Outpatient Compliance Research Articles

TINGKAT KEPATUHAN PENGGUNAAN OBAT ANTIDIABETES DI RS PKU AISYIYAH BOYOLALI

Diabetes mellitus or DM is a degenerative disease that is often found in society. This disease is characterized by high blood sugar caused by impaired insulin production which plays a role in glucose metabolism in pancreatic function. If someone is diagnosed with diabetes, the only treatment is to control blood sugar. This treatment requires compliance because it is carried out over a long and unlimited period of time. However, there is a problem of compliance with treatment because many conditions are neglected. This study aims to determine the level of compliance of outpatients in the internal medicine polyclinic at PKU Aisyiyah Boyolali Hospital in undergoing treatment for diabetes mellitus. This research is a descriptive research. Data collection used the Morisky Medication Adherence Scale-8 (MMAS-8) questionnaire to measure patient compliance. The sample used was 60 respondents with a sampling technique using purposive sampling. The results of the study showed that 14 patients (23%) had a high level of compliance, 40 patients (67%) had a medium level of compliance, and 6 patients (10%) had a low level of compliance.

Adherence and recommended optimal treatment to Azvudine application for the treatment of outpatient COVID-19 patients: A real-world retrospective study

BackgroundAzvudine was approved for the treatment of coronavirus disease 2019 (COVID-19) in China and has been widely used since the outbreak in December 2022. However, real-world research on the adherence of Azvudine is lacking. Additionally, limited research exists on determining the optimal duration for Azvudine treatment. MethodsWe studied adult patients with COVID-19 who got Azvudine or supportive treatment at an outpatient department between December 19, 2022 and January 5, 2023. The enrolled patients were divided into two groups: the Azvudine group, which received Azvudine, and the control group, which only received supportive care. We recorded their information and analyzed it using descriptive statistics. The primary outcome of this study was the compliance of outpatients with Azvudine, and the secondary outcome of this study was the optimal duration of Azvudine. Inverse probability weighting (IPW) was used to address the imbalance between groups when comparing the optimal duration of Azvudine, and Cox regression to evaluate the effect of Azvudine on the 28-day disease progression rate. ResultsWe enrolled a total of 882 patients, of which 382 received Azvudine. Among the patients, 94.0 % (359) had good compliance, and non-compliance was primarily attributed to dosage errors. Azvudine appeared to have a beneficial therapeutic effect when administered for at least 7 days. ConclusionsOutpatients have relatively good compliance with Azvudine, and optimal therapeutic effects were observed with the recommended duration of at least 7 days.

Age as a predictive factor for reduced intracranial compliance in patients with headache.

Increased intracranial pressure (ICP) consists of a set of signs and symptoms related to changes in intracranial compliance (ICC) and ICP. This study presents a retrospective analysis of patients who underwent non-invasive monitoring of ICC based on complaints of headache, correlating decreased brain compliance and increased intracranial pressure. Noninvasive ICC monitoring was performed using a Brain4care device, which contains a strain gauge and a recorder connected to a mechanical device that touches the scalp surface in the frontoparietal area lateral to the sagittal suture. This tool monitors the ICP by identifying small changes in skull measurements that are caused by pressure variations, i.e., skull deformation is associated with the detection of changes in mean ICP. A clinical evaluation of 32 patients with complaints of headache occurred from the analysis of their medical records. Of the 32 patients initially chosen, it was possible to complete the analysis of 18 due to the availability of data in the medical records. From the non-invasive monitoring of the ICC, the following data were collected: time-to-peak, P2/P1 ratio, age, and gender. From the statistical analysis of age and P2/P1 ratio, it was noted that as age increases, ICC tends to decrease regardless of sex (p < 0.05). This study concluded that there is a correlation between changes in intracranial compliance and headache complaints in outpatients. There was also a relationship between age and decreased intracranial compliance but without a specific pain pattern.

