Treatment Compliance Of Patients Research Articles

Effect of non-pharmacological treatment on the full recovery of social functioning in patients with attention deficit hyperactivity disorder

Long-term treatment of attention deficit/hyperactivity disorder (ADHD) is associated with adverse events, such as nausea and vomiting, dizziness, and sleep disturbances, and poor maintenance of late ADHD medication compromises treatment outcomes and prolongs the recovery of patients' social functioning. To evaluate the effect of non-pharmacological treatment on the full recovery of social functioning in patients with ADHD. A total of 90 patients diagnosed with ADHD between May 2019 and August 2020 were included in the study and randomly assigned to either the pharmacological group (methylphenidate hydrochloride and tomoxetine hydrochloride) or the non-pharmacological group (parental training, behavior modification, sensory integration therapy, and sand tray therapy), with 45 cases in each group. Outcome measures included treatment compliance, Swanson, Nolan, and Pelham, Version IV (SNAP-IV) scores, Conners Parent Symptom Questionnaire (PSQ) scores, and Weiss Functional Impairment Rating Scale (WFIRS) scores. The non-pharmacological interventions resulted in significantly higher compliance in patients (95.56%) compared with medication (71.11%) (P < 0.05). However, no significant differences in SNAP-IV and PSQ scores, in addition to the learning/school, social activities, and adventure activities of the WFIRS scores were observed between the two groups (P > 0.05). Patients with non-pharmacological interventions showed higher WFIRS scores for family, daily life skills, and self-concept than those in the pharmacological group (P < 0.05). Non-pharmacological interventions, in contrast to the potential risks of adverse events after long-term medication, improve patient treatment compliance, alleviate patients' behavioral symptoms of attention, impulsivity, and hyperactivity, and improve their cognitive ability, thereby improving family relationships and patient self-evaluation.

Comparison of morbidity and results of chronic myeloid leukemia treatment in Novosibirsk and the Novosibirsk region

Introduction. Over the past decade significant progress has been made in the treatment of patients with chronic myeloid leukemia (CML). In the most patients it is possible to reach a major molecular response (MMR) and maximize overall survival (OS). However, in real clinical practice in the regions of Russia, there is a number of unresolved problems that have led to the deterioration in the results of therapy such as, low patient compliance to treatment and the lack of proper control by doctors of polyclinics over the intake of medications and the course of the disease. Aim — to compare the incidence and results of therapy of patients with chronic myeloid leukemia in Novosibirsk and the Novosibirsk region. Materials and methods. The results of therapy of 333 CML patients were studied. The incidence and prevalence of disease, 5-year OS and predicted 10-year OS as well as 5-years and 10-years predicted event-free survival (EFS) have been evaluated. Results of therapy and compliance to treatment of 214 patients with CML who had been treated with imatinib for more than 18 months also were studied. Results. The incidence from 2004 for 2020 was 0.62 per 100,000 population per year, the prevalence of CML in Novosibirsk over the past 15 years has increased from 3.27 to 10.89 cases per 100,000 population, in the Novosibirsk region – from 1.83 to 5.55 cases per 100,000 population. Median OS was not reached. The 5-year OS and 10-year OS in Novosibirsk were 85.7 and 72.5 %, respectively. The 5-year OS and 10-year OS in Novosibirsk region was 80.5 and 72.3 %, respectively. The 5-year EFS and 10-years predicted EFS in Novosibirsk was 55.8 and 40.8 %, respectively. The 5-year EFS and 10-years predicted EFS in Novosibirsk region was 34.9 and 18.7 %, respectively (p = 0.02882). The median EFS in Novosibirsk and Novosibirsk region was 6.8 and 2.7 years, respectively. Among patients treated in Novosibirsk, 134 patients (95.7 %) achieved a complete clinical and hematological response (CHR), 124 patients (88.5 %) — a complete cytogenetic response (CCyR), 95 patients (67.8 %) achieved MMR. Treatment failure was in 45 patients who did not obtain MMR and 16 (35.5 %) of 45 did not achieve even CCyR. The 2nd generation tyrosine kinase inhibitors (TKI 2) were administered to 18 patients who were resistant to imatinib. CHR was maintained in 17 out of 18 patients (94.4 %), CCyR — in 14 patients (77.7 %), MMR was achieved in 12 patients (66.7 %). In Novosibirsk region CHR was obtained in 72 of 74 patients (97.3 %), CCyR — in 50 patients (67.6 %), MMR — in 13 patients (17.6 %). No MMR was achieved in 61 patients (82.4 %), 17 (22.9 %) of them failed to obtain even CCyR. TKI 2 were administered to 7 out of these 61 patients, and 6 (85.7 %) of 7 maintained CHR, 5 patients (71.4 %) — CCyR, 1 patient (14.3 %) – MMR. Adherence to imatinib therapy was significantly lower in the group of patients with therapy failure than in patients with an optimal response both in Novosibirsk (p &lt; 0.00001) and in Novosibirsk region (р = 0,000002). Conclusion. We have revealed a significant increase in the incidence of CML in Novosibirsk and Novosibirsk region. The problems in treatment are as follows: insufficient control by primary care physicians over patients living in Novosibirsk region and low treatment compliance of patients.

