Morisky-Green Test Research Articles

P-1273 - Short message service to improve treatment adherence and quality of life in patients with schizophrenia in spain: the SMS study

Schizophrenia is a very incapacitating mental diseases. A lack of pharmacological adherence drives to an increased relapse and hospitalizations incidence. Strategies focused on improving adherence could benefit patients and improve their quality of life (QoL). To assess improvements on QoL by increasing treatment adherence. This was a national, multicentre, open-label randomized clinical trial to evaluate the efficacy of a Short Message Service (SMS) system on improving adherence in schizophrenic patients. Patients in the SMS group received reminders via mobile phone about their medication during the first 3 months after inclusion. Controls were not sent any reminder and received standard care. Adherence was assessed by mean of the 4-item Morisky-Green test (Medication Adherence Questionnaire, MAQ) and attitude towards medication was assessed by the 10-Item Drug Attitude Inventory (DAI-10) at baseline and 3 and 6 months after the inclusion. QoL was assessed by the EuroQol (EQ-5D) questionnaire at the same visits. Based on Intention To Treat (ITT) population, 100 (39.4%) patients comprised the SMS Group, whereas 154 (60.6%) patients were controls. There were not statistically significant differences on demographic characteristics between both groups. More patients improved their adherence (MAQ) in SMS group compared to the control group [44.0% vs. 28.6% (p = 0.012)]. No significant differences were found regarding attitude towards medication (DAI-10), however improvements in DAI-10 were associated with improvements in EQ-5D [82.5% vs. 64.9% (p = 0.029)]. SMS reminders improved adherence to treatment and improved patients’ outcomes with a positive impact on QoL.

Factors associated with adherence to antihypertensive treatment in a primary care unit

OBJECTIVES: To analyze the adherence of patients to antihypertensive treatment conducted in a Primary Care Unit (PCU), as well as the related factors of low adherence to this therapy. METHODS: A quantitative, descriptive exploratory study of hypertensive patients interviewed in a PCU, using the Morisky-Green Test for assessing adherence or nonadherence with antihypertensive treatment. RESULTS: A prevalence of 64% of patients who were nonadherent to antihypertensive therapy was identified, and this was significantly related to the variables of: age, occupation, obesity, lack of other chronic disease, lack of employment, continuous use of prescription drugs, misunderstanding of the medical recommendations, and ignorance of the name of antihypertensive medication use. CONCLUSION: We found a high prevalence (64%) of patients nonadherent to therapy, that was significantly associated with users who were: in the youngest age group, working, and presenting with overweight or obesity.

Cumplimiento terapéutico en pacientes con hipertensión arterial y diabetes mellitus 2

Objective1) To determine gender differences regarding therapeutic adherence in patients with arterial hypertension and type 2 diabetes mellitus. 2) To detect differences in terms of age. 3) To determine existing relationships in patient compliance levels between Morisky-Green's test, Batalla's test and the pill count expressed as a percentage of compliance. MethodDescriptive, transversal study, carried out for a period of 7 months in the Primary Health Care, Health Centre in Rentería-Beraun (Guipúzcoa), Basque Health Service (Osakidetza), with an incidental sample of 100 patients diagnosed with hypertension and type 2 diabetes mellitus and receiving oral treatment. Principal variables: age, gender. Conditioning variables: years of evolution of each pathology, number of prescribed medicines, time lapse of prescription collection, Morisky-Green's test, Batalla's test and pill count. ResultsThe statistical analysis yielded similar compliance for men and women, and for different age groups (Morisky-Green and pill count). Approximately 50% of the patients had adequate compliance according to at least one of the 3 tests. A greater relationship was found between Morisky-Green's test and the pill count method, and medication adherence improved when knowledge of the disease increased, and when the number of prescribed pills became smaller. ConclusionsAdherence varies according to the evaluation tool used, non-adherence is high and knowledge of the disease helps compliance. This suggests the convenience of systematically reviewing treatments and supplying more information to patients.

