Medication Adherence Rates Research Articles

Determinants of antiretroviral therapy adherence among people living with HIV in a poor urban setting in Ghana: a hospital-based cross-sectional study.

Without a cure, antiretroviral therapy (ART) continues to be the primary mode of managing HIV, transforming it from a formerly lethal disease to a less severe one. Adherence to ART can be impacted by several factors, including poor quality of care. A quantitative cross-sectional study design was used to assess the factors that influence adherence to ART among adults receiving care at two health facilities in Accra. A structured interviewer-administered questionnaire was used to collect data on factors associated with medication adherence using a modified four-item Medication Adherence Rating from 255 people living with HIV (PLHIV). Descriptive statistics were used to summarise the data, while multiple binary logistic regression was used to assess the factors influencing adherence to ART. Adherence to HIV medication was 44.7% among PLHIV. Adherence was positively correlated with high client health service satisfaction (adjusted OR [AOR]: 26.59, 95% CI 7.46 to 94.82, p<0.001), increased privacy at the HIV clinics (AOR: 3.40, 95% CI 1.40 to 8.21, p<0.007) and among PLHIV who had been diagnosed with HIV for ≥5 y (AOR: 7.59, 95% CI 2.76 to 20.85, p<0.001). Adherence to ART was significantly low among study participants. The study highlights the importance of maintaining privacy and confidentiality at the facility while ensuring client satisfaction with HIV care to promote adherence to ART.

Mediating effect of self-efficacy on the relationship between Big Five personality and medication adherence in Chinese hypertensive patients: a national cross-sectional study.

The study aims to evaluate personality characteristics, self-efficacy, and medication adherence in Chinese patients with hypertension, while also investigating how self-efficacy mediates the relationship between personality traits and medication adherence. This investigation included 787 Chinese patients diagnosed with hypertension, as reported in the "2021 China Family Health Index Survey Report." The study employed several assessment tools such as a General Information Questionnaire, the Brief Big Five Inventory (BFI-10), the New General Self-Efficacy Scale (NGSES), and the Medication Adherence Rating Scale (MARS). Statistical analyses encompassed the Mann-Whitney U test, chi-square test, multiple logistic regression, Spearman's rank correlation, standardized regression coefficients, and Bootstrap techniques. (1) Individuals with debt, who also possess high levels of self-efficacy, tend to adhere more consistently to their medication regimens. (2) An analysis of personality traits indicated that Extroversion,Conscientiousness and Openness positively influences self-efficacy,while Agreeableness and Neuroticism negatively impacts it. (3) Self-efficacy plays a mediating role in the indirect relationship between personality traits such as Extroversion and neuroticism and medication adherence. In the context of Chinese adults, both self-efficacy and Extroversion positively influence medication adherence, whereas high levels of neuroticism adversely impact it. Furthermore, self-efficacy serves as a mediating factor in the linkage between personality traits and medication adherence.

Medication adherence in geriatric patients attending medical outpatient department.

Adherence to medication represents a challenge in managing chronic conditions in the geriatric population. This study assessed adherence rates and factors affecting adherence of geriatric patients attending the Helen Joseph Hospital outpatient department. This was a prospective cross-sectional study of 130 patients aged 65 years and older, with at least two chronic conditions. Participants were administered a survey incorporating the Medication Adherence Rating Scale and the Adherence Barrier Questionnaire to identify medication adherence and patient-specific barriers to adherence, respectively. These instruments are reliable and valid. Descriptive statistics and logistic regression were used for analysis. Most patients were female (63%) with a mean age of 72 (67-78) years. Common comorbidities included type 2 diabetes mellitus (63%), hypertension (98%), dyslipidaemia (92%) and congestive cardiac failure (38%). Polypharmacy was prevalent, affecting 53% of the participants. Despite 96% of participants being adherent, all had at least one barrier to adherence, with the majority (65%) having more than one barrier. The main barriers were forgetfulness (59%), fear of side effects (39%), problems with taking the medications (26%) and believing medications are poisonous (22%). Although most participants accessed the pharmacy easily, only 83% reported consistent medication availability and 11% could not afford to collect their medication. Polypharmacy is common in the population. Despite high adherence rates, barriers such as believing medications are poisonous remain significant. A good patient-doctor relationship improves adherence.Contribution:Understanding the barriers to adherence in older adults with polypharmacy and multimorbidity can assist practitioners improve patient care.