The correlation between knowledge, attitude and family support on compliance of outpatients with hypertension in a healthcare centre in Indonesia

Background: Hypertension is a silent killer disease in the community. The success of hypertension therapy is influenced by adherence to medication. Three factors that shape compliance behaviour are knowledge and attitudes (these are predisposing factors) and family support (as a reinforcing factor). The majority of people in Indonesia choose healthcare centers when seeking hypertension treatment. Non-adherence to treatment has an impact on the incidence of complications. Objective: This current study was conducted on outpatients in the Tanggulangin Primary Healthcare Centre, Sidoarjo, Indonesia. Method: This study used a correlational design and a cross-sectional approach, involving 72 people in the sample. The variables measured were: knowledge, attitudes of patients, family support as well as patient compliance with hypertension treatment. Data was collected through a questionnaire instrument. Data analysis was done descriptively and correlatively. Results: The most widely accepted hypertension drug was amlodipine 78.6%, and a single therapy was given to 86.1% of patients. Most patients had suffered from hypertension for less than one year (38.9%); and half of the patients had family members who suffered from hypertension (52.1%). Patient knowledge of hypertension was moderate (69.4%). Most of the patients had a positive attitude (83.3%), good family support (76.5%), however, 94.5% did not comply with medication. The Spearman Rho test showed compliance with treatment was influenced by knowledge (5.9%) and attitude (14.8%). Meanwhile, the family support variable had no effect on compliance. Conclusion: This study concludes patient compliance to hypertension medication in the Tanggulangin Primary Healthcare Centre is only influenced by patient knowledge and attitudes.

Risks of complicated acute appendicitis in patients with psychiatric disorders

BackgroundAcute appendicitis often presents with vague abdominal pain, which fosters diagnostic challenges to clinicians regarding early detection and proper intervention. This is even more problematic with individuals with severe psychiatric disorders who have reduced sensitivity to pain due to long-term or excessive medication use or disturbed bodily sensation perceptions. This study aimed to determine whether psychiatric disorder, psychotropic prescription, and treatment compliance increase the risks of complicated acute appendicitis.MethodsThe diagnosis records of acute appendicitis from four university hospitals in Korea were investigated from 2002 to 2020. A total of 47,500 acute appendicitis-affected participants were divided into groups with complicated and uncomplicated appendicitis to determine whether any of the groups had more cases of psychiatric disorder diagnoses. Further, the ratio of complicated compared to uncomplicated appendicitis in the mentally ill group was calculated regarding psychotropic dose, prescription duration, and treatment compliance.ResultsAfter adjusting for age and sex, presence of psychotic disorder (odds ratio [OR]: 1.951; 95% confidence interval [CI]: 1.218–3.125), and bipolar disorder (OR: 2.323; 95% CI: 1.194–4.520) was associated with a higher risk of having complicated appendicitis compared with absence of psychiatric disorders. Patients who are taking high-daily-dose antipsychotics, regardless of prescription duration, show high complicated appendicitis risks; High-dose antipsychotics for < 1 year (OR: 1.896, 95% CI: 1.077–3.338), high-dose antipsychotics for 1–5 years (OR: 1.930, 95% CI: 1.144–3.256). Poor psychiatric outpatient compliance was associated with a high risk of complicated appendicitis (OR: 1.664, 95% CI: 1.014–2.732).ConclusionsThis study revealed a close relationship in the possibility of complicated appendicitis in patients with severe psychiatric disorders, including psychotic and bipolar disorders. The effect on complicated appendicitis was more remarkable by the psychiatric disease entity itself than by psychotropic prescription patterns. Good treatment compliance and regular visit may reduce the morbidity of complicated appendicitis in patients with psychiatric disorders.

Factors affecting adherence to physical training in the outpatient phase of rehabilitation, in patients after coronary artery bypass grafting.

