Medication Adherence In Patients Research Articles

Assessing the Efficacy of ChatGPT Versus Human Researchers in Identifying Relevant Studies on mHealth Interventions for Improving Medication Adherence in Patients With Ischemic Stroke When Conducting Systematic Reviews: Comparative Analysis.

ChatGPT by OpenAI emerged as a potential tool for researchers, aiding in various aspects of research. One such application was the identification of relevant studies in systematic reviews. However, a comprehensive comparison of the efficacy of relevant study identification between human researchers and ChatGPT has not been conducted. This study aims to compare the efficacy of ChatGPT and human researchers in identifying relevant studies on medication adherence improvement using mobile health interventions in patients with ischemic stroke during systematic reviews. This study used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Four electronic databases, including CINAHL Plus with Full Text, Web of Science, PubMed, and MEDLINE, were searched to identify articles published from inception until 2023 using search terms based on MeSH (Medical Subject Headings) terms generated by human researchers versus ChatGPT. The authors independently screened the titles, abstracts, and full text of the studies identified through separate searches conducted by human researchers and ChatGPT. The comparison encompassed several aspects, including the ability to retrieve relevant studies, accuracy, efficiency, limitations, and challenges associated with each method. A total of 6 articles identified through search terms generated by human researchers were included in the final analysis, of which 4 (67%) reported improvements in medication adherence after the intervention. However, 33% (2/6) of the included studies did not clearly state whether medication adherence improved after the intervention. A total of 10 studies were included based on search terms generated by ChatGPT, of which 6 (60%) overlapped with studies identified by human researchers. Regarding the impact of mobile health interventions on medication adherence, most included studies (8/10, 80%) based on search terms generated by ChatGPT reported improvements in medication adherence after the intervention. However, 20% (2/10) of the studies did not clearly state whether medication adherence improved after the intervention. The precision in accurately identifying relevant studies was higher in human researchers (0.86) than in ChatGPT (0.77). This is consistent with the percentage of relevance, where human researchers (9.8%) demonstrated a higher percentage of relevance than ChatGPT (3%). However, when considering the time required for both humans and ChatGPT to identify relevant studies, ChatGPT substantially outperformed human researchers as it took less time to identify relevant studies. Our comparative analysis highlighted the strengths and limitations of both approaches. Ultimately, the choice between human researchers and ChatGPT depends on the specific requirements and objectives of each review, but the collaborative synergy of both approaches holds the potential to advance evidence-based research and decision-making in the health care field.

The use of once-daily LCP-Tacrolimus with adolescent and young adult solid organ transplant recipients.

Adolescent and young adult (AYA) solid organ transplant (SOT) recipients experience increased rates of rejection and graft loss surrounding the time of health care transition, in part due to poor medication adherence. This study aims to examine the impact of a once-daily formulation of tacrolimus, LCP-tacrolimus (LCPT), on medication adherence for AYA SOT patients. A retrospective descriptive analysis was performed for all patients who underwent SOT and were prescribed LCPT after the age of 12 at our single-center pediatric hospital. Medication adherence was assessed via provider documentation and the medication level variability index (MLVI). Twenty-nine patients were prescribed LCPT as part of their immunosuppression regimen. Twenty patients were converted to LCPT from immediate-acting (IR) tacrolimus; six patients were initiated immediately following transplant, and three patients were unable to receive LCPT due to insurance denial. There was a numeric improvement in medication adherence for converted patients when measured by provider assessment (45.0% vs. 68.4%, p = .140) and MLVI (40.0% vs. 71.4%, p = .276), though these did not reach statistical significance. There were no differences in episodes of rejection or adverse effects. LCPT prescription was not associated with decreased medication burden, and two patients transitioned back to IR tacrolimus due to increased cost. LCPT use did not significantly improve patient adherence; however, it resulted in numerically higher perceived and measured adherence rates. LCPT appears to be safe and effective in the management of SOT recipients; however, it may not affect pill burden and may result in a higher financial burden. Use may be considered for a select group of AYA SOT recipients.