The rising cost of rhinologic medications

BackgroundThe high prescription drug cost in the United States may negatively affect patient prognosis and treatment compliance. ObjectiveTo fill the knowledge gap and inform clinicians regarding rhinology medications price changes by evaluating trends in price changes of highly used nasal sprays and allergy medications. MethodsThe 2014-2020 Medicaid National Average Drug Acquisition Cost database was queried for drug pricing information for the following classes of medications: intranasal corticosteroids, oral antihistamines, antileukotrienes, intranasal antihistamines, and intranasal anticholinergics. Individual medications were identified by Food and Drug Administration-assigned National Drug Codes. Per unit, drug prices were analyzed for average annual prices, average annual percentage price changes, and inflation-adjusted annual and composite percentage price changes. ResultsBeclometasone (Beconase AQ, 56.7%, QNASL, 77.5%), flunisolide (Nasalide, −14.6%), budesonide (Rhinocort Aqua, −1.2%), fluticasone (Flonase, −6.8%, Xhance, 11.7%), mometasone (Nasonex, 38.2%), ciclesonide (Omnaris, 73.8%), combination azelastine and fluticasone (Dymista, 27.3%), loratadine (Claritin, −20.5%), montelukast (Singulair, 14.5%), azelastine (Astepro, 21.9%), olopatadine (Patanase, 27.3%), and ipratropium bromide (Atrovent, 56.6%) had an overall change in inflation-adjusted per unit cost between 2014 and 2020 (% change). Of 14 drugs evaluated, 10 had an increase in inflation-adjusted prices, for an average increase of 42.06% ± 22.27%; 4 of 14 drugs had a decrease in inflation-adjusted prices, for an average decrease of 10.78% ± 7.36%. ConclusionThe rising cost of highly used medications contributes to increased patient acquisition costs and may pose barriers of drug adherence to particularly vulnerable populations.

Research on the effect of predictive nursing combined with psychological education on students with mania