Aim To evaluate the outpatient physical exercise (PE) compliance and the affecting factors in patients after coronary bypass (CB).Material and methods The study included 67 men with ischemic heart disease younger than 75 years who had had CB. All patients were randomized to 2 groups: group 1 exercised on a bicycle ergometer at the rehabilitation center, under the monitoring of medical staff; patients of group 2 performed home-based exercise (HBE) by dosed walking. In the preoperative period, at one month after CB, and after 3 months of exercise, the following was evaluated: clinical condition of patients in different groups, plasma concentrations of lipids, body weight index, waist circumference, echocardiography and bicycle ergometry data, and questionnaire data (SF-36, Bek's Depression Inventory). At 3 months of follow-up, the outpatient exercise compliance and the affecting factors were also evaluated.Results The study demonstrated the effectiveness of the proposed alternative 3-month program of home-based PE. Both the patients exercising on a bicycle and those performing HBE had increased exercise tolerance (ET) and improved blood lipid concentrations. The number of obese patients decreased. Also, depression severity decreased, quality of life (physical and psychological components) improved, and compliance with drug therapy increased in both groups. Analysis of the training attendance in the recommended period showed that patients who had undergone CB were insufficiently adherent to physical rehabilitation programs, regardless of the program type (home-based or monitored). The highest PE adherence was observed in men with the following characteristics: married, working urban residents, with a previous history of cardiovascular diseases, who had regularly taken medications in the preoperative period, and who also had higher quality of life.Conclusion The proposed outpatient 3-month physical rehabilitation programs increase the effectiveness of CB, which is evident as improved adherence to modifying cardiovascular risk factors, increased ET, optimization of the psychological status and quality of life, and improved compliance with drug therapy. However, despite the proposed alternative, home-based 3-month physical rehabilitation programs aimed at increasing the treatment compliance, the level of ET remained low. This requires further improvement of methods for monitoring and motivation of patients to physical rehabilitation and psychological support that would start already at the preoperative stage.

Determinants of improvement trends in health workers' compliance with outpatient malaria case-management guidelines at health facilities with available "test and treat" commodities in Kenya.

BackgroundHealth workers’ compliance with outpatient malaria case-management guidelines has been improving in Africa. This study examined the factors associated with the improvements.MethodsData from 11 national, cross-sectional health facility surveys undertaken from 2010–2016 were analysed. Association between 31 determinants and improvement trends in five outpatient compliance outcomes were examined using interactions between each determinant and time in multilevel logistic regression models and reported as an adjusted odds ratio of annual trends (T-aOR).ResultsAmong 9,173 febrile patients seen at 1,208 health facilities and by 1,538 health workers, a higher annual improvement trend in composite “test and treat” performance was associated with malaria endemicity-lake endemic (T-aOR = 1.67 annually; p<0.001) and highland epidemic (T-aOR = 1.35; p<0.001) zones compared to low-risk zone; with facilities stocking rapid diagnostic tests only (T-aOR = 1.49; p<0.001) compared to microscopy only services; with faith-based/non-governmental facilities compared to government-owned (T-aOR = 1.15; p = 0.036); with a daily caseload of >25 febrile patients (T-aOR = 1.46; p = 0.003); and with under-five children compared to older patients (T-aOR = 1.07; p = 0.013). Other factors associated with the improvement trends in the “test and treat” policy components and artemether-lumefantrine administration at the facility included the absence of previous RDT stock-outs, community health workers dispensing drugs, access to malaria case-management and Integrated Management of Childhood Illness (IMCI) guidelines, health workers’ gender, correct health workers’ knowledge about the targeted malaria treatment policy, and patients’ main complaint of fever. The odds of compliance at the baseline were variable for some of the factors.ConclusionsTargeting of low malaria risk areas, low caseload facilities, male and government health workers, continuous availability of RDTs, improving health workers’ knowledge about the policy considering age and fever, and dissemination of guidelines might improve compliance with malaria guidelines. For prompt treatment and administration of the first artemether-lumefantrine dose at the facility, task-shifting duties to community health workers can be considered.

