Morisky Medication Adherence Scale Research Articles

The Effectiveness of Using Telenursing in Supporting Patient Adherence to Antimalarial Medication

Malaria, which is still endemic in Papua Indonesia, especially Mimika Regency, has the classic issue of low adherence to antimalarial medication necessitates the use of a technological approach through telenursing, which includes reminders and self-reporting, allowing for optimal monitoring of adherence. To determine the effect of web application-based telenursing on adherence to antimalarial medication. This study used a quasi-experimental design with a pre-post test only approach. The instrument used was the Morisky Medication Adherence Scale-8 (MMAS). The sample consisted of 42 respondents per group. The analysis of medication adherence showed a significant difference between pre- and post-treatment in the intervention group, with a p-value of 0.000 (p-value < 0.05). Additionally, post-hoc pairwise comparisons showed that in the control group, a significant p-value of 0.000 was only found between day 15 and day 3, while in the intervention group, significant p-values ​​of 0.000 were found at every time point. Web application-based telenursing has been proven to significantly affect adherence to antimalarial medication.

The Effect of Cognitive Behavioural Therapy-Based Psychoeducation on Medication Adherence and Aggression in Individuals Diagnosed With Schizophrenia: An Experimental Study.

It is known that treatment compliance is low and aggression is higher in individuals diagnosed with schizophrenia compared to the normal population. Cognitive behavioural therapy (CBT) is known to reduce relapse and hospitalisation and increase well-being in individuals diagnosed with schizophrenia. However, there are almost no studies on increasing treatment compliance and decreasing aggression. This study was conducted to determine how CBT-based psychoeducation affects medication adherence and aggression in individuals diagnosed with schizophrenia. The study was conducted as a quasi-experimental model with the pre-test-post-test control group with 73 schizophrenic patients (33 experimental, 40 control) between June 2022 and July 2023. Data were collected using the Descriptive Characteristics Form, Morisky Medication Adherence Scale (MMAS) and Buss-Perry Aggression Questionnaire (BPSQ). The schizophrenic patients in the experimental group were given eight sessions of CBT-based psychoeducation, while the schizophrenic patients in the control group were not given any training. The data were analysed using mean, standard deviation, chi-squared test, dependent samples t-test and independent samples t-test. It was determined that the aggression level of the experimental group before the training was 80.51 ± 19.38, and after the CBT-based psychoeducation, it was 73.12 ± 15.28. It was determined that the aggression level of the control group before the training was 84.22 ± 12.13, and after the post-test, it was 85.60 ± 11.72. It was determined that the medication adherence level of the experimental group before the training was 2.75 ± 1.25, and after the CBT-based psychoeducation, it was 3.57 ± 0.67. It was determined that the medication adherence level of the control group before the training was 2.05 ± 1.33, and after the post-test, it was 2.17 ± 1.36. The psychoeducation based on CBT caused a statistically significant difference (p = 0.001) in medication adherence and aggression levels in the experimental group. It was determined that CBT applied to individuals diagnosed with schizophrenia was effective on increasing their medication adherence and reducing their aggression. It is recommended for psychiatric nurses to include CBT-based psychoeducation in their nursing practices in order to increase medication adherence and reduce aggression in individuals with schizophrenia. The findings emphasise that CBT-based psychoeducation increases treatment adherence and significantly decreases the level of aggression in individuals diagnosed with schizophrenia. Psychiatric nurses should include CBT-based psychoeducation in their treatments.

Pharmacovigilance monitoring and treatment adherence in patients on antihypertensive drugs at a tertiary care centre.

