Outpatient Adherence Research Articles

Factors Predicting Treatment Adherence in Outpatients with Cancer-Related Edema: Decision Tree Analysis.

This study aimed to determine the combination of factors associated with continuity of care in outpatients with cancer-related edema six months after the initial visit. A total of 101 outpatients were divided into two groups: continuation (n=65) and non-continuation (n=36) groups. Details regarding age, body mass index, sex, affected extremities (upper or lower), site of edema (unilateral or bilateral), International Society of Lymphology (ISL) classification, presence of distant metastasis, and overall score on the lymphedema quality of life questionnaire (LYMQOL) were obtained before initial lymphedema care. In this study, we performed a decision tree analysis using a classification and regression tree (CART) to detect the combination of factors associated with the continuity of edema care for cancer-related edema. Significant differences were observed in the site of edema (unilateral or bilateral) and distant metastasis between the two groups. In the decision tree using CART analysis, the factors selected to influence the possibility of continuation were the side of edema as the first layer, and body mass index of 23.0 and distant metastasis (with/without) as the second layer. Outpatients with unilateral edema and a body mass index higher than 23.0 were most likely to be able to continue care. In contrast, outpatients with bilateral edema and distant metastasis had greater difficulty in continuing care. In this study, factors that were suggested to influence the continuity of cancer-related edema care were the side with edema, body mass index higher than 23.0, and distant metastasis. This information may be helpful for developing care strategies and improving patient adherence.

Statin adherence in coronary outpatients: a novel direct method compared with pharmacy registry data

Statin adherence in coronary outpatients: a novel direct method compared with pharmacy registry data

Cost-effectiveness of outpatient adherence to recommendations for monitoring of patients hospitalized for heart failure.

A set of indicators to assess the quality of care for patients hospitalized for heart failure was developed by an expert working group of the Italian Health Ministry. Because a better performance profile measured using these indicators does not necessarily translate to better outcomes, a study to validate these indicators through their relationship with measurable clinical outcomes and healthcare costs supported by the Italian National Health System was carried out. Residents of four Italian regions (Lombardy, Marche, Lazio, and Sicily) who were newly hospitalized for heart failure (irrespective of stage and New York Heart Association class) during 2014-2015 entered in the cohort and followed up until 2019. Adherence to evidence-based recommendations [i.e. renin-angiotensin-aldosterone system (RAS) inhibitors, beta-blockers, mineralocorticoid receptor antagonists (MRAs), and echocardiograms (ECCs)] experienced during the first year after index discharge was assessed. Composite clinical outcomes (cardiovascular hospital admissions and all-cause mortality) and healthcare costs (hospitalizations, drugs, and outpatient services) were assessed during the follow-up. The restricted mean survival time at 5years (denoted as the number of months free from clinical outcomes), the hazard of clinical outcomes (according to the Cox model), and average annual healthcare cost (expressed in euros per person-year) were compared between adherent and non-adherent patients. A non-parametric bootstrap method based on 1000 resamples was used to account for uncertainty in cost-effectiveness estimates. A total of 41406 patients were included in this study (46.3% males, mean age 76.9±9.4years). Adherence to RAS inhibitors, beta-blockers, MRAs, and ECCs were 64%, 57%, 62%, and 20% among the cohort members, respectively. Compared with non-adherent patients, those who adhered to ECCs, RAS inhibitors, beta-blockers, and MRAs experienced (i) a delay in the composite outcome of 1.6, 1.9, 1.6, and 0.6months and reduced risks of 9% (95% confidence interval, 2-14%), 11% (7-14%), 8% (5-11%), and 4% (-1-8%), respectively; and (ii) lower (€262, €92, and €571 per year for RAS inhibitors, beta-blockers, and MRAs, respectively) and higher costs (€511 per year for ECC). Adherence to RAS inhibitors, beta-blockers, and MRAs showed a delay in the composite outcome and a saving of costs in 98%, 84%, and 93% of the 1000 bootstrap replications, respectively. Strict monitoring of patients with heart failure through regular clinical examinations and drug therapies should be considered the cornerstone of national guidelines and audits.