Food Allergy Management Has Been Negatively Impacted During the COVID-19 Pandemic

ABSTRACT Objective: The coronavirus disease 2019 (COVID-19) pandemic creates secondary problems for the health care system, and understanding specific issues can guide the management of the pandemic and its future consequences. We aimed to characterize the problems and related risk factors experienced with outpatient compliance and dietary compliance of children with food allergies during the COVID-19 pandemic. Materials and Methods: A cross-sectional survey was conducted on the mothers of children with ongoing food allergies, eight months after Turkey’s first confirmed case of COVID 19. Results: Of the 288 patients, 76.3% and 40.2% were non-adherent to their scheduled appointments and oral food challenge, respectively, during the pandemic. The group non-adherent to their scheduled visit was significantly older (p=0.005), had more frequent home food trials without the consent of their physicians (p&lt;0.001), and had less usable epinephrine auto-injectors (EAI) available compared with the adherent group (p&lt;0.001). Eighty-nine patients (30.9%) with home food trial experience had more essential food allergies (p&lt;0.001) and experienced more allergic reactions (p=0.002), compared with patients who adhered to dietary elimination. Thirty parents (10.4%) eliminated some foods from their children’s diet because of the suspected reactions. Conclusion: The COVID-19 pandemic, significantly reduces adherence with scheduled appointments and OFC, and increases home food trials and food eliminations without physician approval. Keywords: The COVID-19 pandemic, food allergy, compliance, telemedicine, oral food challenge

Outpatient Prescription Practices in Patients with Atrial Fibrillation (From the NCDR PINNACLE Registry)

This study sought to evaluate inappropriate prescribing practices in an atrial fibrillation (AF) population, as outlined by the 2016 ACC/AHA Clinical Performance and Quality Measures for Adults with Atrial Fibrillation or Atrial Flutter document. The 2016 AF quality measures document specified medications to avoid in certain AF populations, including aspirin and anticoagulant combination therapy in patients without cardiovascular disease, and non-dihydropyridine calcium channel blockers in patients with reduced ejection fraction. Using data from the NCDR PINNACLE registry, a national outpatient cardiology practice registry, we assessed rates of inappropriate prescription of two types of medications among AF outpatients from 5/1/2008-5/1/2016. Overall rates of inappropriate prescription and variation by practice were calculated. Patient and practice factors associated with inappropriate prescription were assessed in adjusted analyses. A total of 107,759 of 658,250 (16.4%) patients without cardiovascular disease were inappropriately prescribed an antiplatelet and anticoagulant together, and 5,731 of 150,079 (3.8%) patients with reduced ejection fraction were inappropriately prescribed a non-dihydropyridine calcium channel blocker. Overall, 14.8% of AF patients were prescribed medications that were not recommended. Both patient and practice factors were associated with inappropriate prescribing, and the adjusted practice-level median odds ratio for inappropriate prescription was 1.70 (95% CI: 1.61-1.82), indicating a 70% likelihood that 2 random practices would treat identical AF patients differently. In a large registry of AF patients treated in cardiology practices, overall rates of inappropriate prescription practices, as defined by the 2016 AF quality measures, were relatively low, but significant practice variation was present.