Effectiveness of Home-Based Self-monitoring of Blood Pressure in a Primary Care set-up of India (EASE-BP): Protocol for an Open-Label Randomized Controlled Trial.

Rising hypertension from inadequate detection, noncompliance with treatment, and poor control presents a major public health challenge. Previously, adopting the strategy of self-monitoring of blood pressure (SMBP) showed better hypertension detection, control, and medication adherence. However, evidence from India is scarce. Here, we present the trial protocol for the effectiveness of SMBP intervention in hypertension detection, blood pressure (BP) control, and medication adherence in a primary care set-up. EASE-BP is an open-label randomized trial in two distinct adult populations - part-A self-reported non-hypertensive population (total sample size: 400) and part-B known hypertensive population (total sample size: 332). The two populations will be sampled from two separate villages under the Ballabgarh Health and Demographic Surveillance System. In both the populations, participants randomized in the intervention arm will receive a validated electronic BP device and will be advised to self-monitor BP for at least twice a month (or more). Those in the control arm will be advised to monitor BP for at least twice a month (or more) at the nearby health center. Participants in both arms will receive education on hypertension and atherosclerotic disease. In addition, adult family members in the households of randomized participants will be encouraged to monitor their BP. All participants and family members will be instructed to maintain a log of BP recordings in a diary that will be provided to them. Data will be collected at baseline and then every month for three-months. The primary outcome in part-A will be the incidence of new cases of hypertension during 3 months follow-up and in part-B will be the difference in SBP and rate of medication adherence at 3 months follow-up. Secondary outcomes will include (1) uptake of the intervention, (2) any stroke, myocardial infarction, or death, (3) additional yield of new cases of hypertension among the family members, and (4) integrating the intervention into the national programs for long-term noncommunicable disease goals. EASE-BP will help understand if SMBP improves hypertension detection, BP control, and medication adherence. Consequently, this will appraise policymakers on whether provision of BP instruments may be added to the national program for hypertension prevention and control. This trial was registered under Clinical Trial Registry - India with reference number CTRI/2023/02/049949.

Non-Adherence to Antiseizure Medications: Rate and Predictors in Saudi Arabia

Background and Objectives: The objective of this paper is to determine the rate and predictors of non-adherence to antiseizure medications in Saudi Arabia. Materials and Methods: A cross-sectional study which involved questionnaires and data collection from patients’ medical records was conducted at neurology clinics. The rate of non-adherence to antiseizure medications was measured using “the Medication Adherence Rating Scale” (MARS). Predictors of non-adherence to antiseizure medications were evaluated using a multidimensional questionnaire specific to epilepsy. Results: One hundred and sixty-two patients participated in the study. The mean (SD) age was 34.1 (10.4) years, and 56% were male. Epilepsy was controlled (i.e., seizure-free ≥ 1 year) in 42% of patients. The mean ± SD (range) MARS scores were 7.80 ± 1.59 (2–10). Out of 162 patients, 58 (36%) patients had MARS scores ≤ 7 out of 10. The most frequently rated predictor for non-adherence was poor seizure control, which was reported by around 36% of patients. Forgetfulness, dosing frequency, and social stigma were also among the commonest predictors of non-adherence to antiseizure medications that were rated by approximately 27%, 24%, and 22% of the patients, respectively. The impacts of several socio-demographic and clinical factors on adherence were assessed. In the regression analysis, the odds of non-adherence in a patient who experienced adverse effects were twice that of a patient who did not have adverse effects (p = 0.113). Furthermore, females, employers, and patients who had comorbidity, those with focal epilepsy, those on polytherapy of antiseizure medication, and those receiving multiple doses per day, were all more likely (but not significantly, p &gt; 0.05) to be non-adherent compared to their counterparts. Conclusions: The significance of this study is that it reveals that adherence to antiseizure medications is suboptimal in Saudi Arabia. Poor seizure control, forgetfulness, dosing frequency, and social stigma were the primary patient-reported predictors of non-adherence in epilepsy. This emphasizes the importance of routine evaluation of adherence in practice to identify and address what individual patients perceive as a barrier to adherence with antiseizure medications.

