8-item Morisky Medication Adherence Scale Research Articles

Assessment of Alternative Medicine Use, Costs, and Predictors of Medication Adherence among Diabetes Mellitus Patients in Palestine.

Diabetes Mellitus (DM) is considered the fourth leading cause of death in Palestine, with a prevalence of 9.1% in patients aged 20-79 years, and is predicted to increase to 20.6% by 2020. This study aims to estimate DM costs, compare DM total health care cost among patient characteristics and DM management (e.g. Anti-diabetic medications and alternative medicine), as well as assess MA and its predictors including patient characteristics, DM management, alternative medicine use, and DM costs. A cross-sectional study was conducted for the past one year among 479 diabetic patients, selected by convenience sampling and snowball sampling methods via electronic post of an online questionnaire including a web link to the questionnaire page in a Google Form via email or public social media pages and applications. Data on patients' socio-demographic and clinical characteristics, medication profile, use of medicinal plants as alternative medicine, costs, and Medication Adherence (MA) were collected. The Statistical Package for Social Sciences (SPSS v. 25) was used to perform a descriptive, Kolmogorov-Smirnov test, univariate analysis, Mann-Whitney or Kruskal-Wallis test, multiple linear regression, binary logistic regression, and multiple logistic regression analysis. A P value < 0.05 was considered statistically significant. More than half of the participants were male and living in villages (50.7%, 59.1%, respectively). Approximately 51.4% received Oral Hypoglycemic Drugs (OHDs) and only 16.1% received insulin. The participants receiving ≤3 medications daily acquired the highest percentage (55.7%), and less than half received medicinal plants as an alternative medicine for the management of DM. The estimated total DM health care cost per 1 year incurred by patients and family members was Israeli Shekel 988,276 (US Dollar 307,590). More than half of the participants were considered adherent with the Eight-Item Morisky Medication Adherence Scale (MMAS-8) score ≥6. It is noteworthy that the use of alternative medicine was significantly associated with total health care cost and MA. Furthermore, DM duration was significantly associated with MA. These are results worth taking into consideration. This study reflects the need for strengthening the patient-health care professionals' relationship, and to enhance the role of preventive education, and the importance of awareness about MA, DSCMBs, and the use of alternative medicine based on evidence-based strategies to improve MA, glycemic control, meanwhile reducing the costs incurred by patients and family members.

Level of Adherence to Dual Anti-platelet Therapy at 6 and 12 Months after Coronary Stenting; The Impact on Post-angioplasty Cardiovascular Events

Background: Dual antiplatelet therapy (DAPT) following coronary stenting is used to prevent thromboembolic events. Dual antiplatelet therapy discontinuation and poor compliance to the antiplatelet drugs are common and results in various complication, most importantly cardiovascular events. Objectives: Here, we designated a cross-sectional study to evaluate the association of DAPT adherence and post-angioplasty cardiovascular events. Methods: A total of 150 adult patients from Modarres Hospital undergoing successful stent implantation were included and adherence to DAPT following angioplasty were determined via telephone at 6 and 12 months by Persian version of the 8-item Morisky Medication Adherence Scale (MMAS-8). We also recorded the occurrence of ST segment elevation myocardial infarction (STEMI), acute coronary syndrome (ACS), coronary artery bypass grafting (CABG) and re-angioplasty 6- and 12-months following discharge. Results: During the trial, 50 patients were lost to follow-up due to failure to complete the MMAS-8 check list. We analyzed the association of STEMI, ACS, CABG and re-angioplasty with the level of DAPT adherence 6 and 12-month post-angioplasty. Our data suggested an important association of low and high DAPT adherence with lower cardiovascular events at 12 months post- Percutaneous Coronary intervention (PCI). However, at 6 months post-PCI, there was a minor cardiovascular event in patients with moderate DAPT adherence. Conclusions: Here, we observed a significant association of drug adherence along with patient’s risk factors in a course of antiplatelet therapy following coronary stenting.

Factors Related to Treatment Non-Adherence Among Caregivers of Pediatric and Adolescent Growth Hormone Deficiency Patients in Japan.

