Morisky Medication Adherence Scale Scores Research Articles

Asthma control, its related factors, and impact on quality of life among pediatric patients at a tertiary center in Jordan: a cross-sectional study

Introduction Pediatric asthma is a common respiratory disease that burdens affected patients, their caregivers, and the entire healthcare system. Uncontrolled asthma ultimately impacts patients’ quality of life. There are limited studies examining the factors associated with asthma control and quality of life. Thus, this study aimed to explore factors associated with asthma control and examine the relationship between asthma control and quality of life in children with asthma. Methods A cross-sectional study was conducted from October 2023 to January 2024 at the Jordan University Hospital, including 136 children aged 7-17 diagnosed with asthma. Asthma control was assessed using the Asthma Control Test (ACT) or Childhood Asthma Control Test (C-ACT). Medication adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS), and quality of life was evaluated using the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). Results Only 43.4% of patients had proper asthma control. The average quality of life and MMAS scores were 4.9 ± 1.5 and 4.2 ± 1.9, respectively. Uncontrolled asthma was associated with increased hospital admissions (p = 0.008), sensitivity to cold (p = 0.002), spring weather (p = 0.031), and infections (p = 0.001). Patients with controlled asthma had significantly higher quality of life (p < 0.001), but no significant differences in MMAS scores (p = 0.743). On multivariate analysis, QoL score was a positive predictor of control (p < 0.001), while sensitivity to infections were a negative predictor (p < 0.05). Conclusion Most pediatric patients with asthma at the Jordan University Hospital had poor asthma control. Quality of life remained a positive predictor of control irrespective of adherence to asthma treatment. This highlights the need for caregivers and physicians to focus greater attention on these cases, given the substantial clinical and social challanages they poses for affected children.

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.

Low-Density Lipoprotein 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/100 ml. Despite the widespread use of different potent lipid-lowering therapies (LLT), this goal is not always achieved, often owing to less medication adherence. In this prespecified subanalysis of the JET-Low Density Lipoprotein (JET-LDL) registry, we sought to evaluate the relation between LDL-C targets achievement and LLT adherence in a cohort of patients hospitalized for ACS. The patients' self-reported medication adherence was assessed using the Morisky Medication Adherence Scale (MMAS) at 3-month follow-up. Depending on the score obtained, the population was divided into 2 groups: high adherence (HA, MMAS ≥6) versus low adherence (LA, MMAS <6). The occurrence of the primary end point (LDL-C reduction >50% from baseline or level <55 mg/100 ml at 1 month) was compared in the 2 groups. A total of 963 patients were included in the present analysis; in 277 cases (28.7%), an MMAS score <6 was reported (LA group), whereas in the remaining 686 (71.3%), the score obtained was ≥6 (HA group). No difference between the 2 groups was observed regarding LDL-C levels at admission and LLT prescribed at discharge. At 1 month, the primary end point occurred in 62.5% of cases, with a statistically significant difference between the 2 groups (LA 60% vs HA 65%, p = 0.034). At multivariate logistic regression analysis, LA was identified as an independent predictor of not achieving the primary end point (odds ratio 0.48, 0.39 to 0.85, p = 0.006). In conclusion, in a real-world cohort of patients with ACS, less medication adherence to LLT was a common event (28.7%), negatively affecting LDL-C goal achievement.

REBISTART: Adherence of Patients with Multiple Sclerosis to Treatment with Subcutaneous Interferon Beta in the Context of a Patient Support Program.