BackgroundMania is a common psychological disease, which is often treated with drugs in clinical practice, but the effect of conventional nursing intervention is not significant. Therefore, this study tries to intervene manic students through predictive nursing and psychological education.Subjects and MethodsFrom March 2020 to March 2021, 116 manic students who entered our hospital for treatment were selected as research subjects. They were randomly divided into a routine intervention group and a joint intervention group, each containing 58 manic students. The routine intervention group was given routine nursing care in the psychiatric department of our hospital. The joint intervention group was intervened through predictive nursing and psychological education. The intervention effect was evaluated by the Bech Rafaelsdn Mania Rating Scale (BRMS) and the Global Assessment Scale (GAS).ResultsBefore the intervention, there was no significant difference in BRMS and GAS scores between the two groups (P &gt; 0.01). After the intervention, the BRMS score of the joint intervention group was significantly lower than that of the control group, and the GAS score was significantly higher than that of the control group, and the difference was statistically significant (P &lt; 0.01). Table 1 shows the comparison of BRMS and GAS scores between the two groups of manic students before and after the intervention.Table 1.Comparison of BRMS and GAS scores before and after interventionGroupBRMS/scoreGAS/scoreBefore interventionAfter interventionBefore interventionAfter interventionRoutine intervention group19.43±2.418.17±2.42*22.62±5.4381.23±14.81*Joint intervention group19.51±2.5214.51±3.41*22.84±5.3852.56±11.12*P&gt;0.01&lt;0.01&gt;0.01&lt;0.01Compared with before intervention, *P &lt; 0.01.ConclusionsThis study proved that the intervention effect of predictive nursing combined with psychological education on manic students was significant. This therapy can effectively reduce the onset of mania and improve the treatment compliance of patients by changing students’ psychological cognition. This study is of great significance to the psychological intervention of manic students.

Effect of continuous nursing combined with respiratory exercise nursing on pulmonary function of postoperative patients with lung cancer.

Lung cancer is a malignant tumor with high morbidity and mortality among cancers. Surgery is currently one of the primary methods of treating lung cancer. Although it can slow down the progression of the disease by removing the lesion, this invasive surgery inevitably damages the integrity of the patient's chest. Moreover, the patient's pulmonary function may have a low compensatory capacity after surgery, causing various respiratory diseases such as atelectasis, respiratory function decline, and even serious cardiovascular disease. All of these have great negative impacts on the surgical effect and the prognosis of patients. With the continuous exploration and development of nursing, continuous nursing and respiratory exercise nursing have been gradually applied in the nursing of patients after lung cancer surgery, and have achieved good nursing results. To investigate the effect of continuous nursing combined with respiratory exercise nursing on the pulmonary function of postoperative patients with lung cancer. A total of 80 patients with lung cancer who underwent surgery in our hospital from January 2021 to December 2021 were selected as the study subjects. All subjects were randomly divided into the control group (n = 40 cases) and the experimental group (n = 40 cases). Patients with lung cancer in the control group were given conventional nursing after surgery, while the experimental group was given continuous nursing combined with respiratory exercise nursing based on conventional nursing. The recovery of pulmonary function and respiratory symptoms was observed before and after 3 mo of intervention in both groups. The pulmonary function parameters, blood gas analysis, MD Anderson Symptom Inventory-lung cancer module (MDASI-LC) scores, incidence of pulmonary complications, and Morisky compliance scores were compared between the two groups before and after 3 mo of intervention. There was no significant difference in pulmonary function and blood gas analysis between the two groups before intervention (P > 0.05). 3 mo after the intervention, the pulmonary function parameters in the experimental group (SpO2, VC, MVV, FEV1, FEV1% pred, and FEV1/FVC) were higher than those in the control group, and the differences were statistically significant (P < 0.05). There was no significant difference in blood gas analysis between the two groups before intervention (P > 0.05). PaO2 in the experimental group was significantly higher than that in the control group, and PaCO2 was significantly lower than that in the control group 3 mo after the intervention. The difference had statistical significance (P < 0.05). 3 mo after the intervention, the MDASI score of respiratory symptoms in the experimental group was significantly lower than that in the control group (P < 0.05), and the incidence of pulmonary complications was lower than that in the control group (P < 0.05). In addition, the treatment compliance and nursing satisfaction of patients in the experimental group were higher than those in the control group, and the differences were statistically significant (P < 0.05). Continuous nursing combined with respiratory exercise nursing can significantly accelerate the recovery of respiratory function in postoperative lung cancer patients, reduce the incidence of postoperative complications of lung cancer as well as improve the treatment compliance of patients.

