Medium Adherence Research Articles

The association between Self-Reported Medication Adherence scores and systolic blood pressure control: a SPRINT baseline data study

We examined baseline data from the Systolic Blood Pressure Intervention Trial (SPRINT) to investigate whether medication adherence, measured by the 8-item Morisky Medication Adherence Scale (MMAS-8), was associated with systolic blood pressure (SBP) and whether MMAS-8 score and number of antihypertensive medications interacted in influencing SBP. A total of 8435 SPRINT participants were included: 21.2% had low adherence (MMAS-8: <6); 40.0% had medium adherence (6 to <8); and 38.8% had high adherence (8). SBP was <140 mm Hg in 54.6%; 140–160 mm Hg in 36.6%; and >160 mm Hg in 8.8%. In multivariable regression, medium vs. low adherence weakly associated with lower SBP (odds ratio: 1.17; confidence interval: 1.04, 1.31). SPRINT eligibility criteria should be considered when interpreting results. Efforts to understand and enhance adherence are crucial to improve population health, and using self-report instruments might be considered for predicting treatment adherence and response in future efficacy trials and for identifying patients for adherence support in clinical practice.

Factors Affecting Adherence to Statins in Hypercholesterolemic Kuwaiti Patients: A Cross-Sectional Study

Objective: This study examined statin adherence amongst Kuwaiti hypercholesterolemic patients in order to identify factors associated with poor adherence and to determine whether or not an association exists between statin adherence and the risk profile of coronary heart disease (CHD). Subjects and Methods: Two hundred hypercholesterolemic patients (30-69 years of age) were recruited from Kuwaiti primary healthcare clinics and interviewed about demographic characteristics, pre-existing self-reported medical conditions and prescribed medications. The Morisky Medication Adherence Scale was used to assess statin adherence (a self-reported, medication-adherence questionnaire divided into 3 levels, with a score of 8 denoting high adherence, 6 to <8 denoting medium adherence and <6 denoting low adherence). Data regarding anthropometric, psychological and serum risk factors were collected using 2 additional questionnaires, laboratory tests and bioelectrical impedance scales. Binary logistic regression was used to determine predictors of adherence and general linear modelling was used to test relationships between continuous outcomes and statin adherence. Results: Of the 200 participants, 117 (58.5%) reported low adherence, 83 (41.5%) reported medium adherence and no patients (0%) scored high adherence. Younger patients (aged 30-50 years) had lower adherence than older patients (>50 years) [odds ratio (OR) 1.05; 95% confidence interval (CI) 1.01-1.09] for every extra year; p < 0.01). Those without diabetes, i.e. 113 (56.5%), were less likely to report medium adherence than those with diabetes (OR 0.42; 95% CI 0.23-0.75; p < 0.01). Low statin adherence was associated with higher levels of plasma cholesterol (p < 0.001) and low-density lipoprotein (p < 0.01). Conclusion: In this study, there was a high prevalence of low statin adherence, especially among younger patients with fewer concomitant diseases. The results indicated an inverse relationship between statin adherence and CHD risk profile.

PT07.1: Determination of Malondialdehyde (MDA) Levels and Total Antioxidant Capacity (TAC) in Participants with High, Medium and Low Mediterranean Diet Adherence

PT07.1: Determination of Malondialdehyde (MDA) Levels and Total Antioxidant Capacity (TAC) in Participants with High, Medium and Low Mediterranean Diet Adherence

Improving adherence to medication in adults with diabetes in the United Arab Emirates.