Treatment adherence is a critical success factor in the disease-modifying therapy (DMT) of multiple sclerosis (MS). The REBISTART study prospectively evaluated adherence in patients using components of a patient support program (PSP). The 12-month non-interventional multicenter study examined the real-world adherence to subcutaneously (sc) injected interferon beta-1a (Rebif®). Patient-assessed adherence was measured by a visual analog scale (VAS) and the Morisky Medication Adherence Scale (MMAS). Objective adherence data were obtained by readouts from the RebiSmart® injection device. Of 333 patients, 70.9% used the nursing service as the core component of the PSP. Self-assessed VAS-based adherence was stable over time at 94.0-96.3%. Similarly, MMAS score (maximum 4) was 3.8-3.9 at all visits, also reflecting high self-assessed adherence. In 269 patients using the RebiSmart® injection device, mean readout-based objective adherence was similarly high (93.0-98.4% throughout visits). At last available visit, VAS-based adherence was independent of participation in the PSP nursing service (93.1% with participation versus 91.7% without it). Adherence was also independent of injection method or disease-related measures, including fatigue, depression, cognition, and quality of life. The most frequent reason for the premature discontinuations (38.7% of patients) was "change of treatment" (10.0%). We suggest that subgroups that may specifically benefit from PSP include patients who live alone, use multiple comedications, and are affected by cognitive impairment, depression, and/or fatigue. Further studies should investigate the potential usefulness of PSPs in these populations. Very high adherence rates independent of the PSP nursing service over 1year of treatment indicate that IFN beta-1a sc is an easy-to-use and well-tolerated disease-modifying drug. Vfa.de: No. 892. https://www.vfa.de/de/arzneimittel-forschung/datenbanken-zu-arzneimitteln/nisdb/nis-details/_892 .

Unraveling Medication Complexity in the Elderly: A Critical Assessment of Adherence Implications

Background: Chronic illnesses often affect grown-ups over 60 years of age, leading to inadequate and impecunious medication adherence, which increases the risk of bleakness, hospitalization, and mortality, despite the irrefutably factual benefits of certain medications. Aim and Objectives: To appraise the degree of drug intricacy in older patients with chronic diseases and to break down the factors impacting drug adherence among them. Methodology: A 10-month study involving 676 patients was carried out at the general medicine department of a tertiary hospital. Information was gathered for the study using the Morisky Medication Adherence Scale (MMAS) and the Medicine Regimen Complexity Index (MRCI). Results: A sample size of 676 on the whole, with 393 male patients surmounting 283 female patients. The level of intricacy was higher for the larger part of prescriptions. On the off chance that around 645 patients were prescribed more than 5 drugs. The greater part of the populace has shown good adherence (59%), trailed by moderate adherence (23%), and ultimately low adherence (18%). The intricacy of the prescription was recognized as the essential driver of non-adherence in 314 patients, and upon analyzing the responses from MRCI and MMAS scores, it was found that 156 patients on less complicated regimens exhibited moderate and 399 patients had great adherence among the total populace. Conclusion: To further develop drug adherence in more seasoned adults, doctors ought to consider medicine class numbers, high-risk prescriptions, and multi-layered systems, including age-related, natural, and social variables.

Effect of Negative Automatic Thoughts on Medication Adherence in Individuals With Schizophrenia

This study aimed to determine the effect of negative automatic thoughts on medication adherence in individuals with schizophrenia. This was a cross-sectional study carried out in a community mental health center between October 2022 and December 2022. The study included 102 individuals with schizophrenia. Data was collected using the Descriptive Characteristics Form, Negative Automatic Thoughts Questionnaire (NAT-Q), and Morisky Medication Adherence Scale (MMAS). The individuals' total mean NAT-Q score was 106.34 ± 27.32. There was a strong negative correlation between NAT-Q and MMAS scores ( r = −0.822, P &lt; 0.05). The study found that negative automatic thoughts predicted medication adherence by 67%. The negative automatic thoughts of the individuals were high and the medication adherence of half of the individuals was low. It was determined that the level of negative automatic thoughts of individuals with schizophrenia may negatively affect their medication adherence. [ Psychiatr Ann . 2023;53(11):518–524.]