The Fixed-dose Combination Drug for Secondary Cardiovascular Prevention project: Improving equitable access and adherence to secondary cardiovascular prevention with a fixed-dose combination drug. Study design and objectives

In spite of advances in prevention and treatment, the burden of cardiovascular diseases is increasing. A fixed-dose combination (FDC) pill, or "polypill," composed of evidence-based drugs has been proposed as a means of improving cardiovascular prevention by reducing cost and increasing patient adherence to treatment. The aim of the FOCUS project, funded by the 7th Framework Programme of the European Commission, is to characterize the factors that underlie inadequate secondary prevention and to test a new FDC. To achieve these goals, a 9-member consortium has been constituted, including institutions from Argentina, France, Italy, Spain, and Switzerland. FOCUS Phase-1 will examine factors potentially related to lack of adequate secondary prevention in 4,000 post-myocardial infarction (MI) patients and analyze the relationship between these factors and patient treatment adherence. Primary end points will be (1) the percentage of patients receiving aspirin, angiotensin-converting enzyme inhibitors, and statins and (2) adherence to treatment measured by the Morisky-Green test. FOCUS Phase-2 is a randomized trial that will compare adherence to treatment in 1,340 post-myocardial infarction patients either receiving an FDC comprising aspirin (100 mg), ramipril (2.5, 5, or 10 mg), and simvastatin (40 mg) or receiving the same 3 drugs separately.

PDB52 Adherence with Oral Medications for Diabetes Among Brazilian Patients: A Systematic Review of National Literature

To identify studies examining adherence with oral diabetes mellitus (DM) medication and the potential association between adherence rates and glycemic control among Brazilian patients. A systematic literature search was performed by two independent reviewers using MEDLINE via Pubmed and LILACS databases (until May 2011) without limits for time or language. Specific filters to identify studies assessing Brazilian population were not used in the search strategy and this assessment was conducted by reviewers. Publications were included only if adequate documentation of adherence and population could be abstracted (adherence outcomes, thresholds used, and characteristics of the populations). The search strategy identified 289 records (Pubmed=174 and LILACS=115), from which only 2 cross-sectional studies met the eligibility criteria and were included in the systematic review. The most recent study (Araujo 2010) was conducted in 2007 and evaluated 79 DM patients using the 4-item Morisky-Green Test. Gimenes 2006 (n=31) was designed to investigate if DM patients have proper knowledge of their prescription and assessed adherence through self-reported patient compliance with medication schedule. Araujo 2010 found that 54.4% of DM patients were considered non-compliant according to the Morisky-Green Test. Taking medication in the wrong schedule and skipping doses were referred by 54.5% and 34% of patients, respectively. Gimenes 2006 observed that 48.4% of patients reported taking medication in the wrong schedule and 71% of them were classified as having unsatisfactory knowledge about their prescription. Studies examining the association between adherence and glycemic control were not found. This review reinforced the lack of adherence data for Brazilian DM population, but the included studies confirmed that a significant group of DM patients were poor compliers with treatment, although their findings should be interpreted with some concerning given the small sample size and explanatory nature.

Adherence level and knowledge about psychopharmacological treatment among patients discharged from psychiatric internment

This exploratory, descriptive and prospective study aimed to identify the degree of adherence to psychopharmacological treatment of patients who were discharged from psychiatric hospitalization and their knowledge about their prescription and diagnosis. The study was carried out at a Mental Health Service. The sample consisted of all service clients who were discharged from psychiatric hospitalization in the data collection period. A Sociodemographic Questionnaire and the Morisky-Green Test were the instruments used. Data were analyzed through central trend measures. In total, 48 patients participated in the study. Regarding adherence, 70.8% of them showed a low adherence level to psychopharmacological treatment. Moreover, only twenty-one patients knew what their diagnosis was and most did not know or partially knew the name and dose of all prescribed medications.

