Medication Adherence Questionnaire Research Articles

Domains of Adherence and Non-Adherence to Anti-Hypertensive Medications in Hypertensive Patients from Kuala Lumpur: A Qualitative Study

Introduction: Previous medication adherence studies primarily focused on the domains of non-adherence in hypertension treatment and less attention has been given on domains that encourage adherence to anti-hypertensive medications. The current study is aimed to identify the domains of adherence and non-adherence to anti-hypertensive medications among hypertensive patients in Kuala Lumpur, Malaysia. Methods: Hypertensive patients from two public health clinics in Kuala Lumpur were invited for in-depth interviews until thematic saturation. Audio recordings from these interviews were transcribed verbatim. Transcripts were then analysed deductively with the guidance of the World Health Organization Medication Adherence Framework to extract the domains of adherence and non-adherence to anti-hypertensive medications. Results: Ten patients who were predominantly Malays and aged 34-73 years old participated the study. Patient-related (encompassing knowledge, attitude, belief and culture, lifestyle, personal barriers, self-efficacy, and cue to action), socioeconomic (encompassing social support), condition-related (encompassing nature of illness and presence of multiple co-morbidities), therapy-related (encompassing experience of receiving treatment, barrier in treatment, and side effects of treatment), and healthcare system (encompassing access to healthcare and healthcare center experience) domains were identified as central to the medication-taking behaviour of hypertensive patients. Conclusion: Sixteen codes of adherence and 22 codes of non-adherence to anti-hypertensive medications were identified, which were distributed across five domains (patient-related, socioeconomic, condition-related, therapy related, and healthcare system domains). These findings can help to inform future development of medication adherence questionnaires, individualised interventions for patients with adherence problems, and targeted health promotion programmes to reduce uncontrolled hypertension.

Exploring Patient Beliefs and Medication Adherence in the Mediterranean Context: A Cross-Sectional Study in Patients with Cardiovascular Diseases and Cardiometabolic Disorders in Greece-The IACT-Study.

Evidence has shown that poor adherence to vascular medications contributes to a considerable proportion of all cardiovascular disease (CVD) events and mortality. The aim of the present work was to examine patients' beliefs/views that affect their level of adherence to the assigned medical treatment in the context of a multi-center study in Greece. Between July 2022 and April 2023, 1988 patients (1180 females) with established cardiovascular disease or relevant cardiometabolic disorders were chosen from seven medical centers in Greece. The 4-item Morisky Medication Adherence Questionnaire gauged medication adherence and investigated patients' beliefs/views regarding treatment. Among participants, 51.2% showed perfect medication adherence, contrasting with 48.8% displaying poor adherence. Patients with negative medication beliefs were around three times more likely to be non-adherent (OR = 2.73; 95% CI = 2.28-3.28). Non-adherers held concerns about drug efficacy (OR = 2.34; 95% CI = 1.10-4.97) and favored alternative therapies (OR = 2.25; 95% CI = 1.75-2.91). The findings highlight the significance of addressing patient beliefs/views to improve medication adherence. The distinct Mediterranean context, influenced by cultural, socioeconomic, and clinical factors, emphasizes the need for tailored interventions. This underscores the call for contextually sensitive strategies to boost medication adherence and improve health outcomes in this unique region.