The Effect of an Educational Program on Treatment Adherence of Chronic Obstruction Pulmonary Disease: A Randomized Controlled Trial

Purpose: this study evaluates the effectiveness of a health education intervention program on treatment adherence of COPD outpatients.
 Methodology: This randomized controlled trial was conducted in 2022 with 90 COPD outpatient people. Self-management education was developed on the basis of the Theory of Planned Behavior. Medication adherence was assessed using Test of Adherence to Inhalers (TAI-10), and the practice checklist of breathing exercises, respectively.
 Findings: At beginning, there were no significant differences between-group regarding participants’ medication adherence. After 3 months’ intervention, the rates showed a significant increasing for treatment adherence in intervention group (P < 0.05).
 Unique contribution to theory, practice, and policy (recommendations): Health education interventions have proven effective in increasing treatment adherence of outpatients with COPD. So, an intervention program should be conduct on a larger scale to improve treatment adherence for COPD patients in the future.

Treatment Adherence of Out-Patients with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study

Purpose: The study conducted to identify the status of treatment adherence, and factors related to treatment adherence in COPD outpatient. Methodology: A cross-sectional study was conducted on 420 COPD out-patients from April 2021 to August 2022. Treatment adherence was assessed through 2 checklists, including adherent inhaled drugs, and adherent breathing exercises. Descriptive statistics, multivariable logistic regression analysis was used to data analyzed.Findings: 36.9% of participants were being assessed treatment adherence, of which 44.7% adhered to inhaled drugs using, and 36.9% adhered to breathing exercises practice. For correlated factor, smoking was related to treatment adherence (p<0.05). Unique contributor to theory, policy and practice: Patient's knowledge about control COPD, practicing breathing exercises, and treatment adherence level were low. Therefore, intervention programs to support patients improving these problems, thereby enhancing patient's quality of life is necessary.

Potential barriers towards optimal medication adherence in out-patients with stable coronary artery disease

Introduction. The results from foreign and local studies demonstrate that more than a half of patients with cardiovascular diseases do not take medication in compliance with doctors’ recommendations. The search for significant barriers to optimal medication adherence might improve the development of adherence control measures in patients with stable coronary artery disease (SCAD) in routine clinical practice of primary care.Aim. To study the nature and incidence of potential barriers to optimal medication adherence and their association with social and demographic parameters in patients with SCAD.Methods. This publication describes the fragment of the study “PHARMCARE” in which 123 coronary patients were included. Data on demography, social status, medical history and pharmacotherapy were registered. The barriers to medication adherence were identified by means of validated scale (questionnaire) SEAMS (Self-Efficacy for Appropriate Medication Use Scale). Data analysis was conducted by descriptive statistics and regression modeling.Results. The analysis of incidence of barriers to medication adherence allowed to identify the list of most significant ones: “fear of side effects”, “intake of several different medicines each day”, “intake of medicines more than once a day”, “medicines look different than usual”, “normal routine gets messed up”, “busy day planned”, “no one reminds to take medicines” and “staying away from home”. More than a third of all the respondents reported at least one of barriers (37%), that was in major cases “fear of side effects” (22%). Linear one-factor modeling revealed association of number of significant barriers in patients with level of their education (р=0,009) and presence of partner or caregiver (р=0,001), that was also confirmed by the multivariate model. Less barriers were identified in coronary patients that had partner or caregiver (р=0,009) and higher education (р=0,045).Conclusion. The study results revealed that the significant barriers to optimal medication adherence in out-patients with SCAD were related either to patients’ behavior or to pharmacotherapy profile. Uncertainty in overcoming barriers was most typical for single patients without higher education. The obtained results should be taken into consideration when develop strategies for improvement of medication adherence in patients with SCAD in primary care practice.