S3162 Bowel Preparation Compliance in Outpatient Colonoscopy

INTRODUCTION: Modifiable variables influence the effectiveness of colonoscopy. These include patient related such as compliance with pre-colonoscopy guidance (fasting + bowel cleanser) and non-patient related; Endoscopist experience and equipment. Compliance impacts bowel preparation (BP) and optimal BP is essential for a complete effective and efficient colonoscopy. In order to achieve efficient and effective colonoscopy patients require adequate bowel preparation (BP). This is defined as the amount of clear gut mucosa visible. Inadequate BP results in missed lesions (polyps, adenoma's, cancer) and failed colonoscopy. METHODS: Prospective Survey: 45 patients (15 male, 30 female) For inclusion in the compliant group: >90% of liquid laxative consumed in 2 separate doses. Adherence to fasting guidance was defined as clear liquid diet for > 24 hrs prior to colonoscopy. Data retrieval tool: Questionnaire Initially piloted on 5 patients in July 2018 and amended accordingly. Each patient was interviewed by the primary investigator using this questionnaire prior to colonoscopy. RESULTS: Pre-scope preparation comprehension 100%. Adherence with fasting guidance: 87%. Compliance with bowel cleanser: 89%. Previous colonoscopy associated with non-compliance to fasting guidance (P = 0.031). No other significant association with compliance existed within the variables analysed including sex, age, ethnicity, distance travelled, dosing regimen and indication (P > 0.05).Figure 1.: Collated compliance data.CONCLUSION: Compliance with pre-colonoscopy guidance is high in the analysed population. A certain degree of fidelity exists in other outpatient compliance studies conducted in line with this study. This fact and its association with adequate BP has led to colonoscopy being primarily used as an outpatient study.

Daily Short Message Service Reminders Increase Treatment Compliance and Efficacy in Outpatients with Functional Dyspepsia: a Prospective Randomized Controlled Trial.

Many outpatients with functional dyspepsia (FD) do not follow the medication schedule recommendations, which can lead to illness relapse. To investigate whether short message service (SMS) reminders improve medication regimen adherence and therapeutic efficacy in outpatients with FD. Participants with FD were randomly allocated to the control group or intervention group. Patients in the control group received a 4-week medication treatment with no reminders, those in the intervention group received medication treatment plus a daily SMS reminder of dose and medication time. Newly diagnosed FD patients from April 2019 to June 2019 were recruited from the GI outpatient clinics at Renji Hospital. The scores for FD symptoms (LDQ) and psychological conditions (PHQ-9 for depression and GAD-7 for anxiety) were assessed before and after the treatment. The medication possession ratio (MPR) was calculated. A total of 352 eligible patients was enrolled in the study. The overall compliance rates of patients in the intervention and control groups were 87.5% and 80.7% in the intention-to-treat (ITT) analysis (P = 0.08) and 94.48% and 86.59% in per-protocol (PP) analysis (P = 0.015), respectively. In the intervention group, the compliance rate of younger patients (age ≤ 40years) was significantly higher than that of age-matched patients in the control group (ITT: 86.1% vs. 70.5%, P = 0.018). Compared with the control group, the reduction in scores of LDQ (9.33 vs. 8.02, P = 0.017), PHQ-9 (6.97 vs. 5.69, P = 0.004), and GAD-7 (8.70 vs.7.53, P = 0.028) was significantly greater in patients receiving SMS reminders. The MPR of patients positively correlated with the reduction in scores of LDQ, PHQ-9, and GAD-7 in both groups. SMS reminders can improve treatment compliance and efficacy in patients with FD. NCT04052750.

Medication compliance in outpatients with schizophrenia in one veterans hospital in Taiwan

Medication compliance is an important determinant in schizophrenia treatment outcomes. This study aimed to investigate medication compliance in cases of patients receiving a single antipsychotic medication among adult outpatients with schizophrenia, and examine whether their antipsychotic therapy and other factors may affect the medication compliance. Subjects with schizophrenia who had received any single outpatient first- or second-generation antipsychotic therapy from the Yuli Veterans Hospital, Taiwan, during August and November 2006 were identified from medical chart reviews. The selected subjects were surveyed for information including their medication compliance, sociodemographics, treatment-related side effects, social support, and perceived treatment-related benefits. Their physicians were also surveyed on their medication compliance, Clinical Global Impression (CGI) scores, and comorbid mental illness(es). Good medication compliance was defined as consumption of more than 75% of prescribed antipsychotics in the previous month. Subjects were categorized into this group when both their self-reported consumption and their physicians' estimation were higher than 75%. A logistic regression model was adopted to evaluate the association of each factor with medication compliance. Of the 76 subjects surveyed, 39 (51%) received second-generation antipsychotics (amisulpride, risperidone, or olanzapine), while 37 (49%) received first-generation antipsychotics (haloperidol or sulpiride). Thirty-eight (50%) consumed more than 75% of prescribed medications in the previous month. The average age was 41, and 62% of the sample was male. Education level and employment type were significantly different between individuals with good and poor medication compliance. The regression result indicated that education of above nine years was significantly associated with an increased likelihood of good medication compliance. Employment and perceived treatment benefits were marginally significantly correlated with good medication compliance. Second-generation antipsychotics, however, had no correlation with good medication compliance.