Assessment of the Severity of Depression Symptoms, Knowledge, and Medication Adherence in Patients with Major Depressive Disorder in Sulaimaniyah, Iraq

Background: Patients' knowledge and medication adherence are crucial in managing major depressive disorders (MDD). Understanding treatment options empowers patients to make informed decisions, while adherence ensures consistent therapy efficacy. Objectives: To assess the severity of depressive symptoms, as well as patients' knowledge regarding their disease and their medication adherence, within the population diagnosed with MDD. Subjects and Methods: A cross-sectional study was conducted at the Ali-Kamal Psychiatric Clinic in Sulaimaniyah City, Iraq, on 102 individuals diagnosed with MDD. Data collection utilized questionnaires covering participant characteristics, depression assessment tools such as Beck's Depression Inventory, Patient Health Questionnaires, and Quick Inventory of Depressive Symptomatology, questions concerning participants' knowledge regarding depression, and medication adherence utilizing Morisky's Medication Adherence Scale-8. Results: The level of depression severity was mild to moderate for 42%, and it was severe for 34.3% of patients. The severity of depression symptoms was moderately severe in most patients (52.9%), followed by moderate (26.5%) and then severe (12.7%). The change in weight and appetite was most common (2.11 ± 0.84), while suicide ideation was the least common (1.15 ± 0.65). The knowledge of 65.7% was poor, and 87.3% was poorly adhered to medication. Conclusions: Nearly one-third of participants exhibited severe depression, while the majority experienced moderately severe symptoms. Additionally, many had insufficient knowledge and demonstrated low medication adherence.

Pharmacist intervention to improve adherence to medication among heart failure patients at North East Ethiopia hospital.

Heart failure (HF) is a major and growing medical problem and its management is still challenging due to the coexistence of complications, co-morbidity, and medication non-adherence. HF patients who are adherent to their medication have fewer HF exacerbations, improved survival, and lower healthcare expenditure. Adherence to HF medication plays a pivotal role in attaining maximal therapeutic outcomes. The aim was to assess the medication adherence of heart failure patients at Debre Berhan Comprehensive Specialized Hospital (DBCSH). A pre-post interventional study was undertaken from July 1, 2022, to December 31, 2022, at the medical referral clinic of DBCSH. The educational interventions were provided for 6 months. Medication adherence was determined using the Morisky Green Levin Medication Adherence Scale (MGLS). The data was entered into Epidata version 4.2.0 and analyzed using SPSS version 25.0 statistical software. Descriptive statistics and binary logistic regression analysis were performed. The strength of the association between predictor variables and outcome variables was determined using a 95% confidence interval and adjusted odd ratio. In the pre-intervention phase, 54.6% of patients had medium medication adherence, while in the post-intervention phase, 36.4% of patients had high medication adherence and 61.9% of patients had medium medication adherence. Following the intervention, medication cost (120, 50%), inadequate availability of drugs (75, 31%), and forgetfulness (30, 13%) were the main reasons for medication non-adherence. The presence of co-morbidity and the number of co-morbidity (p < .05) were significantly associated with the occurrence of decreased medication adherence in the pre-intervention phase. Interventions by pharmacists to educate HF patients about the nature of their disease and providing brochures to increase awareness of their medications have been shown to improve medication adherence.

Assessment of Patient Medication Adherence Using Digital Health Technologies: A Research

Assessment of Patient Medication Adherence Using Digital Health Technologies: A Research

Recurrent high creatine kinase levels under clozapine treatment - a case report assessing a suspected adverse drug reaction