About one-third of caregivers of pediatric or adolescent growth hormone deficiency (pGHD) patients in Japan have reported poor treatment adherence. However, few studies have examined factors related to adherence for that group. The aim of this study is to consider factors related to poor adherence to daily treatment among caregivers of pGHD patients in Japan. A cross-sectional survey was conducted among caregivers of pGHD patients in Japan. Caregivers were asked about demographic and treatment characteristics, health literacy, treatment satisfaction, opinions about treatment, and treatment adherence. Health literacy was assessed using the 14-item health literacy scale (HLS-14). Adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Statistical association with adherence was considered using Chi-square and Student's t-testing. An exploratory factor analysis (EFA) and K-means cluster analysis was conducted to consider the influence of treatment satisfaction and opinions concerning treatment on adherence. Responses were collected from 112 caregivers. The caregiver's age being 30-39 years old, the primary caregiver being male, the primary caregiver being employed, and low functional health literacy for the caregiver were associated with poor adherence. Patients being pre-elementary school age was also associated with poor adherence. Low satisfaction with drug treatment and/or their device and communication with healthcare professionals (HCPs), and lack of agreement with the importance of treatment management (eg, keeping injection records, getting informed about the disease/therapy, reporting non-adherence, and sticking to an administration schedule), were also associated with poor adherence. Strategies to improve treatment adherence among caregivers of pGHD patients in Japan should consider the age, gender, and employment status of the caregiver - as well as their functional literacy. Improvement in satisfaction with the drug or device used, better communication with HCPs, and greater awareness of the importance of treatment management, may also lead to better adherence.

Adherence to medication during pregnancy in systemic autoimmune diseases: results from a prospective study.

To evaluate adherence to medication in patients with systemic autoimmune diseases (SAD), comparing pregnant and non-pregnant women. 200 patients with SAD were consecutively enrolled, 100 pregnant and 100 non-pregnant women. Each patient completed the 8-item Morisky Medication Adherence Scale (MMAS-8), one copy for hydroxychloroquine (HCQ) and one for other treatments for rheumatic disease, and Hospital Anxiety and Depression Scale (HADS). No significant differences were found in ongoing therapies between pregnant and non-pregnant women. 148 patients (74.0%) were taking HCQ and 160 (80.0%) other therapies for rheumatic disease. The mean MMAS-8 score was >6 in all groups indicating a good adherence, on average. The rate of patients with good medication adherence was higher in pregnant patients (73.9% vs. 63.3% and 76.5% vs. 64.5%, for HCQ and other therapies, respectively) although this difference was not statistically significant. Eight patients had very poor medical adherence, and all were non-pregnant women. Anxiety (15% of patients) was associated to low medication adherence for drugs other than HCQ (p=0.02), while depression (4% of patients) did not seem to have an impact on adherence. In our cohort we recorded a good adherence to prescribed medication, although adequate adherence was not achieved in about 30% of patients, confirming that non-adherence is an important issue in SAD. It is difficult to define a profile of patients at risk of poor adherence, but it appears important to implement communication and adherence monitoring strategies since strict monitoring also during pregnancy could improve medical adherence.

An assessment of treatment compliance using the Morisky scale-8 tool in adult hypertensive patients of Eastern India.

Adequate management of hypertension is crucial for decreasing the likelihood of cardiovascular ailments and associated complications. Nonetheless, in the Indian context, maintaining compliance with prescribed hypertensive therapies presents a notable hurdle, impeding the attainment of favorable health outcomes. Thus, this study was conducted with the aim to evaluate the prevalence of treatment adherence and explore the diverse factors that impact adherence patterns among individuals diagnosed with hypertension. A community-based cross-sectional questionnaire-based study was carried out among the diagnosed hypertensive patients from 12 purposefully selected villages of Khagaul block, Patna. A total of 262 participants were recruited in the study by using non-probability sampling. The 8-item Morisky Medication Adherence Scale (MMAS-8) was used for measuring adherence. The Statistical Package for the Social Sciences (SPSS) for Windows version 21.0 (SPSS Inc; Chicago, IL, USA) was used for statistical analysis of data. As per MMAS scores, 10 (3.8%) had high, 133 (50.8%) moderate, and 119 (45.4%) poor adherence. However, good adherence was reported among geriatric patients [1.65 (1.01-2.7)], those with a history of absence of comorbidities [2.15 (1.21-3.85)], more than 5 years' duration of hypertension [3.2 (1.89-5.41)], once-a-day drug intake [2.8 (1.61-4.87)], and having controlled blood pressure [5.2 (3.08-8.96)]. Controlled blood pressure (AOR = 0.048, 0.023-0.098), perception of high benefit of treatment [0.497 (0.255-0.97)], and absence of comorbidity [0.016 (0.168-0.832)] were identified as predictors of good treatment adherence. Overall medication adherence in the current study was 54.6%. Achieving treatment adherence frequently demands proactive patient engagement, highlighting their active role in disease management. Also, involving the patient's caregivers can offer an additional tactic to tackle non-adherence stemming from forgetfulness of the patient.