A systematic review on telenursing as a solution in improving the treatment compliance of tuberculosis patients in the COVID-19 pandemic

Introduction: The COVID-19 pandemic had made patients scared of coming to clinics or hospitals, and this could affect the treatment of TB. Therefore, one type of service that can be used by nurses to improve compliance to TB treatment is Telenursing. This article aims to ascertain whether telenursing could be a solution in improving the compliance of TB patients to treatments in the COVID-19 pandemic.&#x0D; Design and Method: This research was conducted using the Randomised Controlled Trial design as well as PRISMA. Furthermore, useful research articles were sourced from the database using the keywords, “Message Reminder and Tuberculosis OR Medication Adherence”. The databases used are Scopus, Science Direct, PubMed, and SAGE, all in English text and from 2015 to 2021, with inclusion criteria. 277 articles were obtained, and then filtered to select 3 articles by reading the main focus of the write-up, with regard to the topic of study.&#x0D; Result: Telenursing can be a solution to reduce the spread of COVID-19, and a substitute for remotely motivating individuals, as social support. Furthermore, it could be used as a reminder to patients to be obedient in carrying out treatments, and as a means of educating and improving good relationships with providers.&#x0D; Conclusions: Telenursing is a fairly effective solution in helping TB patients improve treatment compliance, reduce drug dropout rates and missed doses, as well as, raise awareness about the importance of health in the COVID-19 pandemic.&#x0D;

Influence of perception of glucocorticoids on compliance of treatment in patients with rheumatoid arthritis and systemic lupus erythematosus

BackgroundGlucocorticoids (GCs) are alleged as hazardous medications among Egyptian patients and their relatives. Aim of the workTo highlight the beliefs held about GCs and the effect of these beliefs on adherence to GCs treatment. Patients and methodsThe study included 70 systemic lupus erythematosus (SLE) patients, 70 rheumatoid arthritis (RA) patients and 140 GC-naïve subjects as the control. The demographic and socioeconomic standards of the patients and control as well as the GCs use experience in patients were recorded. GCs perception was assessed by Beliefs about medication Questionnaire (BMQ). Adherence was assessed by Compliance Questionnaire of Rheumatology (CQR). ResultsGCs were significantly perceived as harmful and of low benefit by the control (p < 0.001, p < 0.001, respectively), a beneficial drug by SLE patients, while RA patients had significantly higher harm scores (p = 0.015 and p = 0.003 respectively). Most of SLE and RA patients were non-adherent (57.1% and 65.7%, respectively). Higher general-BMQ harm scores were significantly associated with a lower odd of adherence (OR: 0.25, 95%CI: 0.1–0.63). Reduced OR of necessity > concern was associated with higher socioeconomic standards and maximum oral GCs dose (OR:0.09 and 0.96, respectively). Increased OR of high necessity was significantly associated with number of currently used disease modifying anti-rheumatic drugs (DMARDs) (OR:5.54, p = 0.025). High OR of harm perception was significantly associated with higher socioeconomic standards (OR: 5.12, p = 0.016). ConclusionGCs are perceived as pillars in management by SLE and RA patients. Concerns about side effects and dependency are still troublesome. Improvement of patients’ GCs perception impacts level of adherence to treatment.

Low Health Literacy (LHL): A Conniving Opponent of Patient Treatment Compliance

In order to access, comprehend, and use information to make decisions about their health, people must possess certain personal traits and social resources, which are referred to as health literacy. Patients' ability to engage in complex disease management and self-care is strongly related to their level of health literacy. It can help us stay healthy by preventing illness and effectively managing existing illnesses. Personal health literacy refers to a person's ability to locate, comprehend, and apply information and services to support health-related decisions and actions for themselves and others. The World Health Organization recommends health literacy as a tool for achieving several key targets outlined in the Sustainable Development Goals. Low health literacy (LHL) is most commonly associated with mature patients with chronic health conditions who have limited education and are not necessarily from a lower income group. Furthermore, being literate in general does not imply being literate in health.

Retracted: Influence of Continuous Nursing Intervention on Treatment Compliance of Patients with Depression.

[This retracts the article DOI: 10.1155/2022/7080678.].