Medication Adherence and Functioning in Individuals With Bipolar Disorder Type I.

To determine the correlation between medication adherence and functioning in individuals with bipolar disorder (BD) and the predictors of functionality. This cross-sectional and correlational study was conducted with 145 individuals with BD type I. Data were collected using a Patient Information Form, the Medication Adherence Rating Scale, and Functioning Assessment Short Test. Findings showed that most participants did not take medication as prescribed. Medication adherence was negatively correlated with functionality. Predictors of functionality were years of treatment, number of hospitalizations, working status, medication adherence, family history of mental illness, and history of suicide. Medication nonadherence is a fundamental problem for individuals with BD. Nursing interventions to increase functionality and medication adherence among this at-risk group should be planned and implemented. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Discrepancy between Subjective and Objective Measurements for the Evaluation of Medication Adherence-A Cross-Sectional Study in Patients with Cardiovascular Diseases.

Medication adherence is important for the appropriate drug-based treatment in patients with chronic diseases, especially those with cardiovascular diseases (CVDs). The purpose of the present study was to evaluate medication adherence among patients with CVDs using subjective and objective measurements. We enrolled outpatients who visited Fukuoka University Chikushi Hospital from June to December 2022. As a subjective measurement, we used a self-reported questionnaire developed by Ueno et al., which consists of 12 questionnaire items grouped into the following four domains: medication compliance (subjective compliance), collaboration with health care providers (collaboration), willingness to access and use information about medication (willingness), and acceptance to take medication and how taking medication fits a patient's lifestyle (acceptance). The pill counting method was used as an objective measurement to calculate the medication adherence rate; Poor Adherence was defined as a medication adherence rate of <100%. Ninety-four patients were analyzed. No statistically significant differences were observed between the patients in the Good and Poor Adherence groups classified by pill counting, an objective indicator; in the subjective evaluation index Ueno scale scores of subjective compliance, collaboration, willingness, and acceptance domains; and in the total score. A multivariate analysis revealed that obesity (odds ratio, 3.527; 95% confidence interval, 1.387-9.423; p = 0.008) was an independent factor associated with Poor Adherence. In conclusion, we found a discrepancy between subjective and objective measurements for the evaluation of medication adherence. Furthermore, obesity was an independent factor associated with poor medication adherence assessed by the pill counting method; thus, patients with CVD and obesity require a careful follow-up.

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.

Prevention of Radiotherapy-Induced Enteropathy by Probiotics (PREP): Double-Blind Randomized Placebo-Controlled Trial.

Probiotics are thought to be effective in the treatment of radiation-induced enteropathy (RIE). However, little is known regarding their efficacy in preventing RIE. In this prospective, randomized, double-blinded, placebo-controlled, single-center study, the incidence of grade 2 acute RIE was compared and the safety of probiotics was evaluated. Patients receiving pelvic radiotherapy for a minimum of 40 Gy at the pelvic level were randomized into two groups: (i) a probiotic group receiving Bacillus licheniformis from two weeks before radiotherapy until the end and (ii) a control group receiving a placebo with the same schedule. The toxicities of 234 patients were graded according to the Common Terminology Criteria for Adverse Events v5.0. Grade 1 RIE was observed in 65 (56%) of the probiotics group compared with 75 (64%) of the placebo group. Grade 2 RIE occurred in 30 patients (26%) in the probiotics group compared with 26 (22%) in the placebo group, indicating that probiotics failed in their preventive role compared with placebo (p = 0.493). Medication adherence rates were good, and no difference was observed between the two arms. These findings suggest that B. licheniformis does not significantly prevent RIE.