Related factors to non-adherence to antiretroviral therapy in HIV/AIDS patients

ObjectiveTo identify sociodemographic, clinical, and pharmacological factors associated with nonadherence to antiretroviral treatment in patients with human immunodeficiency virus/acquired immunodeficiency syndrome treated between 2017 and 2020 in four cities in Colombia. MethodAn observational, cross-sectional, retrospective study was conducted of a population of patients with human immunodeficiency virus/acquired immunodeficiency syndrome treated between 2017 and 2020. The Morisky-Green scale, the simplified medication adherence questionnaire, and the simplified scale to detect adherence problems to antiretroviral treatment were applied to determine patient adherence. A binomial multiple logistic regression was performed to evaluate the factors that best explain nonadherence. ResultsA total of 9,835 patients were evaluated, of whom 74.4% were men, 71.1% were aged between 18 and 44 years, 76.0% had attended at most secondary school, 78.1% were single, and 97.6% resided in an urban area. After applying three different scales to each patient, 10% of the study population were identified as nonadherent to treatment. The risk of nonadherence was significantly higher in patients who presented any drug-related problem or had an adverse reaction to antiretroviral drugs. ConclusionsThe variables most strongly associated with nonadherence to antiretroviral treatment were drug-related problems, adverse drug reactions, a history of nonadherence to treatment, and psychoactive substance use.

Health-Related Quality of Life in Patients Living with Wilson Disease in Spain: A Cross-Sectional Observational Study.

Wilson disease (WD) is a rare copper metabolism disorder caused by mutations in the ATP7B gene. It usually affects young individuals and can produce hepatic and/or neurological involvement, potentially affecting health-related quality of life (HRQoL). We assessed HRQoL in a cohort of Spanish patients with WD and evaluated disease impact on several domains of patients' lives, treatment adherence, drug preference and satisfaction, and healthcare resource utilisation in a cross-sectional, retrospective, multicentric, observational study. A total of 102 patients were included: 81.4% presented isolated liver involvement (group H) and 18.6% presented neurological or mixed involvement (group EH). Up to 30% of patients reported a deteriorated emotional status with anxiety and depression, which was greater in the EH subgroup; the use of neuropsychiatric drugs was high. Over 70% of the patients were satisfied with their current treatment but complained about taking too many pills, stating they would consider switching to another more patient-friendly treatment if available. The Simplified Medication Adherence Questionnaire revealed only 22.5% of patients were fully adherent to therapy, suggesting that alternative therapies are needed. This real-world study, even though is highly enriched with hepatic patients and mild disease, shows that WD impacts patients' HRQoL, especially in the emotional domain.

Effect of depression on treatment adherence among elderly tuberculosis patients: A prospective interventional study

BackgroundTuberculosis is a major public health concern, especially in the geriatric age group. Up to one-third of the population with serious medical illness are prone to depression and risk increases with increased severity of underlying illness. Treatment nonadherence is another major concern in elderly tuberculosis patients. Hence this study was focused to assess depression and non-adherence due to depression in elderly tuberculosis patients, and reassessing treatment adherence by giving intervention to improve depression. Materials and methodsThis prospective interventional study was done on 100 elderly TB patients. Depression was assessed by using Hamilton Depression Rating Scale (HDRS) and medication adherence by using Morisky's 8-item Medication Adherence Questionnaire (MMAS-8). Risk for low to medium adherence was expressed in odds ratio (OR) with an appropriate 95% confidence interval (CI). ResultsThe overall prevalence of depression among the participants was 55% and 28% of the participants had low adherence. A significantly higher proportion of depressed patients (41.8% > 11.1%) were with lower adherence to the medication. On the regression model, participants with depression (adjusted OR 43.6, 95% CI 9.5–199) have a significantly higher chance of low to medium adherence with medication. With intervention for depression, the risk of low to medium adherence was reduced by 50.9% (95% CI: 35.9%–65.9%). ConclusionAlmost one in every two elderly TB patients suffers from comorbid depression. Around 90% will have low to moderate treatment adherence, which makes them treatment defaulters and increases the risk of drug-resistant tuberculosis.

Prescription auditing and assessment of medication adherence patterns in patients with diabetic foot ulcer.

