Medication Adherence Report Scale Research Articles

A multidisciplinary approach to improve adherence to medical recommendations in older adults at hospital discharge: The APPROACH study protocol.

Poor comprehension and medication adherence are common in older people, especially after hospitalizations, in case of changes or prescriptions of new therapeutic regimes. This randomized controlled trial aims to evaluate the effectiveness of an integrated approach in improving older individuals' adherence to medical recommendations after hospital discharge. Data from an expected sample of 360 older inpatients (and their caregivers) will be collected. Medical recommendations' understanding will be tested before and after the routine explanation received by in-charge physicians. Participants will be randomized in the control (usual care) and intervention group. The intervention consists of educational training by a multidisciplinary team (occupational therapist, dietician, and physician, in consultation with a pharmacologist) at hospital discharge and, after hospital discharge, receiving a phone recall checking for therapy adherence and having the possibility to contact the study team for potential related concerns. After 7 days, medication adherence will be assessed through structured phone interviews comparing ongoing and prescribed medications and by administering the 4-item validated Morisky, Green, Levine scale and the Medication adherence report scale (MARS-5). At 30 and 90 days from discharge, data on medication adherence, falls, rehospitalizations, and vital status will be collected through phone interviews and hospital records. Registration: NCT05719870 (clinicaltrial.gov). https://classic.clinicaltrials.gov/ct2/show/NCT05719870.

Medication compliance and related factors among readmission people with type 2 diabetes at 108 Military central Hospital

Objectives: Survey on medication compliance rate and related factors in people with type 2 diabetes readmitted for inpatient treatment at 108 Central Military Hospital. Participants and methods: A cross-sectional descriptive study was conducted on 168 patients with Type 2 diabetes readmission from January 2021 to December 2022. The study assessed medication adherence using the MARS–5 questionnaire (Medication Adherence Report Scale 5). Results: The rate of medication compliance in patients was 21.8%, non-compliance accounted for 78.2%. Patients who occasionally forget to take medication account for the highest rate of 51.8%, arbitrarily reducing the dose to less than the prescribed dose accounted for 32.1%, rarely skipping doses, and stopping medicine for a period of time accounted for 35.7% and 50.2%, respectively. There was a relationship between age and current medication and medication compliance. The difference was statistically significant(p < 0.05). Conclusion: The medication compliance rate in diabetic patients readmitted to the hospital in the study was low, only 21.8%, of which patients forgot to take medication and arbitrarily reduced the dose and stopped using medication for a period of time accounting for the highest proportion. high rate. Strengthening health education on medication adherence during follow-up examinations for patients and caregivers is extremely necessary to reduce the risk of hospital readmission, maintain blood sugar at normal levels, and minimize diabetes complications.

Adult patients with alopecia areata report a significantly better medication adherence compared to those with atopic dermatitis: Results from a large cross-sectional cohort study

BackgroundAlopecia areata (AA) and atopic dermatitis (AD) are chronic skin diseases where the suboptimal MA may result in poor clinical outcomes. ObjectiveTo assess the impact of AA on MA among adults compared to AD. MethodsPatient reported MA of adults with AA were compared with AD. Patients were identified from the Danish Skin Cohort, a nationwide prospective cohort of dermatological patients in Denmark. We used the Medication Adherence Report Scale- 5 (MARS-5), a self-reporting questionnaire, to assess MA. Demographic and disease characteristics were collected. Logistic regression was conducted. ResultsPatients with AA reported higher MA than AD (Mean 21.81 vs 18.29). Logistic regression analyses showed AA diagnosis had a statistically significant positive effect on MA (OR=3.94, 95% CI 2.01-8.89). Men reported significantly higher MA (OR=1.49, 95% CI 1.14-1.94). Current disease severity did not impact MA. LimitationsData were self-reported by patients. Data regarding the specific treatment undergone by patients was not available. ConclusionPatients with AA have significantly higher MA compared to patients with AD. The stability of AA patients' symptoms may lead to higher MA due to a desire for disease control. Conversely, the sporadicity of AD symptoms could negatively affect adherence, causing fluctuations in medication use.