Suspected adverse drug reactions (ADRs) during treatment with clozapine often prompt therapeutic drug monitoring (TDM) in clinical practice. Currently, there is no official recommendation for pharmacogenetic (PGx) testing in the context of clozapine therapy. In this case report, we demonstrate and discuss the challenges of interpreting PGx and TDM results highlighting the possibilities and limitations of both analytical methods. A 36-year-old male patient with catatonic schizophrenia was treated with clozapine. He experienced multiple hospitalizations due to elevated creatine kinase (CK) levels (up to 9000 U/L, reference range: 30-200 U/L). With no other medical explanation found, physicians suspected clozapine-induced ADRs. However, plasma levels of clozapine were consistently low or subtherapeutic upon admission, prompting us to conduct a PGx analysis and retrospectively review the patient’s TDM data, progress notes, and discharge reports. We investigated two possible hypotheses to explain the symptoms despite low clozapine plasma levels: Hypothesis i. suggested the formation and accumulation of a reactive intermediate metabolite due to increased activity in cytochrome P450 3A5 and reduced activity in glutathione S-transferases 1, leading to myotoxicity. Hypothesis ii. proposed under-treatment with clozapine, resulting in ineffective clozapine levels, leading to a rebound effect with increased catatonic symptoms and CK levels. After considering both data sources (PGx and TDM), hypothesis ii. appeared more plausible. By comprehensively assessing all available TDM measurements and examining them in temporal correlation with the drug dose and clinical symptoms, we observed that CK levels normalized when clozapine plasma levels were raised to the therapeutic range. This was achieved through hospitalization and closely monitored clozapine intake. Therefore, we concluded that the symptoms were not an ADR due to altered clozapine metabolism but rather the result of under-treatment. Interpreting TDM and PGx results requires caution. Relying solely on isolated PGx or single TDM values can result in misinterpretation of drug reactions. We recommend considering the comprehensive patient history, including treatment, dosages, laboratory values, clinic visits, and medication adherence.

Impact of Pharmacist-led Interventions on Medication Adherence and Inhalation Technique in Adult Patients with COPD and Asthma

Introduction: Inhalation technique and medication adherence are essential prerequisites for achieving optimal therapeutic effects in patients with chronic obstructive pulmonary disease (COPD) and asthma. Although there are various effective treatments for respiratory disorders, disease control in these patients is still sub-optimal because of incorrect inhalation techniques and poor medication adherence. Pharmacist-led interventions have  demonstrated a positive impact on improving inhalation technique, better medication adherence, and thus subsequently improving the quality of life of patients. Methods: Search engines such as PubMed, Google Scholar, and Science Direct were used to identify the relevant information using keywords: Chronic Obstructive Pulmonary Disease, Asthma, Pharmaceutical care, Pharmacist Intervention, Medication Adherence and Inhalation Technique. The relevant articles that were published between 2005 to 2021 were included and reviewed for the Pharmacist-led interventions to improve medication adherence, inhalation technique, and quality of life of patients with COPD and asthma. Results: Of the 300 articles screened, a total of 14 articles met the inclusion criteria and were included for review. Pharmacist-led interventions help to improve the medication adherence, inhalation technique, and quality of life of patients with COPD and asthma. Similarly, the articles mentioned in this review found that the interventions provided by the pharmacist to COPD and asthma patients were cost-effective in terms of reducing hospitalization rates and severe exacerbation rates. Conclusion: Our review concluded that the pharmacists’ interventions have a significant improvement in medication adherence and inhalation techniques with the enhancement of therapeutic effects in adult patients with COPD and asthma.

Factors affecting medication adherence in patients using oral chemotherapy: A descriptive study.

The utilization of oral chemotherapy agents for cancer treatment has witnessed a steady rise in recent years. The pivotal determinant for the success of oral chemotherapy lies in the adherence of cancer patients to the prescribed treatment. This study aims to explore oral chemotherapy adherence and identify factors influencing medication adherence among cancer patients. A total of 103 cancer patients participated in this descriptive study. Data were collected using the Oral Chemotherapy Adherence Scale, the Turkish Translation of the Beliefs about Medicines Questionnaire (BMQ-T) and The Functional Living Index-Cancer. Of the participants, 66% reported good adherence to oral chemotherapy. Key findings indicate that access to health services (β = -1.473, p = 0.009), cancer stage (β = -1.570, p = 0.015) and the BMQ-T subscale of General Overuse (β = .696, p = 0.041) were independent predictors of medication adherence. The study observed medication non-adherence in one-third of patients undergoing oral chemotherapy. Primary contributors to non-adherence included difficulties in accessing health services, advanced cancer stage and the belief that drugs are over-recommended by doctors. These results underscore the need for a heightened focus on preventable factors, such as improving access to health services and addressing beliefs about drug overuse, to enhance medication adherence in patients receiving oral chemotherapy.