Hipertansiyon ve Diyabet Hastalarının Algılanan Stres ve Depresyon Düzeyleri ile İlaç Uyumlarının Değerlendirilmesi

Objective: The aim of this study was to determine the perceived stress and depression level of diabetes and hypertension patients who applied to the family medicine outpatient clinic and to investigate its relationship with the treatment compliance of the patients. Methods: A total of 201 people over the age of 18 who were followed up in the family medicine outpatient clinic with the diagnosis of Hypertension and Diabetes were included in the study. The study consisted of three different groups of hypertension patients, diabetes patients and healthy volunteers. Beck Depression Scale, Perceived Stress Scale, Morisky Medication Adherence Scale-8 and sociodemographic data questionnaire were administered to the participants by face-to-face interview technique. Results: In our study, depression and perceived stress scores were lower in the healthy group compared to the other groups (p&amp;lt;0.05). Morisky medication adherence scale scores were 5.7±2.18 and 5.39±2.29 in the HT and DM patient groups, respectively, and 46.3% had a low compliance score. Factors such as education level, presence of additional disease, dietary compliance, physical activity status, and smoking were found to play an active role in medication compliance (p&amp;lt;0.05). It was observed that patients with high depression and stress scores had low adherence to medication adherence (p&amp;lt;0.001). Conclusion: Hypertensive and diabetic patients with high depression and perceived stress scores were found to have low adherence to medication adherence.

Are anxiety and depression risk factors for poor medication adherence in patients with an implantable cardioverter defibrillator?

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): TrygFonden The Lundbeck Foundation Patient@Home Background The implantable cardioverter defibrillator (ICD) is the preferred treatment for prevention of sudden cardiac death. Most patients with an ICD receive adjunctive medication to manage their heart disease. Poor medication adherence is a prognostic risk factor for cardiac patients and is linked to psychological factors, such as anxiety and depression. To our knowledge, no studies have examined if anxiety and/or depression at the time of ICD implantation is associated with medication adherence during the first year post-implantation. This information is important as it could help health care professionals identify and prevent poor medication adherence in ICD patients. Purpose To examine if anxiety and/or depression at ICD implantation are associated with medication adherence one-year post-implantation in ICD patients. Methods Secondary outcome analysis of the ACQUIRE-ICD, multisite, randomised controlled trial. Out of 478 patients with a first-time ICD or cardiac resynchronization therapy defibrillator (CRT-D) included in the trial, 433 patients (90.6%) took heart medication. Of these 433 patients, 322 patients (74.4%) were included in the analyses as they completed assessments at both baseline (implantation) and at 12 months post-implantation. Medication adherence was measured with the 8-item Morisky Medication Adherence Scale (MMAS), anxiety with Generalized Anxiety Disorder scale (GAD-7), and depression with Patient Health Questionnaire-9 (PHQ-9). Results The mean age of the participants was 60.2 ± 11.2, mainly male (83.9%). Medication adherence was generally medium to high at baseline [6.8% low adherence, 40.1% medium adherence, 53.1% high adherence, mean MMAS score: 7.31 ± 0.94), and at 12-months follow-up (8.1% low adherence, 37.3% medium adherence, 54.6% high adherence, mean MMAS score: 7.33 ± 0.93). In univariate analyses, depression scores at baseline were significantly negatively associated with medication adherence at 12-months post-implantation while adjusting for baseline MMAS scores (B = -0.02, 95% CI [- 0.04, -0.00], p = .04). This association remained statistically significant in the multivariate analysis also adjusting for gender, intervention group, heart failure severity (NYHA class I-II versus III-IV), and implantation center (B = -0.03, 95% CI [- 0.05, -0.00], p = .02). Anxiety scores at baseline were not significantly associated with medication adherence at 12-months post-implantation in neither the univariate (B = -0.02, 95% CI [- 0.04, 0.01], p = .14) nor adjusted analyses (B = -0.02, 95% CI [- 0.04, 0.00], p = .09). Conclusion Depression symptoms at the time of ICD implantation were associated with medication adherence at 12 months post-implantation with higher depression symptoms being associated with lower medication adherence. Anxiety symptoms were not predictive of medication adherence. Patients presenting with depressive symptoms at ICD implantation might be at risk for poor medication adherence.