Treatment adherence of outpatients with chronic myeloid leukemia at National institute of Hematology & Blood transfusion

Objective: To describe the treatment adherence of outpatients with chronic myeloid leukemia at national institute of hematology & blood transfusion. Subjects and Methods: A cross-sectional descriptive study was conducted on 170 outpatients at National Institute of Hematology and Blood Transfusion from January 2022 to June 2022. Results: 98.8% of patients came to the clinic for examination on time. The percentage of patients with drug adherence accounted for 68.8%. There were still many patients who did not comply because they forgot to take the medicine, stopped taking it on their own, and found it difficult to take the medicine. 42.35% of patients had limited knowledge about the disease. Adherence to the diet was relatively good. However, the salt and fat reduction diet was still not well implemented. The exercise regime was still limited, the percentage of people who do exercise occasionally and do not exercise accounted for 50.6%. Conclusion: The rate of patient adherence to treatment was still not high. Interventions are needed to enhance the drug adherence of patients.

Analysis of Outpatient Adherence in 45,237 Patients Referred by an Emergency Department to Surgical Clinics.

IntroductionThis study examines referral patterns to surgical clinics from the emergency department and the impact of sociodemographic factors on adherence.MethodsPatients from 2017 to 2021 were identified who had a referral placed to surgical specialties from the ED. The primary outcome was the proportion of patients who had a referral to surgery placed during an ED visit but who showed up to surgery clinic visit within 60 days of referral placement. Univariate and multivariate analysis was performed.ResultsReferrals were made for 45,237 patients overall and 4130 for general surgery specifically. 44% showed up to general surgery clinic visit. In univariate and multivariate analysis, those who showed up to clinic were older, tended to be female, had a lower social economic status, had Medicaid or Medicare insurance and had more comorbidities compared to those who did not show up. Asians and Hispanics were more likely to show up to clinic compared to Whites.ConclusionsAssigning navigators in the ED to follow-up with patients who are younger and healthier, with private insurances who have existing PCPs to ensure they follow up as advised is a potential targeted intervention to improve clinic adherence.

Attitude and influencing factors of patients with schizophrenia toward long-acting injections: A community-based cross-sectional investigation in China.

BackgroundLow prescription rates of antipsychotic long-acting injections (LAIs) may be a major challenge in the prevention and treatment of schizophrenia. However, there are few studies on the usage and attitude toward LAIs among community-based patients with schizophrenia.MethodsA large community-based cross-sectional investigation was conducted among 6,336 patients with schizophrenia from Shanghai, China from March 1 to June 30, 2021. The structured Attitude and Status toward Treatment of Community Patients with Schizophrenia Questionnaire (AST-CSQ) was used to investigate the attitude and influencing factors of community-dwelling patients with schizophrenia toward LAIs.ResultsAmong the 6,336 participants, the average age was 49.28 ± 11.23. The rate of agreement to LAI antipsychotics among participants was 3.16% (n = 200). The family financial resources, care ability, and disease course of the LAIs group were less than those of the non-LAIs group. However, the LAIs group had higher immediate family guardianship, social activity, previous hospitalization, number of hospitalization, outpatient adherence, previous antipsychotic use, antipsychotic adherence, and attitude toward oral antipsychotics than the non-LAIs group, with significant differences between the two groups (p < 0.05). Furthermore, age (β = −0.036, OR 0.964, 95% CI 0.947–0.982), marital status (β = 0.237, OR 1.267, 95% CI 1.002–1.602), care ability (β = 0.709, OR 2.032, 95% CI 1.437–2.875), outpatient adherence (β = −0.674, OR 0.510, 95% CI 0.358–0.725), antipsychotic adherence (β = 0.920, OR 2.509, 95% CI 1.092–5.764), and attitude toward oral antipsychotics (β = −1.357, OR 0.258, 95% CI 0.103–0.646) were significant predictors of attitude toward LAI antipsychotics (p < 0.05).ConclusionsThe community-dwelling patients with schizophrenia in China had a low willingness to use LAIs. Patients of a younger age, more hospitalizations, and a shorter course of disease were prone to be more willing to accept LAIs. The patients' age, marital status, care ability, outpatient adherence, antipsychotic adherence, and attitude toward oral antipsychotics were important predictor of patients' attitudes toward LAIs. Under the global deinstitutionalized management model of mental disorders, these results highlight an urgent problems for public mental health service providers and policy-makers and provide more solutions for them.