The Effect of Stress and Sense of Coherence on Health Behavior Compliance in Outpatients with Stroke

The Effect of Stress and Sense of Coherence on Health Behavior Compliance in Outpatients with Stroke

814 Do Patients Receive Reliable Outpatient Occupational Therapy After Hand Burns

Abstract Introduction Hands are the most commonly burned body part, and are prone to developing limited range of motion and scar contractures, which benefit from aggressive occupational therapy (OT). Many burn survivors are vulnerable with limited resources and poor follow up. The purpose of this study is to determine outpatient OT referral and compliance rates in our patient population. Methods All patients with hand burns admitted to a single ABA verified burn center from January 2015 to May 2016 were reviewed. Demographics (living situation, substance use, psychiatric illness), TBSA, interventions (type/number of surgeries), outcomes (length of stay [LOS]), and OT outcomes (inpatient and outpatient treatment, reason for discontinuation) were evaluated. Results Sixty-one patients met inclusion criteria. Mean age was 33±18 years. In terms of living situation, 17% (n=10) were homeless, and 3% (n=2) were incarcerated. A documented history of alcohol abuse was present in 13% (n=8), 23% (n=14) had positive urine toxicology screens, and 15% (n=9) had diagnosed psychiatric illness. Mean TBSA was 10%±6. Half (N=30, 51%) were managed non-operatively. At discharge, 30% (n=18) had normal hand function and did not meet criteria for outpatient hand therapy. Over 70% (n=43) received outpatient referrals, but only 44% (n=19) of those referred reliably returned for outpatient OT. Despite having outpatient OT referrals, 33% (n=14) did not present to outpatient therapy after repeats attempts of contact, and 67% (n=29) of those with referrals only came to one visit. Of those that did not complete therapy, most (n=14, 58%) were lost to follow up and unable to be contacted. Other reasons for not completing therapy within our system were out-of-network insurances requiring follow-up outside our hospital (36%) and incarceration (6%). Conclusions At our center, nearly 1 in 3 patients with hand burns had excellent function upon discharge and did not require outpatient therapy. However, when patients are referred for outpatient therapy, many do not show up or maintain reliable compliance. Many patients are simply lost to follow up. Applicability of Research to Practice While occupational therapy remains an effective and viable option for hand rehabilitation, further efforts must be aimed at providing patients mechanisms and education for achieving reliable outpatient follow up.

Portable compression devices in total joint arthroplasty: poor outpatient compliance.

BackgroundAspirin and mechanical compression devices are approved means of venous thromboembolism (VTE) prophylaxis after total joint arthroplasty. Prior studies of mechanical compression pumps after joint arthroplasty have been limited to the inpatient setting. The purpose of this study was to evaluate outpatient compliance and utilization factors in a rural population after elective hip or knee arthroplasty.MethodsUtilization for portable pneumatic compression pumps after joint arthroplasty was prospectively recorded (hours). Compliance was defined as the recommended 20 hours per day. A questionnaire 2 weeks postoperatively assessed factors that may contribute to noncompliance. Patients were followed up for 90 days postoperatively to record VTE events.ResultsData were collected for 115 joint arthroplasty patients (50 hips, 65 knees). Postdischarge day one had the highest average usage at 13.2 hours/day (66.0%, range 0%-100%), but this number fell to 4.8 hours/day (24.0, range 0%-100%) by day 14. Patient compliance (>20 hours use/day) was highest on postdischarge day one at 40 patients (34.7%). By postdischarge day 14, patient compliance fell to 17 patients (14.8%). Difficulty using the pumps (P = .027) and pump-associated heat (P = .009) were significantly associated with patient compliance. A deep vein thrombosis and nonfatal pulmonary embolism were recorded in 2 separate patients.ConclusionsThis study demonstrated poor outpatient compliance with portable pneumatic compression devices. Poor compliance was related to pump heat and difficulty with pump use. Even with poor compliance, a low incidence of VTE events was observed.