Analysis of Therapeutic Compliance in Women With Osteoporosis

ObjectiveTo assess therapeutic compliance in osteoporosis in women in a primary care (PC) setting. Patients and methodsObservational, descriptive, cross-sectional and multicenter study, conducted in PC centers of the 17 Spanish autonomous regions. 1649 women who had initiated treatment for osteoporosis at least 3 months before entering the study were recruited. To assess therapeutic compliance, two questionnaires, the Haynes–Sackett or self-communicated compliance test (AC) and the Morisky–Green test (MG) were used. ResultsPatients’ mean age (±SD) was 66.59 years (9.5) and the mean time since diagnosis was 5.08 years (4.87). Bisphosphonates were the most prescribed drugs (82% of the patients) and only 52% of the patients were taking calcium and vitamin D supplements. Analysis of the therapeutic compliance level shows that, as per the MG test, 68.7% of the patients were non-compliers, and 11.2% were non-compliers as per the AC test. ConclusionsAn important percentage of women with post-menopausal osteoporosis in Spain's PC setting show a high level of non-compliance.

Esquizofrenia: adesão ao tratamento e crenças sobre o transtorno e terapêutica medicamentosa

Este estudo verificou a adesão de pessoas com esquizofrenia à medicação, identificou e comparou as crenças sobre transtorno e medicamento entre pacientes aderentes e não aderentes. Participaram do estudo 14 pacientes de um ambulatório de psiquiatria. Foi realizada entrevista semi-estruturada e aplicação do Teste de Morisky-Green. Os dados foram analisados com abordagem quali-quantitativa. Os resultados revelaram que 64,3% dos pacientes não aderem ao medicamento. A maioria dos entrevistados considerou a medicação capaz de reduzir a seriedade e severidade do transtorno. Entretanto, entre pacientes não aderentes, as barreiras no seguimento da terapêutica foram mais expressivas. Efeitos colaterais foram razão para descontinuidade do tratamento em 80% dos pacientes não aderentes intencionalmente. Observou-se conhecimento insuficiente sobre a esquizofrenia e tratamento medicamentoso. A fé foi mencionada pelos pacientes como estratégia para enfrentamento do processo vivenciado. Este estudo aponta para a necessidade de estratégias direcionadas à promoção da adesão ao medicamento entre pessoas com esquizofrenia.

Effect of a 36-month pharmaceutical care program on pharmacotherapy adherence in elderly diabetic and hypertensive patients

The primary objective of this study was to evaluate the effect of a pharmaceutical care program on pharmacotherapy adherence in elderly diabetic and hypertensive patients. The clinical outcomes of this pharmacotherapy adherence approach were the secondary objective of the study. Public Primary Health Care Unit in a municipality in the Brazilian State of Sao Paulo. A 36-month randomized, controlled, prospective clinical trial was carried out with 200 patients divided into two groups: control (n = 100) and intervention (n = 100). The control group received the usual care offered by the Primary Health Care Unit (medical and nurse consultancies). The patients randomized into the intervention group received pharmaceutical care intervention besides the usual care offered. Pharmacotherapy adherence (Morisky-Green test translated into Portuguese and computerized dispensed medication history) and clinical measurements (blood pressure, fasting glucose, A1C hemoglobin, triglycerides and total cholesterol) were evaluated at the baseline and up to 36 months. A P value <0.05 was considered statistically significant. A total of 97 patients from the intervention group and 97 patients from the control group completed the study (n = 194). Significant improvements in the pharmacotherapy adherence were verified for the intervention group according to the Morisky-Green test (50.5% of adherent patients at baseline vs. 83.5% of adherent patients after 36 months; P < 0.001) and the computerized dispensed medication history (52.6% of adherent patients at baseline vs. 83.5% of adherent patients after 36 months; P < 0.001); no significant changes were verified in the control group. Significant improvements in the number of patients reaching adequate values for their blood pressure (26.8% at baseline vs. 86.6% after 36-months; P < 0.001), fasting glucose (29.9% at baseline vs. 70.1% after 36 months; P < 0.001), A1C hemoglobin (3.3% at baseline vs. 63.3% after 36 months; P < 0.001), triglycerides (47.4% at baseline vs. 74.2% after 36 months; P < 0.001) and total cholesterol (59.8% at baseline vs. 80.4% after 36 months; P = 0.002) were verified in the intervention group, but remained unchanged in the control group. These results indicated the effectiveness of pharmaceutical care in improving pharmacotherapy adherence, with positive effects in the clinical outcomes of the patients studied.