Self-rated health and its determinants in patients with hypertension in Isfahan in 2019

Background and objectivesSelf-rated health (SRH) serves as an assessment of contentment regarding one’s social, mental, and physical well-being and has been linked to both cardiovascular mortality and morbidity. Nonetheless, the relationship between SRH and medical outcomes in individuals with hypertension unsettled. This research endeavors to pinpoint the determinants that affect SRH in Iranian patients with hypertension.Materials and methodsThis cross-sectional study took place in Isfahan, Iran, from November 2018 to August 2019 and involved 886 patients with essential HTN. The data collection methods included a checklist for demographic information and risk factors, blood pressure measurements (systolic and diastolic), the Persian version of the 8-Item Morisky Medication Adherence scale, and a self-rated health questionnaire recommended by the World Health Organization. Independent sample T-test and chi squared test were used for comparison of variables between two groups of SRH. Additionally, multivariable logistic regression was used to analyze the factors influencing self-rated health status.ResultsAmong 886 participants (mean age 57.8 ± 8.8 years, 71.9% women), 89.62% reported good SRH. Comorbid conditions were significantly associated with poorer SRH (p < 0.05). Notably, higher education (odd ratio (OR) = 1.88, 95% confidence interval (CI) = 1.13–3.11, p = 0.015) and increased income (OR = 4.34, 95% CI = 1.43–13.18, p = 0.010) were identified as positive determinants of good SRH.ConclusionWe concluded that socioeconomic factors (education and income) and comorbid conditions (diabetes, hyperlipidemia, and pulmonary diseases) are risk factors for poor SRH among hypertensive patients. These findings could help planning of health enhancement initiative.

Adherence to thyroid therapy and depressive status among patients with hypothyroidism in the northern of Jordan: A cross-sectional study.

Hypothyroidism is a chronic and progressive medical condition that requires extreme adherence to medication in order to effectively manage the disease. The aim of this study was to examine patients' adherence to their thyroid therapy and their depressive status and their associated predictors. This is a cross-sectional study that was conducted between April and June 2023 using a sample of chronic hypothyroidism patients visiting the Jordan University of Science and Technology Health Center in Irbid, along with the Family Medicine and Endocrine clinic at King Abdullah University Hospital. The 8-item Morisky Medication Adherence Scale (MMAS-8) and Patient Health Questionnaire (PHQ)-2 were used to examine patients' adherence level and mental status. A total of 296 patients were involved in this study. Around 35.5% of the patients found to have high level of adherence. Around 27.4% of the patients demonstrated a low level of adherence. The mean PHQ-2 score for the study sample was 2.00 (SD: 1.7) out of 6. Using a cutoff point of 3, we identified that 29.7% of the patients are at risk of developing major depressive disorder. Patients aged 31 to 50 years and married patients were identified to have higher adherence level compared to other patients (P < .05). This study observed a notable low to moderate level of adherence among patients diagnosed with hypothyroidism in Jordan with regards to their prescribed therapeutic regimen. Furthermore, a significant part of the individuals had a susceptibility to the development of major depressive disorder.

Factors that influence medication adherence in women with fibromyalgia: A path analysis.

To investigate the relationships between depression symptoms, perceived stigma, disease severity, patient-provider communication and medication adherence in fibromyalgia patients. The objectives were to explore how these factors influence treatment adherence and to develop a comprehensive model illustrating their interconnections. Fibromyalgia is a chronic pain syndrome with fatigue, sleep issues and idiopathic pain. Medication adherence is limited by insufficient symptom relief, side effects and costs. Stigma further complicates fibromyalgia. Disease severity affects patient-provider communication. Associations between depression, stigma, severity, communication and adherence in fibromyalgia are unclear. A cross-sectional, correlational study. The STROBE guidelines for cross-sectional studies were followed. Participants included Hebrew-speaking participants who were members of two Facebook groups: 'Shades of Purple' and 'Fibromyalgia- Get to Know!' Between February and April 2022. They undertook evaluations using The Patient Health Questionnaire-9 to gauge depression symptoms, assessed perceived stigma, utilised The Revised Fibromyalgia Impact Questionnaire to determine disease severity, employed The Patient Reaction Assessment questionnaire for patient-provider communication, and used the 8-item Morisky Medication Adherence Scale (MMAS-8). Associations between the variables were explored using Pearson's correlations and path analyses. The study included 141 women with fibromyalgia, aged 22 to 76 years. Most reported having a stable partner (69.5%) and 75.2% had children. The treatment adherence levels were as follows: 53.2% (N = 75)-low, 33.3% (N = 47)-medium and 13.5% (N = 19)-high. Depression positively correlated with stigma. Stigma negatively correlated with patient-provider communication. Patient-provider communication positively correlated with treatment adherence. A significant negative indirect effect of depression on treatment adherence through stigma and patient-provider communication was found. Perceived stigma and patient-provider communication played a mediating role in the relationships between depression and treatment adherence among women with fibromyalgia. Addressing stigma related to fibromyalgia and effective patient-provider communication can positively influence treatment adherence. No patient or public contribution.

Association Between Self-Reported Medication Adherence and Therapeutic Inertia in Hypertension: A Secondary Analysis of SPRINT (Systolic Blood Pressure Intervention Trial).