DEPRESYON HASTALARINA YAPILAN MOTİVASYONEL GÖRÜŞMENİN TEDAVİ UYUMUNA ETKİSİ

Aim: Major depression is one of the most common psychiatric disorders, and treatment non-adherence is one of the important problems that negatively affect treatment outcomes in the treatment of depression. The aim of this study is to determine the effect of motivational interview on the treatment adherence.&#x0D; Material and Method: This study is a control group experimental research with pre-test and post-test repetitive measurements. The sampling of the study consists of 81 depressive patients, 40 experimental and 41 controls, who applied to the Psychiatry service/polyclinic of the Training and Research Hospital. The personal information form and The Morisky Medication Adherence Scale (MMAS) were used in data collection. &#x0D; Results: As a result of the motivational interviews, the MMAS scores of the experimental group decreased to a significant level in the mid-test and post-test compared to the pre-test, and no significant difference was found in the mean scale scores of the control group without intervention (p&gt;0.05).&#x0D; Conclusion: It has been found that motivational interviews are an effective intervention to improve medication adherence in the patients with depression. Healthcare professionals can facilitate adherence with the medical treatment regimen in depressed patients through motivational interview practices.

The Relationship Between the Use of Medicinal Plants and Medication Adherence in the Elderly with Chronic Diseases

Objectives Many older patients use medicinal plants, assuming that they are safe and without side effects. The present study aims to investigate the relationship between the use of medicinal plants and medication adherence in the elderly patients with chronic diseases. Methods &amp; Materials In this descriptive cross-sectional study, 358 patients aged ≥60 years with chronic diseases were selected by a convenience sampling method. Data collection instrument was a three-part questionnaire assessing demographic information, history of using medicinal plants, and medication adherence using the Morisky medication adherence scale (MMAS). The data were entered into SPSS v.21 and analyzed using one-way analysis of variance, Chi-square test, independent t-test and logistic regression. Results The mean age of participants was 69.44±8.13 years and 52.23% were female. The majority of them were married (87.68%) with a junior high school education (71.64%).The overall mean score of MMAS was 5.48 (poor adherence). The percentage of patients with a history of taking medicinal plants in the last year with the prescription of physician was 41.34% (n=148) while the percentage of those used medicinal plants without the physician’ prescription was 27.3% (n=98). The mean of MMAS score in the groups who used medicinal plants was lower than in the group with no history of using medicinal plants (P=0.001). The number of used medicinal plants, the frequency of using medicinal plants, and the duration of chronic disease had a statistically significant relationship with the medication adherence (P &lt;0.05). Conclusion Due to the high consumption of medicinal plants in the elderly with chronic diseases and its relationship with poor medication adherence, it is necessary to educate them about the correct use of medicinal plants, their side effects, herb-drug interactions, the need to inform the doctor about use of medicinal plants, and adherence to medication.

Effectiveness of a Nutritional Mobile Application for Management of Hyperphosphatemia in Patients on Hemodialysis: A Multicenter Open-Label Randomized Clinical Trial.

This study aims to determine the effectiveness of a phosphate mobile app (PMA), MyKidneyDiet-Phosphate Tracker ©2019, on hemodialysis (HD) patients with hyperphosphatemia. A multicenter, open-label, randomized controlled trial design allowed randomization of patients with hyperphosphatemia to either the usual care group (UG; receiving a single dietitian-led session with an education booklet) or the PMA group (PG). Thirty-three patients in each intervention group completed the 12-week study. Post-intervention, serum phosphorus levels were reduced in both groups (PG: −0.25 ± 0.42 mmol/L, p = 0.001; UG: −0.23 ± 0.33 mmol/L, p < 0.001) without any treatment difference (p > 0.05). Patients in both groups increased their phosphate knowledge (PG: 2.18 ± 3.40, p = 0.001; UG: 2.50 ± 4.50, p = 0.003), without any treatment difference (p > 0.05). Dietary phosphorus intake of both groups was reduced (PG: −188.1 ± 161.3 mg/d, p < 0.001; UG: −266.0 ± 193.3 mg/d, p < 0.001), without any treatment difference (p > 0.05). The serum calcium levels of patients in the UG group increased significantly (0.09 ± 0.20 mmol/L, p = 0.013) but not for the PG group (−0.03 ± 0.13 mmol/L, p = 0.386), and the treatment difference was significant (p = 0.007). As per phosphate binder adherence, both groups reported a significant increase in Morisky Medication Adherence Scale scores (PG: 1.1 ± 1.2, p < 0.001; UGa: 0.8 ± 1.5, p = 0.007), without any treatment difference (p > 0.05). HD patients with hyperphosphatemia using the PMA achieved reductions in serum phosphorus levels and dietary phosphorus intakes along with improved phosphate knowledge and phosphate binder adherence that were not significantly different from a one-off dietitian intervention. However, binder dose adjustment with meal phosphate content facilitated by the PMA allowed stability of corrected calcium levels, which was not attained by UC patients whose binder dose was fixed.