Adherence to medical treatment for Wilson’s disease in children and adolescents: a cohort study from Turkey

BackgroundThis study aimed to assess medication adherence and demographic, clinical, and psychopathological parameters such as quality of life, depression, and anxiety levels that can affect pediatrics with Wilson’s Disease (WD).MethodsA prospective cohort study was conducted at an outpatient clinic in Turkey among pediatric patients (2 to 18 years) with WD between November 2022 and April 2023. The Medication Adherence Report Scale (MARS-5) as a subjective and Medication Possession Ratio (MPR) as an objective assessment were scored. Physical, genetic and biochemical parameters, the Pediatric Quality of Life Inventory (PedsQL) for both parents and patients, Childhood Depression Inventory, State Trait Anxiety Inventory were also administered.ResultsA total of 30 pediatric outpatients who were prescribed D-penicillamine (n = 27) or trientine (n = 3) as chelators and zinc (n = 29) and pyridoxine (n = 19) as supplements were included. Proteinuria (n = 3), skin rash (n = 2), and gastrointestinal upset (n = 2) were observed. When the correlation between MARS-5 and duration of follow-up was examined, a significant negative correlation was found (p = 0.014). According to MPRs, non-adherence rates (missed doses ≥ 20%) were 29.6%, 17.2% and 5.3% for D-penicillamine, zinc and pyridoxine, respectively. PedsQL scores were higher than those of parents, with a positive correlation between them (p < 0.001). Also, there was a significant positive correlation between PedsQL and State Anxiety Inventory (p < 0.001). Comparing the change in urinary copper levels between different levels of treatment knowledge, significant differences were observed between high- and low levels (p = 0.043).ConclusionsOverall, nonadherence rates were 23.3% based on MARS-5 and 5.3–29.6% based on MPR. It is essential to consider factors such as the duration of follow-up, biochemical parameters, treatment knowledge, quality of life and anxiety as potential influencers of medication adherence.

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

Background &amp; Aim: Low compliance with medication in patients with schizophrenia may negatively affect the quality of life and subjective recovery. The objective was to analyze the association between medical adherence and subjective recovery in individuals diagnosed with schizophrenia.&#x0D; Methods &amp; Materials: This descriptive and correlational research was conducted between July and August 2023. 120 patients registered with a Schizophrenia Relatives Association in Türkiye were included in the study using simple random sampling. Demographic questionnaire, Medication Adherence Report Scale, and Subjective Recovery Assessment Scale were used in the study. Percentage, mean, t-test in independent groups, one-way ANOVA, and Pearson correlation coefficient were used to data analysis in SPSS 25.&#x0D; Results: Medication Adherence and Subjective Recovery mean scores were 22.85±3.57 and 61.82±15.37 respectively. It was revealed that there is a positive and statistically significant relationship between Medication Adherence and Subjective Recovery scores (r=0.269, p&lt;0.01). As well as between age and Medication Adherence Report Scale (r=0.215, p&lt;0.05). The subjective recovery level was significantly lower in smokers compared to non-smokers (p&lt;0.05).&#x0D; Conclusion: Subjective recovery levels of psychiatric patients can be increased by monitoring their medication adherence levels. Supportive interventions (giving motivational talks for medication use, following up with patients by phone or home visit, etc.) should be implemented for those who do not adhere to their medication regimen.

Intervention for a correct medication list and medication use in older adults: a non-randomised feasibility study among inpatients and residents during care transitions

Abstract Background Medication discrepancies in care transitions and medication non-adherence are problematic. Few interventions consider the entire process, from the hospital to the patient’s medication use at home. Aim In preparation for randomised controlled trials (RCTs), this study aimed (1) to investigate the feasibility of recruitment and retention of patients, and data collection to reduce medication discrepancies at discharge and improve medication adherence, and (2) to explore the outcomes of the interventions. Method Participants were recruited from a hospital and a residential area. Hospital patients participated in a pharmacist-led intervention to establish a correct medication list upon discharge and a follow-up interview two weeks post-discharge. All participants received a person-centred adherence intervention for three to six months. Discrepancies in the medication lists, the Beliefs about Medicines Questionnaire (BMQ-S), and the Medication Adherence Report Scale (MARS-5) were assessed. Results Of 87 asked to participate, 35 were included, and 12 completed the study. Identifying discrepancies, discussing discrepancies with physicians, and performing follow-up interviews were possible. Conducting the adherence intervention was also possible using individual health plans for medication use. Among the seven hospital patients, 24 discrepancies were found. Discharging physicians agreed that all discrepancies were errors, but only ten were corrected in the discharge information. Ten participants decreased their total BMQ-S concern scores, and seven increased their total MARS-5 scores. Conclusion Based on this study, conducting the two RCTs separately may increase the inclusion rate. Data collection was feasible. Both interventions were feasible in many aspects but need to be optimised in upcoming RCTs.