Treatment adherence in asthma outpatients at Ba Ria hospital in 2021-2022

Background: The Global Burden of Disease Study found that in 2017, asthma caused about 495 thousand deaths, affecting about 300 million people worldwide. Adherence increases the effectiveness of treatment. Studies on asthma in the world and in Vietnam show that the adherence rate fluctuates in various regions, ranging from 30 to 70%. Objectives: To determine the rate of treatment adherence and some associated factors in outpatients with asthma at Ba Ria Hospital in 2021-2022. Materials and methods: A cross-sectional study on 247 asthma patients from October 2021 to January 2022. Assessment of treatment adherence using Atta Abbas Naqvi's General Medication Adherence Scale (GMAS) scale. Results: The study showed that 77.7% of asthmatics had adherence with GMAS 30-33 points (GMAS=33 accounted for 48.6%, GMAS=30-32 points accounted for 29.1%). Multivariable logistic regression analysis showed that age, smoking, Covid- 19 epidemic statistically significantly affect treatment adherence of asthma patients. Conclusion: The study showed that treatment adherence in asthma outpatients at the hospital reached a high level compared with domestic and international studies.

Medication Adherence of Vietnamese Outpatients with Chronic Diseases during the COVID-19 Pandemic.

The purpose of this study was to determine the medication adherence of outpatients with chronic diseases and the association between both patient attitudes and preventive practices regarding COVID-19 and their medication adherence. We performed a cross-sectional study in Vietnam. Medication adherence was determined using the translated and validated Vietnamese version of the General Medication Adherence Scale (GMAS). Patient attitudes and preventive practices regarding COVID-19 were measured using the 5K message of the Vietnam Ministry of Health (facemasks, disinfection, distance, no gatherings, health declarations). The associations between patient characteristics and medication adherence were determined by multivariable regression. The study included 1852 outpatients, and 57.6% of the patients adhered to their medications. Patients who recognized the pandemic’s obstruction of medical follow-ups (OR = 1.771; 95%CI = 1.461–2.147; p < 0.001), who applied ≥2 preventive methods (OR = 1.422; 95%CI = 1.173–1.725; p = 0.001), who were employed (OR = 1.677; 95%CI = 1.251–2.248; p = 0.001), who were living in urban areas (OR = 1.336; 95%CI = 1.090–1.637; p = 0.005,) who possessed higher education levels (OR = 1.313; 95%CI = 1.059–1.629; p = 0.013), or who had ≤2 comorbidities (OR = 1.293; 95%CI = 1.044–1.600; p = 0.019) were more likely to adhere to their medications. The adherence percentage for outpatients with chronic diseases was quite low during the pandemic. Patients who did not recognize the COVID-19 pandemic’s obstruction of medical follow-ups or who had poor preventive practices were less likely to adhere to medications. Healthcare providers should pay more attention to these groups to achieve desired treatment outcomes.

The effect of initial antidepressant type on treatment adherence in outpatients with new onset depression

BackgroundContinuous use of antidepressants can relieve depressive symptoms and prevent recurrence in people with depression; however, many studies have reported low drug compliance rates. This study aimed to investigate the relationship between the type of initial antidepressants and treatment adherence in outpatients with new onset depression. MethodsThis was a retrospective cohort study using National Health Insurance claim data for services provided in 2012. We examined data from 142,336 individuals aged 18 years or older, who were continuously enrolled in treatment after a new episode of depression, and had initiated antidepressant treatment. A new diagnosis of depression, is defined as a first reported diagnosis of depression in the preceding five years. Adherence was operationally defined as the antidepressant being dispensed to the patient at least 80% of the time during the first three- and six-month treatment periods. To investigate the relationship between the initial type of antidepressants and treatment adherence, we estimated adjusted odds ratios and 95% confidence intervals using logistic regression analysis, adjusting for socio-demographic and health care utilization characteristics. ResultsA statistically significant association was found between initial antidepressant type and adherence in the first three- and six-month treatment periods for employed and self-employed patients newly diagnosed with major depression. In addition, patients with starting prescriptions for tricyclic antidepressants had significantly lower adherence compared to selective serotonin reuptake inhibitors. LimitationsThis study used national insurance data; therefore, only variables on the claim form were available, and psychological and environmental factors were not considered. ConclusionsThis was the first study to demonstrate the relationship between initial antidepressant type and treatment adherence among Korean outpatients with new onset depression.