Diabetic foot ulcer (DFU) is a serious infectious disease, which can be managed very well through proper medication, but if left untreated it may lead to amputation of the affected area leading to permanent immobility which will compromise the patient's quality of life. To carry out prescription auditing and to assess medication adherence patterns among DFUpatients. A prospective interview-based study was carried out in the surgery department among inpatients aged above 18 years diagnosed with a DFU. A disease specific medication adherence questionnaire consisting of 15 questions was developed, validated and implemented among 65 patients. All the relevant data were analyzed and subjected to statistical analysis. The majority (49.2%) of the population had an intermediate adherence pattern followed by high adherence (43%) during the first visit, later the reassessment after the counseling, reports a gradual increase in adherence pattern. Prescription auditing reveals the intensity of drug burden, on anaverage a prescription might carry 8 drugs and more than 95.3% of prescribed drugs were in injectable form. This study highlights the depth of drug burden through prescription auditing and the necessity of proper patient counseling and educating the patient about the importance of medication adherence for limiting disease progression.

Mobile Health Application and Hypertension Management in Rural, Middle-Aged Adults: A Quality Improvement Project.

Over 29% of the adult population in the United States are diagnosed with hypertension, and rates are significantly higher in those adults who live in rural areas. Hypertension is recognized as the most prevalent comorbidity and modifiable risk factor leading to premature death. The purpose of this quality improvement project was to determine if using a mobile phone-based health application called Medisafe could enhance medication adherence and improve blood pressure control in rural-dwelling adults. A small group (N = 14) of middle-aged (45-64 years old) patients with hypertension were recruited to download the free Medisafe phone-based health application. Patients utilized the Medisafe application between their initial visit and a 4- to 6-week follow-up. At the follow-up visit, 64% (n = 9) of participants improved their level of hypertension control by blood pressure classification and improved their scores on the medication adherence questionnaire. The findings from this quality improvement project suggest the Medisafe application is useful to enhance medication adherence and blood pressure control. Future research and quality improvement initiatives are necessary to determine the broader efficacy of phone-based health applications in the rural adult population.

MEDICATION ADHERENCE AND GENDER DIFFERENCE IN HYPERTENSIVE PATIENTS

Objective: One of the major clinical problems in the management of arterial hypertension (AH) is adherence to the medical regimen. Failure to adhere affects not only patients causing disease progression, reduced functional abilities as well as lower quality of life, but also the healthcare system due to medication waste and increased hospital visits and admissions. Data about hypertensive medication adherence in our region are lacking. Therefore, we aimed to assess medication adherence in our hypertensive patients in order to identify possible strategies to improve and enhance mentioned adherence. Design and method: This study included 324 participants with AH, of which 51.2 % were men, and with an overall median age of 64 years (IQR = 17). Along with the 24-hour ambulatory blood pressure measurement, each patient completed a medication adherence questionnaire, Morisky Medication Adherence Scale (MMAS-8). This self-reported questionnaire consists of 8 questions with a total score ranging from 0 to 8 and a lower score indicates lower adherence to the prescribed pharmacological antihypertensive therapy. Results: 51 (15.7%) participants had low, 114 (35.2%) had moderate and 159 (49.1%) had high medication adherence. There was no significant difference in MMAS-8 score regarding age (p = 0.334), however, men were found to have -higher adherence to antihypertensive therapy than women (58.5% vs. 41.5% had high adherence, respectively, p = 0.018). Conclusions: The results of our study showed that more than half of our hypertensive patients (50.9%) are not completely adherent to antihypertensive medication. Among all of them women were found to have lower adherence compared to men. Low medication adherence could lead to substantial worsening of disease as well as increased health care costs in care of hypertensive patients. Therefore, the presented results highlight the need for patient education and support to increase patient adherence in order to reduce cardiovascular risk.