Treatment Adherence and Related Factors Among Children with Attention-Deficit/Hyperactivity Disorder in Saudi Arabia.

Attention-deficit/hyperactivity disorder (ADHD) is a common childhood psychiatric disorder. It frequently persists into adulthood and is a risk factor for other mental disorders and adverse outcomes, mainly if not managed optimally. This study aimed to assess ADHD treatment adherence and explore the underlying causes of non-adherence in ADHD children in Saudi Arabia. A cross-sectional study of a convenience sample of 221 participants. The survey included demographic characteristics of the child and parents, the child's medical history, quality of services evaluation, as well as medication adherence assessment by Medication Adherence Report Scale (MARS), the general beliefs about medicines questionnaire (General-BMQ), in addition to assessing the parents' beliefs about ADHD and provided/recommended treatment. The sample was primarily 6 to 8-year-old children (32.81%) and males (78.52%). Most subjects were prescribed extended-release agents (45.7%), and overall, high-quality services were provided to the patients. The adherence rate of ADHD patients to their medication was 89.77%. The mother's education correlated significantly with patient adherence (p=0.029), and the mother's age correlated significantly with their beliefs (p=0.021), in addition to the family income (0.033). Children on Methylphenidate Immediate Release had good compliance with the medication (p=0.008). Moreover, Methylphenidate Extended Release has shown continuity results, increasing the adherence rates (p=0.035). ADHD medication adherence was high and associated with older age, educational status, and type of medication used. Physicians should consider these factors to improve adherence in their patients.

Validity and Reliability Test of the Medication Adherence Report Scale (MARS) Questionnaire for Tuberculosis (TB) Patients

In terms of tuberculosis cases, Indonesia is second only to India. Successful outcomes in the treatment of tuberculosis depend on patient compliance with their prescribed medication. The MARS (Medication Adherence Report Scale) questionnaire can be used to assess medication adherence in tuberculosis patients. The researchers in this study set out to see if the MARS questionnaire was sufficiently valid and reliable to be used with tuberculosis (TB) patients in Indonesia. Descriptive quantitative analysis using a cross-sectional design was employed for this study. The MARS survey was the instrument used for this study. Sixty tuberculosis patients from the Lamongan District Health Center met the inclusion criteria and made up the sample size of 70. Sampling with the help of a planned strategy. Apply the Pearson Product Moment correlation test to the questionnaire to see if it is reliable. The Cronbach alpha coefficient was used to determine the questionnaire's reliability in this study. According to the data, the r count correlation value was higher than the r table value of 0.2542. The Cronbach Alpha Coefficient obtained from the reliability analysis was 0.486. The results of the validity and reliability tests indicated that the Indonesian translation of the MARS questionnaire was a valid and reliable tool for gauging the degree to which TB patients took their prescribed medications as directed. Adherence should be measured with a reliable questionnaire or instrument to ensure accurate results.

Using the 5-Item Medication Adherence Report Scale (MARS-5) to Screen for Non-adherence to Vitamin and Mineral Supplementation After Bariatric Surgery

IntroductionPoor adherence to recommended vitamin and mineral supplementation after bariatric surgery is common and challenging for healthcare professionals to identify. There are several questionnaires for self-reporting of adherence to chronic medication, but none has so far been evaluated for assessment of adherence to vitamin and mineral supplementation after bariatric surgery. The aim of this study was to assess the accuracy of the 5-item Medication Adherence Report Scale (MARS-5) in measuring adherence to vitamin and mineral supplementation post bariatric surgery (gastric bypass or sleeve gastrectomy).MethodThe psychometric properties of MARS-5 for vitamin and mineral supplementation were validated in two cohorts: one at 1 year post bariatric surgery (n = 120) and the other at 2 years post-surgery (n = 211). MARS-5 was compared to pharmacy refill data for vitamin B12 and combined calcium/vitamin D as reference.ResultsCorrelation analyses demonstrated that the MARS-5 had acceptable validity compared to objectively measured adherence rates from pharmacy refill data (calculated as continuous, multiple-interval measures of medication availability/gaps-coefficient ranged from 0.49 to 0.54). Internal reliability (Cronbach’s α) was high: 0.81 and 0.95, respectively. There was a clear ceiling effect where one out of three had a maximum score on MARS-5.ConclusionMARS-5 demonstrated acceptable psychometric properties for assessment of adherence to vitamin and mineral supplementation post bariatric surgery.Graphical

Psychometric evaluation of the 5-item Medication Adherence Report Scale questionnaire in persons with multiple sclerosis.