Improving Medication Adherence in Geriatric T2DM Patients: A Factorial Randomized Controlled Trial

Abstract Background: The complexity of managing type 2 diabetes (T2D) in the elderly is compounded by the need to balance over-prescription, under-prescription, and appropriate prescription. Managing hyperglycemia and its complications, along with geriatric syndromes such as cognitive impairment and falls, often leads to use of an increased number of medications. Quality improvement measures, while aimed at better management, can inadvertently contribute to the burden of polypharmacy. Addressing medication non-adherence is crucial, as it is a significant contributor to poor clinical outcomes, increased hospitalizations, and healthcare costs. Objectives: This study thus aimed to evaluate the effectiveness of interventions to improve medication adherence among elderly patients with T2D. It assessed the impact of a medication adherence device, clinical pharmacological intervention, and their combination compared to standard of care (SOC) alone on adherence rates, adverse drug reactions (ADRs), and glycemic control. Materials and Methods: This pilot study was a factorial randomized controlled trial. A total of 120 elderly T2D patients with a medication adherence rate of less than 80% over the past year were randomized into four groups: (1) medication adherence device + SOC, (2) clinical pharmacological intervention + SOC, (3) combined intervention + SOC, and (4) SOC alone. The primary outcome was medication adherence, assessed through pill counting. ADRs were evaluated using the Naranjo ADR causality assessment scale, and glycemic control was monitored through HbA1c levels. Statistical analyses included chi-square tests and ANOVA, with significance set at P &lt; 0.05. Results: Interim analysis showed the highest adherence rate in the combined intervention group (82.1%), followed by the clinical pharmacological intervention + SOC group (75.3%), the medication adherence device + SOC group (73.1%), and the SOC alone group (70.0%). The combined intervention group also recorded the lowest ADR rate (6.6%). Regarding glycemic control, 81% of the combined intervention group achieved an HbA1c level of less than 7%, compared to 80% in the clinical pharmacological intervention + SOC group, 78% in the medication adherence device + SOC group, and 69% in the SOC alone group. Differences in glycemic control were not statistically significant (P = 0.950). Conclusions: The study indicates that combined interventions including medication adherence devices along with SOC significantly improve medication adherence and reduce ADRs in elderly T2D patients. Future research should focus on diverse populations and long-term sustainability of these interventions.

Perceived Stress and Health Outcomes Among Latinx and Non-Latinx White Adult People With HIV in East Harlem, New York: A Cross-Sectional Study.

Stress and HIV disproportionately affect Latinx adults in the United States, contributing to numerous health inequities. Among people living with HIV (PLWH), increased stress is associated with decreased medication adherence, effectiveness, and higher rates of immunosuppression and comorbidities. Our study (N = 126) examined the relationship between perceived stress and HIV-related health among Latinx (n = 83) and non-Latinx White (n = 43) PLWH. Latinx PLWH reported better HIV-related health outcomes than non-Latinx White PLWH, despite higher viral load (all p's < .05). An interaction effect showed that higher perceived distress was associated with worse health outcomes and lower CD4+ T cell count only in Latinx PLWH (p's < .05). Our findings highlight the consequences of stress on HIV-related health. Notably, higher stress may be especially detrimental among Latinx PLWH, underscoring the need for more culturally tailored interventions in HIV-related care. Future research should include additional sociocultural factors and longitudinal assessment in a larger sample.

Study of Medication Adherence in Patients with Schizophrenia

Introduction: Non-adherence to treatment is a major issue in the management of schizophrenia. Objectives: To evaluate medication adherence among patients with schizophrenia and to identify predictive factors of poor therapeutic adherence. Methods: This is a cross-sectional study conducted among patients with schizophrenia at Ar-Razi Hospital in Salé, Morocco, from January 1 to March 31, 2024. Data collection (sociodemographic, clinical, and therapeutic) was carried out using a specifically designed questionnaire. Medication adherence was assessed using the Medication Adherence Rating Scale (MARS), and insight was evaluated using the Q8 scale. Results: In our study, 44.4% of the included schizophrenia patients were non-adherent. Poor therapeutic adherence was associated with lower socioeconomic status, lack of employment, lack of family support, substance use, negative insight, and a higher number of medication doses. Conclusion: The implementation of therapeutic and preventive strategies to address substance use, structured psychoeducational strategies to improve insight, and training for therapists to enhance the therapeutic alliance should be established to improve medication adherence among patients with schizophrenia.

"Lupus Doesn't Have Me, I Have Lupus": Using Patient-Centered Interviews to Understand Medication Nonadherence.