Breaking Barriers in Behavioral Change: The Potential of AI-Driven Motivational Interviewing.

Patient outcomes in ophthalmology are greatly influenced by adherence and patient participation, which can be particularly challenging in diseases like glaucoma where medication regimens can be complex. A well-studied and evidence-based intervention for behavioral change is Motivational Interviewing (MI), a collaborative and patient-centered counseling approach, which has been shown to improve medication adherence in glaucoma patients. However, there are many barriers to clinicians being able to provide motivational interviewing in-office, including short visit durations within high-volume ophthalmology clinics and inadequate billing structures for counseling. Recently, Large Language Models (LLMs), a type of artificial intelligence, have advanced such that they can follow instructions and carry coherent conversations, offering novel solutions to a wide range of clinical problems. In this paper, we discuss the potential of LLMs to provide chatbot-driven MI to improve adherence in glaucoma patients, and provide an example conversation as a proof of concept. We discuss the advantages of AI-driven MI, such as demonstrated effectiveness, scalability, and accessibility. We also explore the risks and limitations, including issues of safety and privacy, as well as the factual inaccuracies and hallucinations to which LLMs are susceptible. Domain-specific training may be needed to ensure accuracy and completeness of information provided in subspecialty areas such as glaucoma. Despite the current limitations, AI-driven Motivational Interviewing has the potential to offer significant improvements in adherence, and should be further explored to maximally leverage the potential of artificial intelligence for our patients.

Temporal characteristics and associated factors of discontinuation and outcomes after percutaneous coronary intervention.

Background: Medication adherence in patients after percutaneous coronary intervention (PCI) is suboptimal, and discontinuation is common. Information on the temporal characteristics and associated factors of discontinuation and outcomes after PCI is insufficient to improve medication adherence interventions. Methods: We conducted a single-center retrospective study of post-PCI patients by telephone survey and medical record extraction. Temporal characteristics and associated factors of discontinuation and outcomes were examined by survival curve analysis, Cox regression, or time-dependent Cox regression. Results: Discontinuation and major adverse cardiovascular events (MACE) after PCI had similar temporal characteristics, with the highest incidence in the first year, followed by a decline. Temporary discontinuation was associated with pre-PCI medication nonadherence (HR 1.63; 95% CI: 1.09-2.43), lack of medication necessity (HR 2.33; 95% CI: 1.44-3.78), economic difficulties (HR 2.09; 95% CI: 1.26-3.47), routine disruption (HR 2.09; 95% CI: 1.10-3.99), and emotional distress (HR 2.76; 95% CI: 1.50-5.09). Permanent discontinuation was associated with residence in rural areas (HR 4.18; 95% CI: 1.84-9.46) or small to medium-sized cities (HR 4.21; 95% CI: 1.82-9.73), lack of medication necessity (HR 10.60; 95% CI: 6.45-17.41), and side effects (HR 3.30; 95% CI: 1.94-5.62). The MACE after PCI was associated with pre-PCI hypertension (HR 1.42; 95% CI: 1.04-1.96), two coronary stents (HR 1.42; 95% CI: 1.01-1.99) or three coronary stents (HR 1.66; 95% CI: 1.11-2.49) compared to one coronary stent up to this PCI, and temporary discontinuation (≤60 months HR 2.18; 95% CI: 1.47-3.25; >60 months HR 8.82; 95% CI: 3.65-21.28). Conclusion: Discontinuation and MACE after PCI have similar temporal characteristics, temporary discontinuation and permanent discontinuation have different associated factors, and the former is associated with MACE. These findings may provide guidance for medication adherence interventions.