Predictors of poor medication adherence of older people with hypertension.

AimsTo explore the risk factors for poor medication adherence in older people with hypertension.DesignA cross‐sectional study.MethodsParticipants were administered with a self‐report questionnaire about their demographic characteristics; additionally, their four‐item Morisky Medication Adherence Scale scores were calculated. The STROBE checklist was applied as the reporting guideline for this study (File S1).ResultsUnivariate analysis indicated that the following five factors were statistically significantly associated with medication adherence: education level (χ 2 = 8.073, p = .045), co‐living (χ 2 = 11.364, p = .010), hypertension complications (χ 2 = 10.968, p = .001), admission blood pressure (χ 2 = 8.876, p = .003), and falls (χ 2 = 6.703, p = .010). Multivariable binary logistic regression analysis showed that there were four statistically significant predictors, such as people who lived with spouses and offspring (OR = 3.004, p = .017), and those who had high admission blood pressure (OR = 1.910, p = .003) had a greater risk of poor medication adherence, whereas those without hypertension complications (OR = 0.591, p = .026) and those without falls (OR = 0.530, p = .046) had a lower risk.Relevance to clinical practiceWe believe that these findings contribute to the identification of high‐risk people with poor adherence, allowing nurses to identify people with poor adherence in a timely manner, and pay attention to the people's medication.

Medication adherence in type 2 diabetes mellitus patients during Covid-19 pandemic: a cross-sectional study from the United Arab Emirates

Background: Patients with chronic diseases often experience difficulty adhering to recommended treatments as instructed by their healthcare professionals. Recently, diabetes has been associated with the severity of the novel coronavirus disease (Covid-19), which raises the importance of improving medication adherence for diabetic patients to enhance the right use of antidiabetics amid the Covid-19 pandemic. Methods: This work assesses medication adherence among type 2 diabetes mellitus patients in the United Arab Emirates (UAE) and identifies the set of key demographic and health factors significantly associated with medication adherence. A descriptive cross-sectional study was conducted on an appropriate sample of type 2 diabetic patients in the UAE, with 180 patients of both genders and various social levels. A validated version of the eight-item Morisky Medication Adherence Scale (MMAS) was used for data collection. Results: The average MMAS score was 4.88, with 95% confidence intervals (CI) 4.6 and 5.2. 61.67% (n=111), 28.89% (n=52), and 9.44% (n=17) of patients were categorized into low, medium, and high adherent groups, respectively. These findings indicate that a high level of non-compliance to antidiabetic regimens among the population in the UAE. Conclusions: Patients demonstrated low level of compliance to antidiabetic regimens. Therefore, they must receive up-to-date knowledge about the disease and the treatment and enable easy access to their health care providers to enhance medication adherence.