Application of health education based on the integrated theory of health behavior change in the pelvic floor rehabilitation of patients with cervical cancer after radical surgery

To analyze the effect of applying health education based on the integrated theory of health behavior change in the pelvic floor rehabilitation of patients with cervical cancer after radical surgery. We recruited 130 patients with cervical cancer who underwent gynecological surgery in our hospital between the 01 February 2021 and the 01 March 2022. According to the random number table method, the patients were divided into a control group and an observation group (65 cases per group). The control group received routine health education, while the observation group received health education based on the integrated theory of health behavior change. We compared the two groups with regards to pelvic floor function, quality-of-life, and psychological status before and after intervention by analyzing PFDI-20 (Pelvic Floor Distress Inventory Questionnaire-20), PFIQ-7 (Pelvic Floor Impact Questionnaire-7), HAMA (Hamilton Anxiety Scale) and HAMD (Hamilton Depression Scale) questionnaires, treatment compliance and nursing satisfaction. After intervention, the PFDI-20 scores and total scores of patients in the observation group were lower than those in the control group (p &lt; 0.05). The PFIQ-7 scores and total scores of patients in the observation group were lower than those in the control group (p &lt; 0.05). The HAMA and HAMD scores in the observation group were significantly lower than those in the control group (p &lt; 0.05). The treatment compliance and nursing satisfaction rate of patients in the observation group were higher than those in the control group (p &lt; 0.05). Health education based on the integrated theory of health behavior change can improve pelvic floor muscle strength, the quality-of-life, and the treatment compliance of patients after radical surgery for cervical cancer. In addition, this strategy can alleviate anxiety and depression, and improve nursing satisfaction and is worthy of wider clinical application.

Analysis of the effect of health education model based on BCW theory in patients with acute retinal necrosis

To explore the effect of the health education model based on the behavior change wheel (BCW) theory in patients with acute retinal necrosis (ARN). 78 patients diagnosed with ARN were randomly divided into the control group (n = 39) and observation group (n = 39). The control group received standard eye care, whereas the observation group was given the BCW theory-based health education model based on standard care. The two groups were compared on the uncertainty of the disease, anxiety and depression levels, treatment compliance, disease cognition, and nursing satisfaction. After the intervention, the scores of various dimensions of uncertainty in illness and the total score, the Self-Rating Anxiety Scale/Self-Rating Depression Scale (SAS/SDS) scores, treatment compliance, the degree of disease cognition, and nursing satisfaction in the observation group were higher than those in the control group, and the differences were statistically significant. The application of the health education model based on BCW theory in ARN can reduce the disease uncertainty and the level of anxiety and depression, thus improving the treatment compliance, disease cognition, and satisfaction of patients, which is worthy of widespread use in clinical practice.

Teriflunomide treatment outcomes in multiple sclerosis: A Portuguese real-life experience.

Teriflunomide is an oral disease-modifying therapy for relapsing-remitting multiple sclerosis patients. A decline in physical and cognitive functions, which negatively impacts their quality of life (QoL), is observed in relapsing-remitting multiple sclerosis patients. The aim of this study was to characterise adult Portuguese relapsing-remitting multiple sclerosis patients treated with teriflunomide in routine clinical practice concerning their quality of life, comorbidities, treatment effectiveness, satisfaction, compliance and safety. TeriLIVE-QoL was a multicentre, non-interventional, prospective cohort study that collected demographic and clinical characteristics, patient-reported outcomes and adverse events from patients treated with teriflunomide of 14 mg over 2 years. Notably, around 18 months of this period occurred during the COVID-19 pandemic. Of the 99 participants, 25% were treatment-naïve. Annualised relapse rate and the score for the Hospital Anxiety and Depression Scale decreased after 1 (p = 0.01) and 2 years of treatment (p < 0.001), respectively. Convenience (p = 0.001), effectiveness (p = 0.002) and global satisfaction scores (p < 0.001) presented high values (up to 95.6) and continued to improve along the study. Treatment persistence was 77%, and compliance reached 82% 2 years after initiation. Three patients experienced serious adverse events. TeriLIVE-QoL provides real-world evidence of clinical effectiveness, high treatment satisfaction, consistent safety and improved psychiatric outcomes, associated with elevated treatment persistence and compliance in patients treated with teriflunomide.iance reached 82% 2 years after initiation. Three patients experienced serious adverse events.