The 5-item Medication Adherence Report Scale (MARS-5) is a reliable and valid questionnaire for evaluating adherence in patients with asthma, hypertension, and diabetes. Validity has not been determined in multiple sclerosis (MS). We aimed to establish criterion validity and reliability of the MARS-5 in persons with MS (PwMS). Our prospective study included PwMS on dimethyl fumarate (DMF). PwMS self-completed the MARS-5 on the same day before baseline and follow-up brain magnetic resonance imaging (MRI) 3 and 9 months after treatment initiation and were graded as highly and medium adherent upon the 24-cut-off score, established by receiver operator curve analysis. Health outcomes were represented by relapse occurrence from the 1st DMF dispense till follow-up brain MRI and radiological progression (new T2 MRI lesions and quantitative analysis) between baseline and follow-up MRI. Criterion validity was established by association with the Proportion of Days Covered (PDC), new T2 MRI lesions, and Beliefs in Medicines questionnaire (BMQ). The reliability evaluation included internal consistency and the test-retest method. We included 40 PwMS (age 37.6 ± 9.9 years, 75% women), 34 were treatment-naive. No relapses were seen during the follow-up period but quantitative MRI analysis showed new T2 lesions in 6 PwMS. The mean (SD) MARS-5 score was 23.1 (2.5), with 24 PwMS graded as highly adherent. The higher MARS-5 score was associated with higher PDC (b = 0.027, P<0.001, 95% CI: (0.0134-0.0403)) and lower medication concerns (b = -1.25, P<0.001, 95% CI: (-1.93-(-0,579)). Lower adherence was associated with increased number (P = 0.00148) and total volume of new T2 MRI lesions (P = 0.00149). The questionnaire showed acceptable internal consistency (Cronbach α = 0.72) and moderate test-retest reliability (r = 0.62, P < 0.0001, 95% CI: 0.33-0.79). The MARS-5 was found to be valid and reliable for estimating medication adherence and predicting medication concerns in persons with MS.

Medication adherence in adults after hospitalization for heart failure: A cross-sectional study

BackgroundMedication non-adherence in heart failure (HF) leads to increased mortality, morbidity and healthcare costs. However, no study has investigated HF patients’ post-hospitalization medication non-adherence in Switzerland. ObjectivesOur primary aim was to assess the prevalence of post-discharge medication non-adherence in patients with HF. A secondary objective was to identify differences between fully and partially adherent patients regarding selected unplanned therapy-related inpatient/outpatient cardiology visits. MethodsA non-experimental cross-sectional study was applied. The prevalence of medication adherence was assessed with a German-translated version of the Medication Adherence Report Scale (MARS-5) and analyzed descriptively. Differences between adherent and partially adherent patients’ numbers of medications, dosing per day and 180-day unplanned inpatient stays or cardiology outpatient visits were explored. ResultsOf 153 recruited patients, 72 participated in the survey. Of these, 26.4 % were not fully adherent. Their most common reason was forgetfulness (23.7 %). There were no significant group differences regarding therapy-related variables or 180-day unplanned cardiology stays/visits. ConclusionsConsidering that over one-quarter of surveyed HF patients were not fully medication adherent, Swiss cardiology nurses need to be sensitized to this issue and trained in adherence-enhancing interventions. Reaching acceptable adherence levels in patients with HF will require further research and action.

Exploring adherence in patients with advanced breast cancer: focus on CDK4/6 inhibitors.

Treatment adherence is crucial for optimal outcomes in advanced breast cancer, but can be challenging due to various factors, i.e. patients' attitudes and behavior upon diagnosis, and complex therapies with high adverse effect rates. Our aim was to explore the adherence to oral anticancer medications (OAM) in women with advanced breast cancer, focusing on cyclin-dependent kinase 4 and 6 inhibitors (CDKI), and identify factors associated with the adherence. We conducted a cross-sectional study at the University Hospital Centre Zagreb, Croatia, involving women with stage IV advanced breast cancer receiving OAM. Data collection included a questionnaire assessing socio-demographic and clinical information, Beck Depression Inventory-II for depressive symptoms, Medication Adherence Report Scale (MARS-5) for adherence to OAM, and Beliefs about Medicines Questionnaire. Plasma concentrations of CDKI were confirmed by LC-MS/MS in three randomly selected participants. A total of 89 women were included. The most prescribed OAMs were anti-estrogen (71.3 %) and CDKI (60.9 %). MARS-5 scores (mean: 24.1 ± 1.6) correlated with CDKI plasma concentrations. Forgetfulness was the primary reason for non-adherence (25.9 %). Women receiving CDKI (p = 0.018), without depressive symptomatology (p = 0.043), and with more positive beliefs about medicines were more adherent (p < 0.05). This study enhances understanding of medication adherence in advanced breast cancer and identifies influential factors.