Hypertension is one of the main factors contributing to the global burden of non-communicable diseases. Previous research has revealed that stress, bad lifestyle choices and a lack of knowledge about the disease are the main causes of hypertension that can be controlled. The key cause behind the prevalence of the condition is the lack of medication adherence by patients. This study aims to evaluate medication adherence in patients with hypertension through the Morisky Medication Adherence Scale (MMAS) and to observe any adverse drug reaction leading to non-adherence of medications. A descriptive, cross-sectional study was conducted on 124 patients who attended the outpatient department of medicine. The descriptive tools were MMAS and causality scales for adverse drug reactions. The mean MMAS score was 5.20±1.29. Amongst the demographic profile, age, sex, comorbidities and duration of disease were significantly associated with decreased mean MMAS scores. Forty-two patients experienced drug reactions and only four patients were adherent to their medications. Our study suggests that patients were poorly adherent to their medications. Effective interventions should be considered to improve adherence in patients. Monitoring for adverse drug reactions can lead to improved patient outcomes, whilst interventions to improve adherence can lead to better blood pressure control and reduced risk of cardiovascular events.

Hubungan Kepatuhan Minum Obat dengan Kualitas Hidup Pasien TB Paru di Puskesmas Mustika Jaya Tahun 2023

Pulmonary tuberculosis is caused by a Mycobacterium tuberculosis infection, which attacks the lungs and causes respiratory issues such as chronic cough and shortness of breath. This study aims to analyze the relationship between medication adherence and the quality of life of pulmonary TB patients at Mustika Jaya Public Health Center in 2023. The research design is observational analytic with a cross-sectional approach, using a sample of 78 TB patients selected through purposive sampling. The instruments used include the Morisky Medication Adherence Scale (MMAS-8) for medication adherence and the WHOQOL-BREF questionnaire for quality of life assessment. Chi-square test results showed a significant relationship between medication adherence and quality of life, with a p-value of 0.00. A total of 51.7% of patients who adhered to their medication had a good quality of life. In conclusion, there is a significant positive relationship between medication adherence and quality of life in pulmonary TB patients at Mustika Jaya Health Center in 2023.

Factors that Influence Intraocular Pressure Target in a Sample of Iraqi Patients Using Antiglaucoma Medications: A Cross-Sectional Study

Background: Anti-glaucoma eye drops are mainly used to lower intraocular pressure (IOP) and manage glaucoma. Many studies found that achievement of the IOP target is poor. Objective: This study aimed to assess the achievement of the IOP target and factors affecting it among a sample of Iraqi patients with glaucoma. Methods: A single-center, cross-sectional study was conducted on patients with glaucoma from December 2023 to April 2024 at Ibn Al-Haytham Hospital, Baghdad, Iraq. All patients who received medical therapy for at least one month were eligible to participate in this study. Intraocular pressure values at the time of initial diagnosis and at the time of enrolment in the study were documented for all included patients. Medication adherence was measured by the Arabic version of the Morisky medication adherence scale-4. Eyedrop administration technique was assessed through direct observation by the researcher using a newly developed and validated checklist. Results: Most participants in the current study were males with primary education. The average disease duration was 14 months. The target IOP was achieved among 36% of participants. The adherence to eye drops was good in 55% of participants. Only 9% of participants administered eye drops with a good technique. Achievement of the IOP target was significantly influenced by good adherence and technique for administration of eye drops (p<0.05). Conclusions: IOP-target achievement is poor among Iraqi patients. Adherence to and administration technique of eye drops are significant factors that could affect IOP-target achievement.

Medication Adherence and Its Relationship With Quality of Life and Functionality in Individuals With Bipolar Disorder: A Cross-Sectional Correlational Study.

The current cross-sectional correlational study aimed to determine the relationship of medication adherence with functionality and quality of life in individuals with bipolar disorder (BD). The research was conducted with 141 individuals with BD followed as outpatients. Data were collected using an information form, Morisky Medication Adherence Scale (MMAS), Quality of Life in Bipolar Disorder Scale (QoL.BD), and Bipolar Disorder Functioning Questionnaire (BDFQ). A significant positive correlation was found between participants' MMAS total score and QoL.BD (p < 0.001) and BDFQ (p < 0.05) scores. A significant positive correlation was also found between QoL.BD and BDFQ scores (p < 0.001). Medication compliance positively affects quality of life and social functionality in individuals with BD. Thus, interventions to increase medication adherence are recommended. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