BackgroundDiabetes is a chronic medical condition and adherence to medication in diabetes is important. Improving medication adherence in adults with diabetes would help prevent the chronic complications associated with diabetes. A case control trial was used to study the effects of an educational session on medication adherence among adults with diabetes as measured by the Morisky Medication adherence scale (MMAS-8©).MethodsThe study took place at the Dubai Police Health Centre between February 2015 and November 2015. Questionnaires were used to collect socio-demographic, clinical and disease related variables and the primary measure of outcome was adherence levels as measured by the Morisky Medication Adherence Scale (MMAS-8©). The intervention group involved a standardized thirty minute educational session focusing on the importance of adherence to medication. The change in MMAS-8© was measured at 6 months.ResultsFour hundred and forty six patients were enrolled. Mean age 61 year +/− 11. 48.4 % were male. The mean time since diagnosis of diabetes was 3.2 years (Range 1–15 years). At baseline two hundred and eighty eight (64.6 %) patients were considered non-adherent (MMAS-8© adherence score < 6) while 118 (26.5 %) and 40 (9.0 %) had low adherence (MMAS-8© adherence score < 6) and medium adherence (MMAS-8© adherence scores of 6 to 7) to their medication respectively. The percentage of patients scoring low adherence MMAS-8 scores in the interventional group dropped from 64.60 % at baseline to 44.80 % at 6-months (p = 0.01). There was no obvious change in the adherence scores at baseline and at 6-months in the control group. Based on the study data, the Wilcoxon signed-rank test showed that at 6 months, the educational 30-min session on diabetes and adherence to medication did elicit a statistically significant change in adherence levels in adults with diabetes enrolled in the intervention arm (Z = −6.187, p <0.001).ConclusionAdults with diabetes would benefit from educational sessions focusing on the importance of adherence to medication. Public health strategies should focus on wider educational strategies targeting medication adherence in diabetic patients in the UAE.

Patient adoption of an internet based diabetes medication tool to improve adherence: A pilot study

ObjectiveTo investigate the effect of a video intervention, Managing Your Diabetes Medicines, on patient self-efficacy, problems with using medication, and medication adherence in a rural, mostly African American population. MethodsPatients selected their problem areas in medication use and watched one of nine 2-min videos with a research assistant at a clinic or pharmacy and were given an access code to watch all the videos at their convenience. Outcomes were measured at baseline and 3-month follow-up. ResultsFifty-one patients were enrolled; 84% were African American and 80% were female (mean age: 54 years). Seventy-three percent watched at least one module after the initial visit. Improved self-efficacy was associated with a decrease in concerns about medications (r=−0.64). Low literate patients experienced greater improvement in self-efficacy than more literate patients (t=2.54, p=0.02). Patients’ mean number of problems declined from 6.14 to 5.03. The number of patients with high or medium adherence rose from 33% at baseline to 43% at 3-month follow-up. ConclusionsA practical, customized video intervention may help improve patient self-efficacy, reduce problems with medication use, and improve medication adherence in diabetes patients. Practice implicationsProviders should consider implementing technology-based interventions in the clinic to address common problems that patients have with self-management.

240 Discord between patients' general practitioner repeat prescriptions and the medication list held by a paediatric CF centre

About 60% of the people with CF have low or medium adherence to their PEP therapy. Both patients under frequent and occasional medical supervision (50 to 1 visit per trimester) are concerned by a lack of intrinsic motivation. Indeed, Health professionals have limited impact on the key determinants of adherence: high self-esteem, feeling of autonomy, positive mindset, supporting environment, appropriate time management, etc. Health games can provide a window into the “real time” behaviors of patients. Objectives: We develop a community based on non-proprietary technologies to foster collaboration between patient groups, health practitioners, researchers and professionals of other fields. We conceive low-tech devices to collect daily therapy data. We build a game engine to enable children and their relatives to create games based on configurable therapy patterns. Results: Following the prototypes tested at CHU Sainte-Justine (Canada, poster WS05.4 in 2015), we started to develop the game and devices to connect the PEP to computers and smartphones – one using a pressure sensor, one sound analysis. We released our documentation and code under public licence so that everyone can improve and use it (breathinggames.net). We set up a system to log contributions and redistribute the funds we raise. Up to now, 60 people contributed. Next steps are a crowdfunding campaign to mobilize new contributors and a multisites research coordinated by Haute ecole Arc (Switzerland).