Lupus nephritis (LN) is the most common cause of kidney injury in systemic lupus erythematosus and associated with higher morbidity and mortality. Low medication adherence correlates with adverse clinical outcomes. In a large, integrated health system at Kaiser Permanente East Bay Area, the authors identified mycophenolate mofetil (MMF) prescriptions for LN and collected patient demographics, medication adherence, and copay data. They interviewed patients with low medication adherence rates to understand contributing factors, such as side effects, cost, refill processes, and laboratory draws. Adherence was defined as a proportion of days covered at > 80%. The proportion of days covered is the number of days covered by a medication divided by the number of days in a defined period. Between November 30, 2021, and November 30, 2022, the authors identified 36 patients with LN on MMF. Almost a third (11/36) of these patients were nonadherent to medication. More than half (7/11) of these patients agreed to be interviewed. They identified the following causes of medication nonadherence: forgetfulness (57%, or 4/7), incomplete laboratory work (28%, or 2/7), medication cost (14%, or 1/7), and intentionally missed doses (14%, or 1/7). No patients identified medication side effects as a cause. The median 30-day copay for MMF was $4.55, and 28% (2/7) of patients paid $0 for their medications. In the authors' integrated health system, 69% of their patients with LN on MMF were adherent to their medication regimen. Forgetfulness was a challenge for the nonadherent patients. Kaiser Permanente East Bay Area provides convenient refills and laboratory draws; this likely facilitates medication adherence.

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.

The patient-reported outcomes for the new brand-generic teriflunomide in relapsing-remitting multiple sclerosis

BackgroundPatient-reported outcomes (PROs) provide valuable insights into the impact of disease-modifying therapies (DMTs) on patients' daily lives and disease progression. This study evaluates treatment satisfaction and tolerability among patients using a brand-generic Teriflunomide (Tebazio®, 14 mg tablet) manufactured by Zistdaru Danesh Biopharmaceuticals. Materials and MethodsA Phase IV observational study was conducted on patients with Relapsing-Remitting Multiple Sclerosis (RRMS) who were either initiated on or switched to Teriflunomide 14 mg. The primary focus was on the medication's safety. Patient satisfaction was measured using the Treatment Satisfaction Questionnaire for Medication [Version 1.4] (TSQM-14). Additionally, medication adherence and discontinuation rates were monitored. ResultsOf the 235 RRMS patients enrolled, participated in this study, all received the Teriflunomide treatment orally on a daily basis. Over the 18-month follow-up period, 25.96 % of patients discontinued the treatment. Discontinuation was mainly due to adverse events (11 %), lack of patient willingness to continue (12.7 %), and disease progression (4.2 %). The most commonly reported adverse events included dermatologic disorders, elevated liver enzymes, and gastrointestinal issues. TSQM-14 scores demonstrated significant improvements over the 18-month period. A high medication adherence rate of 98.1 % was also recorded. ConclusionPatients reported notable satisfaction with Teriflunomide, as reflected in their TSQM scores, which suggests a likelihood of improved patient adherence. The 14 mg brand-generic Teriflunomide was well-accepted by Iranian RRMS patients, with no significant concerns arising during the study. These findings also highlight the significance of patient-reported outcomes in DMTs, with potential benefits for adherence and clinical practice.

Assessing the Effectiveness of Telepharmacy Services in Rural and Underserved Areas

This study evaluates the effectiveness of telepharmacy services in improving healthcare delivery in rural and underserved areas. Utilizing a mixed-methods design, both quantitative and qualitative data were collected over a 12-month period. The study involved 200 patients who used telepharmacy services, providing remote access to pharmacists for medication dispensing, consultations, and patient education. Quantitative data included patient surveys on medication adherence and satisfaction, along with medication records to assess dispensing errors. Qualitative data were obtained through interviews with patients and pharmacists to explore their experiences. Results indicated a significant increase in medication adherence rates from 60.0% to 85.0% post-telepharmacy implementation. Patient satisfaction scores across various domains improved notably, with mean scores for access to pharmacists, quality of consultations, and overall satisfaction showing significant enhancements (p &lt; 0.001). Additionally, there was a substantial reduction in medication errors, with dispensing errors decreasing from 15.0% to 5.0% (p &lt; 0.01) and prescription errors from 10.0% to 4.0% (p &lt; 0.05). Economic analysis revealed a decrease in healthcare costs per patient from $2000 to $1500, along with a reduction in hospitalizations per 1000 patients from 50 to 30 (p &lt; 0.01). These findings are consistent with previous studies and underscore the potential of telepharmacy as a cost-effective and efficient solution to healthcare disparities in rural and underserved regions. Despite technological and regulatory challenges, telepharmacy represents a promising approach to enhancing healthcare access, improving clinical outcomes, and achieving significant cost savings in rural healthcare systems.

