOVA), and Repeated Measures ANOVA tests.ResultsThe results indicate that both the TTM and pillbox organizers groups had significantly higher medication adherence compared to the control group, as measured by pill counting (MD = 0.05, 95%CI = 0.03–0.06; p < 0.001 for TTM group, MD = 0.04, 95%CI = 0.03–0.06; p < 0.001 for pillbox organizers group) and the MARS (MD = 1.32, 95%CI = 0.93 to 1.72; p < 0.001 for TTM group, MD = 1.33, 95%CI = 0.95 to 1.72; p < 0.001 for pillbox organizers group). However, there was no statistically significant difference in medication adherence between the two intervention groups using either measurement method. The TTM group exhibited a lower hospitalization rate than the other groups in the first follow up (p = 0.016).ConclusionsBoth the TTM and pillbox organizers were shown to be effective in enhancing medication adherence among patients with HF. Therefore, healthcare providers should take into account the patient’s condition and preferences when selecting one of these methods to promote medication adherence. Future research should aim to address the limitations of this study, such as controlling for confounding variables, considering long-term effects, and comparing the effectiveness of different interventions.

Pain medication beliefs in individuals with headache.

To evaluate pain medication beliefs in a community sample of individuals with headache. Previous studies of medication adherence for individuals with headache have identified a high rate of prescription nonfulfillment, frequent medication discontinuation, and widely varying levels of medication-related satisfaction. Still, there is a limited understanding of how these individuals view their medications and their relationships with health-care providers. Insight into these perceptions could prove useful in explaining medication adherence behaviors. In this secondary analysis of a cross-sectional study, data from N = 215 adults with headache were analyzed. Participants completed the Pain Medication Attitudes Questionnaire (PMAQ), Center for Epidemiologic Studies Depression Scale (CES-D), State-Trait Anxiety Inventory Form Y-2, Weekly Stress Inventory Short Form, and Migraine Disability Scale. These participants also provided a list of their current pain medications. Using the PMAQ, participants could be characterized as having medication beliefs that were "trusting and unconcerned" (n = 83/215 [38.6%]), "skeptical and somewhat worried" (n = 99/215 [46.0%]), or "skeptical and concerned" (n = 33/215 [15.3%]). Individuals with skeptical and concerned beliefs expressed elevated concerns (z > 1.15) about side effects, scrutiny, perceived need, tolerance, withdrawal, and addiction. Individuals who were trusting and unconcerned expressed low levels (z < -0.40) of these beliefs. Increasing levels of mistrust and medication concerns were correlated with higher depression scores on the CES-D, with values ranging from r = 0.23 to r = 0.38. Subgroups of pain medication beliefs were identified, including two groups of patients with at least some concerns about their medical providers. Beliefs ranged from a lack of concern about using pain medications to worries about scrutiny and harm. It is unclear if poor experiences with pain medications cause these beliefs or if they prevent individuals from effectively utilizing medications. Additionally, more negative beliefs about pain medications were associated with more depressive symptoms.

The Effect of Mindfulness-based Psychoeducation on Negative Automatic Thoughts and Medication Adherence in Individuals with Cannabis Use Disorder: a Randomized Controlled Trial

AbstractThe aim of this study is to evaluate the effect of mindfulness-based psychoeducation on negative automatic thoughts and medication adherence in individuals with cannabis use disorder. The randomized controlled study was conducted between September 2021 and December 2022 in the psychiatry clinic of a university hospital in Turkey. The sample size of the study consisted of 60 individuals (30 experimental groups, 30 control groups). Descriptive Characteristics Form, Negative Automatic Thoughts Questionnaire, and Morisky Medication Adherence Scale were used to collect data. In the study, while eight sessions of mindfulness-based psychoeducation were given to the experimental group, no intervention was applied to the control group. Experimental group posttest negative automatic thoughts and medication adherence scale total mean scores were found to be statistically significant (p &lt; 0.05). It was determined that the posttest negative automatic thoughts scale total score mean in the experimental group decreased compared to the control group, and the medication adherence scale total score mean increased compared to the control group. It was determined that mindfulness-based psychoeducation given to individuals with cannabis use disorder was effective in negative automatic thoughts and adherence to treatment.