Serial mediation of illness perception and beliefs about medicines in the relationship between patient satisfaction and medication adherence: An evaluation of self-regulatory model in rheumatoid arthritis and ankylosing spondylitis patients.

This study examined the effect of patient satisfaction on medication adherence through serial mediation of Self Regulatory Model (SRM) components which are illness perception and beliefs about medicines in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). The 222 outpatients (nRA = 112; nAS = 110) were administered a sociodemographic form, the Medication Adherence Report Scale, the Brief Illness Perception Questionnaire, the Short Assessment of Patient Satisfaction, and the Beliefs about Medicines Questionnaire. The results showed that SRM components fully mediated the relationship between patient satisfaction and medication adherence. This proposed model had acceptable and better fit indices than the alternative model where patient satisfaction was introduced as a direct predictor. Furthermore, patient satisfaction, illness perception, and beliefs about medicines had an extremely good relationship, so these may be interpreted as variables of a latent construct of the illness experience which deserves further research in these group of patients.

Factors Affecting Treatment Compliance of Patients With COPD During the COVID-19 Pandemic

Objective: This study aimed to investigate the effects of difficulties experienced in the follow-up and treatment during the Coronavirus 2019 pandemic (COVID-19p), which included COVID-19 phobia and depression, on treatment compliance in patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: This study included 123 patients with COPD. The COVID-19 Phobia Scale (C19P-S), Beck Depression Inventory (BDI), and Medication Adherence Report Scale (MARS) were used to assess the patients. Results: The mean age of patients with COPD was 64.56 ± 9.31 years. It was determined that our patients did not maintain regular outpatient follow-up mostly because of the fear of COVID-19 transmission (78.8%). Overall, 24% of our patients showed treatment noncompliance. A statistically significant relationship was found between COPD stages B and D and treatment compliance (p=0.01). Patients with frequent emergency department admissions (p = 0.01) and those with high BDI (p = 0.01) and C19P-S (p = 0.02) scores during the pandemic were found to have reduced treatment compliance. Conclusion: Patients with COPD with COVID-19 phobia, and depression had reduced treatment compliance. İt is necessary to be aware of these conditions and to plan appropriate interventions.

Non-adherence, medication beliefs and symptom burden among patients receiving hemodialysis -a cross-sectional study

BackgroundNon-adherence to medication is a common and complex issue faced by individuals undergoing hemodialysis (HD). However, more knowledge is needed about modifiable factors influence on non-adherence. This study investigated the prevalence of non-adherence, medication beliefs and symptom burden and severity among patients receiving HD in Denmark. Associations between non-adherence, medications beliefs and symptom burden and severity were also explored.MethodA cross-sectional questionnaire-based multisite study, including 385 participants. We involved patient research consultants in the study design process and the following instruments were included: Medication Adherence Report Scale, Beliefs about Medication Questionnaire and Dialysis Symptom Index. Logistic regression analysis was performed.ResultsThe prevalence of non-adherence was 32% (95% CI 27–37%) using a 23-point-cut-off. Just over one third reported being concerned about medication One third also believed physicians to overprescribe medication, which was associated with 18% increased odds of non-adherence. Symptom burden and severity were high, with the most common symptoms being tiredness/ lack of energy, itching, dry mouth, trouble sleeping and difficulties concentrating. A high symptom burden and/or symptom severity score was associated with an increased odd of non-adherence.ConclusionThe study found significant associations between non-adherence and, beliefs about overuse, symptom burden and symptom severity. Our results suggest health care professionals (HCP) should prioritize discussion about medication adherence with patients with focus on addressing patient-HCP relationship, and patients’ symptom experience. Future research is recommended to explore the effects of systematically using validated adherence measures in clinical practice on medication adherence, patient-HCP communication and trust. Additionally, studies are warranted to further investigate the relationship between symptom experience and adherence in this population.Trial registrationNCT03897231.