Prescribing Pattern and Medication Adherence in Patients with Epilepsy in a Tertiary Neuro-Center, Kathmandu

Abstract Background Epilepsy is a chronic condition characterized by unusual, frequent, excessive, and self-terminating neuronal firing. Adherence to medication is crucial to achieve the intended therapeutic outcome. However, not much research has been done on drug adherence in our context. Thus, the purpose of this study is to investigate the antiseizure medication prescribing pattern, medication adherence, and associated factors. Methodology A cross-sectional, analytical research was done on randomly selected epileptic patients through interview and documentary analysis using a semi-structured interview schedule and the eight-item Morisky Medication Adherence Scale (MMAS-8). The clinical and demographic characteristics were described using descriptive statistics (median, interquartile range [IQR], frequency, and percentage). The Shapiro–Wilk and chi-squared tests were used to examine the factors influencing medication adherence and the relationships between research variables. The analysis was performed using SPSS version 16. Result From a total of 104 patients, 77.3% were males, the median age was 29 years (IQR: 16), the majority (42.3%) had higher secondary education, 15.4% had secondary education and 5.8% were illiterate, 25% were job holders, 26% were laborers, 41.3% were from province 3, and 16.3% were from province 4. Two-thirds (63.5%) of the patients were highly adherent to antiseizure medication and 54.8% were seizure free for more than 2 years.The most common type of epilepsy diagnosed was generalized epilepsy (54.8%). Seizures were usually treated with monotherapy (65.4%), with sodium valproate being the most often used single antiseizure medicine (26.8%), followed by carbamazepine (16.3%) and levetiracetam (15.4%). Additionally, sodium valproate was the medication most frequently used in polytherapy for epilepsy. There was a strong association established between adherence and drug therapy type, age, adverse drug reaction, and seizure control. The study revealed that adherence was not significantly associated with factors such as gender, occupation, regional distribution, or type of epilepsy. Conclusion Low adherence was observed in 36.5% of patients. As a significant association was observed between medication adherence and seizure control, health care providers should focus on improving medication adherence. Evaluation of adherence needs to be a regular component of managing epilepsy. Further patients who do not stick to their drug regimens should receive more attention and assistance. It will support better therapy results.

Treatment Adherence in Pediatric Atopic Dermatitis: A Systematic Review.

Adherence to pediatric atopic dermatitis (AD) treatment regimens can be complex and a major challenge to optimizing treatment outcome. We aimed to review factors associated with nonadherence in pediatric AD and propose interventions to improve adherence. PubMed and EMBASE databases were systematically searched for articles from 2000 to February 2023 related to AD and adherence, with an additional update in December 2023. Non-human studies, reviews, commentaries, and meta-analyses were excluded. Articles were sorted into pediatric versus adult study population based on volume. Herein, we examine the results of papers discussing adherence factors related to pediatric patients. A total of 62 studies met inclusion criteria. Thirty-six studies surveyed patients and caregivers (N = 10,268) to identify barriers to treatment adherence. None of the included studies were specific to systemic medications. Barriers includedpoor caregiver quality of life, inadequate AD-related education, topical corticosteroid (TCS) phobia, unclear therapy-related instructions, and dissatisfaction with physician interaction. Five studies solely measured adherence using medication electronic monitoring systems, Morisky medication adherence scale, or self-reported adherence to measure adherencetotopical medications. Twenty-one studies described interventions involving nurse-led or web-based education programs, text message or email reminders, and TCS education. Adherence was improved with caregiver education programs, daily text-message reminders, eczema action plans, TCS potency "traffic light" color system, and frequent follow-up visits. Adherence to pediatric AD treatment poses a multifactorial challenge for caregivers and patients. This study provides an index of strategies to optimize adherence, as it is essential for prevention of long-term sequela associated with AD in children. As the AD treatment landscape rapidly expands, further studies are vital to assess pediatric adherence to new topical, oral, and injectable medications. PROSPERO: CRD42023488557.