Determination of anxiety level, treatment compliance and sleep quality index in patients with type 2 diabetes and arterial hypertension

Determination of anxiety level, treatment compliance and sleep quality index in patients with type 2 diabetes and arterial hypertension

A Prospective Observational Study on Medication Use Management and Prevalence of Cardiovascular Disease with Comorbidities in a Tertiary Care Hospital

Background and Aim Medication use management involves a set of regulations and analytical techniques for defining comprehending and assessing medicine prescription distribution and consumption and also evaluating measures to improve the efficacy of these processes. The present study aimed to assess the medication use pattern prevalence and comorbidity conditions associated with cardiovascular diseases CVD.Methods A prospective observational study was conducted for a duration of six months in the inpatient medicine department of Chigateri District hospital Davangere Tertiary care teaching hospital. Two hundred four case reports of patients with CVD were reviewed and details such as demographics specified drugs prescribed Health Related Quality of Life HRQOL were recorded.Result Two hundred four patients were enrolled out of which 57.35 were males and 42.65 were females. Most of the patients were in the age range of 58-67 years. The most prevalent CVD treated was hypertension HTN 28.23 and the most common comorbidity associated was HTN 32.17. Social habits like smoking 13.75 and HTN 16.92 were found to be the most frequent associated risk factors in CVD patients. The most commonly prescribed class of drugs was antiplatelet 28.41 the common prescribed drug was Furosemide 13.39 and Fixed Dose Combination FDC was Ecosprin gold Atorvastatin Clopidogrel Aspirin 35.29. Most of the prescriptions showed polypharmacy 84.31. While assessing the HRQOL physical component summary PCS 56.94 and mental component summary MCS 54.24 were in a modest range.Conclusion The most prevalent type of CVD was HTN. HTN and DM were the prevalent comorbid conditions among the study population. In the study polypharmacy was noted which may have an impact on rationality. Statins and antiplatelet use was appropriate however excessive use of Furosemide must be controlled. Proper prescription writing increases patient treatment compliance which promotes reason.

Association Between Buprenorphine Dose and the Urine "Norbuprenorphine" to "Creatinine" Ratio: Revised.