The effect of cognitive decline on the medication adherence in patients with type II diabetes mellitus

Background: Type II Diabetes Mellitus (T2DM) is a risk factor for decreased cognitive function that is rarely recognised by patients, apart from age and other factors. Objective: This study aims to assess the effect of decreased cognitive function on medication adherence in T2DM patients. Method: This study used a cross-sectional design conducted at the Pasar Minggu Community Health Center, Jakarta, Indonesia. Cognitive function was assessed using the validated Indonesian version of the Montreal Cognitive Assessment (MoCA-Ina) questionnaire. Results: One hundred twenty-seven T2DM patients (75.6% female) with a mean age of 58.69 years were recruited. The proportion of T2DM patients with decreased cognitive function was quite high, namely 61%. The proportion of non-adherent patients in the group with decreased cognitive function (70.6%) was greater than in the normal group (29.4%). Decreased cognitive function significantly affected non-adherence in taking medication with aOR 3.744 (95% CI 1.485–9.442), p = 0.005, after controlling for age, education level, HbA1c value, and comorbid dyslipidemia. Conclusion: Patients with decreased cognitive function are 3.7 times more likely to be non-compliant with medication, regardless of age, education level, HbA1c value, and dyslipidemia. Special management is needed for T2DM patients with decreased cognitive function, such as caregiver assistance, education by pharmacists, and simpler drug regimes.

Telepharmacy intervention: Can it impact medication adherence among patients with chronic disease?

Background: Medication adherence among patients with chronic diseases remains challenging for healthcare professionals. The large number and types of drugs that must be taken in the long term and the lack of knowledge related to drugs and diseases are factors that affect patient compliance. Telepharmacy is expected to improve patient medication adherence by providing easy access to consult with pharmacists. Objective: To assess the effect of telepharmacy on chronic patient medication adherence. Methods: This study had a cross-sectional study design, and the study population was Lifepack application users. The data was collected through an online questionnaire distributed through the Lifepack platform. The adherence was evaluated using the Morisky Medication Adherence Scale, and the association of telepharmacy and patient medication adherence was examined using the chi-square independence test with significance at p &lt; 0.05. Results: In a study comprising of 94 respondents, a proportional ratio of respondents who used and did not use telepharmacy services was observed (45.75% and  54.25%, respectively). Analysis using the chi-square statistic (χ²) demonstrated a significant association between telepharmacy and patient adherence (χ² = 64.745, df = 1, p &lt; 0.001). Furthermore, the odds ratio (OR) revealed a substantial difference in adherence, with an OR of 122.67 (95% CI [27.58, 545.66]). Conclusion: Telepharmacy has a significant impact on medication adherence in chronic patients.

Is CONNECTDROP®, a Medication Event Monitoring System Add-On Paired with a Smartphone Application, acceptable to Patients with Glaucoma for taking their daily medication? The CONDORE Pilot Study.

ObjectiveThis pilot study tested the feasibility of a future efficacy trial examining the effect of CONNECTDROP®, a novel Medication Event Monitoring System (MEMS) paired with a mHealth application, on medication adherence in patients with glaucoma. DesignA single-center, single-arm, prospective interventional pilot study (NCT04552964) ParticipantsAdults with glaucoma managed with at least a fixed combination timolol/dorzolamide who are adherent to treatment. MethodsParticipants (n=31) were provided with the MEMS device and a smartphone with the Application installed. They were required to use the MEMS with their usual timolol/dorzolamide prescription for nine weeks. The study endpoint was at the end of week nine, when all study materials were returned, and participants completed a 17-item patient satisfaction questionnaire. Data collected continuously by each MEMS for the nine weeks was analyzed for its suitability to quantify adherence of the individual participant and characterize adherence trends within the study cohort. Clinical data were collected at baseline, week eight and week nine for the safety evaluation. Main outcome measuresThe primary outcome was global patient satisfaction after nine weeks. Secondary outcome measures included participant feedback on handling the MEMS and its usability, along with that of the connected Application. Objective data was used to determine participant medication adherence. The proportion of participants who successfully changed the MEMS to a new bottle at week eight was reported. ResultsThe MEMS-connected device achieved a global satisfaction score of 74.1% from study participants after nine weeks. Furthermore, 70.4 % of participants found the MEMS easy to use. However, only 59.2% reported feedback from the mHealth Application useful in reminding them to take their treatment. MEMS-derived data showed that 70.4% of participants achieved an "adherence score" of 80% or above after eight weeks and that 40.7% who completed the study had not changed the bottle correctly. No adverse events were reported. ConclusionIn this pilot study, the MEMS device had high satisfaction amongst this cohort of patients and was easy to use. The user satisfaction score for the Application was lower. The objective adherence data obtained appears reliable but must be validated for use in an efficacy trial.