Understanding multi-level barriers to medication adherence among adults living with sickle cell disease.

There is limited research that identifies and examines multi-level barriers to medication adherence among adults with Sickle Cell Disease (SCD); Identify multi-level barriers to medication adherence among adults with SCD; and Examine the relationship between multi-level barriers and medication adherence levels. A cross-sectional study included 130 adults (ages ≥ 18 years old) living with SCD who receive treatment/care from one of the 10 adult SCD clinics within the Networking California for sickle cell care initiative. Study measures included the medication adherence report scale (Professor Rob Horne), Beliefs about Medicine Questionnaire (Professor Rob Horne), and patient reported outcomes measurement information system. Participants reported barriers to medication adherence across 3 levels: Community-level barriers (e.g., COVID-19 pandemic); Institutional-level barriers (e.g., bad experiences with the health care system); and Individual-level barriers (e.g., beliefs and depression severity). Depression severity and patient concerns about SCD medication were inversely correlated with medication adherence (rs = -0.302, P < .001; rs = -0.341, P < .001 respectively). Patient beliefs about the necessity of SCD medication were insignificantly correlated with medication adherence (rs = 0.065, P = .464). Medication adherence was higher among patients who had fewer adherence barriers than multiple adherence barriers (Median medication adherence: fewer barriers = 22 vs multiple barrier = 20.50, P = .085), suggesting clinical significance although statistically insignificant. Identifying multi-level adherence barriers and examining their relationship with medication adherence will help develop targeted public health strategies to promote improved medication adherence and wellness among adults with SCD.

Description of patient characteristics and medication adherence among medication access mobile application users and nonusers: a single-center questionnaire-based cross-sectional study

BackgroundIn this study, we aimed to describe patient characteristics and medication adherence among medication access mobile application users and nonusers. MethodsThis was a cross-sectional study of a randomly selected sample of patients who refilled their medications either through the mobile application ‘MNG-HA Care’ or by phone call to a government-funded multispecialty hospital in Riyadh, Saudi Arabia. Data were collected through an online survey and filed either via WhatsApp or by phone call. Medication adherence was assessed using the five-item Medication Adherence Report Scale (MARS-5).ResultsA total of 280 respondents were recruited, and their mean age was 48.8 years (standard deviation (SD): 17.8). More than 75% of application users and nonusers were younger (18–64 years) and lived in urban areas, 58% were male, 37.5% held a bachelor’s degree, and 40% were unemployed. The number of respondents who accessed the mobile application (mobile application users) was 212, and 64.2% of them were adherent to their medications. Sixty-eight of the respondents used a phone call for refills (mobile application nonusers), and 77.9% of them were adherent to their medications. The most common self-reported reasons for using the application were to book an appointment and to request a medication refill. The most common self-reported reasons for not using the application were respondents’ lack of knowledge about the availability of the application and preference for speaking directly to the health care provider. Adjusted multivariate logistic regression analysis revealed that medication adherence was not associated with application use (Odds Ratio (OR): 0.65; 95% CI: 0.33–1.29). However, male patients had significantly higher adherence than females (OR 2.68, 95% CI 1.31 to 5.51), and employed patients had significantly lower adherence than unemployed patients (OR 0.37, 95% CI 0.17 to 0.81).ConclusionsProviding patients with access to their medication list through a mobile application alone did not significantly impact medication adherence. Further research is needed to explore the potential benefits of incorporating additional features, such as medication instructions and reminders within mobile applications, to improve medication adherence.

Compliance level to Tuberculosis prophylaxis in patients undergoing therapy with tumor necrosis factor-alpha inhibitors: a cross-sectional study.