Therapeutic inertia (TI), failure to intensify antihypertensive medication when blood pressure (BP) is above goal, remains prevalent in hypertension management. The degree to which self-reported antihypertensive adherence is associated with TI with intensive BP goals remains unclear. Cross-sectional analysis was performed of the 12-month visit of participants in the intensive arm of SPRINT (Systolic Blood Pressure Intervention Trial), which randomized adults to intensive (<120 mm Hg) versus standard (<140 mm Hg) systolic BP goals. TI was defined as no increase in antihypertensive regimen intensity score, which incorporates medication number and dose, when systolic BP is ≥120 mm Hg. Self-reported adherence was assessed using the 8-Item Morisky Medication Adherence Scale (MMAS-8) and categorized as low (MMAS-8 score <6), medium (MMAS-8 score 6 to <8), and high (MMAS-8 score 8). Poisson regressions estimated prevalence ratios (PRs) and 95% CIs for TI associated with MMAS-8. Among 1009 intensive arm participants with systolic BP >120 mm Hg at the 12-month visit (mean age, 69.6 years; 35.2% female, 28.8% non-Hispanic Black), TI occurred in 50.8% of participants. Participants with low adherence (versus high) were younger and more likely to be non-Hispanic Black or smokers. The prevalence of TI among patients with low, medium, and high adherence was 45.0%, 53.5%, and 50.4%, respectively. After adjustment, neither low nor medium adherence (versus high) were associated with TI (PR, 1.11 [95% CI, 0.87-1.42]; PR, 1.08 [95% CI, 0.84-1.38], respectively). Although clinician uncertainty about adherence is often cited as a reason for why antihypertensive intensification is withheld when above BP goals, we observed no evidence of an association between self-reported adherence and TI.

Adherence to Hydroxyurea and Patients' Perceptions of Sickle Cell Disease and Hydroxyurea: A Cross-Sectional Study.

Background and Objectives: Hydroxyurea is a crucial treatment for sickle cell disease (SCD), but some patients' adherence to it remains suboptimal. Understanding patients' perspectives on SCD and HU is essential for improving adherence. This study aimed to assess hydroxyurea adherence and patients' perceptions of SCD and hydroxyurea among SCD patients in the Jazan region of Saudi Arabia. Materials and Methods: This cross-sectional study collected data from 217 SCD patients using self-administered questionnaires from August 2022 to January 2023. The survey covered patient demographics, SCD consequences, and other clinical data. We used the Brief Illness Perception Questionnaire (B-IPQ) to measure patients' disease perception and the 8-item Morisky Medication Adherence Scale (MMAS-8) to evaluate patients' adherence to HU. Data were analysed using descriptive, t-test, and chi-square tests, and the p-value was set at <0.05 for significance. Results: More than half of the patients were male, with a mean age of 28.09 ± 8.40 years. About 57.6% of the patients were currently using HU. About 81.6% of HU users reported low adherence. The adherence was lower among individuals with infections/recurrent infections and in patients who received repeated blood transfusions. ICU admission, blood transfusion, and certain SCD complications were associated with HU use. Male patients had a higher perception of SCD consequences, concern, and understanding. ICU-admitted and recurrent hospitalized patients had a higher perception of the SCD-related consequences, symptoms, concerns, and emotional responses. Conclusions: HU seems a well-established and efficacious disease-modifying agent, but its underutilization for SCD patients remains challenging. To overcome the adherence challenges, healthcare providers must educate SCD patients about the role of hydroxyurea in lowering disease severity and addressing side effects to obtain maximum benefits. Healthcare providers may consider tailored educational interventions to improve adherence, particularly for patients with infections, recurrent hospitalizations, or repeated blood transfusions. Further research is needed to identify strategies for improving hydroxyurea adherence and patient education among SCD patients.

Prevalence and factors associated with medication adherence in children with central precocious puberty: a cross-sectional study.

Objectives: This study aimed to investigate the prevalence and influencing factors of medication adherence in children with central precocious puberty (CPP), and provide references for clinical practice. Methods: Children under 12years of age with CPP and their caregivers at a women's and children's hospital were selected for a cross-sectional study from February to May 2023, and a questionnaire was used to collect basic characteristics of pediatric patients and their caregivers, information of medication, cognition of medication, and medication adherence. The 8-item Morisky Medication Adherence Scale (MMAS-8) was adopted to assess medication adherence, and the potential influencing factors were explored by univariate and multivariate analyses. Results: A total of 125 valid questionnaires were collected. The medication adherence rate of children with CPP reported by caregivers was 76.0%. The univariate analysis showed that the percentage of parental caregivers (p = 0.027), the age of caregivers (p = 0.029), the education level of caregivers (p = 0.001), the financial burden (p < 0.000), the incidence of adverse effects (p = 0.008), and the cognition of medication including the importance of medication (p = 0.002), the dosage of medication (p = 0.002), the adverse effects of medication (p = 0.007), the harm of non-compliance with medication (p < 0.000), and the evaluation of the price of medication (p = 0.003) in the poor adherence group were significantly inferior to those in the better adherence group. The multivariate analysis showed that the higher incidence of adverse effects (p = 0.20), not understanding the harm of non-compliance with medication (p = 0.004), and evaluation of the price of medication as expensive (p = 0.043) were independent risk factors for poor medication adherence. Conclusion: Medication adherence in children with CPP is relatively better, and the factors leading to poor medication adherence are mainly on the caregivers of pediatric patients. It is recommended to increase the health education among caregivers of children with CPP to enhance the cognition of the condition and medication, and further improve the therapeutic efficacy for CPP.