Abstract P330: Next-Gen Hypertension Control: Integrating Clinical Pharmacists And Cutting-Edge EPIC Electronic Medical Record For Quality And Result Driven Approaches at Federally Qualified Health Centers

Hypertension management in Federally Qualified Health Centers (FQHCs) requires innovative and comprehensive strategies beyond traditional methods. This study explores a collaborative approach by integrating clinical pharmacists into the healthcare team and utilizing the EPIC Electronic Medical Record (EMR) system. The model addresses medical and non-medical health determinants, offering comprehensive treatment for underserved communities regardless of their ability to pay. We hypothesized that integrating clinical pharmacists would improve and sustain blood pressure control, resulting in more patients achieving their target health outcomes. As part of multidisciplinary teams, clinical pharmacists identify, track, and analyze patient data, manage medication therapies under collaborative practice agreements, and coordinate with other healthcare providers to ensure continuous care. By leveraging EPIC EMR’s data management and patient monitoring capabilities, clinical pharmacists use real-time data to tailor medication regimens, ensure timely interventions, and conduct follow-ups every 2 to 4 weeks via telemedicine or in-clinic visits until patients reach their goals. This approach enhances patient engagement and medication adherence, which is crucial for adequate blood pressure control and cost management. It also supports personalized care addressing medical needs, lifestyle, and socioeconomic factors affecting patient health. The study, initiated in January 2024, involves adult patients with hypertension at one of the largest FQHC in Houston, TX. Key performance indicators include the percentage of patients achieving target blood pressure levels, medication adherence rates, and the frequency of follow-up visits. Preliminary data from quarter 1, 2024, shows that out of 327 patients, 58% have had at least 2 consultations with a clinical pharmacist. Out of those patients, 46% reached blood pressure control below 140/90 mmHg, while 27% showed improvement toward their goal. This quality and result-driven approach elevates hypertension management standards, reduces health disparities, and enhances healthcare delivery within FQHCs. Clinical pharmacists have proven to be indispensable members of the healthcare team. This session aims to provide practical insights and strategies for healthcare professionals to implement similar models, paving the way for the future of hypertension care.

Relationship Between Depression and Medication Adherence Among Chronic Disease Patients in the Middle East.

Background and aim Medication adherence is a crucial factor in the management of chronic diseases. Depression is a common psychiatric disorder that has been correlated with poor adherence to medication. Adherence to medication in patients with chronic diseases is a well-known concern among the medical community, particularly when considering the adverse outcomes of adherence failure in such patients. Therefore, this study aims to investigatethe relationship between depression and medication adherence among chronic disease patients in the Middle East. Methodology This cross-sectional study was conducted between January 2024 and April 2024 among patients with chronic diseasesfrom the Middle East. The data were collected through convenient sampling using structured online-based questionnaires that included demographic information, type of chronic condition, medication adherence (measured by the Adherence to Refills and Medications Scale (ARMS)), and depression severity (measured by the Patient Health Questionnaire-9 (PHQ-9)). Statistical analyses were conducted to examine the associations between these variables. Results The study involved492 participantswith chronic diseases and found significant associations between demographic factors and medication adherence. Female participants were more likely to be non-adherent than males (p = 0.001), and younger participants aged 20-30 years exhibited higher non-adherence rates (46.7%) compared to older participants, 61 years and above (16.1%, p = 0.001). Non-working individuals showed higher non-adherence (45.4%) compared to retired individuals (21.5%, p = 0.003). Depression severity was inversely related to medication adherence; participants with severe depression were significantly more likely to be non-adherent (relative risk (RR) = 8.41, 95% confidence interval (CI): 4.26-16.57, p < 0.001). In addition, certain chronic conditions were more impactful on medication adherence and depression rates, such as patients withrheumatoid disease that had lower rates of none to minimal depression (8.6%) and higher rates of moderately severe - severe depression each (28.6%). Meanwhile, asthma patients showed notably lower adherence rates (41.0%) and higher levels of severe depression (24.6%). Conclusion The study highlights the intricate relationships between demographic factors, chronic conditions, medication adherence, and depression in patients with chronic diseases in the Middle East. Gender, age, occupational status, and marital status significantly influence adherence and depression levels. Depression is a significant factor associated with decreased levels of adherence among patients with chronic conditions. Regular screening todetect and manage depression among chronically ill patients is advised to help improve medication adherence.