Discharge to a Post-Acute Care Facility after Emergent Femoral Artery Repair is Not Protective Against Wound Complications

Access site complication is the most common adverse event after endovascular intervention, and when emergent operative repair of the common femoral artery (CFA) is needed, patient morbidity can be significantly increased. The intent of this project was to identify predictors of wound events after emergent operative repair of the CFA due to an access site complication. It was hypothesized that patients discharged to a facility would benefit from an ongoing relationship with healthcare professionals as evidenced by more consistent follow-up and lower wound complication rates. Patients who had a percutaneous CFA access complication and required emergent open CFA repair at an academic medical institution between 2015 and 2018 were included, and the charts were reviewed retrospectively. Primary outcomes included wound complication and outpatient compliance with vascular surgery clinic visit. Dichotomous groups were evaluated by the chi-squared test, and continuous variables were evaluated by Student's t-test. Univariate and multivariate regression analyses were completed to assess risk factors contributing to wound event or failure of clinic follow-up. Forty-four patients were identified with emergent CFA repair due to an access complication between July 2015 and June 2018. Among this population, 33% of patients had wound complications and 27% were discharged to a facility. Among those discharged to a facility, the rate of follow-up to the vascular surgeon's clinic was significantly lower than those discharged to home (40% vs. 85%, P<0.05), and the incidence of wound complications appeared greater but did not reach statistical significance (50% vs. 27%, P=0.11). Univariate analysis indicated that kidney disease, albumin <3g/dL, and current smoking were predictive of wound complication, whereas on multivariate analysis, only kidney disease remained predictive (P<0.05, odds ratio=22). The modified frailty index (mFI) was not predictive of wound complications or compliance with follow-up. However, mFI did approach statistical significance when predicting discharge to a facility. Despite the availability of medical personnel to arrange transportation and provide wound care in post-acute care facilities, patients who were discharged to a facility after CFA injury requiring emergent repair experienced lower compliance with clinic follow-up and may have suffered more wound complications. Strategies to improve compliance with patient follow-up and wound healing in patients sent to post-acute care facilities are warranted.

Extended thromboprophylaxis for hip or knee arthroplasty. Does the administration route and dosage regimen affect adherence? A cohort study.

Prevention of thromboembolic disease requires patients' adherence to the extended thromboprophylaxis scheme. Oral anticoagulants are expected to improve adherence as a result of their route of administration; however, this assumption is yet to be confirmed. The purpose of this study was to assess the impact of the route of administration and dosage regimen on the compliance to the prescription. This prospective cohort study included hip and knee arthroplasty patients who received pharmacological extended thromboprophylaxis with one daily injection, one daily oral tablet, or two daily oral tablets. A telephonic questionnaire was applied 35days after the day of the surgery. Patients who omitted one or more doses of medication during the follow-up period were classified as "non-adherent." Differences of adherence rates were assessed. Five hundredand twenty patients were included: 153 received Apixaban (oral, twice a day), 155 Enoxaparin (injectable, once a day), and 212 Rivaroxaban (oral, once a day). Patients receiving oral once a day medication was more compliant compared with those who received an oral medication twice a day. Non-adherence rates were 3.2 and 9.2%, respectively (p = 0.033). No significant differences (p = 0.360) were found between oral once a day and injectable once a day medication. The number of daily doses prescribed was related to adherence to extended chemical prophylaxis, while the route of administration did not seem to have a significant impact. Strategies to promote outpatient compliance must be implemented, especially when regimes including more than one daily dose are prescribed.