Family Self-management Program for Hypertension Management and Sodium Consumption Adherence: A Parallel Randomized Control Trial Among Family Caregivers and People With Hypertension.

Hypertension (HTN) has become a serious health problem in developing countries. The family has an important role in maintaining blood pressure (BP) at home, and sodium diet compliance in people with HTN needs to be developed. Therefore, this research aimed to evaluate the effectiveness of a family self-management program (FSMP) in HTN management and compliance with sodium consumption in rural areas of Indonesia. Study Design: A parallel-group, single-blind randomized controlled trial. One hundred twenty-six eligible participants were randomly allocated to an intervention (n=63) and a control group (n=63). Participants in the intervention group received a 24-week (6-month) FSMP intervention. The primary outcome measures included the systolic and diastolic BP, the Score Sodium Questionnaire (SSQ), and the Morisky Medication Adherence Scale 8 (MMAS-8). The Knowledge of Health Care for HTN questionnaire and the Efficacy and Behavior Toward Health Care for Patients with HTN questionnaire were used to assess the secondary outcome. The final results were analyzed from 121 participants (n=61 intervention and n=60 control group). The repeated analysis of variance (ANOVA) test results demonstrated significant effects on the management of HTN and adherence to sodium consumption as indicated by systolic (P=0.004) and diastolic BP (P=0.006), SSQ (P<0.001), MMAS 8 (P<0.001), caregivers' knowledge (P<0.001), caregivers' self-efficacy (P<0.001), and caregivers' behaviors (P=0.005). The FMSP emerges as a promising strategy for managing BP and adherence to sodium consumption in people with HTN through the support of family caregivers and selfmanagement activities.

The interplay of knowledge, motivation, and treatment response in medication adherence among patients with chronic myeloid leukemia treated with Imatinib

Chronic Myeloid Leukemia (CML) requires consistent medication adherence to Imatinib (IM) for optimal outcomes, however, adherence to oral chemotherapy is challenging. This observational study explores the relationship between patient knowledge, motivation, and adherence to IM therapy, and their collective impact on clinical outcomes. A prospective, observational study was conducted with 101 CML patients. The 6-Item Morisky Medication Adherence Scale (MMAS-6) was used to assess adherence, motivation, and knowledge levels. The study found that high motivation was significantly associated with lower BCR-ABL expression (p = 0.025). Patients with high knowledge and motivation had a 71% favorable response rate, compared to 0% in those with low knowledge and motivation (p = 0.01). As conclusion both patient motivation and knowledge are crucial for favorable treatment outcomes in CML. High levels of both significantly correlate with better clinical responses. Tailored interventions to enhance patient knowledge and motivation are essential.

Barriers to adherence to secondary prevention therapy in patients with ischemic heart disease: a cross-sectional study of a Mexican reference center.

This article aims to assess the adherence level to second-line therapy for cardiovascular prevention in a tertiary hospital in Mexico City and identify key barriers to adequate pharmacological adherence. A single-center prospective cross-sectional study was conducted between August 2018 and February 2020. Sociodemographic data were collected, and the Morisky medication adherence scale was performed. Directed interviews during medical consultations were also conducted to determine reasons for non-adherence. Showed that out of 991 patients included with a median age of 65 (58.72) years, 70.3% exhibited inadequate adherence, with forgetfulness being the most common reason (55.4%). Patients receiving combined therapy with coronary revascularization showed higher adherence compared to those on optimal medical therapy alone. Low educational level (OR 1.68, IC 95% 1.23-2.23, p = 0.0001) and the use of optimal medical therapy alone (OR 1.2, I 95% 1.11-2.007 p = 0.007) were identified as predictors of poor adherence. Among patients with ischemic heart disease and pharmacological therapy for secondary prevention, inadequate adherence is observed in 70% of cases. Factors associated with poor pharmacological adherence were low educational level and prescription of medical therapy without revascularization.