The Patterns of Non-adherence to Medication in the Management of Cardiovascular Disease: A Descriptive Study.

Cardiovascular diseases (CVDs) such as hypertension, ischemic heart disease, and stroke are highly prevalent and have a significant impact on quality of life and the healthcare economy. This study aimed to evaluate adherence to medication regimens in CVD patients. A cross-sectional descriptive study of 203 patients was conducted using a semi-structured questionnaire which included an eight item Morisky Medication Adherence Scale (MMAS-8) to assess medication compliance. The survey included 203 patients, 164 (81%) males and 39 (19%) females. Overall, 156 (76.8%) had medical insurance, while only 47 (23.2%) were not medically insured. In total, 161 patients (79.3%) adhered to the medical regimen. Most participants adhered to their treatment regimen in the present study. However, inadequate knowledge regarding side effects and abrupt discontinuation of medications without physician consultation was reported to a high degree. These findings highlight the areas for improvement in healthcare to improve medication adherence rates.

Measuring Diabetic Medication Adherence and Factors That Lead to Non-adherence Among Patients in Erbil.

Introduction T2D is a chronic and progressive disorder characterized by persistent hyperglycemia resulting from inadequate insulin secretion or utilization. The global prevalence of T2D is increasing rapidly, posing a significant health burden in many regions. In the Kurdistan region of Iraq, T2D presents a significant health burden, exacerbated by socioeconomic changes, dietary shifts, and rising obesity rates. Poor adherence to antidiabetic medications is a major factor contributing to poor glycemic control, accelerating disease progression, and increasing complications. This study aims to assess medication adherence rates among adult T2D patients in Erbil using the Kurdish version of the Morisky Medication Adherence Scale-8 (MMAS-8) and identify factors associated with non-adherence. Methods We conducted a cross-sectional study at public and private clinics in Erbil City, Kurdistan, Iraq, between May 1 and September 30, 2023. A convenience sample of 300 adult Kurdish T2D patients, aged ≥ 25 years and on antidiabetic medications for three months or more, was recruited. Data were collected using a structured questionnaire comprising sociodemographic characteristics, clinical and anthropometric measures, and medication adherence assessed by the Kurdish version of the MMAS-8. Statistical analysis included analysis of variance, Kruskal-Wallis, chi-square, and logistic regression models to identify factors associated with medication adherence. Results Of the 300 participants, 81 (27%) demonstrated high adherence, 98 (32.6%) moderate adherence, and 121 (40.3%) low adherence based on the MMAS-8. Low adherence was significantly associated with lower education (56/121, 46.3% vs. 13/81, 16.0%, p < 0.001), unemployment (73/121, 60.3% vs. 29/81, 35.8%, p = 0.008), rural residence (41/121, 33.9% vs. 10/81, 12.3%, p < 0.001), and lower income (62/121, 51.2% vs. 12/81, 14.8%, p < 0.001). High adherence was linked to better diabetes knowledge, home glucose monitoring, and exercise. High adherence was also associated with better glycemic control, with 76/81 (93.8%) of highly adherent patients achieving glycated hemoglobin (HbA1c) <7%, compared to 15/121 (12.4%) in the low adherence group (p < 0.001). Multivariate analysis identified HbA1c, dyslipidemia, and home blood glucose monitoring as independent factors associated with high adherence. Conclusions This study highlights the substantial impact of socioeconomic, behavioral, and clinical factors on medication adherence among T2D patients in Erbil. Low adherence is associated with lower education, income, and awareness of diabetes management, while high adherence is linked to improved glycemic control and reduced complications. Targeted interventions addressing these factors are essential to enhance adherence and optimize T2D management in this population.