Tumor necrosis factor-alpha (TNF-α) inhibitors are used to treat autoimmune diseases such as rheumatoid arthritis, ankylosing spondylitis, and inflammatory bowel disease. However, patients using TNF-α inhibitors are at a high risk of developing tuberculosis. Therefore, this study aimed to evaluate the compliance level of patients who were prescribed TNF-α-based tuberculosis prophylactic treatment. The study included 135 patients who were followed up at a tuberculosis dispensary between December 2020 and June 2021 and agreed to participate in the study. The study was conducted after obtaining necessary permissions from the institution, ethics committee, and patients. Data were collected using a questionnaire and evaluated using the Medication Adherence Report Scale (MARS). The MARS scale scores range from 5 to 25, with high scores indicating a high level of "medication compliance level". Of the included patients, 42.2% were females, 46.7% were primary school graduates, and their mean age was 43.75±11.86 years. Additionally, 35.6% of patients had ankylosing spondylitis, among whom 54.1% had a disease duration of 1-5 years and 57.8% had been using TNF-α inhibitors for a year. Of the patients taking isoniazid (INH) for tuberculosis prophylaxis, 47.4% missed their prescribed INH doses, with "forgetfulness" being the reason in 28.9% of these patients. The patients had a mean MARS score of 15.71±6.18. Patients using TNF-α inhibitors were found to have "moderate" compliance levels for INH-based prophylactic therapy. It is recommended that the compliance levels of patients and factors influencing their compliance should be regularly monitored.

Managing Symptom Distress: Key Factors for Patients on Adjuvant Endocrine Therapy for Breast Cancer

ContextPatients with breast cancer taking adjuvant endocrine therapy (AET) experience significant symptoms impacting mood, quality of life (QOL), and AET adherence and satisfaction. ObjectivesThe aim of this study was to examine the extent to which coping ability and self-efficacy for symptom management moderate the relationships between patients’ symptom distress and their mood, QOL, and AET adherence and satisfaction. MethodsAs part of a randomized controlled trial, participants completed baseline measures including: sociodemographics, symptom distress (breast cancer prevention trial symptom checklist), coping skills (measure of current status), self-efficacy (self-efficacy for managing symptoms), anxiety and depression (hospital anxiety and depression scale), QOL (functional assessment of cancer therapy - general), AET adherence (medication adherence report scale), and AET satisfaction (cancer therapy satisfaction questionnaire). We conducted moderated regression analyses to examine whether coping and self-efficacy moderated the associations of symptom distress with baseline measures. ResultsCoping skills moderated the associations of symptom distress with depression and QOL. Among those with lower coping, higher symptom distress was associated with worse depression symptoms (p=.04) and worse QOL (p < 0.001). Self-efficacy moderated the associations of symptom distress with depression symptoms and AET adherence and satisfaction. Among those with higher self-efficacy, higher symptom distress was associated with worse depression symptoms (p < 0.001), worse AET adherence (p < 0.001), and less AET satisfaction (p = 0.01). ConclusionCoping skills may buffer the effect of AET symptom distress. Findings indicate the relationship between symptom distress and self-efficacy is more nuanced and requires further research to better understand.

Improvements in Treatment Adherence after Family Psychoeducation in Patients Affected by Psychosis: Preliminary Findings.

(1) Background: Family psychoeducation is a well-recognized intervention which aims to improve the outcomes of illness in patients affected by psychosis. It has benefits in treatment adherence and leads to a reduction in relapses, higher levels of patient insight, and lower levels of stress within the family and among caregivers. (2) Methods: Eight patients and their families were recruited and randomly assigned to a Falloon-based family psychoeducation (FPP) intervention, and nine patients and their families were randomized to a Gestalt-based family intervention (GT). We compared the outcomes of these two treatment groups at a baseline assessment (T0), at the end of the programs (T1), and 6 and 12 months after the end of the programs (T2 and T3). The assessments included examinations of cognition (The Mini-Mental State Examination (MMSE) and The Five Point Test (5 Point)), the psychopathology and severity of illness (The Brief Psychiatric Rating Scale (BPRS), The Positive and Negative Syndrome Scale (PANSS), and The Clinical Global Impression Scale (CGI)), expressed emotion in families (Expressed Emotionality (Family Questionnaire-EE)), patient quality of life (The World Health Organization Quality of Life-BREF (WHOQOL-B)), social functioning (The Personal Social Performance (SPS)), aggression (Modified Overt Aggression Scale (MOAS)), and treatment adherence (The Brief Medication Adherence Report Scale (BMARS)). The primary aim was to test whether the FFP vs. GT program was more effective in improving treatment adherence over time. (3) Results: treatment adherence improved much more in the FFP group over time at any follow-up: +43.1% at T1, +24.0% at T2, and +41.6% at T3. Other characteristics, including psychopathology and the clinical stability of the subject, did not change over time. (4) Discussion: Family psychoeducation based on the Falloon program was effective at improving treatment adherence and contributed to avoiding relapses in the long term. Further studies on larger samples should be conducted to confirm this evidence, and similar psychoeducational programs should be routinely promoted in the clinical setting.