Validation of the model medication adherence questionnaire to measure the adherence to oral medication among patients with type 2 diabetes mellitus in Sri Lanka

Background: The model medication adherence questionnaire (MMA) measures oral medication adherence among patients with type 2 diabetes (DM). The validity of the questionnaire needs to be objectively demonstrated. Methods: A descriptive cross-sectional study was carried out among adult patients with type 2 DM who attended clinics in District General Hospital (DGH) Gampaha. A sample of 150 patients was recruited consecutively to establish the criterion and construct validity. The criterion was the composite index of pill count, recital dosage and regular clinic attendance. Sensitivity and specificity with 95% confidence-intervals (CI) were established. Construct validity: convergent and discriminative, was assessed. Results were analyzed by Spearmen correlation and Man-Whitney-U test with p values. Results: The accuracy of the test was denoted by the area under the curve which is 0.87 (95% CI 0.81–0.93) with p<0.0001. The best cut-off point was 70. Patients who score >70 have good adherence to the medication while ≤70 have average adherence. This has a sensitivity of 92.9% (95% CI 85.5–96.9%), a specificity of 72.5% (95% CI 58–83.7%) with a misclassification rate of 14%. The positive likelihood ratio (LR) is 10.2. High positive LR (>10) represents that adherence is very likely in a person with a score >70. The negative likelihood ratio is 0.3 and is in the intermediate range. It suggests that a score <70 is suggestive but insufficient to rule out the non-adherence. The ideal cutoff to predict the optimum HbA1C of MMA is 67. Conclusions: MMA is a valid questionnaire to measure medication adherence.

Two-year clinical trial examining the effects of speed of processing training on everyday functioning in adults with human immunodeficiency virus-associated neurocognitive disorder (HAND) and borderline HAND in the U.S. Deep South: Findings of the Think Fast Study

Many people living with human immunodeficiency virus (HIV) (PLWH) experience cognitive decline that impairs everyday functioning. Cognitive training approaches, such as speed of processing (SOP) training, may reduce the impact of HIV-Associated Neurocognitive Disorder (HAND) on everyday functioning. In this experimental design study called the Think Fast Study, 216 participants age 40 and older with HAND or borderline HAND were randomized to one of three groups: (1) 10 h of SOP training (n = 70); (2) 20 h of SOP training (n = 73); or (3) 10 h of Internet Navigation Control Training (a contact control group; n = 73). Participants completed several everyday functioning measures at baseline, posttest, and year 1 and year 2 follow ups, which included: (a) Modified Lawton and Brody Activities of Daily Living (ADL) Questionnaire; (b) Timed Instrumental Activities of Daily Living (TIADL) Test; (c) Patient’s Assessment of Own Functioning (PAOFI); (d) Medication Adherence Questionnaire (MAQ); and (e) Medication Adherence Visual Analog Scale (VAS). Linear mixed-effect models and generalized estimating equation models were fitted to estimate between group differences at all follow-up time points. At follow-up timepoints, those in the 10-h and 20-h training groups had better scores on medication adherence measures (MAQ and VAS) than those in the control group, with effects (Cohen’s d) ranging 0.13–0.41 for MAQ and 0.02–0.43 for VAS. In conclusion, SOP training improved some indicators of everyday functioning, specifically medication adherence; however, the therapeutic effects diminished over time. Implications for practice and research are posited.

Impact of COVID-19 on Adherence to Treatment in Patients with HIV.

In patients with human immunodeficiency virus (HIV), adherence to treatment is affected by the adverse effects of treatment, the presence of additional comorbidities, the complexity of dosage, and family and community support. However, one recent circumstance that was likely to have influenced therapeutic adherence was the COVID-19 pandemic and the applied containment measures. An observational retrospective study of a sample of patients with HIV was conducted to establish the relationship between sociodemographic, clinical, and pharmacological variables and therapeutic adherence before and after the pandemic. Adherence was measured using the validated simplified medication adherence questionnaire (SMAQ) and medication possession rate. A statistical analysis was performed to determine the mean, standard deviation, and median of the quantitative variables and the frequencies of the qualitative variables, and the relationship between the dependent and independent variables was analysed using the chi-squared test and Student's t-test. No statistically significant differences were found between treatment adherence measured before and 22 months after the start of the pandemic. Sex, occupation, treatment regimen, viral load levels, and COVID-19 disease status did not influence adherence during either period. However, the age of patients with HIV had an impact on adherence during both periods (p = 0.008 and p = 0.002, respectively), with the age group under 45 years being less adherent. In addition, experiencing adverse drug reactions (ADRs) was shown to have an impact on adherence before the pandemic (p = 0.006) but not afterwards. The COVID-19 pandemic was not shown to have an impact on the degree of adherence to antiretroviral treatment in patients with HIV. Instead, adherence was influenced by patient age and ADR occurrence; therefore, measures must be taken in this regard. The SMAQ demonstrated sensitivity in assessing adherence.