Análisis del cumplimiento terapéutico en mujeres con osteoporosis

Objective To assess therapeutic compliance in osteoporosis in women in a Primary Care (PC) setting. Patients and methods Observational, descriptive, cross-sectional and multicenter study, conducted in PC centers of the 17 Spanish Autonomous Regions. 1,649 women who had initiated treatment for osteoporosis at least 3 months before entering the study were recruited. To assess therapeutic compliance, two questionnaires, the Haynes-Sackett or self-communicated compliance test (AC) and the Morisky-Green test (MG) were used. Results Patients’ mean age (± SD) was 66.59 years (9.5) and the mean time since diagnosis was 5.08 years (4.87). Bisphosphonates were the most precribed drugs (82% of the patients) and only 52% of the patients were taking calcium and vitamin D supplements. Analysis of the therapeutic compliance level shows that, as per the MG test, 68.7% of the patients were non-compliers, and 11.2% were non-compliers as per the AC test. Conclusions An important percentage of women with post-menopausal osteoporosis in Spain's PC setting show a high level of non-compliance.

Efficiency of the Information Given at Discharge and Adherence of Polymedicated Patients

ObjectiveTo evaluate the utility of a post-discharge pharmaceutical care programme. MethodThree-month prospective study where patients were randomised into two groups according to whether or not they received verbal and written information about their treatment at hospital discharge. Treatment compliance was assessed by the Morisky–Green test at discharge and at 30–50days via a telephone interview, also collecting information on patient medication. ResultsA total of 59 patients were included, 30 in the control group and 29 in the experimental group. 42.1±9.6days had elapsed between discharge and the telephone interview. While a higher percentage of patients were adherent to treatment at discharge in the control group (83.3 versus 62.1%, OR=0.33, 95% CI: 0.1–1.1, P=.07), in the telephone interview the percentage in the experimental group was greater (62.5 versus 88.5%, OR=4.6, 95% CI: 1.1–19.8, P=.03). The differences between the two groups for the rest of the variables (deaths, visits to emergency department and hospital readmissions) were not statistically significant. In the telephone interview, 70% of patients’ treatment was changed in some way since hospital discharge. ConclusionA post-discharge pharmaceutical care programme is a tool to improve treatment compliance, which needs continuity due to the large number of treatment changes suffered by these patients.

Eficacia de la información al alta en la adherencia del paciente polimedicado

Objective To evaluate the utility of a post-discharge pharmaceutical care programme. Method Three-month prospective study where patients were randomised into two groups according to whether or not they received verbal and written information about their treatment at hospital discharge. Treatment compliance was assessed by the Morisky Green test at discharge and at 30-50 days via a telephone interview, also collecting information on patient medication. Results A total of 59 patients were included, 30 in the control group and 29 in the experimental group. 42.1 ± 9.6 days had elapsed between discharge and the telephone interview. While a higher percentage of patients were adherent to treatment at discharge in the control group (83.3 versus 62.1%, OR = 0.33, 95% CI: 0.1-1.1, P = .07), in the telephone interview the percentage in the experimental group was greater (62.5 versus 88.5%, OR = 4.6, 95% CI: 1.1-19.8, P = .03). The differences between the two groups for the rest of the variables (deaths, visits to emergency department and hospital readmissions) were not statistically significant. In the telephone interview, 70% of patients’ treatment was changed in some way since hospital discharge. Conclusion A post-discharge pharmaceutical care programme is a tool to improve treatment compliance, which needs continuity due to the large number of treatment changes suffered by these patients.