Utilizing a 1-year chart review as the data, Furo et al. conducted a research study on an association between buprenorphine dose and the urine "norbuprenorphine" to "creatinine" ratio and found significant differences in the ratio among 8-, 12-, and 16-mg/day groups with an analysis of variance (ANOVA) test. This study expands the data for a 2-year chart review and is intended to delineate an association between buprenorphine dose and the urine "norbuprenorphine" to "creatinine" ratio with a higher statistical power. This study performed a 2-year chart review of data for the patients living in a halfway house setting, where their drug administration was closely monitored. The patients were on buprenorphine prescribed at an outpatient clinic for opioid use disorder (OUD), and their buprenorphine prescription and dispensing information were confirmed by the New York Prescription Drug Monitoring Program (PDMP). Urine test results in the electronic health record (EHR) were reviewed, focusing on the "buprenorphine," "norbuprenorphine," and "creatinine" levels. The Kruskal-Wallis H and Mann-Whitney U tests were performed to examine an association between buprenorphine dose and the "norbuprenorphine" to "creatinine" ratio. This study included 371 urine samples from 61 consecutive patients and analyzed the data in a manner similar to that described in the study by Furo et al. This study had similar findings with the following exceptions: (1) a mean buprenorphine dose of 11.0 ± 3.8 mg/day with a range of 2 to 20 mg/day; (2) exclusion of 6 urine samples with "creatinine" level <20 mg/dL; (3) minimum "norbuprenorphine" to "creatinine" ratios in the 8-, 12-, and 16-mg/day groups of 0.44 × 10-4 (n = 68), 0.1 × 10-4 (n = 133), and 1.37 × 10-4 (n = 82), respectively; however, after removing the 2 lowest outliers, the minimum "norbuprenorphine" to "creatinine" ratio in the 12-mg/day group was 1.6 × 10-4, similar to the findings in the previous study; and (4) a significant association between buprenorphine dose and the urine "norbuprenorphine" to "creatinine" ratios from the Kruskal-Wallis test (P < .01). In addition, the median "norbuprenorphine" to "creatinine" ratio had a strong association with buprenorphine dose, and this association could be formulated as: [y = 2.266 ln(x) + 0.8211]. In other words, the median ratios in 8-, 12-, and 16-mg/day groups were 5.53 × 10-4, 6.45 × 10-4, and 7.10 × 10-4, respectively. Therefore, any of the following features should alert providers to further investigate patient treatment compliance: (1) inappropriate substance(s) in urine sample; (2) "creatinine" level <20 mg/dL; (3) "buprenorphine" to "norbuprenorphine" ratio >50:1; (4) buprenorphine dose >24 mg/day; or (5) "norbuprenorphine" to "creatinine" ratios <0.5 × 10-4 in patients who are on 8 mg/day or <1.5 × 10-4 in patients who are on 12 mg/day or more. The results of the present study confirmed those of the previous study regarding an association between buprenorphine dose and the "norbuprenorphine" to "creatinine" ratio, using an expanded data set. Additionally, this study delineated a clearer relationship, focusing on the median "norbuprenorphine" to "creatinine" ratios in different buprenorphine dose groups. These results could help providers interpret urine test results more accurately and apply them to outpatient opioid treatment programs for optimal treatment outcomes.

Study on the intervention effect of SMG health management in patients with ischemic stroke.

The aim of the study was to explore the clinical effect of brain and heart health managers combined with the "SMG" health management mode on nursing intervention in ischemic stroke patients. A total of 187 ischemic stroke patients divided into 96 patients in the observation group and 91 patients in the control group with the random number table method. The control group conducted the routine care intervention, and the observation group used the brain and heart health managers combined with the "SMG" health management model for the nursing intervention. The control of stroke risk factors was explored by comparing blood pressure, blood glucose and blood lipid and other indicators between the two groups before and after treatment. Compared with that before the intervention, the Stroke Self-Efficacy Questionnaire (SSEQ) score of both the observation group and the control group were significantly higher ( p < 0.05), and the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), National Institutes of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) scores were all decreased ( p < 0.05). The proportion of patients with treatment adherence did not differ significantly before and after the intervention in the control group ( p > 0.05), and it increased significantly in the observation group after the intervention ( p < 0.05). The observation group had higher SSEQ score and lower HAMA, HAMD, NIHSS, and mRS scores after the intervention compared with the control group, with statistically significant differences. The combination of brain and heart health managers and "SMG" is more conducive to improving the selfefficacy of ischemic stroke patients, alleviating patient anxiety and depression, improving patient treatment compliance, controlling stroke risk factors, and promoting neurological function recovery.

Prediction of Radiotherapy Compliance in Elderly Cancer Patients Using an Internally Validated Decision Tree.

This study aims to analyze the relationship between the available variables and treatment compliance in elderly cancer patients treated with radiotherapy and to establish a decision tree model to guide caregivers in their decision-making process. For this purpose, 456 patients over 74 years of age who received radiotherapy between 2005 and 2017 were included in this retrospective analysis. The outcome of interest was radiotherapy compliance, determined by whether patients completed their scheduled radiotherapy treatment (compliance means they completed their treatment and noncompliance means they did not). A bootstrap (B = 400) technique was implemented to select the best tuning parameters to establish the decision tree. The developed decision tree uses patient status, the Charlson comorbidity index, the Eastern Cooperative Oncology Group Performance scale, age, sex, cancer type, health insurance status, radiotherapy aim, and fractionation type (conventional fractionation versus hypofractionation) to distinguish between compliant and noncompliant patients. The decision tree's mean area under the curve and 95% confidence interval was 0.71 (0.66-0.77). Although external validation is needed to determine the decision tree's clinical usefulness, its discriminating ability was moderate and it could serve as an aid for caregivers to select the optimal treatment for elderly cancer patients.