LDL-cholesterol goal achievement and self-reported medication adherence: insights from the JET-LDL registry

In patients with recent acute coronary syndromes (ACS), current guidelines recommend a low-density lipoprotein cholesterol (LDL-C) level <55 mg/dl. Despite the widespread use of different potent lipid-lowering therapies (LLT), this goal is not always achieved, often due to poor medication adherence. In this prespecified subanalysis of the JET-LDL registry, we sought to evaluate the relationship between LDL-C targets achievement and LLT adherence in a cohort of patients hospitalized for ACS. Patients self-reported medication adherence was assessed using the Morisky Medication Adherence Scale (MMAS) at 3-months follow-up. Depending on the score obtained, the population was divided into two groups: high adherence (HA, MMAS≥6) vs low adherence (LA, MMAS<6). The occurrence of the primary-endpoint (LDL-C reduction >50% from baseline or level <55 mg/dl at 1-month) was compared between the two groups. 963 patients were included in the present analysis; in 277 cases (28.7%) a MMAS score <6 was reported (LA-group), while in the other 686 (71.3%) the score obtained was ≥6 (HA-group). No difference between the two groups was observed regarding LDL-C levels at admission and LLT prescribed at discharge. At 1-month, primary-endpoint occurred in 62.5% of cases, with a statistically significant difference between the two groups (LA 60% vs HA 65%, p-value 0.034). At multivariate logistic regression analysis, LA was identified as an independent predictor of not achieving the primary-endpoint (OR 0.48 [0.39-0.85], p-value 0.006). In conclusion, in a real-world cohort of patients with ACS, low medication adherence to LLT was a common event (28.7%), having a negative impact on LDL-C goal achievement.

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

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

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

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

Perceived benefit is the strongest determinant factor of medication adherence in the elderly with hypertension

Background: The level of medication adherence among the elderly with hypertension is decreasing globally, including in Indonesia. Medication adherence is a major factor in treatment effectiveness for hypertensive patients. The Health Belief Model is one of the theories illustrating factors influencing patients’ medication adherence. Purpose: This study aimed to analyze determinant factors of medication adherence among the elderly with hypertension based on the application of the health belief model. Methods: This is a descriptive-analytic study with a cross-sectional approach. Sampling used a proportional stratified random sampling technique involving 193 patients with hypertension recruited from one of the Regional General Hospitals in Denpasar City Center. Data were obtained using three questionnaires, namely demographic characteristics, the health belief model (HBM), and the Morisky Medication Adherence Scale (MMAS-8). Data were analyzed using binary logistic regression. Results: The research results showed the majority of respondents (62.7%) were compliant in taking medication. Multivariate test results showed that perceived susceptibility (p &lt;0.001; AOR: 5.163), perceived benefits (p &lt;0.001; AOR: 12.061), self-efficacy (p &lt;0.001; AOR: 3.213), perceived barriers (p &lt;0.001; AOR: 0.133) and cues to action (p &lt;0.001; AOR: 3.480) is related to medication adherence in the elderly with hypertension. Conclusions: Perceived benefit is the strongest determining factor of medication adherence among the elderly with hypertension. Respondents with high belief in perceived benefits tend to adhere to medication 12.061 times compared to respondents with low belief in perceived benefits. Health workers are advised to increase the elderly's belief in the perceived benefits and perceived susceptibility to increase their medication adherence.