Correlates of treatment compliance in infertile patients with polycystic ovary syndrome

Objective To investigate factors that correlated to compliance of treatment in infertile patients with polycystic ovary syndrome (PCOS) to provide basis for clinical treatment, specialist consultation and health education. Methods Compliance was assessed by a questionnaire designed by reference to Morisky-Green test and therapeutic principles for PCOS. Interviews were performed in 128 infertile patients with PCOS in Renmin Hospital of Wuhan University, Wuhan, Hubei in China during March 2009 to September 2010. Data were analyzed with logistic regression. Results Logistic regression analysis revealed that a total of 41 (34.2% ) of 120 participants investigated showed good compliance. Factors that might significantly (P ＜ 0.05 ) correlate compliance of treatment included body mass index (BMI) of the patients ( OR = 2.426, 95% CI = 1.428 - 4.121 ), length of their marriage ( OR = 0.398, 95% CI =0.225 - 0.704) and their concerns for adverse drug reactions ( OR= 0.216, 95% CI = 0.067 - 0.694).Conclusions Patients with obesity, shorter length of marriage and concerns for adverse drug reactions show lower compliance. Publicity and intervention to those patients should be strengthened in clinics to improve their treatment compliance in patients with PCOS. Key words: Polycystic ovary syndrome; Infertility, female; Patient compliance; Regression analysis

Prevalencia y factores asociados a la no adherencia en el tratamiento farmacológico de mantenimiento en adultos con trastorno afectivo bipolar

IntroductionThis study aims to determine the prevalence and factors associated with non-adherence in maintenance treatment of adult patients diagnosed with bipolar disorder. MethodsCross sectional study with 124 patients. Adherence to treatment was evaluated by the Morisky-Green Test. A structured questionnaire was applied. It included variables associated with demographics factors and factors related to the patient, illness, treatment, family, therapeutic relationship, and health system. The Global Impression Scale Modified for Bipolar Disorder (CGI-BPM) and Family Apgar were used as well. ResultsThe prevalence of non-adherence to maintenance drug treatment was 29.8%. It was greater in women (64.9%) than men (35.1%), although this difference was not statistically significant (p = 0.17). The factors statistically significant associated with non-adherence factors were: Increased severity of the disease (OR 1.9), history of non-adherence (39% P=0,001), negative perception of the psychiatrist (100%, P=0.001), less insight (87%, RP4.65), greater stigma (50%, RP 6.2), having no family member to remind taking the drug (73%, P=0.001). ConclusionsThe prevalence was inside the range found in other studies. The statistically significant factors associated with non-adherence were: Severity of disease, history of non-compliance, stigma, no family support, poor insight, smoking habit, and negative perception of the psychiatrist.

P03-112 - Adherence and satisfaction survey in outpatients on treatment with antipsychotics

IntroductionOne of the problems of many studies and clinical trials is that don’t reflect the patient's opinion about the medication that they receive and their satisfaction.Objetive and aimsThe aim of this study was to assess the degree of outpatients satisfaction with antipsychotic treatment in four outpatients clinics in Mallorca. The adherence rates was estimated from information provided by the patients and their psychiatrists.MethodsA cross.-sectional and descriptive study was conducted during one month, from May to June 2010, by administering several questionnaires to outpatients with psychotic disorders. It was designed a case report data which recorded the following variables: age, gender, diagnosis (schizophreniform, schizophrenia, schizoaffective disorder, delusional, psychotic disorder not otherwise specified), time since diagnosis, substance use, number of antipsychotic drugs, type of antipsychotic (oral and / or im), number of doses per day and number of tablets, via of administration (buttocks or deltoid). The psychometric instruments used were: the Morisky-Green test, Haynes-Sacket test, the MSQ (Medication Satisfaction Questionnaire) and CGI (Clinical Global Impression).ResultsThe sample was of 92 patients with a mean age of 42.1 years (SD 12.2): 57.6% male and the most frequent diagnosis was schizophrenia in 65.2%. The duration of treatment from diagnosis was more than 5 years in 66.3%.ConclusionsThe patients on maintenance monotherapy with RLAI showed better adherence rates and more insight, evaluated by their psychiatrits.78% of patients receiving antipsychotic medication injections were satisfied with the treatment.Patients with RLAI administrating in deltoid were satisfied in 65.7%.