Diabetes related knowledge, self-care behaviours and adherence to medications among diabetic patients in Southwest Ethiopia: a cross-sectional survey.

BackgroundThe provision of health education involving self-care and good adherence to medications has been acknowledged to be a cost effective strategy for improving quality of life of diabetes patients. We assessed levels of knowledge about type 2 diabetes mellitus (T2DM), self-care behaviours and adherence to medication among DM patients.MethodsA facility based cross-sectional survey of 325 adults with T2DM patients attending Jimma University Teaching Hospital, Southwest Ethiopia was conducted. We used diabetes Knowledge Test, Expanded Version of the Summary of Diabetes Self-Care Activities and Morisky 8-Item medication adherence as tools to measure diabetic knowledge, self-care behaviours and adherence to medications respectively. Multinomial logistic regression analyses were used to assess the independent predictors of diabetes knowledge and adherence to medications. The binary logistic regression was applied for self-care behaviours.Results309 respondents were included in the survey. Of all the respondents, 44.9 %, 20.1 % and 34.9 % had low, medium and high level diabetic knowledge respectively. High level of diabetic knowledge was the reference group. Being illiterate (AOR = 3.1, 95%CI: 1.03-9.3), having BMI <18 kg/m2 (AOR = 6.4, 95%CI: 1.2-34.9) and duration of DM < 5 years (AOR = 4.2, 95%CI: 1.9-9.5) were significantly associated with low level of diabetic knowledge. T2DM patients who practiced good self-care (AOR = 0.5, 95%CI: 0.3-0.9) were less likely to have low knowledge. Duration of DM < 5 years (AOR = 9.8, 95%CI: 3.2-30.2) was significantly associated with medium level of diabetic knowledge. 157(50.8 %) patients had poor self-care behaviour and this was associated with level of education and adherence to medication. The proportions of patients with low, medium and high adherence to medication were 24.9 %, 37.9 % and 37.2 % respectively. Being a merchant, having medium level of diabetic knowledge and having good glycemic control level were associated with low adherence to medications.ConclusionsSignificant number of DM patients had low level of knowledge, poor self-care behaviours and low level of adherence to medications. These findings call for the need of integrated interventional management on diabetic knowledge, self-care behaviours and adherence to medications. To ensure effective T2DM management, a strategic approach that improves health literacy could be a cross cutting intervention.Electronic supplementary materialThe online version of this article (doi:10.1186/s12902-016-0114-x) contains supplementary material, which is available to authorized users.

Longitudinal study of psychopathological, anthropometric and sociodemographic factors related to the level of Mediterranean diet adherence in a community sample of Spanish adolescents.

The Mediterranean diet (MD) pattern has important health benefits; however, it seems that Spanish school-aged children have been abandoning this healthy pattern recently. We aimed to identify psychopathological, anthropometric and sociodemographic factors that may influence the risk of low MD adherence. Longitudinal study in three phases. MD adherence was assessed using the Krece Plus food questionnaire and psychopathological symptoms using the Screen for Childhood Anxiety Related Emotional Disorders, Children's Depression Inventory, Youth's Inventory-4 and Eating Disorder Inventory-2. Anthropometric data were collected in the first and third phases. Settings All five representative areas in Reus, Spain. Adolescents (n 241). Regardless of past and current BMI, socio-economic status was a protective factor for low MD adherence (OR=0·805, P=0·003) and a risk factor for high BMI (OR=0·718, P=0·002; OR=0·707, P=0·001). Regardless of socio-economic status, depression was involved with risk of low adherence (OR=1·069, P=0·021). Girls with lower MD adherence presented significantly higher scores for eating disorders measured using the Eating Disorder Inventory-2 (low adherence, mean 18·9 (sd 13·5); high adherence, mean 8·9 (sd 9·0), P=0·020) and the Youth Inventory-4 (low adherence, mean 5·2 (sd 4·3); medium adherence, mean 3·6 (sd 3·2), P=0·044). They also presented higher depression symptoms (low adherence, mean 17·7 (sd 9·6); medium adherence, mean 12·3 (sd 7·2), P=0·01) than girls with high adherence. The results highlight the influence of psychosocial factors on levels of MD adherence. These factors need to be taken into account when developing prevention and health promotion initiatives.