Medication adherence in patients with type 2 diabetes after disability onset: a difference-in-differences analysis using nationwide data

BackgroundEffectively managing the coexistence of both diabetes and disability necessitates substantial effort. Whether disability onset affects adherence to type 2 diabetes medication remains unclear. This study investigated whether disability onset reduces such adherence and whether any reduction varies by disability type.MethodsThis study used the National Disability Registry and National Health Insurance Research Database from Taiwan to identify patients with type 2 diabetes who subsequently developed a disability from 2013 to 2020; these patients were matched with patients with type 2 diabetes without disability onset during the study period. Type 2 diabetes medication adherence was measured using the medication possession ratio (MPR). A difference-in-differences analysis was performed to determine the effect of disability onset on the MPR.ResultsThe difference-in-differences analysis revealed that disability onset caused a reduction of 5.76% in the 1-year MPR (P < 0.001) and 13.21% in the 2-year MPR (P < 0.001). Among all disability types, organ disabilities, multiple disabilities, rare diseases, and a persistent vegetative state exhibited the largest reductions in 2-year MPR.ConclusionsPolicies aimed at improving medication adherence in individuals with disabilities should consider not only the specific disability type but also the distinct challenges and barriers these patients encounter in maintaining medication adherence.

The Impact of Clinical Pharmacist Diabetes Education on Medication Adherence in Patients with Type 2 Diabetes Mellitus: An Interventional Study from Khartoum, Sudan.

Continuous therapeutic care with good medication adherence is the cornerstone of management of all chronic diseases including diabetes. This study aimed to evaluate the impact of clinical pharmacist intervention on the medication adherence in individuals with type 2 diabetes (T2DM). This was a randomized, double-blind, controlled trial conducted at a diabetes clinic located at Omdurman Military Hospital, Sudan. Individuals with T2DM attending the diabetes clinic within 1 year were selected. The sample size was 364 participants (182 control and 182 interventional group). We used a pre-structured standardized questionnaire and checklist to collect the data. Data were analyzed by using the Statistical Package for the Social Sciences (SPSS) (version 28). Majority, 76.4% (n = 278) were females, and they consisted of 80.8% (n = 147) of the interventional group and 72% of the controls. The mean age of the interventional group was 54.5 (±10) years; 31.9% (n = 58) of the interventional group had diabetes for 6-10 years, compared with 26.4% (n = 48) of the control group. Among the control group, the mean adherence score was 6.8 (±1.7) at baseline and it was 6.7 (±1.6) at the end of the study (p < 0.001), while in the interventional group, the mean adherence score was 6.8 (±1.7) at baseline and it was 7.4 (±1.5) at the end of the study (p < 0.001). Adherence score among the intervention group was increased significantly from baseline to the end of the study when compared to the control group.

Unveiling the Nexus: Depressive Symptoms and Medication Adherence in Hypertensive Patients' Self-care: A Systematic Review.

Hypertension, a significant public health concern, is frequently linked to emotional disorders like depression. Research shows a reciprocal link between depression and hypertension, potentially influencing patients' adherence to self-care routines. This systematic review aimed to examine the association between depressive symptoms and aspects of self-care, with a focus on medication adherence in individuals diagnosed with hypertension. Following PRISMA guidelines, a systematic review was conducted by searching PubMed, PsycINFO and Scopus until March 17, 2023. The included studies involved quantitative primary research conducted in English, focusing on adults (≥18 years) diagnosed with hypertension and experiencing depressive symptoms. Observational studies were assessed using the Newcastle-Ottawa Scale, and randomized controlled trials were evaluated using the revised Cochrane Risk of Bias Tool (RoB 2.0). Due to the great diversity of these studies, a narrative synthesis of the results was undertaken. Results: A total of 18 studies involving 6,131 people with hypertension, that met our eligibility criteria were ultimately included. The reported rates of depressive symptoms ranged from 4% to 43%. Of these studies, nine reported a statistically significant association, showcasing an adverse impact of depressive symptoms on medication adherence. The remaining nine did not confirm the above. This systematic review highlights the diverse body of research exploring depressive symptoms and medication adherence among individuals with hypertension. The review suggests a need for increased attention to self-care practices, particularly in relation to adherence to antihypertensive medication. However, it recommends the conduction of more robust longitudinal studies to comprehensively explore this relationship.