Structural Equation Modelling to Identify Psychometric Determinants of Medication Adherence in a Survey of Kidney Dialysis Patients.

Medication non-adherence in dialysis patients is associated with increased mortality and higher healthcare costs. We assessed whether medication adherence is influenced by specific psychometric constructs measuring beliefs about the necessity for medication and concerns about them. We also tested whether medication knowledge, health literacy, and illness perceptions influenced this relationship. This study is based on data from a cross-sectional in-person questionnaire, administered to a random sample of all adult dialysis patients at a teaching hospital. The main outcome was self-assessed medication adherence (8-Item Morisky Medication Adherence Scale). The predictors were: concerns about medications and necessity for medication (Beliefs About Medication Questionnaire); health literacy; medication knowledge (Medication Knowledge Evaluation Tool); cognitive, emotional, and comprehensibility Illness perceptions (Brief Illness Perception Questionnaire). Path analysis was performed using structural equations in both covariance and variance-based models. Necessity for medication increased (standardized path coefficient [β] 0.30 [95% CI 0.05, 0.54]) and concerns about medication decreased (standardized β -0.33 [-0.57, -0.09]) medication adherence, explaining most of the variance in outcome (r2=0.95). Medication knowledge and cognitive illness perceptions had no effects on medication adherence, either directly or indirectly. Higher health literacy, greater illness comprehension, and a more positive emotional view of their illness had medium-to-large sized effects in increasing medication adherence. These were indirect rather and direct effects mediated by decreases in concerns about medications (standardized β respectively -0.40 [-0.63,-0.16], -0.60 [-0.85, -0.34], -0.33 [-0.52, -0.13]). Interventions that reduce patients' concerns about their medications are likely to improve adherence, rather than interventions that increase patients' perceived necessity for medication. Improving patients' general health literacy and facilitating a better understanding and more positive perception of the illness can probably achieve this. Our study is potentially limited by a lack of generalizability outside of the population and setting in which it was conducted.

The role of psycho-emotional factors in assessing the prognosis of different types of myocardial infarction

Aim. To study the features of psycho-emotional status and its clinical and prognostic significance in patients with type 1 and 2 myocardial infarction (MI).Material and methods. Of the 1293 patients hospitalized at the District Cardiology Dispensary "Center for Diagnostics and Cardiovascular Surgery" with a diagnosis of acute coronary syndrome, 277 (21,4%) patients with confirmed MI were consecutively included in the observational study. There were 194 (15,0%) patients with type 1 MI (MI1) and 83 (6,4%) with type 2 MI (MI2). MI types were determined based on the IV Universal Definition of Myocardial Infarction (UDMI). During the hospital period, type D personality was identified using the Russian version of the Type D scale-14 (DS-14), while the presence and severity of anxiety and depression was assessed using the Hospital Anxiety and Depression Scale (HADS). Follow-up was conducted through outpatient visits, telephone or email interviews for 12 months after discharge. Patients' adherence to drug therapy was assessed using 8-item Morisky Medication Adherence Scale, and quality of life (QoL) using Short Form Medical Outcomes Study (SF-36) questionnaire.Results. During the hospital period, in the group of patients with MI2, patients with type D personality were more often identified compared with MI1 (30 (36,1%) vs 55 (28,3%), p&lt;0,05). Patients with MI2 had a significantly higher subclinical level of anxiety (34 (41,0%) vs 43 (22,2%), p=0,002), expressed level of anxiety (10 (12,1%) vs 12 (6,2%), p=0,011), as well as a significant level of depression (13 (15,7%) vs 14 (7,2%), p=0,03). At the same time, in patients with type D, regardless of MI type, subclinical levels of anxiety and depression were significantly expressed (63 (74,1%) vs 14 (7,3%) (p&lt;0,001) and 58 (68,2%) vs 25 (13,0%) (p&lt;0,001)). There were no significant differences in inhospital complications between the MI1 and MI2 groups depending on type D personality. After 12-month follow-up, patients with the distressed personality type had higher rate of all-cause death (5 (7,2%) vs 5 (1,6%), p&lt;0,05 without type D), rehospitalization for decompensated heart failure (8 (11,5%) vs 9 (4,8%), p=0,04). Patients with type D were less adherent to drug therapy compared to patients without type D (30 (43,4%) vs 9 (4,8%) p=0,001, respectively), and they had lower QoL scores.Conclusion. Type D personality, the presence of anxiety and depression, high all-cause mortality and rehospitalization rate of decompensated heart failure were more often observed in MI2 compared to MI1, as well as in patients with type D, regardless of MI type. Low adherence to drug therapy and poor quality of life, regardless of MI type, were also associated with the type D personality.