Registro del historial farmacoterapéutico de la historia clínica informatizada en pacientes con hipertensión arterial: un nuevo instrumento para valorar la adherencia terapéutica

Objective To study the validity of a prescription register (PR) incorporated into computerized medical records (CMR) compared with the Morisky-Green test in patients with high blood pressure using anti-hypertensive medication. Design Cross-sectional study. Setting Primary Care. Participants A total of 252 patients with hypertension using drug therapy with no changes in drugs or dosage were randomly selected. Main measurements Descriptive variables, blood pressure, proportion of drug therapy collected from pharmacies according to the PR over 12 months compared with drug therapy prescribed in CMR (poor medication adherence [MA] if <80%), and Morisky-Green test. Validity of the PR was analysed using the Kappa index to compare PR with the Morisky-Green test (reference) and blood pressure levels . Results Mean age was 68 years, 50% were women, and 77% completed the study. Poor MA was 51.3% according to the PR (95% CI 44.3%-58.3%) and 15.4% (95% CI; 10.3%-20.4%) when using the Morisky-Green test. The Kappa index was -0.068. Patients with poor MA according to the PR had higher levels of systolic and diastolic blood pressure (4.3 and 2.9 mmHg, respectively, P < 0.05). No differences in blood pressure were observed in patients with poor MA if the Morisky-Green test was used (0.1 and 1 mmHg, respectively, P > 0.05). Conclusions Poor MA according to the PR is high and is associated with poorer control of blood pressure; the Morisky-Green test does not pick up on these differences. These results suggest that the PR could be useful for evaluating MA and that the Morisky-Green test underestimates poor MA.

Is it possible to diagnose the therapeutic adherence of patients with COPD in clinical practice? A cohort study

BackgroundTherapeutic adherence of patients with chronic obstructive pulmonary disease (COPD) is poor. It is therefore necessary to determine the magnitude of non-adherence to develop strategies to correct this behaviour. The purpose of this study was to analyse the diagnostic validity of indirect adherence methods.MethodsSample: 195 COPD patients undergoing scheduled inhaled treatment attending 5 Primary Care Centres of Malaga, Spain. Variables: Sociodemographic profile, illness data, spirometry, quality of life (St. George Respiratory Questionnaire: SGRQ), and inhaled medication counting (count of dose/pill or electronic monitoring) were collected. The patient's knowledge of COPD (Batalla test:BT),their attitude towards treatment (Morisky-Green test: MGT) and their self-reported therapeutic adherence (Haynes-Sackett test: HST) were used as methods of evaluating adherence. The follow-up consisted four visits over one year (the recruitment visit: V0; and after 1 month:V1; 6 months:V2; and 1 year:V3).ResultsThe mean age was 69.59 (95% CI, 68.29-70.89) years old and 93.8% were male. Other findings included: 85.4% had a low educational level, 23.6% were smokers, 71.5% mild-moderate COPD stage with a FEV1 = 56.86 (SD = 18.85); exacerbations per year = 1.41(95% CI, 1-1.8). The total SGRQ score was 44.96 (95% CI, 42.46-47.46), showing a mild self-perceived impairment in health. The prevalence of adherence (dose/pill count) was 68.1% (95% CI, 60.9-75.3) at V1, 80% (95% CI, 73-87) at V2 and 84% (95% CI, 77.9) at V3. The MGT showed a specificity of 67.34% at V1, 76.19% at V2 and 69.62% at V3. The sensitivity was 53.33% at V1, 66.66% at V2 and 33.33% at V3.The BT showed a specificity of 55.1% at V1, 70.23% at V2 and 67.09% at V3. The sensitivity was 68.88% at V1, 71.43% at V2 and 46.66% at V3. Considering both tests together, the specificity was 86.73% at V1, 94.04% at V2 and 92.49% at V3 and the sensitivity was 37.77% at V1, 47.62% at V2 and 13.3% at V3.ConclusionsThe prevalence of treatment adherence changes over time. Indirect methods (dose/pill count and self-reported) can be useful to detect non-adherence in COPD patients. The combination of MGT and BT is the best approach to test self-reported adherence.