Improving medication adherence of patients with heart failure using tele-motivational interviewing.

The patient's self-care behavior encompasses various aspects, including medication adherence, which has been identified as a significant concern in the context of heart failure. To encourage patients in their medication, tele-motivational interviewing can be used. The main aim of this research is to examine the effects of tele-motivational interviewing on medication adherence in individuals who have been diagnosed with heart failure. In this research, an experimental pretest-posttest design with a control group was chosen. The study involved the implementation of tele-motivational interviewing, which spanned a duration of two months, with interventions taking place on a weekly basis. To measure medication adherence, the Morisky Medication Adherence Scale (MMAS-8) was employed. In a randomly selected sample of 176 respondents, half were assigned to the experimental group (n=88), and the other half were assigned to the control group (n=88). Pre-test medication adherence levels for the experimental group indicate that 68 respondents (77.2%) fall into the low category (score >2), whereas post-test medication adherence levels for the same group indicate that 55 respondents (62.5%) fall into the highest category (score 0). The Wilcoxon Signed Rank Test demonstrates the p-value to be less than 0.001. Tele-motivational interviewing as a skill in education that supports the patients directly and continuously by monitoring during treatment by telephone, gradually changes and affects the patients' behavior. Hence, the utilization of tele-motivational interviewing presents a viable approach for enhancing medication adherence in individuals diagnosed with heart failure.

Effect of Negative Automatic Thoughts on Medication Adherence in Individuals With Schizophrenia

This study aimed to determine the effect of negative automatic thoughts on medication adherence in individuals with schizophrenia. This was a cross-sectional study carried out in a community mental health center between October 2022 and December 2022. The study included 102 individuals with schizophrenia. Data was collected using the Descriptive Characteristics Form, Negative Automatic Thoughts Questionnaire (NAT-Q), and Morisky Medication Adherence Scale (MMAS). The individuals' total mean NAT-Q score was 106.34 ± 27.32. There was a strong negative correlation between NAT-Q and MMAS scores ( r = −0.822, P &lt; 0.05). The study found that negative automatic thoughts predicted medication adherence by 67%. The negative automatic thoughts of the individuals were high and the medication adherence of half of the individuals was low. It was determined that the level of negative automatic thoughts of individuals with schizophrenia may negatively affect their medication adherence. [ Psychiatr Ann . 2023;53(11):518–524.]

The Relationship Between Level of Education, Cognitive Function and Medication Adherence in Patients with Schizophrenia.

Several studies have explored the relationship between level of education and medication adherence, as well as the relationship between level of education and cognitive function. However, there have been few studies on the relationships between level of education, cognitive function, and medication adherence. This study aimed to explore whether cognitive function has a mediating effect between level of education and medication adherence in patients with schizophrenia. A total of 329 participants were included in this study. Cognitive function was assessed using the Brief Assessment of Cognition in Schizophrenia, and medication adherence using the Medication Adherence Questionnaire. The relationships between the clinical factors and cognitive function that contributed to medication adherence were tested through multivariable linear regression analysis. The mediatingeffect of medication adherence was tested using the bootstrapping approach with the PROCESS macro. Family history, insight and executive function were associated with medication adherence in individuals with schizophrenia, and executive function had a mediating effect between level of education and medication adherence. Adopting specific education programs that promote cognitive development as well as actively intervening in executive function might be conducive to improve medication adherence in patients with schizophrenia.