Concern between medication non-adherence and diabetes associated depression

Background: Diabetes mellitus is one of the health disorders that acquire mankind immensely. An ominous twin of diabetes mellitus is diabetes associated depression which is often unrecognised in routine diabetic care. The objective of this study was to find the prevalence and correlation between medication adherence and diabetes associated depression. Methods: It is a conducted as cross sectional study using Morisky medication adherence scale to evaluate treatment adherence of type II diabetes mellitus. Patient health questionnaire-9 was used to scale the level of depression among our study subjects. Correlation between measures of treatment non adherence and level of depression was elucidated. Results: Out of 250 patients, 167 (66.8%) (Males -103, Females-64) and 83 (33.2%) (Males-31, Females-52) subjects has medium & low adherence to medication with an average score 6.8 and 4.2 respectively. Total prevalence of depression among diabetics in our study is 41.1% (males-19.2%, females 21.9%). Percentage of patients found to have minor depression was 22.3 % and 18.8 % of depressive subjects falls under major depression category according to PHQ-9 questionnaire with average score of 8.6 for minor depression and 11.9 for major depression. Positive correlation is seen between medication non adherence and diabetes associated depression (Low adherence & Major depression -0.85, Medium adherence &Minor depression -0.79). Conclusions: Unnoticed depression among diabetic individuals reduces treatment adherence and must be addressed in any patient showing poor response to the treatment. Improving treatment adherence helps to combat diabetes as well as depression.

Prevalence and Predictors of Medication Non-Adherence in Patients of Chronic Kidney Disease: Evidence from A Cross Sectional Study

Introduction: A high level of adherence to prescribed medication is essential to obtain the desired outcomes in patients of chronic kidney disease (CKD). Non-adherence to medication leads to increased morbidity and mortality. Non-adherence to medication has not been studied extensively in patients of CKD in India. Objective: To study the prevalence and predictors of medication non-adherence in patients of CKD. Method: Medication non-adherence was studied with the help of Morisky 8-item Medication Adherence Scale (MMAS-8) through a cross sectional study. Patients, aged 18 yrs or more, diagnosed with CKD according to Kidney Disease: Improving Global Outcomes (KDIGO) definition, and willing to participate in the study were included. On the basis of MMAS-8 scores, patients were classified to have high, medium and low adherence. Binary logistic regression was used to determine the various factors affecting adherence to drug therapy in CKD patients. Results: A total of 150 patients were included in study. Only 22% of the patients had high adherence to medications. Of all, 55% and 23% of the patients belonged to low and medium adherence, respectively. Adherence to drug therapy was found significantly different in different stages of CKD, gender, Body Mass Index (BMI) categories, hemodialysis status, co-morbidities, treatment funding and in patients of different socioeconomic status. Forgetfulness was found to be most common reason for non-adherence, while maximum non-adherence were reported for antihypertensive medications. Pill burden, age, literacy, reimbursement, medication by caregivers was found to significantly affecting the medication adherence. Conclusion: Medication non adherence was found to be highly prevalent in patients of CKD.