Prevalence and Correlates of Medication Non-adherence among Hypertensive Patients on Follow-up in Central Kenya

Background and Objective: Poor adherence to antihypertensive medications is a major barrier to blood pressure control among patients living with hypertension. In Kenya, a significant number of hypertensive patients have uncontrolled blood pressure, but data on medication adherence among this patient population is scarce. This study sought to determine the prevalence and correlates of medication non-adherence among hypertensive patients on follow-up in two referral hospitals in central Kenya. Methods: We undertook a cross-sectional study comprising of 339 hypertensive patients undergoing follow-up care in two referral hospitals located in Nyeri County between October and December 2019. Medication adherence was assessed using a validated medication adherence questionnaire. Medication adherence was a dichotomous variable (adherent vs non-adherent), with the prevalence of non-adherence being measured as a proportion. Independent predictors of medication non-adherence were identified by fitting a multiple logistic regression model, where adjusted odds ratios (AORs) were computed for various covariates and interpreted at a 5% level of significance and 95% confidence interval (CI). Results: The study sample largely comprised of the female gender (65.2%) and elderly people (mean age, 65 years +/- 12). Nearly half (46.6%) of the hypertensive patients interviewed were non-adherent to their medications. The factors associated with non-adherence were: having poor hypertension knowledge (AOR, 5.6, 95% CI, 3.3, 9.4); being on more than one antihypertensive medication (AOR, 2.8, 95% CI, 1.7, 4.7) and being on two or more daily doses of medications (AOR, 2.3, 95% CI, 1.3, 4.1). Conclusion and Implications for Translation: Non-adherence to prescribed medications is highly prevalent among hypertensive patients in central Kenya, and it should therefore be identified as a public health concern. Strategies aimed at optimizing medication adherence among hypertensive patients in this region may consider focusing on educational interventions to increase hypertension knowledge and also on simplification of treatment regimens. Copyright © 2023 Mutua, et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

Medication Adherence, Glycemic Control and Quality of Life in Patients with Type 2 Diabetes Mellitus: a cross-sectional study

Medication adherence is important in controlling blood sugar levels (HbA1c) in patients with Diabetes Mellitus (DM). Studies on the relationship between medication adherence and blood sugar control on the quality of life (QoL) in Type 2 DM patients are limited in Indonesia. This study aims to assess the relation between medication adherence with blood sugar control and the quality of life of Type 2 DM patients. This study used a cross-sectional design conducted at Universitas Indonesia Hospital. It used Medication Adherence questionnaires and EuroQoL 5D-5L questionnaires to assess patients’ medication adherence and quality of life. This study involved a total of 74 Type 2 DM patients with an average age of 57 ± 10.74 years. Medication adherence with good blood sugar control (HbA1c <7%) showed a significant relationship (p-value <0.05) with COR values of 3.74 (1.21 - 11.6) compared to non-adherent patients. But not on the QoL Index and VAS (Visual Analog Scale) values, where the value is lower in patients with high adherence and good blood sugar control. Factor asscociated with blood sugar controlled were comorbidites and medication adhrence while factor that associated with quality of life were comorbidities, ages, education and employment status

Physical Activity, Anxiety, Depression, and Adherence to Antiretroviral Therapy in People with HIV.