Toward the Design of Sensing-Based Medication Adherence Aids That Support Individualized Activities of Daily Living: Survey and Interviews With Patients and Providers

Background Nearly half of Americans taking prescription medications do not take them properly. The resulting implications have a broad impact. Nonadhering patients develop worsened medical conditions and increased comorbidity of disease or die. Objective Clinical studies have shown that the most effective strategies for addressing adherence are those that are individualized to the context that each patient and situation require. However, existing aids for adherence are relatively ridged and poorly support adaptation to individual behaviors and lifestyles. The aim of our study was to better understand this design tension. Methods A series of 3 qualitative studies was conducted: a web-based survey of 200 Americans that investigated existing adherence strategies and behaviors and perception of how hypothetical in-home tracking technologies would assist adherence; in-person semistructured interviews with 20 medication takers from Pittsburgh, PA, that investigated personal adherence behaviors, which included demonstration of medication locations and routines as well as an assessment of hypothetical technologies; and semistructured interviews with 6 pharmacists and 3 family physicians to gain a provider perspective on patient adherence strategies, which included feedback on hypothetical technologies in the context of their patient populations. Inductive thematic coding of all interview data was performed. Studies were conducted consecutively, with the results informing the subsequent studies. Results Synthesized, the studies identified key medication adherence behaviors amenable to technological interventions, distilled important home-sensing literacy considerations, and detailed critical privacy considerations. Specifically, 4 key insights were obtained: medication routines are heavily influenced and adapted by and through the physical location and placement of medications relative to activities of daily living, routines are chosen to be inconspicuous to maintain privacy, the value of provider-involved routines is motivated by a desire to build trust in shared decision-making, and the introduction of new technologies can create further burden on patients and providers. Conclusions There is considerable potential to improve individual medication adherence by creating behavior-focused interventions that leverage emerging artificial intelligence (AI), machine learning (ML), and in-home Internet of Things (IoT) sensing technologies. However, success will be dependent on the technology’s ability to learn effectively and accurately from individual behaviors, needs, and routines and tailor interventions accordingly. Patient routines and attitudes toward adherence will likely affect the use of proactive (eg, AI-assistant routine modification) versus reactive (eg, notification of associated behaviors with missed dosages) intervention strategies. Successful technological interventions must support the detection and tracking of patient routines that can adjust to variations in patient location, schedule, independence, and habituation.

Pengaruh Edukasi Emo-Demo Terhadap Kepatuhan Minum Obat Pasien Hipertensi Pada Peserta Prolanis

The problem of medication adherence in individuals with hypertension remains a challenge, even in developing countries. The purpose of this study was to determine the effect of Emo demo education on adherence to taking medication in hypertensive patients enrolled in the Prolanis program at Puskesmas Sumbersari Lumajang. This study was conducted at Sumbersari Health Center in March 2023. This study used a quasi-experimental research design with a one group pre-post test design. The purposive sampling technique was chosen to select a sample of 50 respondents. This study used the MMAS-8-4 (Morisky Medication Adherence Scale) questionnaire as a measuring tool for medication adherence. Statistical tests using the Wilcoxon Signed Rank test. Before the emo-demo, most of the 22 (44%) respondents were at a low level of compliance. After emo-demo education, most of the respondents were in moderate compliance 33 (66%) and high compliance 14 (28%). The results of bivariate analysis show that Emo demo education has a significant effect on drug compliance in hypertensive patients participating in Prolanis, with a p-value of 0.000 which is smaller than the predetermined level of significance of 0.05. The provision of Emo Demo in health education with a focus on the target group is expected to be facilitated by the puskesmas. Effective medication adherence among hypertensive patients can improve control of blood pressure and prevent complications of the disease.

Use of machine learning to predict medication adherence in individuals at risk for atherosclerotic cardiovascular disease.