Evaluation of Outpatient Prescription Compliance in A Bukittinggi Hospital

&lt;p&gt;&lt;em&gt;Prescriptions are written requests from doctors or dentists to pharmacists, whether in paper or electronic form to provide and deliver medicines to patients in accordance with applicable regulations. Pharmacists play an important role in preventing medication error by performing prescription screening to reduce the risks of harm on patients. The objective of the study was to evaluate the compliance of outpatient prescriptions in Bukittinggi Hospital. This research was performed using descriptive observational with a cross-sectional design. An amount of 119 prescriptions from July to September 2017 were collected. All prescriptions were screened for their compliance to Pharmaceutical Care Standard in Indonesian Hospitals, which consists of three criteria: 1) administrative requirements, 2) pharmaceutical compatibilities and 3) clinical considerations, and derived into 21 sub-criteria. Data analysis was performed using descriptive statistics. After screened thoroughly, there were no prescriptions which totally comply with the standard. There were only 10 of 21 sub-criteria which were fulfilled by the prescriptions, which were registration number, R/ mark, patient`s name, dosage form, frequency, duration of therapy, drug name, strength, drug interaction, and drug duplication. It can be concluded that the prescriptions have not fulfilled the pharmaceutical care standard. Thus, hospital pharmacists need to improve pharmaceutical services.&lt;strong&gt;&lt;/strong&gt;&lt;/em&gt;&lt;/p&gt;

Nutritional status, glycaemic control and barriers to treatment compliance among patients with type 2 diabetes attending public primary health clinics in Maseru, Lesotho

Objectives: To evaluate the nutritional status, glycaemic control and barriers to treatment compliance of outpatients with type 2 diabetes mellitus (T2DM) attending two public primary health clinic...

Application of simulated family wards in training illiterate rural patients with peritoneal catheterization

Objective To explore the effect of simulated family ward in training and management of illiterate rural peritoneal dialysis catheter patients. Methods Between January 2013 and December 2013 in our department, 80 patients with peritoneal dialysis catheter rural illiteracy as the research object, using the random number table method, the patients can be divided into the experimental group and control group, 40 cases of control group accepted traditional way standard training, the experimental group adopted simulation training family ward as the carrier, two groups of patients were carried out by the same pd specialist nurse training, the control group patients take traditional 7 days training courses for training, the experimental group according to the characteristics of the illiterate patients, an interactive learning mode of explanation-demonstration-imitation-case analysis-feedback and so on was established in the simulated family ward based on real objects and pictures. The training lasted for 5-7 days.After 12 months of observation, the changes of peritonitis and outlet infection cases, edema, blood pressure, outpatient follow-up compliance and laboratory examination indexes in the two groups were statistically analyzed. Results There were 5 cases of peritonitis, 2 cases of exit infection and 27 cases of edema in the experimental group, and 13 cases, 10 cases and 34 cases in the control group, respectively. The difference between the two groups was statistically significant (χ2=4.126, 5.847, Z=2.382, all P<0.05).The systolic blood pressure and diastolic blood pressure in the experimental group were (131± 13) and (86± 9) mmHg, respectively, and those in the control group were (140±15) and (92±11) mmHg, respectively. The differences between the two groups were statistically significant (t=2.789 and 2.595, all P<0.05). Compliance of outpatient follow-up was good in 33 cases in the experimental group and 27 cases in the control group, and the difference between the two groups was statistically significant (χ2=4.551, P<0.05). Conclusions The education and training of rural illiterate patients with peritoneal dialysis catheterization in simulated family wards has mobilized the patients' participation, improved their cognitive level, and improved their treatment compliance, thus effectively improving the patients' peritoneal dialysis effect and quality of life. Key words: Peritoneal dialysis; Illiterate population in rural areas; Simulated family ward; Education and training