Compliance with and awareness about long-term oral anticoagulant therapy among Saudi patients in a University Hospital, Riyadh, Saudi Arabia

Context: Oral anticoagulant therapy (OAT) is one of the most widely used therapies. Being on such regimens requires high degree of compliance and adequate knowledge to avoid serious complications. Aims: This study aims to assess compliance with and awareness about OAT among Saudi patients, and their willingness to use the point-of-care (POC) international normalized ratio (INR) testing devices for self-monitoring. Settings and Design: This cross-sectional study was conducted at a tertiary hospital in Riyadh, Saudi Arabia, over 6 months. Subjects and Methods: A face-to-face interview has been carried out for all patients based on the questionnaire carried out for all patients based on the questionnaire. Results were analyzed according to demographics, adherence, knowledge, and INR control. Statistical Analysis Used: Statistical Package for the Social Sciences version 19 software (SPSS Inc., Chicago, IL, USA) was used. Results: One hundred sixty-two patients were interviewed, of which females (69.1%) exceeded males (30.1%). Most of them were on warfarin (80.2%), received education by their physicians. In general, patients had poor knowledge and medium adherence (53.1%) (scored < 50%). About 24% of the poor knowledge group (PKG) were highly adherent compared to 14.5% of the fine knowledge group (FKG). However, 53.2% of FKG had a controlled INR where this percentage reduces to 27% in PKG. The most incorrect answered question in both groups was related to warfarin-drug-interactions (75.3%). The majority (74.7%) was eager to make use of the POC-INR devices. Conclusions: The participants' knowledge was generally poor but level of knowledge did not play a role in compliance. Regardless, an education program should be accommodated to help patients in improving their medication control and reducing clinical visits. The majority was willing to adopt (POC) INR devices that will certainly help them in managing their treatment and potentially reducing adverse clinical outcomes.

Mediterranean Diet and 10-year (2002-2012) Incidence of Diabetes and Cardiovascular Disease in Participants with Prediabetes: The ATTICA study.

Prediabetes has been related to an increased risk of developing diabetes and cardiovascular disease (CVD). The aim of the present study was to examine the effect of the Mediterranean diet on diabetes and CVD risk in subjects with impaired fasting glucose (IFG, i.e. fasting plasma glucose 100-125 mg/dl). During 2001-2002, 3042 men and women (>18y) were enrolled for the study. The participants showed no clinical evidence of CVD or any other chronic disease, and were living in the greater Athens (Greece) area. In 2011 and 2012, the 10-year follow-up examinations were performed, including a working sample of n = 1875 participants without diabetes at baseline. Adherence to the Mediterranean diet at baseline evaluation was assessed using the MedDietScore (range 0-55). The prediabetic subjects (n = 343) had a significantly higher incidence of diabetes (25% vs. 10%, p < 0.001) and CVD (17.8% vs. 12.3%, p = 0.007) compared with subjects with normal glucose values. A significant trend towards lower diabetes and CVD incidence was observed with medium and high adherence to the Mediterranean diet compared with low adherence (p < 0.001). High adherence to the Mediterranean diet (>35/55 score) was associated with lower 10-year incidence of diabetes and CVD. In multiple logistic regression models, participants with high levels of adherence to the Mediterranean diet were significantly less affected by diabetes and CVD than those with low adherence levels. High adherence to the Mediterranean diet is associated with a low risk of developing diabetes and CVD in prediabetic subjects.