Medical Students’ Self-Assessment of Communication Skills During COVID-19 Pandemic at Tabriz University of Medical Sciences

Background. In addition to patient satisfaction and treatment compliance by patients, appropriate physician-patient communication leads to development of a relationship between physicians and patients based on trust. The purpose of this study was self-assessment of medical interns and stagers of Tabriz University of Medical Sciences in communicating with the patients during COVID-19 pandemic. Methods. The population of this cross-sectional study included all medical stagers and interns at Tabriz University of Medical Sciences, Iran from November to December, 2020. The research tool was a standard questionnaire of Interpersonal Communication Skills Scale developed by Vakili et al. to assess interpersonal communication skills. After the online questionnaires were filled by the students, we calculated and compared the mean score of self-assessment of communication skills for the medical stagers and interns. Additionally, we compared the mean scores of students’ self-assessment in term of educational level, gender, wards and on duty hours during a week. Results. In this study, a total of 152 medical stagers and interns participated. More than half of the participants were female (55.92%). The mean self-assessment score of the participants was 93.83±9.78. The mean self-assessment score of medical stagers and interns was 93.15±8.13 and 94.51±12.26, respectively. There was no statistically significant difference in self-assessment score of patient communication based on educational level and ward (surgical and non-surgical), but the mean score of self-assessment was significantly higher in females (P=0.044). Conclusion. Most medical interns and stagers had an average self-assessment score regarding patient communication during COVID-19 pandemic. So, appropriate training can improve medical students’ communication skills. However, the communication skills required for medical students may vary depending on whether they are dealing with a pandemic or non-pandemic situation.

Reasons and the Nursing Countermeasures of Affecting the Compliance of Pain Treatment in Cancer Pain Patients

Reasons and the Nursing Countermeasures of Affecting the Compliance of Pain Treatment in Cancer Pain Patients

An Orthopaedic Surgeon Led Osteoporosis (OSLO) Model of Care reduces early recurrent fracture rates and improves treatment compliance in patients treated for osteoporotic fractures.

This study aims to evaluate the efficacy of an Orthopaedic Surgeon Led Osteoporosis Model of Care (OSLO-MoC) as compared to a Case Manager Led Osteoporosis Model of Care (CMLO-MoC) in reducing early osteoporotic re-fracture rates and treatment compliance in patients. This was a single centre, retrospective, comparative cohort study of all patients screened and treated for secondary osteoporotic fracture prevention from the 2008 to 2018 at an orthopaedic surgical unit. From the 2008 to 2013, patients were recruited under the CMLO-MoC and from 2014 to 2018, under the OSLO-MOC. Logistics regression analysis was used to identify significant predictors such as OSLO-MOC implementation, gender, ethnicity, marital status and education level for patient recruitment, treatment compliance and secondary fracture rates at 12-month follow-up. Over a 10-year period, 7388 patients were screened of which 2855 patients were eligible for analysis. A total of 1234 patients were recruited under CMLO-MoC and 1621 patients under OSLO-MOC. Implementation of the OSLO-MOC was associated with greater patient recruitment, OR 1.26 (95%CI 1.06-1.49, P = 0.007). Of the 2855 patients recruited, OSLO-MOC implementation, OR 2.61 (95%CI 2.03-3.36, P < 0.001), and a higher level of education, OR 1.428 (95%CI 1.02-1.43, P = 0.037), were associated with improved compliance to medication at 12months. OSLO-MOC implementation was the only factor associated with reduced risk of secondary fractures at 12months, OR 0.14 (95%CI 0.03-0.66, P = 0.013). The OSLO-MOC has shown to be effective in reducing the rate of re-fracture and osteoporotic medication initiation and compliance of patients. IV.