Physical activity (PA) levels, as well as symptoms of anxiety and depression, can affect adherence to antiretroviral therapy (ART) impacting people's health. This study aimed to evaluate the association between PA levels, clinical symptoms of anxiety and depression, and adherence to ART in people living with HIV (PLHIV). A cross-sectional study, including 125 PLHIV was conducted. Adherence to ART was assessed using the Simplified Medication Adherence Questionnaire (SMAQ). For anxiety and depression, the Hospital Anxiety and Depression Scale was applied. The level of PA was assessed using the short version of the International Physical Activity Questionnaire. SPSS version 22.0 was used for statistical analysis. The prevalence of clinical levels of anxiety and depression symptoms was 53.6% and 37.6%, respectively. Fifty-three percent presented clinical levels of depression and anxiety symptoms. Sixty-one people (48.8%) had vigorous PA levels, 36 people (28.8%) had moderate PA levels, and 28 people (22.4%) had low PA levels. According to the SMAQ, 34.5% of the patients were adherent to ART. People who performed low PA levels had more risk to develop clinical levels of depression symptoms. Clinical level of anxiety, depression, and psychological distress (PD) symptoms was found to increase the risk of nonadherence to ART.

Factors influencing adherence to anti-retroviral therapy in amazonian indigenous people living with HIV/AIDS

BackgroundIndigenous communities in Peru has been historically affected by high mortality rates attributable to HIV-AIDS infection, associated with a low access to health services, and socio-cultural barriers. In this context, the study aimed to describe factors associated with antiretroviral treatment adherence in people from Awajun and Wampis indigenous communities, living with HIV-AIDS in a Peruvian Amazonian region.MethodsA cross-sectional study was completed with a consecutive sample of people from indigenous communities (Awajun or Wampis) living with HIV, who were receiving antiretroviral treatment for at least the last three months. Participants were recruited between October 1 and December 30, 2021, from four districts of Bagua and Condorcanqui provinces in the Amazonian region. An ad-hoc questionnaire was used to collect information about demographic, economic, and socio-cultural factors and access to health services. The Simplified Medication Adherence Questionnaire (SMAQ) was used to evaluate adherence to antiretroviral therapy. Multivariate logistic regression analysis with backward stepwise was performed to explore factors that might influence adherence.ResultsOf the 208 participants, 28.8% reported complete adherence to antiretroviral treatment. The multivariate logistic regression showed that occupation (aPR: 1.86; 95%CI 1.15–3.02), economic income (aPR: 0.64; 95%CI 0.41–0.99), and adverse reactions to antiretroviral therapy (aPR: 0.36; 95%CI 0.18–0.70) were related to complete adherence to medication.ConclusionOnly a third of participants reported complete adherence to antiretroviral therapy. Factors associated with adherence to antiretroviral medication were related to socioeconomic conditions and adverse reactions to the therapeutic scheme. Interventions to improve adherence in indigenous people living with HIV should consider these factors in order to develop effective implementation strategies.

Assessment of Adherence and Common Non-adherence Factors for Inhaled Medications in Asthma and Chronic Obstructive Pulmonary Disease (COPD) Patients

Abstract: Background: Inhaled medications are the cornerstone for the treatment of asthma and chronic obstructive pulmonary disease (COPD). Adherence of inhaled medications can be influenced by many factors such as patient preferences, education and awareness. Therefore, it is fundamental to identify and address the factors that helps to improve adherence to inhaled medications. Hence, this study aims to assess the adherence and common non-adherence factors for inhaled medications in asthma and COPD patients. Materials and Methods: A prospective observational study was conducted at the department of respiratory medicine for 6 months in a tertiary care teaching hospital. A total of 150 patients who were diagnosed with asthma and COPD, and used inhaled medications were enrolled. Patients were interviewed and administered with Inhaled Medication Adherence Questionnaire (IMAQ). The identified factors for non-adherence were classified based on the five dimensions of adherence instrumented by the World Health Organization (WHO). Results: A total of 97/150 (64.7%) patients [asthma: 42 (64.2%) and COPD: 55 (68.7%)] were found non-adherent to inhaled medications. Between them, 54% were attributable to socioeconomic reasons, 38% were patient-related, 4.6% therapy-related and 3.3% healthcare system-related. According to the study results majority of patients showed non-adherence due to socioeconomic-related factors followed by patient-related factors. Conclusion: This study concluded that non-adherence to inhaled medication was high in asthma and COPD patients. Low economic status, social stigma, lack of knowledge, inappropriate usage technique and complexity of treatment were the most common factors influencing non-adherence to inhaled medications in asthma and COPD. Keywords: Asthma, Chronic obstructive pulmonary disease (COPD), Medication adherence, Medication adherence questionnaire, Non-adherence factors.