The association between adherence to the New Nordic Diet and diet quality

BackgroundPrevious studies have reported a positive association between scoring on healthy Nordic diet scales and the intake of healthy foods and nutrients, and also with higher intake of meat, sweets, cakes, and energy in general. These studies have used the same food frequency questionnaire (FFQ) responses for constructing the diet score as for calculating intakes of foods and nutrients. Thus, it is not clear whether the coexistence of healthy and less healthy dietary aspects among adherers to Nordic diets would occur even though separate methods were applied for exploring these relations.ObjectiveTo assess the association between adherence to the New Nordic Diet (NND), derived from an FFQ, and diet quality, determined from two 24-h dietary recall interviews.DesignIn total, 65 parents of toddlers in Southern Norway answered the NND FFQ and two 24-h dietary recall interviews. NND adherence was determined from the FFQ and categorized into low, medium, and high adherence. The two 24-h recalls provided data for the intake of specific foods and nutrients, selected on the basis of the Norwegian food-based guidelines as an indicator of a healthy diet. The Kruskal–Wallis test was used for assessing differences in food and nutrient intake across NND groups.ResultsHigh NND adherence derived from FFQ was associated with a high intake of fruits (p=0.004) and fiber (p=0.02), and a low intake of meat (p=0.004) and margarines (p=0.05), derived from recalls. A larger proportion of high NND adherers (68%) complied with the national dietary recommendation targeting meat intake compared with low NND adherers (29%) (p=0.04).ConclusionThe present study showed that higher NND adherence measured with FFQ was associated with a higher intake of selected healthy foods and nutrients, measured with recalls. However, a higher intake of meat, sweets, and energy, as earlier reported, was not observed.

Evaluation of medication adherence patterns amongst anti-hypertensive drug users in a tertiary care hospital in north India

Background: Non-adherence to prescribed medications is a major barrier in management of chronic diseases like hypertension, which can lead to treatment failure and can increase morbidity, mortality and health care costs. The objective of this study was to assess the level of adherence of hypertensive patients to their anti-hypertensive medications and various factors influencing the adherence among these patients. Methods: A cross sectional, observational, questionnaire based study was carried out amongst 70 patients diagnosed with hypertension. Adherence was measured using Morisky medication adherence score questionnaire (MMAS-8). Co-relation of various factors like age, sex, education level, number of drugs taken, presence of concomitant diseases etc. were assessed. Univariate and multivariate analysis was done to determine the factors associated with adherence. Results: The mean age of 70 patients (35 male, 35 female) were 52.29±11.39 years. Using MMAS-8, high, medium and low adherence was seen in 58.6%, 20.0% and 21.4% patients respectively. Middle age group patients were more adherent (60.8%) than younger age group and elderly (37.5%) (p-value &lt;0.05). Adherence rates were comparable in men and women. There was a positive correlation of adherence with education level, knowledge of BP goals and presence of diabetes. It showed negative correlation with chronicity of hypertension and number of drugs taken. Conclusions: Medication adherence rate was found to be low in the present study. The level of adherence to treatment among the participants can be achieved through better health promotion and education strategies.

Assessment and barriers to medication adherence for secondary prevention of cardiovascular disease among patients with coronary artery disease in Chandigarh, India

Context: Medication adherence is critical for the secondary prevention of cardiovascular disease (CVD). Nonadherence to prescribed treatment is associated with adverse health outcomes and higher costs of care. Aims: The present study aimed to assess medication adherence among patients diagnosed with coronary artery disease (CAD) in Chandigarh, India. Settings and Design: This cross-sectional study was conducted in five different hospitals or health centers of Chandigarh. Materials and Methods: The standardized Morisky Medication Adherence Scale-8 item was used to assess medication adherence among adult patients with CAD seen during a visit to major tertiary hospitals, secondary and primary health-care center in Union Territory, Chandigarh. In a separate qualitative study, barriers and facilitators to adherence were assessed through twenty in-depth interviews (ten males and ten females) and one focus group discussion. Statistical analysis was completed using SPSS 16.0 software and simple frequencies and proportions were computed. Results: A total of 260 patients were included in the cross-sectional survey, of which 70.4% were males with a mean age of 58.61 years. More than half (52.7%) of the respondents were from the age group of 41 to 60 years. Low to medium adherence to treatment was observed in about half (47.3%) of the respondents with low adherence among females. Adherence was better in a tertiary hospital as compared to the primary or secondary facility. Provider barriers and access to drugs due to cost barriers were found to be major barriers to treatment adherence in the in-depth interviews. Conclusions: Medication adherence to the secondary prevention of CVD among the CAD patients surveyed in Chandigarh, India, is poor and increased access to essential drugs and improved provider-patient communication is required.