Assessment of insulin adherence in diabetic outpatients: An observational study

In the management of diabetic patients on insulin therapy, adherence to medication is a key element for avoiding chronic complications. The purpose of this study was to evaluate diabetic patients' ability to translate glycemic results into an appropriate insulin dose and thus, adherence to insulins. This was an observational, retrospective, monocentric pilot study. Diabetic patients on insulin therapy being followed at the metabolic and endocrine diseases department were divided into two groups depending on their mode of glycemic control at home: capillary glycemia (Notebook group) or interstitial glycemia using the FreeStyle Libre® flash system (FSL group). Adherence was assessed based on the rate of compliance in adapting insulin doses to the prescribed protocols (depending on type of insulin, glycemic targets, and patients' characteristics) by a pharmacy resident and a senior diabetologist. Good adherence was defined as a minimum rate of 80% of conforming insulin injections for each patient. A total of 50 patients were included, 35 in the Notebook group and 15 in the FSL group. Two-thirds of patients were non-adherent to insulin. Dose adjustment errors mainly concerned rapid-acting insulin with 51.1% of non- conformities, 10.0% of which were due to underdosing in the Notebook group and 21.7% to overdosing in the FSL group. Hyperglycemia was predominant in both populations with a median time in range of 19.0% in the FSL group and well below recommendations (>70%). Despite the use of increasingly efficient, easy-to-use devices in diabetes monitoring, insulin non-adherence and glycemic imbalance are unresolved major issues. Diabetic patients require reinforced medical follow-up for optimal insulin management.

The Impact of Pharmacist Intervention on Clinical Outcome, Adherence, and Quality of Life of Patients with Type 2 Diabetes Mellitus

Diabetes Mellitus (DM) is a chronic disease that occurs when the body cannot produce enough insulin or cannot use insulin (insulin resistance) and diagnosed by measuring blood glucose level (BGL). BGLs of DM patients should always be controlled to prevent complications. The purpose of this analytical cohort study was to analyze the effect of pharmacy intervention (PI) on BGL, adherence, and quality of life (QOL) of DM Type 2 (T2DM) patients (n=48) admitted to Dr. Tengku Mansyur hospital in Tanjung Balai period December 2020 to May 2021. The BGL, adherence, and QOL of the patients were compared before and after PIs. The patients’ BGLs were recruited from their medical records, their adherence to medication was analyzed using MMAS-8 questionnaire, and the patients QOLs were analyzed using the EQ-5D-3L questionnaire and the scores were categorized into 3 categories (&lt; 0.60 = bad, 0.6 - &lt;0.80 = moderate, ≥0.80 = good). The obtained data were analyzed using descriptive and Wilcoxon Signed-Rank tests in the SPSS Program.&#x0D; Mean age of the patients was 59.20 ± 8.20 (years). Most (58.3%) of them were females. The mean BGLs (mg/dL) of the patients: before PI 1, 262.02±5.91; before PI 2, 259.39±5.53; after PI, 202.35±4.80; and follow up after PI, 168.60±3.07. The mean adherence scores: before PI 1, 4.833 ± 0.08; before PI 2 4.70±0.07; after PI 6.833±0.09; follow up after PI 7.793±0.05. The mean QOLs of the patients: before PI 1, 0.719±0.005; before PI 2, 0.719±0.001; after PI, 0.801±0.009; follow up after PI 0.977 ± 0.009. There were significant differences among BGLs, patients’ adherence, and their QOLs before and after PI. p=0.000&#x0D; The present study proved that PI improved medication adherence, BGLs, and QOLs of outpatients with T2DM.