Medication adherence in type 2 diabetes mellitus patients during Covid-19 pandemic: a cross-sectional study from the United Arab Emirates

Background: Patients with chronic diseases often experience difficulty adhering to recommended treatments as instructed by their healthcare professionals. Recently, diabetes has been associated with the severity of the novel coronavirus disease (Covid-19), which raises the importance of improving medication adherence for diabetic patients to enhance the right use of antidiabetics amid the Covid-19 pandemic. Methods: This work assesses medication adherence among type 2 diabetes mellitus patients in the United Arab Emirates (UAE) and identifies the set of key demographic and health factors significantly associated with medication adherence. A descriptive cross-sectional study was conducted on an appropriate sample of type 2 diabetic patients in the UAE, with 180 patients of both genders and various social levels. A validated version of the eight-item Morisky Medication Adherence Scale (MMAS) was used for data collection. Results: The average MMAS score was 4.88, with 95% confidence intervals (CI) 4.6 and 5.2. 61.67% (n=111), 28.89% (n=52), and 9.44% (n=17) of patients were categorized into low, medium, and high adherent groups, respectively. These findings indicate that a high level of non-compliance to antidiabetic regimens among the population in the UAE. Conclusions : Patients demonstrated low level of compliance to antidiabetic regimens. Therefore, they must receive up-to-date knowledge about the disease and the treatment and enable easy access to their health care providers to enhance medication adherence.

Medication adherence in type 2 diabetes mellitus patients during Covid-19 pandemic: a cross-sectional study from the United Arab Emirates.

Background: Patients with chronic diseases often experience difficulty adhering to recommended treatments as instructed by their healthcare professionals. Recently, diabetes has been associated with the severity of the novel coronavirus disease (Covid-19), which raises the importance of improving medication adherence for diabetic patients to enhance the right use of antidiabetics amid the Covid-19 pandemic. Methods: This work assesses medication adherence among type 2 diabetes mellitus patients in the United Arab Emirates (UAE) and identifies the set of key demographic and health factors significantly associated with medication adherence. A descriptive cross-sectional study was conducted on an appropriate sample of type 2 diabetic patients in the UAE, with 180 patients of both genders and various social levels. A validated version of the eight-item Morisky Medication Adherence Scale (MMAS) was used for data collection. Results: The average MMAS score was 4.88, with 95% confidence intervals (CI) 4.6 and 5.2. 61.67% (n=111), 28.89% (n=52), and 9.44% (n=17) of patients were categorized into low, medium, and high adherent groups, respectively. These findings indicate that a high level of non-compliance to antidiabetic regimens among the population in the UAE. Conclusions : Patients demonstrated low level of compliance to antidiabetic regimens. Therefore, they must receive up-to-date knowledge about the disease and the treatment and enable easy access to their health care providers to enhance medication adherence.

The Use of SMS Text Messaging to Improve the Hospital-to-Community Transition in Patients With Acute Coronary Syndrome (Txt2Prevent): Results From a Pilot Randomized Controlled Trial.