Evaluation of Adherence to Therapy In Patients of Type 2 Diabetes Mellitus

Objective: To evaluate adherence to therapy and study factors associated with non-adherence in patients of type 2 diabetes mellitus (DM). Methods: A prospective, cross-sectional, questionnaire based study was conducted in a tertiary care teaching hospital. 150 patients suffering from type 2 DM since six months or more were interviewed using self-designed, semistructured questionnaire to get information about adherence to medication, diet/exercise schedule and self-monitoring of blood glucose. Morisky medication adherence questionnaire was used to calculate overall adherence. Results: Average number of medicines taken by each patient daily was 4.75 ± 1.73 (mean + SD). 70% patients reported non-adherence to medication schedule. Not buying all medicines (58.66%), not taking prescribed dose of medicines (34%), taking additional non-prescribed medicines (30%) and not taking medicines for required duration (25.33%) were common types of nonadherence. Unawareness about need of each medicine (55.66%), forgetfulness (50.66%) and high cost (43.33%) were the common causes of non-adherence. In Morisky medication adherence questionnaire high, medium and low adherence was reported by 0%, 26% and 74% of patients, respectively. Moderately positive correlation was observed between poor adherence and number of concurrent illnesses, number of medicines taken and female gender. Regular monitoring of blood glucose and diet schedule was followed by 46% and 68% patients respectively. Conclusion: Since, not buying all medicines, which was mostly due to high cost was the commonest type of non-adherence, measures to provide free medicines to non-affording patients need to be implemented. Majority of patients were not aware about need of taking each medicine, hence, creating awareness about the same is essential for improving adherence to therapy. Key words: Causes of medication non-adherence in DM, Medication non-adherence, Morisky medication adherence questionnaire, Polypharmacy in diabetes mellitus, Types of medication non-adherence in DM.

Adherence to a Mediterranean-Style Diet and Appendicular Lean Mass in Community-Dwelling Older People: Results From the Berlin Aging Study II

Selected nutrients or food groups have often been studied with regard to long-term mortality and cardiovascular disease, whereas the relation between diet quality and appendicular lean mass (ALM) has rarely been researched. The aim of this study was to explore the association between a Mediterranean-style diet and ALM in community-dwelling older people. Cross-sectional data from the Berlin Aging Study II were available for 1,509 participants (51% women, 68.2±3.7 years). Nutrient intake was assessed using the European Prospective Investigation into Cancer and Nutrition Food Frequency Questionnaire. Adherence to a Mediterranean-style diet was evaluated with the modified Mediterranean-type diet score (mMedTypeDiet). ALM was determined by dual-energy X-ray absorptiometry and related to body mass index (ALM/BMI). A general linear regression model was carried out to assess the association between mMedTypeDiet score groups and ALM/BMI. ALM/BMI was higher in women with a higher adherence to the mMedTypeDiet (0.64±0.1 vs 0.62±0.1 and 0.61±0.1 in low and medium adherence, retrospectively, p = .004). In the risk factor-adjusted general linear regression analysis, a higher adherence to the mMedTypeDiet was associated with higher ALM/BMI in women and better ALM/fat mass ratio when compared to a medium and a low diet quality. No significant associations were seen in men. Higher adherence to a Mediterranean-style diet was associated with a positive effect on ALM/BMI in women.

Drinking habits in a sample of university students. Relationship between the adherence to the Mediterranean Diet and BMI.