Multivariate analysis of medication adherence among outpatients with stable coronary artery disease

Introduction. The results of local studies indicated that medication adherence of coronary outpatients is low (not more than 60 %). The search for significant predictors of adherence to recommended treatment might allow tailoring specific strategies to control adherence for further optimization of the pharmacotherapy of coronary artery disease (CAD) in routine primary care practice. Aim. To determine the factors associated with medication adherence in outpatients with stable CAD. Methods. This paper describes the results of the fragment of randomized controlled study of the effects of Pharmacy Care Program on medication adherence of coronary outpatients, that was conducted in 2019-2020 in one of the primary care clinics of Moscow. 123 subjects with stable CAD were included in line with the pre-specified criteria. Demography, social status, medical history, pharmacotherapy, healthcare burden data were registered. Medication adherence was measured by validated questionnaire MMAS-8 (8-item Morisky Medication Adherence Scale). The analysis of predictors of adherence was performed by linear regression. Results. Simple regression analysis revealed the list of parameters, that showed statistically significant (or as statistical trend) association with medication adherence of coronary patients in univariate models. The level of medication adherence was associated with patient’s having a partner or caregiver (p=0,002), higher education (p=0,009), additional medicinal maintenance (p=0,006). Medication adherence did not depend on medical history and pharmacotherapy characteristics, but the association of high values of low-density lipoproteins cholesterol (LDL-C) (p=0,001) with suboptimal adherence was demonstrated. Good medication adherence was associated with more frequent visits to general practitioner (p=0,036) and (as statistical trend) to cardiologist (p=0,093). The multivariate regression analysis revealed two positive independent predictors of medication adherence - patient’s having a partner or caregiver (р=0,015) and regular visits to cardiologist (р=0,025). Also, the negative association was confirmed for high LDL-C (р=0,002). Conclusion. Patient’s having a partner or caregiver and regular visits to cardiologist were revealed as independent predictors of good medication adherence of coronary outpatients. Subjects with suboptimal adherence had higher LDL-C.

A randomised controlled trial of clinical pharmacy intervention versus standard care to improve medication adherence in outpatients with head and neck cancer receiving radiotherapy.

Patient understanding of medicines information and adherence to medication instructions are important variables for ensuring optimal cancer care. This randomised controlled trial (RCT) aimed to evaluate the impact of an outpatient clinical pharmacy service on medication adherence and symptom burden in cancer patients. In this single-centre RCT, 115 patients were randomised 1:1 to a pharmacist-led pharmaceutical care program (intervention, n = 59) versus standard of care (control, n = 56) within an outpatient multidisciplinary radiotherapy clinic. The primary endpoint was medication adherence as assessed by Medication Understanding and Use Self-Efficacy (MUSE) scale and Teach-Back assessment. Secondary endpoints were patient-reported symptom burden assessed by the Edmonton Symptom Assessment Scale (ESAS). Patients were assessed at baseline (weeks 1-2) and at discharge from radiotherapy (weeks 5-7). Polypharmacy (use of five or more medications) was observed in 26% of patients at baseline compared to 97% at discharge. Patient self-efficacy and medication adherence was higher in the intervention arm compared to the control arm, with a mean MUSE score difference of 2.70 (95% CI 1.24, 4.17) after adjustment for baseline, and a higher proportion of patients with average Teach-Back score of four or more (86% vs 14%; odds ratio (OR) 46.09, 95% CI 14.49, 146.56). The mean (SD) scores for aggregate ESAS (0-100) at discharge were 26.2 (14.0) in the intervention arm and 32.0 (15.8) in the control arm demonstrating lower overall symptom burden associated with the intervention (mean score difference adjusted for baseline - 0.52; 95% CI - 1.03, - 0.01). A structured outpatient clinic pharmacy service significantly improved medication adherence and reduced overall symptom burden in patients receiving radiotherapy.

Association between previous and future antipsychotic adherence in patients initiating clozapine: real-world observational study.