A Machine Learning Model to Predict Patients' Adherence Behavior and a Decision Support System for Patients With Metastatic Breast Cancer: Protocol for a Randomized Controlled Trial.

Adherence to oral anticancer treatments is critical in the disease trajectory of patients with breast cancer. Given the impact of nonadherence on clinical outcomes and the associated economic burden for the health care system, finding ways to increase treatment adherence is particularly relevant. The primary end point is to evaluate the effectiveness of a decision support system (DSS) and a machine learning web application in promoting adherence to oral anticancer treatments among patients with metastatic breast cancer. The secondary end point is to collect a set of new physical, psychological, social, behavioral, and quality of life predictive variables that could be used to refine the preliminary version of the machine learning model to predict patients' adherence behavior. This prospective, randomized controlled study is nested in a large-scale international project named "Enhancing therapy adherence among metastatic breast cancer patients" (Pfizer 65080791), aimed to develop a predictive model of nonadherence and associated DSS and guidelines to foster patients' engagement and therapy adherence. A web-based DSS named TREAT (treatment adherence support) was developed using a patient-driven approach, with 4 sections, that is, Section A: Metastatic Breast Cancer; Section B: Adherence to Cancer Therapies; Section C: Promoting Adherence; and Section D: My Adherence Diary. Moreover, a machine learning-based web application was developed to predict patients' risk factors of adherence to anticancer treatment, specifically pertaining to physical status and comorbid conditions, as well as short and long-term side effects. Overall, 100 patients consecutively admitted at the European Institute of Oncology (IEO) at the Division of Medical Senology will be enrolled; 50 patients with metastatic breast cancer will be exposed to the DSS and machine learning web application for 3 months (experimental group), and 50 patients will not be exposed to the intervention (control group). Each participant will fill a weekly medication diary and a set of standardized self-reports evaluating psychological and quality of life variables (Adherence Attitude Inventory, Beck Depression Inventory-II, Brief Pain Inventory, 13-item Sense of Coherence scale, Brief Italian version of Cancer Behavior Inventory, European Organization for Research and Treatment of Cancer Quality of Life 23-item Breast Cancer-specific Questionnaire, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, 8-item Morisky Medication Adherence Scale, State-Trait Anxiety Inventory forms I and II, Big Five Inventory, and visual analogue scales evaluating risk perception). The 3 assessment time points are T0 (baseline), T1 (1 month), T2 (2 months), and T3 (3 months). This study was approved by the IEO ethics committee (R1786/22-IEO 1907). The recruitment process started in May 2023 and is expected to conclude on December 2023. The contribution of machine learning techniques through risk-predictive models integrated into DSS will enable medication adherence by patients with cancer. ClinicalTrials.gov NCT06161181; https://clinicaltrials.gov/study/NCT06161181. DERR1-10.2196/48852.

Abstract C100: An effective intervention toolkit to promote medication adherence among Asian Americans living with chronic hepatitis B

Abstract Introduction: Asian Americans is a Hepatitis B (HBV) disparity population who only account for 7% of the US population but experience nearly 60% burden of chronic HBV, which is associated with 75% of hepatocellular carcinoma (HCC). Adherence to HBV medication guideline is a practical approach to preventing liver cancer. However, limited studies have been conducted on promoting HBV medication adherence among underserved Asian American HBV patients. Methods: This study utilized 18-month follow-up data from a randomized controlled clinical trial aimed at improving long-term adherence to HBV medication adherence. Eligible Asian American HBV patients were recruited in the Greater Philadelphia and New York City areas from community-based organizations and clinics that serving the targeted population. Guided by Community-based Participatory Research (CBPR) approach, we developed and implemented Virtual Patient Navigation Toolkit and Text Messaging (VPN Toolkit+TM) to promote HBV pill-taking among the targeted population. HBV medication adherence was assessed using the Morisky 8-Item Medication Adherence Scale with a score ranges from 0 to 8, depression was measured with Patient Health Questionnaire-9, and knowledge of HBV was evaluated with a 10-item scale. A p-value that is smaller than 0.5 is considered statistically significant. Results: Among 149 participants (108 Chinese and 41 Vietnamese) who were prescribed HBV medication, 44.97% were female. Bivariate analysis showed that medication adherence was significantly higher in the intervention group than in the control (7.25 vs. 5.57, p&amp;lt;0.001 ) group at the 18-month follow-up. Results from the multivariable analysis revealed that compared with their control group counterparts, intervention group participants had significantly higher Morisky medication score (Coef.= 0.66, p=0.044), controlling for demographics, depression level, and HBV knowledge score. The results indicated that there was a significant intervention effect in medication adherence at 18-month follow-up. In addition, we found that a lower depression score (Coef.=-0.11, p&amp;lt;0.001) and a higher level of HBV related knowledge (Coef.=0.40, p&amp;lt;0.001) were significant predictors of better HBV medication adherence at 18-month follow-up assessment, with other variables held constant. Conclusion: The findings imply the necessity of promoting VPN Toolkit+ TM intervention among medically underserved HBV pill-taking patients. Moreover, targeted interventions addressing psychosocial barriers and promoting HBV-related knowledge would effectively promote HBV medication adherence among Asian Americans with chronic HBV infection. Citation Format: Wenyue Lu, Lin Zhu, Thoin Begum, Yin Tan, Minhhuyen T. Nguyen, Xiaoli Ma, Sarah Lai, Tam Tran, Phuong Do, Elizabeth Handorf, Ming-Chin Yeh, Grace X. Ma. An effective intervention toolkit to promote medication adherence among Asian Americans living with chronic hepatitis B [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C100.