Abstract P433: Predictors of Self-Reported Medication Non-Adherence in Older Adults: The Atherosclerosis Risk in Communities Study

Introduction: Medication non-adherence increases the risk of hospitalization and mortality in older adults. Evidence from previous studies was not conclusive due to small sample size or lack of adjustment for potential confounders. This study aims to investigate the prevalence and predictors of medication non-adherence in older adults, considering both individual-level and neighborhood-level factors. Methods: We studied participants (aged 66-90 years) who were on at least one medication at visit 5 (2011-2013) of the ARIC Study. Potential predictors included demographic factors, individual-level and neighborhood-level socioeconomic factors, behavioral factors, depressive symptoms, and cognitive function. We estimated the prevalence of self-reported medication adherence using the Morisky Green Levine medication adherence questionnaire and considered intermediate and low as medication non-adherence. We used multivariable logistic regression to identify independent predictors of medication non-adherence, further adjusting for race-center, insurance types, comorbidities, and number of medications. Results: Among 5304 participants (mean age of 75.5 [SD 5.1] years, 21.6% Black, and 58.2% female), 2.3% and 37.1% reported low and intermediate medication adherence, respectively. After adjustment, age 66-74 (odds ratio [OR]= 1.23 [95% CI, 1.10-1.38]), current drinker (1.31 [1.10-1.55]), lack of physical activity (PA) (1.18 [1.01-1.37] for intermediate PA; 1.38 [1.21-1.58] for low PA), and depressive symptoms (2.30 [1.82-2.91]) were significant predictors of medication non-adherence ( Table ). Education and ADI were not associated with medication non-adherence. Conclusions: We found that almost 40% of older adults have medication non-adherence. Unhealthy lifestyle factors and depressive symptoms were associated with medication non-adherence. Education and neighborhood-level SES were not. Depression is an important modifiable factor to improve medication adherence in older adults.

A multi-center, prospective, observational study of patients with prostate cancer being treated with relugolix: OPTYX.

TPS398 Background: Androgen deprivation therapy (ADT) with gonadotropin-releasing hormone (GnRH) receptor agonists or antagonists are the foundation of advanced prostate cancer (aPC) treatment. Relugolix is an oral non-peptide GnRH receptor antagonist approved in the US for the treatment of aPC. In the phase 3 HERO trial, relugolix maintained suppression of testosterone to castration levels in 96.7% of men from Day 29 to 48 weeks, with superiority to leuprolide acetate. Relugolix was well tolerated and associated with a 54% lower risk of major adverse cardiovascular events relative to leuprolide acetate (Shore N, NEJM 2020;382;23). The goal of this current study (OPTYX) is to generate real-world evidence about the safety and effectiveness of relugolix in patients with prostate cancer during routine clinical care. Methods: This prospective observational cohort study (registry) is enrolling patients who have planned initiation with relugolix within 1 month prior to the time of study enrollment. The study is designed to prospectively understand the actual experience of patients with prostate cancer treated with relugolix through data collection on patients selected for treatment, treatment patterns, adherence, patient reported quality of life (QoL) and safety data. Additionally, a better understanding of the trajectory of patients with prostate cancer following cessation of relugolix therapy will be gained by observing the clinical course of the disease, health outcomes, and health-related quality-of-life (HRQoL) in these patients. Inclusion criteria include patients > 18 years old with prostate cancer and planned total treatment with relugolix of at least 4 months. Estimated enrollment is 1000 patients, and patients will be followed for up to 5 years. In addition to assessing routine clinical care and disease progression, patient reported outcomes will be assessed with the Functional Assessment of Cancer Therapy-Prostate (FACT-P) for HRQoL and Simplified Medication Adherence Questionnaire (SMAQ) for adherence at 3 and 6 months then every 6 months. Clinical trial information: NCT05467176 .