Introduction: The university pariod is marked by changes in food consumption patterns. Hydration habits affect students’ physical and cognitive performance. Objective: analyze beverage consumption, calculate the total water intake and compare it with the recommendations of the EFSA and analyze its relationship with the adherence to the Mediterranean Diet and BMI in a sample of university students. Method: This is a descriptive cross-sectional study on a sample of 1978 students from the Rey Juan Carlos University of Madrid (2010/2011 academic year). The frequency and amount of beverage consumption was determined by Hendrick 2010. To assess the adherence to the Mediterranean Diet the TestkidMed was used. Results: The average consumption of water from all drinks was 1673.6 ml/day in women and 1701.8 ml/day in men. The most consumed beverages were water (886.22 ml / day), dairy (341.38 ml / day), juices (202.17 ml / day), coffee and tea (171, 86 ml / day) and soft drinks (155, 10 ml / day). The average value in the test Kidmed was 6.18(± 2.61), 32.5% of cases reported high adherence, and 53.2% medium adherence. Only the 14.3% was classified as low adherence, showing a significant association between low adherece and younger subjects (≤ 20 years). This age group showed a higher proportion of underweight and greater total water consumption was observed. Conclusions: The sample does not meet the minimum recommendations set out by EFSA but women are more in line with those recommendations. Further studies on the habits of hydration in university population are needed.

Abstract 12685: Hospital Variation in Adherence to Secondary Prevention Medications After Acute Myocardial Infarction

Background: Hospital transition of care practices may influence patient adherence to secondary prevention medications post-discharge. We assessed inter-hospital variation in 90-day post-MI medication adherence and its association with downstream patient outcomes. Methods: We linked 19,704 post-acute MI patients &gt;65 years discharged alive from 459 hospitals in ACTION Registry-GWTG to Medicare data. Adherence was defined as ≥80% proportion of days covered using Part D prescription fill data. Based on the distribution of odds ratios, hospitals were divided into high (&gt;75 th percentile), medium, or low (&lt;25% percentile) adherence. We used Cox regression to compare 2-year MACE outcomes (death, MI, stroke, or non-staged revascularization) after adjusting for hospital case mix differences. Results: By 90 days post-MI, 68% of patients were adherent to discharge-prescribed beta-blocker therapy, 63% to statins, 64% to ACEI/ARBs, and 72% to thienopyridines. There was significant inter-hospital variation in 90-day adherence (p&lt;0.001), the probability of which varied the least for ACE-I/ARBs, and most for beta-blockers (Figure). Hospitals with medium medication adherence had lower unadjusted 2-year MACE risk than hospitals with low adherence, but this did not reach statistical significance after adjusting for differences in patient case mix (unadjusted 33.4% vs. 37.3%, adjusted HR 0.94, 95% CI 0.86-1.02); however, high medication adherence hospitals had significantly lower unadjusted (29.9%) and adjusted risk of MACE (HR 0.90, 95% CI 0.82-0.98). Conclusion: Patient adherence to secondary prevention medications varied markedly across U.S. hospitals. Discharge from hospitals with higher adherence rates was associated with lower risks of MACE. Our results suggest that the development of collaborative initiatives between healthcare providers and patients to improve post-discharge medication adherence may enhance longitudinal patient outcomes.

Low Adherence to Immunosuppressants Is Associated With Symptom Experience Among Kidney Transplant Recipients

PurposeThe purpose of this study was to investigate the relationship between immunosuppressant-related symptom experience (SE) and adherence to immunosuppressant regimens among kidney transplant (KT) recipients. MethodsA total of 239 KT recipients on an immunosuppressant regimen who were followed up after transplantation participated in this study. Data was collected through a self-reported questionnaire survey (medication adherence, SE, and quality of life) and medical record review. ResultsLow adherence in the immunosuppressant group was associated with longer time since KT, less comorbidity (<3), and a higher rehospitalization rate. Low adherence among KT recipients showed significantly greater overall symptom occurrence (P = .001) and symptom distress (P = .002) levels than patients with high or medium adherence after adjusting for a number of covariates. The most common symptom both in terms of occurrence (96.4%) and distress (91.1%) among poorly adherent KT recipients was tiredness. ConclusionLow adherence to an immunosuppressant regimen was significantly associated with high SE among KT recipients. Strategies to decrease immunosuppressant-related SE are needed to improve adherence to immunosuppressants.