BackgroundAcute coronary syndrome (ACS) is a leading cause of hospital admission in North America. Many patients with ACS experience challenges after discharge that impact their clinical outcomes and psychosocial well-being. SMS text messaging has the potential to provide support to patients during this postdischarge period.ObjectiveThis study pilot tested a 60-day SMS text messaging intervention (Txt2Prevent) for patients with ACS. The primary objective was to compare self-management domains between usual care and usual care plus Txt2Prevent. The secondary objectives were to compare medication adherence, health-related quality of life, self-efficacy, and health care resource use between groups. The third objective was to assess the feasibility of the study protocol and the acceptability of the intervention.MethodsThis was a randomized controlled trial with blinding of outcome assessors. We recruited 76 patients with ACS from St. Paul’s Hospital in Vancouver, Canada, and randomized them to 1 of 2 groups within 7 days of discharge. The Txt2Prevent program included automated 1-way SMS text messages about follow-up care, self-management, and healthy living. Data were collected during the index admission and at 60 days after randomization. The primary outcome was measured with the Health Education Impact Questionnaire (heiQ). Other outcomes included the EQ-5D-5L, EQ-5D-5L Visual Analog Scale, a modified Sullivan Cardiac Self-Efficacy Scale, and Morisky Medication Adherence Scale scores, and self-reported health care resource use. Analyses of covariance were used to test the effect of group assignment on follow-up scores (controlling for baseline) and were considered exploratory in nature. Feasibility was assessed with descriptive characteristics of the study protocol. Acceptability was assessed with 2 survey questions and semistructured interviews.ResultsThere were no statistically significant differences between the groups for the heiQ domains (adjusted mean difference [Txt2Prevent minus usual care] for each domain—Health-directed activity: –0.13, 95% CI –0.39 to 0.13, P=.31; Positive and active engagement in life: 0.03, 95% CI –0.19 to 0.25, P=.76; Emotional distress: 0.04, 95% CI –0.22 to 0.29, P=.77; Self-monitoring and insight: –0.14, 95% CI –0.33 to 0.05, P=.15; Constructive attitudes and approaches: –0.10, 95% CI –0.36 to 0.17, P=.47; Skill technique and acquisition: 0.05, 95% CI –0.18 to 0.27, P=.69; Social integration and support: –0.12, 95% CI –0.34 to 0.10, P=.27; and Health services navigation: –0.05, 95% CI –0.29 to 0.19, P=.69). For the secondary outcomes, there were no statistically significant differences in adjusted analyses except in 1 self-efficacy domain (Total plus), where the Txt2Prevent group had lower scores (mean difference –0.36, 95% CI –0.66 to –0.50, P=.03). The study protocol was feasible, but recruitment took longer than expected. Over 90% (29/31 [94%]) of participants reported they were satisfied with the program.ConclusionsThe Txt2Prevent study was feasible to implement; however, although exploratory, there were no differences between the 2 groups in adjusted analyses except for 1 self-efficacy domain. As the intervention appeared acceptable, there is potential in using SMS text messages in this context. The design of the intervention may need to be reconsidered to have more impact on outcome measures.Trial RegistrationClinicalTrials.gov NCT02336919; https://clinicaltrials.gov/ct2/show/NCT02336919International Registered Report Identifier (IRRID)RR2-10.2196/resprot.6968

Does the use of herbal medicine affect adherence to medication - a cross sectional study of outpatients with chronic disease?

IntroductionThe use of herbal medicine is common and is increasing globally but it is unknown whether this affects patients’ use of western medicine. The aim of this study was to investigate whether herbal medicine (HM) use may effect medication adherence in Turkish patients with chronic disease attending internal medicine outpatient clinics. MethodsPatients prescribed medication by a medical doctor for longer than one year for a chronic disease and with any symptoms were identified from the register of patients attending a general internal medicine outpatient clinic. Medication adherence was measured using the Morisky Medication Adherence Scale (MMAS) score. Patients were questioned about whether they had used any HMs. ResultsOut of 912 patients examined, 516 patients (51.7% female patients, mean age 52.4) met the inclusion criteria. Use of the HMs was positively correlated with educational status and monthly income and negatively correlated with the MMAS score. Multivariate logistic regression analysis demonstrated that use of herbs and/or herbal products was significantly associated with the MMAS score (OR: 0.85, 95% CI 0.78-0.93, p < 0.001). ConclusionLow medication adherence was found to be independently associated with the use of HMs in this study population. Medication non-adherence is an important public health problem for all departments of medicine. Hospitalizations, drug resistance and disease relapse in patients with chronic diseases could be prevented if medication adherence is achieved

Validity and Reliability of the Japanese Version of the Morisky Medication Adherence Scale-8 in Patients With Ulcerative Colitis

The Morisky Medication Adherence Scale is a clinically relevant tool used to evaluate medication adherence. In the current study, the validity and reliability of a Japanese version of the Morisky Medication Adherence Scale and factors related to low adherence were investigated in patients with ulcerative colitis. The original English version was translated into Japanese and then 3 institutions in Japan administered that Japanese version to 428 patients taking medication. Factor validity, internal consistency, and correlations between the Morisky Medication Adherence Scale and adherence were calculated on the basis of patients' own reports of skipped medication, and known group validity between clinically different groups was assessed. Logistic regression was used to assess relationships between low adherence and other factors. The Morisky Medication Adherence Scale identified 184 of 428 patients (43.0%) who exhibited low adherence. Confirmed factor analysis indicated one-dimensionality of the scale. Cronbach's α was 0.74. The Morisky Medication Adherence Scale score was significantly correlated with self-reported missed medication. Patients who were on concomitant induction therapy exhibited significantly better Morisky Medication Adherence Scale scores than those who were not. Patients with low adherence reported difficulty taking medicine, having proctitis, and ulcerative colitis duration of less than 5 years, and were of younger age. The Japanese Morisky Medication Adherence Scale yielded clinically relevant measures of adherence in patients with ulcerative colitis and may promote further international comparative studies.