Adherence to tuberculosis treatment among patients attending national tuberculosis elimination centre in tertiary care hospital, Bangalore

Background: Annually ten million cases of tuberculosis (TB) and 1.8 million mortalities are recorded. Adherence to TB treatment not only reduces death outcomes but prevents prolonged sickness, transmission to others and development of multi drug resistant TB. This study was aimed at determining the rate of treatment adherence and possible factors influencing adherence to TB treatment in the NTEP Centre at Rajarajeswari medical college and hospital, Bangalore. Methods: It was a cross sectional study design. A validated 8 item Morisky medication adherence scale was used to obtain data from respondents. Adherence to TB treatment was assessed. Chi square test was used to determine the variables that were associated with treatment adherence. Results: Out of 60 patients, majority i.e. 18 (30%) were in the age group 25-34 years, males were more compared to females. Majority i.e. 21 (35%) were studied up to post high school diploma, 31(51.67%) were unemployed, majority i.e. 48 (80.00%) were married, 42 (70.00%) were from nuclear family. Out of 60 patients, majority 54 (90.00%) were Hindus 24 (40.00%) were from lower middle class. Conclusions: The adherence rate for TB treatment in this study was 68.33%. There was no significant association between socio demographic variables, personal habits, health status, current TB status, type of TB, and common symptom with treatment adherence. An intensified health education on the adherence of TB treatment therefore recommended.

Abstract 13622: Association Between Self-Reported Medication Adherence and Therapeutic Inertia in Hypertension: A Secondary Analysis of the Systolic Blood Pressure Intervention Trial (SPRINT)

Introduction: Therapeutic inertia (TI), the failure to intensify antihypertensive medication when blood pressure (BP) is above goal, remains highly prevalent in hypertension management. The degree to which self-reported antihypertensive adherence is associated with TI when targeting intensive BP goals remains unclear. Methods: Cross-sectional analysis of the 12-month visit of participants randomized to the intensive systolic BP (SBP) arm of the SBP Intervention Trial (SPRINT), which randomized adults at high cardiovascular disease risk to an intensive (&lt;120 mm Hg) vs. standard (&lt;140 mm Hg) SBP treatment group. TI was defined as no change in the antihypertensive medication regimen intensity score, which incorporates the medication number and dose, when the SBP &gt;120 mm Hg. Self-reported medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8) and categorized as low (&lt;6), medium (6 to &lt;8), and high (8). Poisson regression models with robust error variance estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) for TI associated with MMAS-8 category. Results: Among 1,009 intensive arm participants with SBP &gt;120 mm Hg at the 12-month visit (mean age 69.6 years, 35.2% female, 28.8% non-Hispanic Black), TI occurred in 50.8% of participants. Participants with low self-reported adherence (vs. high) were younger and more likely to be non-Hispanic Black or current smokers. The prevalence of TI among low, medium, and high adherence was 45.0%, 53.5%, and 50.4%, respectively. After adjustment, neither low nor medium adherence (vs. high) were associated with TI (PR 1.11; 95% CI 0.87,1.42, PR 1.08; 95% CI 0.84,1.38, respectively). Conclusion: Although clinician uncertainty about medication adherence is often cited as a reason for why antihypertensive intensification is withheld when the BP is above goal, we observed no evidence of an association between self-reported adherence to antihypertensive medication and TI.