Medication nonadherence is a critical problem with severe implications in individuals at risk for atherosclerotic cardiovascular disease. Many studies have attempted to predict medication adherence in this population, but few, if any, have been effective in prediction, sug-gesting that essential risk factors remain unidentified. This study's objective was to (1) establish an accurate prediction model of medi-cation adherence in individuals at risk for atherosclerotic cardiovascular disease and (2) identify significant contributing factors to the predictive accuracy of medication adherence. In particular, we aimed to use only the baseline questionnaire data to assess medication adherence prediction feasibility. A sample of 40 individuals at risk for atherosclerotic cardiovascular disease was recruited for an eight-week feasibility study. After collecting baseline data, we recorded data from a pillbox that sent events to a cloud-based server. Health measures and medication use events were analyzed using machine learning algorithms to identify variables that best predict medication adherence. Our adherence prediction model, based on only the ten most relevant variables, achieved an average error rate of 12.9%. Medication adherence was closely correlated with being encouraged to play an active role in their treatment, having confidence about what to do in an emergency, knowledge about their medications, and having a special person in their life. Our results showed the significance of clinical and psychosocial factors for predicting medication adherence in people at risk for atherosclerotic cardiovascular diseases. Clini-cians and researchers can use these factors to stratify individuals to make evidence-based decisions to reduce the risks.

The effect of mindfulness on medication adherence in individuals diagnosed with Schizophrenia: A cross-sectional study.

The aim of this study is to determine the effect of mindfulness on medication adherence in individuals diagnosed with schizophrenia. This cross-sectional study was conducted with 147 individuals diagnosed with schizophrenia. The data were collected using the Descriptive Characteristics Form, Morisky Medication Adherence Scale, and Mindful Attention Awareness Scale. A strong positive correlation was determined between the mindfulness level and medication adherence of the individuals diagnosed with schizophrenia. Furthermore, mindfulness of the individuals diagnosed with schizophrenia was statistically significant in explaining medication adherence (p < 0.05) and mindfulness predicted medication adherence by 64%. It was observed that the individuals' mindfulness level was low and half of the participants had low medication adherence. Moreover, as their mindfulness level increased, so did their medication adherence.

Technologies for Medication Adherence Monitoring and Technology Assessment Criteria: Narrative Review.

BackgroundAccurate measurement and monitoring of patient medication adherence is a global challenge because of the absence of gold standard methods for adherence measurement. Recent attention has been directed toward the adoption of technologies for medication adherence monitoring, as they provide the opportunity for continuous tracking of individual medication adherence behavior. However, current medication adherence monitoring technologies vary according to their technical features and data capture methods, leading to differences in their respective advantages and limitations. Overall, appropriate criteria to guide the assessment of medication adherence monitoring technologies for optimal adoption and use are lacking.ObjectiveThis study aims to provide a narrative review of current medication adherence monitoring technologies and propose a set of technology assessment criteria to support technology development and adoption.MethodsA literature search was conducted on PubMed, Scopus, CINAHL, and ProQuest Technology Collection (2010-present) using the combination of keywords medication adherence, measurement technology, and monitoring technology. The selection focused on studies related to medication adherence monitoring technology and its development and use. The technological features, data capture methods, and potential advantages and limitations of the identified technology applications were extracted. Methods for using data for adherence monitoring were also identified. Common recurring elements were synthesized as potential technology assessment criteria.ResultsOf the 3865 articles retrieved, 98 (2.54%) were included in the final review, which reported a variety of technology applications for monitoring medication adherence, including electronic pill bottles or boxes, ingestible sensors, electronic medication management systems, blister pack technology, patient self-report technology, video-based technology, and motion sensor technology. Technical features varied by technology type, with common expectations for using these technologies to accurately monitor medication adherence and increase adoption in patients’ daily lives owing to their unobtrusiveness and convenience of use. Most technologies were able to provide real-time monitoring of medication-taking behaviors but relied on proxy measures of medication adherence. Successful implementation of these technologies in clinical settings has rarely been reported. In all, 28 technology assessment criteria were identified and organized into the following five categories: development information, technology features, adherence to data collection and management, feasibility and implementation, and acceptability and usability.ConclusionsThis narrative review summarizes the technical features, data capture methods, and various advantages and limitations of medication adherence monitoring technology reported in the literature and the proposed criteria for assessing medication adherence monitoring technologies. This collection of assessment criteria can be a useful tool to guide the development and selection of relevant technologies, facilitating the optimal adoption and effective use of technology to improve medication adherence outcomes. Future studies are needed to further validate the medication adherence monitoring technology assessment criteria and construct an appropriate technology assessment framework.