Self-care behaviors, medication adherence status, and associated factors among elderly individuals with type 2 diabetes

Elderly individuals face an increased likelihood of developing chronic diseases such as diabetes. Self-care practices and medication adherence play crucial roles in preventing complications and adverse effects of this condition. Therefore, this study aimed to determine self-care behaviors, medication adherence status, and related factors among elderly patients with type 2 diabetes. This descriptive-analytical study was conducted on 374 elderly patients with type 2 diabetes who visited educational healthcare centers in Qazvin, Iran, during 2023 (March–September). Sampling was performed using the convenience method. Data collection instruments included a demographic characteristics checklist, the summary of diabetes self-care activities questionnaire, and the Morisky medication adherence scale. Data analysis was conducted using SPSS-22 software, employing the Kolmogorov–Smirnov test, mean, standard deviation, univariate and multivariate regression analyses. The significance level was set at p ≤ 0.05. The mean age of participants was 67.56 ± 5.93 years. In the self-care questionnaire, the highest score pertained to adherence to the diet recommended by the treating physician (3.16 ± 1.87). In contrast, the lowest scores were related to the frequency of checking inside shoes (0.17 ± 0.93) and foot examination (0.31 ± 1.07), respectively. Furthermore, results in self-care behaviors indicated that with increasing education levels, self-monitoring of blood glucose (SMBG) significantly decreased (P = 0.048). This variable was considerably higher in rural residents than in urban dwellers (P = 0.016). Additionally, the frequency of blood glucose measurements was significantly higher in urban residents than in rural inhabitants (p = 0.006). Based on the results, the mean score for medication adherence among patients was 5.53 ± 1.65. Based on our findings, the level of self-care in physical activity, SMBG, and foot care among the elderly is below average. Furthermore, medication adherence in these patients is poor. We expect that managers and policymakers take steps to reduce complications and improve these two variables by developing educational programs on self-care and emphasizing the importance of treatment adherence for these patients.

Medication Adherence of Children with Congenital Hypothyroidism in Iran: A National Cross-Sectional Study

Background: Congenital hypothyroidism is the most common preventable and treatable cause of intellectual disability in children. A key component of the surveillance system for congenital hypothyroidism is ensuring a regular treatment program for affected children. Despite nearly 20 years since the successful implementation of the newborn screening program for hypothyroidism in Iran, a comprehensive evaluation of patients' adherence to treatment has not been conducted. Objectives: The aim of this study was to investigate the adherence to treatment among patients with congenital hypothyroidism in Iran. Methods: In this national cross-sectional study conducted in 2024, the adherence to treatment of 400 children with congenital hypothyroidism born between 2019 and 2023 in Iran was examined using the Morisky Medication Adherence Scale. The patients were randomly selected from national registry data. Data were analyzed using chi-squared tests, Fisher's exact test, and logistic regression in Stata software version 16. Results: The mean and standard deviation of medication adherence was 6.35 ± 1.41. Overall, adherence was good (≥ 6) in 284 (71.0%) of the study participants. In the univariate analysis, the most significant factors influencing adherence were place of residence, higher maternal education, lower paternal education, and type of congenital hypothyroidism (CH). In the multivariate analysis, children with permanent CH had good adherence, and parental education was not statistically significant (P &gt; 0.05). Conclusions: The results of this study showed that medication compliance in more than two-thirds of hypothyroid children diagnosed by national newborn screening is good. Given the importance of treatment in these patients, it is recommended that intervention plans be implemented, including educational programs and active follow-up of patients to increase compliance.

Adherence to Cysteamine Therapy Among Patients Diagnosed with Cystinosis in Saudi Arabia: A Prospective Cohort Study.