Family Size Effect on Mental Health and medication Adherence on a Sample of Copd Patients. The Moderating Role of Financial Strain

Aim: The aim of the study is to evaluate the family size and the financial strain effects on medication adherence, testing in particular the hypothesis that mental health mediates the relation between family size and medication adherence. Methods: The results of the study are based on a purposive sample of 105 COPD patients (94 male, 11 female) with an average age of 68.9 (SD = 9.2). The participants completed the 8-Item Morisky Medication Adherence Scale (MMAS-8) and the 36-item Short Form health survey (SF-36) from which their medication-taking behavior and their mental health was evaluated. Further, they were asked to complete a sociodemographic questionnaire including self-evaluation items about their current financial situation and the impact of the economic crisis on family, health, and treatment. A path analysis approach was used to test the indirect effect of family size on medication adherence and the moderating role of impact and mortgage debt, controlling for age, duration of COPD illness, and income of the respondents. Results: Financial health, as is reflected in the monthly income and an obligation to repay a mortgage debt was found to be positively associated with medication adherence. The impact of the financial crisis was significantly associated with mental health for the patients that experienced parenthood in families with 2 or more children. Not an analogous effect was reported for patients having been parents of one child or no children. That is, the family size effect on mental health is moderated by the impact of the financial crisis. No significant effect on mental health was reported on medication adherence. Further, neither age nor illness duration was found to have a significant effect on both mental health and adherence. Conclusions: Financial health is confirmed to be positively related to medication adherence. The hypothesized mediating role of mental health in the relation between family size and adherence is not confirmed. Having been a parent of a large family is associated with a greater vulnerability to the effects of financial strain on mental health in the long run.

A descriptive study evaluating quality of life and factors affecting it in adult asthmatics

IntroductionPredictors of impaired quality of life (QoL) among asthmatic subjects are not completely understood. The aim of this study is to evaluate the demographic and clinical factors affecting QoL. MethodsAdults who had a diagnosis of asthma for at least 1 year and applied to allergy and pulmonology clinic were included in the study. The accuracy of subjects’ inhaler techniques were evaluated by the clinicians. Medication adherence was assessed with 8-item Morisky Medication Adherence Scale (MMAS-8). QoL of patients was evaluated with 36-Item Short Form Survey (SF-36). Relationship between the data collected and SF-36 subscale scores were evaluated. ResultsOne hundred forty-eight (113 female) asthmatics (mean age; standard deviation: 48.34; 12.81 years) were included in the study. As subjects’ age increased physical functioning subscale scores decreased (r=−0.252, P<0.01). As body mass index increased physical functioning subscale scores (r=−0.362, P<0.01), physical role limitations (r=−0.240, P<0.01), social functioning (r=−0.168, P<0.05), and general health perceptions subscale scores (r=−0.331, P<0.01) decreased. As asthma control decreased physical functioning (r=−0.396, P<0.01), physical role limitations (r=−0.336, P<0.001), emotional role limitations (r=−0.244, P<0.001), energy/vitality (r=−0.183, P<0.05), bodily pain (r=−0.453, P<0.01), and general health perceptions subscale scores (r=−0.270, P<0.01) increased. As MMAS-8 scores increased, mental health subscale scores increased (r=0.163, P<0,05). Multivariate regression analysis revealed that patients with poorly controlled asthma had lower physical function and bodily pain subscale scores. ConclusionLevel of asthma control is associated with QoL in asthmatics.

Satisfaction of Cancer Patients Treated with Oral Anticancer Medications regarding Dispensing by Community Pharmacists: A Cross-Sectional Study

Purpose. The growing choice of oral anticancer medications (OAMs) delivered in pharmacies puts the patients at the center of their own therapeutic management. Patient satisfaction regarding their pharmaceutical management is particularly important for adherence to their treatment. The aim of this study was to assess the satisfaction of patients treated with OAMs regarding their dispensing in community pharmacies. Methods. A cross-sectional study was conducted with a self-questionnaire proposed to patients in hospital centers and community pharmacies. The patient’s satisfaction regarding pharmacy dispensing was assessed with a visual analogue scale. Answers to questions about the quality of information they received from health professionals were recorded. The patient’s adherence to their medication was assessed with the 8-item Morisky Medication Adherence Scale (MMAS-8). Symptoms and quality of life were recorded with the QLQ-C30 questionnaire. Results. Ninety-one patients were included in the analysis. The median score of satisfaction was 89 (interquartile range: 68, 100), and 49.5% had a satisfaction score ≥90/100. Satisfaction scores were higher for patients reporting information from pharmacists for the method of administration, the management of adverse effects, and drug interactions than for patients reporting no information from pharmacists. Patient satisfaction was not related to MMAS-8 scores, symptoms, or quality of life. Multivariate analysis of patient satisfaction revealed a positive relationship with information on the administration method provided by pharmacists. Conclusions. The level of information provided on OAMs to patients should be the same between pharmacists and oncologists. Good medication dispensing practices by the pharmacist are important components of patient care and satisfaction. We encourage pharmacists to provide more medication information to their patients.