Knowledge and adherence to antihypertensive therapy in primary care: results of a randomized trial

Objectives To evaluate the efficacy of a healthcare education program for patients with hypertension. Methods A multicenter, prospective, cluster-randomized trial was conducted. Randomization was by primary care center; 18 of 36 urban primary care centers in Barcelona and its metropolitan area were randomized to the intervention group (IG) and 18 to the control group (CG). The study sample consisted of patients with hypertension (n = 996; 515 in the IG and 481 in the CG) receiving outpatient treatment with antihypertensive drugs. The intervention consisted of personalized information by a trained nurse and written leaflets. Questionnaires on knowledge and awareness of hypertension and its medication, treatment adherence, healthy lifestyle habits, systolic and diastolic blood pressure, and body mass index were assessed at each visit, with a 12-month follow-up. An intention-to-treat analysis was applied. Results Knowledge of hypertension increased by 27.8% in the IG and by 18.5% in the CG, while that of medication increased by 10.1% in the IG and 5.5% in the CG. Treatment adherence measured by the Morisky-Green test increased by 9.6% (95% CI: 5.5–13.6) in the IG and 8.8% (95% CI: 4.9-12.6) in the CG. There were no differences in adherence on the other tests used. No differences were observed between the IG and CG in clinical variables such as blood pressure or BMI at the end of the trial. Conclusions The educational intervention had no significant impact on patients’ adherence to the medication.

Socio-demographic and clinical factors influencing the adherence to treatment in Parkinson’s disease: the ADHESON study

Symptoms of Parkinson's disease (PD) are usually controlled by a continuous titration of medication and addition of multiple therapies over the course of the disease. Therapeutic complex schemes, polymedication, comorbidities and the number of medications required contribute to non-adherence. This cross-sectional survey was performed in 418 patients with PD on treatment with any antiparkinsonian medication. Patient adherence was assessed through physicians' subjective perception and the Morisky-Green test (MGT). Several social, demographic and clinical features were correlated through bivariate and multivariate analyses. According to the physician's opinion 93.7%, and according to the MGT 60.4% of patients were adherent to parkinsonian therapy. The bivariate analysis showed greater adherence in patients with a high level of knowledge about the disease (62.8%), good clinical control (63.6%), a spouse or life partner (63%) and higher incomes (66%). Negative correlation with psychiatric symptoms was found. In relation to the MGT, the logistic regression model showed a negative correlation between cognitive deterioration and psychiatric pathology and adherence to therapy. The physician's impression overestimated the compliance of patients when compared with an objective evaluation such as the MGT. Cognitive impairment and psychiatric symptoms are the clinical variables associated with a lower level of adherence.

Blood pressure levels and adherence to treatment of hypertensive patients, users of a school pharmacy

Adherence to pharmacological treatment for hypertension is considered a key factor in guaranteeing successful therapy outcomes. Knowledge of the disease, its complications, as well as the need for changes in lifestyle, call for patient motivation and continuous interactive education. The evidence regarding the beneficial effects of changes in life style by hypertensive individuals in reducing the complications of the disease, as well as in its prevention are indisputable. However, the challenges posed by patient adherence to treatment prescribed by doctors remain. The aim of this study was to assess blood pressure levels together with degree of adherence to pharmacological treatment with Enalapril Maleate by means of the Morisky-Green Test, in hypertensive patients who were users of a School Pharmacy. Of the 102 patients interviewed, 65.7% had controlled blood pressure, but only 36.3% indicated total compliance with the pharmacological treatment. The Morisky-Green test proved ineffective in associating controlled blood pressure levels and positive attitudes toward taking antihypertensive medicines.