Evaluation of the Simple Suspension Method for Oral Anticancer Drugs.

The simple suspension method (SSM) involves administering tablets or capsules using a tube after disintegration and suspension in hot water without crushing or opening the capsule. Particularly, for anticancer drugs, it is an excellent method of administration that reduces the risk of exposure during dispensing. In contrast, information on SSM for individual drugs is insufficient. Anticancer drugs present a therapeutic challenge because their information is limited. We investigated whether SSM is possible with 36 anticancer drugs. Furthermore, we examined the pH of the suspension of these drugs, for which no information on SSM is available. We found that suspension was possible for 24 of the 36 drugs. Furthermore, the pH of the suspension was measured, which provided important information when considering dissolution solutions other than hot water. Little changes in the pH were observed before or after passing through the tube. The results of this study may improve medication adherence in patients with cancer experiencing dysphagia.

Evaluation of Medication Adherence in Geriatric Patients with Chronic Illnesses in a Tertiary Care Hospital

Evaluation of Medication Adherence in Geriatric Patients with Chronic Illnesses in a Tertiary Care Hospital

The relationship between medication adherence and complementary medicine use in epilepsy patients

ObjectiveThe aim of this research is to examine the usage of Complementary and Integrated Medicine (CIM) in individuals with epilepsy and the impact of CIM usage on medication adherence. Materials and methodsThis descriptive and cross-sectional study was conducted in a university hospital in northern Turkey between July and October 2023, involving 101 individuals with epilepsy (PWE). Descriptive information forms and the Morisky Medication Adherence Scale-4 (MMS-4) were used as data collection tools. Descriptive statistics, t-tests, ANOVA, and post-hoc LSD analyses were employed for data evaluation. ResultsThe participants consisted of 65.3 % males, 25.7 % were not working due to epilepsy, and 61.4 % with generalized epilepsy. The average MMS-4 score was found to be 3.08 ± 0.96. MMS-4 scores showed significant differences based on epilepsy type (F = 3.998, p = 0.021; η2 = 0.07). 76.2 % (n = 21) of the participants who used at least one CIM technique preferred “having a religious person read a prayer.” ConclusionMedication adherence in PWE was at a moderate level. Individuals with focal and secondary generalized epilepsy showed better medication adherence compared to those with generalized types. Of those participant who used at least one CIM technique to improve their general health or control seizures, the most common was “having a religious person read a prayer.”

Associations between daily home blood pressure measurements and self-reports of lifestyle and symptoms in primary care: the PERHIT study

Objective To explore in a primary care setting the associations between patients’ daily self-measured blood pressure (BP) during eight weeks and concurrent self-reported values of wellbeing, lifestyle, symptoms, and medication intake. We also explore these associations for men and women separately. Design and setting The study is a secondary post-hoc analysis of the randomised controlled trial PERson-centeredness in Hypertension management using Information Technology (PERHIT). The trial was conducted in primary health care in four regions in Southern Sweden. Patients Participants (n = 454) in the intervention group in the PERHIT-trial used an interactive web-based system for self-management of hypertension for eight consecutive weeks. Each evening, participants reported in the system their wellbeing, lifestyle, symptoms, and medication adherence as well as their self-measured BP and heart rate. Main outcome measures Association between self-reported BP and 10 self-report lifestyle-related variables. Results Self-reported less stress and higher wellbeing were similarly associated with BP, with 1.0 mmHg lower systolic BP and 0.6/0.4 mmHg lower diastolic BP (p < 0.001). Adherence to medication had the greatest impact on BP levels (5.2/2.6 mmHg, p < 0.001). Restlessness and headache were also significantly associated with BP, but to a lesser extent. Physical activity was only significantly associated with BP levels for men, but not for women. Conclusion In hypertension management, it may be important to identify patients with high-stress levels and low wellbeing. The association between medication intake and BP was obvious, thus stressing the importance of medication adherence for patients with hypertension.