Associated factors with treatment adherence of patients diagnosed with chronic disease: Relationship with health literacy

AimThis study aimed to examine the relationship between the health literacy level and treatment adherence in patients with chronic disease. BackgroundNonadherence to treatment and insufficient health literacy can cause a decrease in understanding treatment methods, an increase in medication errors, and an increase in morbidity and mortality rates. Materials and methodsThis cross-sectional study comprised a total of 200 patients who were taking medication for a chronic disease. Data were collected using an 18-item questionnaire for sociodemographic and medical characteristics, the Adult Health Literacy Scale (AHLS), and the Morisky Medication Adherence Scale (MMAS). ResultsOf the patients, 42.5% reported that they took three or more medications per day, and 32.0% reported that they did not know the side effects of these medications. Of the patients, 39.0% had low adherence to treatment. The mean score of the AHLS was 12.8 ± 4.74 (min = 2; max = 21). A statistically significant positive correlation was found between the AHLS scores and MMAS scores (r = 0.604; p = 0.001). ConclusionsThis study revealed that patients' adherence to treatment increased as their health literacy increased. Thus, it is recommended that health literacy levels of the patients be raised through effective interventions to ensure better adherence to treatment.

Evaluating the User Preference and Level of Insulin Self-Administration Adherence in Young Patients With Type 1 Diabetes: Experience With Two Insulin Pen Needle Lengths.

BackgroundSelecting the appropriate insulin pen needle is important to reduce pain and injection-related adverse events like insulin leakage. It also helps to improve medication adherence and glycemic control in patients with type 1 diabetes mellitus (T1DM).ObjectiveThis study aimed to compare the 6-mm and 8-mm 32.5-gauge insulin pen needles in terms of glycemic control, pain score, user preference, medication adherence, and injection adverse events in patients with T1DM.MethodsWe conducted a prospective cohort study of 62 patients with T1DM. All patients constituted an experimental group initially and then changed the length of the needle to be part of a self-control group. The glycemic control, visual analog scale (VAS) pain score, Morisky Medication Adherence Scale (MMAS) score, needle attribute score, and injection-related adverse events were measured for all patients with both lengths of needles. Patients were assessed at the baseline visit and followed up for three months. Statistical comparisons were done by the chi-squared test, paired t-test, and paired Wilcoxon test when appropriate with a two-tailed alpha level below 0.05 indicating statistical significance.ResultsWith the NanoPass® 32.5-gauge, 6-mm needle (Terumo Corp., Tokyo, Japan), patients had significantly lower glycated hemoglobin (HbA1c) compared to 8-mm needles (7.9% vs. 8.3%; p<0.001). The proportions of patients who reported no hypoglycemic episodes were 22/62 and 9/62, with the 6-mm and 8-mm needles, respectively. The 6-mm needles were better in terms of the following parameters compared to 8-mm needles: mean needle attribute scores (36.7 vs. 24.2; p<0.001), median VAS pain scores (20 vs. 55; p<0.001), insulin leakage (6/62 vs. 20/62; p=0.002), and the MMAS score (4.9 vs. 3.4; p<0.001).ConclusionThis study provided an overview of the safety, adherence, pain score, and glycemic control relating to the 6-mm and 8-mm insulin needle lengths. Insulin injections using the NanoPass 32.5-gauge, 6-mm needle were associated with lower pain score, higher patient adherence, fewer adverse events, and better glycemic control compared to the 8-mm needle. Therefore, we recommend the use of the NanoPass 6-mm needle for patients with T1DM. Further studies are needed to confirm these findings in patients with type 2 diabetes mellitus (T2DM).