Evaluation of antiglaucoma drug treatment awareness and patient-reported medication adherence: Determinants of glaucoma management.

Primary open angle glaucoma (POAG) treatment is characterized by long-duration therapy, prescription variability, and non-adherence. Patient awareness toward drug treatment is crucial to ensure adherence. The present study was planned to evaluate drug treatment awareness, patient-perceived drug adherence, and prescription patterns in POAG patients. This was a cross-sectional, single-center, questionnaire-based study conducted in the ophthalmology out patient department of a tertiary care hospital from April 2020 to November 2021. Patients of either gender, aged 40-70 years, with a confirmed diagnosis of POAG, who had records of POAG medications for at least last 3 months and who provided written informed consent, were included. Prescription details were recorded, and subsequently, patients were administered a pre-validated drug treatment awareness (14 items) questionnaire, a self-reported medication adherence (9-item) questionnaire, and then they performed eye drop instillation in a simulated setting. The total number of patients enrolled was 180, which yielded 200 prescriptions. The mean drug treatment awareness score was 8.18 ± 3.30, and 135 (75%) patients scored more than 50% (≥7/14). Similarly, 159 patients (83.33%) had scored >50% (i.e. >5/9), with a mean score of 6.30 ± 1.70 in the medication treatment adherence questionnaire. The mean eye drop instillation performance score was 7.18 ± 1.20. The 200 POAG prescriptions containing 306 drugs were analyzed, with beta blockers (184/200, 92%) and timolol (168/200, 84% encounters) being the highest prescribed classes/drugs. POAG patients did have adequate treatment awareness with good self-reported medication adherence and performance of eye drop instillation technique. Around 25% patients lacked awareness; hence, reinforcement education programs on medication regimens need to be implemented.

Patient Medication Adherence Assessment Tools for Primary Healthcare Physicians in Research and Practice

The current issues of patient adherence and how to diagnose adherence at the primary health care level are relevant. One of the simplest, easiest, and most cost-effective ways to assess adherence is to administer patient surveys using questionnaires. The identification of factors associated with adherence will justify the implementation of a number of interventions to improve the effectiveness of patient care. reduce cases of exacerbations, and rehospitalization rates, and reduce treatment costs. The purpose of the study: is to analyze the advantages and disadvantages of different tools in the assessment of adherence to medication therapy.Methodology: The study used evidence-based data mining methods. 210 publications were found using keywords and clinical outcomes according to PICO in the international databases PubMed / Medline, Cochrane Central Register of Controlled Trials, and Google Scholar. The application of PRISMA and inclusion/exclusion criteria made it possible to select the most relevant sources (20 publications).Conclusions are drawn from the review: the Morisky scale (MMAS-8) is the most qualitative, simple, and widely used questionnaire. MMAS-8 has been used in more than 200 international studies in the last 9 years. The Self-Effectiveness Scale and the Short Drug Questionnaire are preferred for scientific research, as the interpretation of the results is not very convenient to use in outpatient settings due to the difficulty of scoring, given the limited time to the doctor and patient. The Medication Adherence Reporting Scale is recommended in preference to patients with psychiatric illness. The Medication Replenishment and Adherence Questionnaire has some limitations and isn’t very reliable given the study in which it was used. The Hill-Bone score requires further testing. Unfortunately, there is no "gold standard" for assessing adherence to therapy, but the Morisky scale (MMAS-8) is closer to it. Keywords: adherence assessment tools, scales, questionnaires, primary health care.