Relationship between Patients’ Knowledge and Medication Adherence of Tuberculosis at Islamic Hospital Pondok Kopi Jakarta

Background: Tuberculosis (TB) remains a health problem in Indonesia. Currently, the number of new TB cases in Indonesia ranks second after India. Patient compliance in using antituberculosis drugs is critical in achieving successful treatment outcomes, prevent further spread of the bacteria that cause TB and the development of drug resistance. Adherence to taking medication can be influenced by various factors, one of which is the level of knowledge.Objectives: This study was aimed to determine the relationship between the level of knowledge about TB and medication adherence of TB patients at the Jakarta Islamic Hospital Pondok Kopi.Methods: This study was conducted from May to June 2022 with a cross sectional design.  The inclusion criteria in this study were TB patients who were over 18 years old, willing to become respondents, and had used antituberculosis drugs for at least one month. The level of knowledge about TB was assessed using a questionnaire and medication adherence was assessed using the MARS-5 questionnaire.Results: The number of respondents in this study was 83 patients. Most patients were male (57.83%), less than 60 years old (83.13%), and had a high school education (53.01%). The results showed that most patients (73.47%) had a good level of knowledge and were compliant with taking medication (77.11%). The level of patient knowledge about TB has a significantly moderate and positive correlation with the level of adherence in taking medication (p 0.001; r 0.517).Conclusion: increasing patients’ knowledge about TB can lead to better patients’ adherence, which may lead to better treatment outcome.

What Are the Perceptions of Recipients of Allogeneic Hematopoietic Stem Cell Transplant About Medication Adherence?: A Synthesis of Qualitative Studies.

Recipients of allogeneic hematopoietic stem cell transplant (HSCT) may encounter difficulties in adhering to their post-transplant medication as prescribed to avoid complications. Despite the relevance of patients' perspectives to inform the clinical practice, to date, no summary regarding their lived experience of oral medication adherence (MA) has been produced. To summarize the lived experience of MA by recipients of allogeneic HSCT as documented in qualitative studies. A systematic review and meta-synthesis of qualitative research was performed. Six databases were searched up to June 27, 2023. Four qualitative studies met eligibility and were included: those designed and conducted with scientifically sound methodologies and those regarding adult patients who had undergone allogeneic HSCT and required an oral medication regimen in the post-transplant phase. Data were extracted and synthesized using thematic analysis. Four analytical themes were identified: "The initiation is a challenge," "Time as a new issue," "Internal and external obstacles threaten medication adherence," and "Different strategies are the answer to medication non-adherence." Medication adherence in patients after HSCT is a complex phenomenon wherein different factors play a role. When designing targeted interventions to improve MA, it is imperative to start with patients' experiences and perspectives. Patients developed different strategies to deal with obstacles to MA that may inform daily practice. Before discharge, healthcare professionals should emphasize to both patients and carers the importance of MA.

Motivational interviewing to support medication adherence in older patients: Barriers and facilitators for implementing in hospital setting according to healthcare professionals

ObjectiveThe aim of this study was to understand through Healthcare professionals’ (HCPs) opinions the barriers and facilitators to implement MI in older hospitalized patients. MethodsA qualitative study with semi-structured interviews was performed among 23 HCPs involved in the medication management of older hospitalized patients (geriatricians, nurses, psychologists and pharmacists). A thematic analysis was conducted using a deductive approach through the Theoretical Domain Framework (TDF), and an inductive approach. ResultsThe thematic analysis reported 25 factors influencing MI implementation, mapped into 8 TDF themes, and including 13 facilitators, 8 barriers, and 4 both. The main factors identified were: ‘cognitive and sensory disorders’ (barrier), ‘having dedicated time and HCPs’ (facilitator and barrier), and the ‘HCP’s awareness about MI’ (facilitator). Ten factors were identified as specific to the older population. ConclusionsImplementing MI in a hospital setting with older patients presented both barriers and facilitators. Practice implicationsTo ensure successful MI implementation, it is important to take into account the older patients’ context, the hospital environment, and the HCPs-related factors.