Cystinosis is a rare autosomal recessive disorder in which cystine crystals accumulate within the cellular lysosomes, causing damage to multiple organs. Due to challenges with the stringent cysteamine treatment regimen and side effects, adherence is often sub-optimal. This study aimed to assess the level of adherence to cysteamine therapy among cystinosis patients in Saudi Arabia and its impact on their quality of life. Electronic medical record data of 39 cystinosis patients from the Department of Nephrology at King Faisal Specialist Hospital and Research Center in Saudi Arabia were reviewed, and 25 patients were included in this study. Out of the 25 patients included in the final analysis, 64% (n = 16) were female. The mean age was 19.04 years. Almost all patients (23/25, 92%) were on oral IR cysteamine therapy, and 52% (13/25) were on topical cysteamine eye drop treatment. Of the 15 patients who responded to the Morisky Medication Adherence Scale-8 (MMAS-8) questionnaire, only 4 (26.7%) were highly adherent to cysteamine therapy. Most of the respondents (7/15, 46.7%) showed a medium level of treatment adherence. Based on the medication possession ratio for oral cysteamine, only 6 out of 23 patients (26.1%) were found to be 96-100% adherent. For the cysteamine eye drops, only 5/13 patients (38.4%) were 76-95% adherent. The 36-Item Short Form Health Survey (SF-36) used to assess patients' health-related outcomes showed that their quality of life was affected in the domains of 'social functioning' and 'energy/fatigue.' Despite a small sample size, this study shows sub-optimal adherence to cysteamine treatment in patients from Saudi Arabia. The possible reasons for low treatment adherence could be a high frequency of administration and treatment-related side effects.

Apixaban plasma concentrations before and after catheter ablation for atrial fibrillation.

Catheter ablation in patients with atrial fibrillation is associated with a transient increase in thromboembolic risk and adequate anticoagulation is highly important. When patients are anticoagulated with apixaban, monitoring of plasma concentrations of the drug is not routinely performed. This study aimed to assess the influence of clinical patient characteristics, concomitant drug treatment and self-reported adherence on apixaban concentrations, and to describe the intra- and inter-individual variability in apixaban concentrations in this group of patients. Method Apixaban concentrations from 141 patients were measured in plasma one week before ablation and two, six and ten weeks after ablation, employing ultra-high performance liquid chromatography coupled with tandem mass spectrometry. In samples not obtained at trough, apixaban concentrations were adjusted to trough levels. Self-reported adherence was registered by means of the 8-item Morisky Medication Adherence Scale before and after ablation. There were statistically significant, positive correlations between apixaban concentrations and increased age, female sex, lower glomerular filtration rate, higher CHA2DS2-VASc score, use of cytochrome P450 3A4 and/or p-glycoprotein inhibitors, and use of amiodarone. Self-reported adherence was generally high. The mean intra-individual and inter-individual coefficients of variation were 29% and 49%, respectively. In patients undergoing catheter ablation for atrial fibrillation, age, sex, renal function, interacting drugs and cerebrovascular risk profile were all associated with altered plasma apixaban concentration. In this group of patients with a generally high self-reported adherence, intra-individual variability was modest, but the inter-individual variability was substantial, and similar to those previously reported in other patient apixaban-treated populations. If a therapeutic concentration range is established, there might be a need for a more flexible approach to apixaban dosing, guided by therapeutic drug monitoring.

Medication Adherence among Drug-Resistant Tuberculosis (DR-TB) Patients at Universitas Indonesia Hospital

Background: Drug-resistant tuberculosis (TB-DR) is a deadly disease caused by infectious agents. Indonesia is one of the countries with the highest drug-resistant tuberculosis (TB-DR) rates in the world. The prevalence of tuberculosis cases in Depok City between 2019-2022 showed an increase in cases every year. This study aims to measure the level of adherence of drug-resistant tuberculosis (TB-DR) patients to their treatment using the Eight-Item Morisky Medication Adherence Scale (MMAS-8) questionnaire.Methods: This study is an observational study using a cross-sectional study design, conducted from February 2024 to March 2024 at the University of Indonesia Hospital. Eighty-seven respondents participated in this study. Respondents completed the validated Indonesian version of the MMAS-8 questionnaire after signing informed consent forms.Results: The results of the study showed that 50.6% of respondents had low adherence levels, 47.1% had moderate adherence levels, and 2.3% had high adherence levels. The data was then statistically analyzed using the SPSS version 29 statistical package with Chi-Square analysis, which resulted in a significant correlation (P&lt;0.05) between adherence levels and gender.Conclusion: There was a significant correlation between gender and respondent adherence. More than 50% of drug-resistant tuberculosis (TB-DR) patients at the University of Indonesia Hospital still have low adherence levels to their treatment.