Although recognised as the most effective antipsychotic for treatment-resistant schizophrenia, clozapine remains underused. One reason is the widespread concern about non-adherence to clozapine because of poor adherence before initiating clozapine. To determine if prior poor out-patient adherence to treatmentbefore initiating clozapine predisposes to poor out-patient adherence to clozapine or to any antipsychotics (including clozapine) after its initiation. This cohort study included 3228 patients with schizophrenia living in Quebec (Canada) initiating (with a 2-year clearance period) oral clozapine (index date) between 2009 and 2016. Using pharmacy data, out-patient adherence to treatment was measured by the medication possession ratio (MPR), over a 1-year period preceding and following the index date. Five groups of patients were formed based on their prior MPR level (independent variable). Two dependent variables were defined after clozapine initiation (good out-patient adherence to any antipsychotics and to clozapine only). Along with multiple logistic regressions, state sequence analysis was used as a visual representation of antipsychotic-use trajectories over time, before and after clozapine initiation. Although prior poor adherence to antipsychotics was associated with poor adherence after clozapine initiation, the absolute risk of subsequent poor adherence remained low, regardless of previous adherence level. Most patients adhered to their treatment after initiating clozapine (>68% to clozapine and >84% to any antipsychotics). Despite the fact that poor adherence prior to initiating clozapine is widely recognised by clinicians as a barrier for the prescription of clozapine, the current study supports the initiation of clozapine in all eligible patients.

Mind Your Heart: Exploring Feasibility, Acceptability, and Preliminary Effects of Phone-Delivered Mindfulness Training on Medication Adherence in Outpatients With Chronic Heart Failure.

Mindfulness training (MT) may promote medication adherence in outpatients with heart failure. The aims of this study were to determine the feasibility and acceptability of MT (primary outcomes) and explore effects on medication adherence, functional capacity, cognitive function, depression, and mindfulness skills (secondary outcomes). In this pre/post-design study, participants received a 30-minute phone-delivered MT session weekly for 8 weeks. We enrolled 33 outpatients (32% women; 69.7 White; mean age, 60.3 years). Retention was 100%, and session attendance was 91%. Overall, participants (97%) rated MT as enjoyable. Objectively assessed ( P &lt; .05) adherence decreased post intervention, whereas improvements were noted in functional capacity ( P = .05), mindfulness ( P &lt; .05), and cognitive function (reaching significance for Flanker scores). Phone-delivered MT was feasible and acceptable. Whereas no improvements were noted in medication adherence and depression, cognitive function, functional capacity, and mindfulness levels increased post intervention, suggesting MT may have beneficial effects in outpatients with heart failure.

Effects of Pharmacy Care Program on medication adherence in outpatients with stable coronary artery disease: a randomized controlled study

Aim. To assess the effects of the Pharmacy Care Program on medication adherence in outpatients with stable coronary artery disease (SCAD).Material and methods. An open randomized controlled study was conducted in primary care clinic over the period of 2019-2020. All subjects (n=126) were randomized at visit 1 into the multifaceted intervention group (n=63) or control group (n=63) and invited 12 months after to visit 2. Patients of intervention group were included into the Pharmacy Care Program, which consisted of the following components: pharmacist-led counseling, provision of education materials and 7-day pillbox, weekly SMS-reminders. Medication adherence was measured initially and at the end of the study period by means of eight-item Morisky Medication Adherence Scale (MMAS-8) and Self-Efficacy for Appropriate Medication Use Scale (SEAMS).Results. The implementation of the Pharmacy Care Program improved medication adherence in SCAD outpatients with MMAS-8 median score of 7,0-8,0 (p&lt;0,001) and SEAMS median score of 35,0-36,0 (p=0,017). In the control group, no changes (p=0,123) in MMAS-8 score were revealed, while SEAMS score decreased from 35,0 down to 34,5 (p=0,003). The reduction in systolic blood pressure (p=0,049) and risk of urgent hospital admission (OR=0,28; 95% CI, 0,08-0,99; p=0,041) was registered in the intervention group in contrast to the control group over the 12-month period.Conclusion. The multicomponent intervention within the Pharmacy Care Program contributed to an increase in the adherence to pharmacotherapy of outpatients with stable CAD.

An Empirical Study on Factors Affecting Medication Adherence in Outpatients with Depression: From the Perspective of Medication Support for Patients Using Pharmacies

An Empirical Study on Factors Affecting Medication Adherence in Outpatients with Depression: From the Perspective of Medication Support for Patients Using Pharmacies