Perception Of Adverse Effects Research Articles

Changes in Students' Perceptions Regarding Adolescent Vaccinations through a Before-After Study Conducted during the COVID-19 Pandemic: GIRASOLE Project Study.

The COVID-19 pandemic caused a reduction in vaccination coverage for all age groups, especially in non-infant age. The main objective of the present study is to evaluate the effectiveness of an online intervention conducted among adolescents during the COVID-19 pandemic in increasing knowledge and positive attitudes toward vaccinations. The study, which took place online from March to May 2021, involved 267 students from six lower secondary schools in Palermo city (Italy); they filled out the questionnaire before and after the intervention. The questionnaire was based on the protection motivation theory (PMT), which estimates the improvement in vaccination-related knowledge and attitudes. The pre- and post-intervention comparison showed a significant increase in the perception of the disease severity: strongly agree pre-intervention n = 150 (58.6%) and post-intervention n = 173 (67.6%, p < 0.001), rated on a five-point Likert scale. In a multivariate analysis, the factor associated with the improvement in the score after the intervention was the school dropout index (low vs. very high dropout index OR 4.5; p < 0.03). The educational intervention was more effective in schools with lower early school leaving rates, an indirect index of socio-economic status. The topic of vaccination has caught the adolescents' attention, it is, therefore, important that interventions tackling teenagers are tailored to reduce their emotional tension about the perception of adverse effects and improve vaccination coverage.

Factors Influencing Adherence to Antipsychotic Medications in Women with Delusional Disorder: A Narrative Review.

Adherence to medication regimens is of great importance in psychiatry because drugs sometimes need to be taken for long durations in order to maintain health and function. This study aimed to review influences on adherence to antipsychotic medications, the treatment of choice for the delusional disorder (DD), and to focus on adherence in women with DD. This is a non-systematic narrative review of papers published since 2000 using PubMed and Google Scholar, focusing on women with DD and medication adherence. Several factors have been identified as exerting influence on adherence in women with persistent delusional symptoms who are treated with antipsychotics. Personality features, intensity of delusion, perception of adverse effects, and cognitive impairment are patient factors. Clinical time spent with the patient, clarity of communication, and regular drug monitoring are responsibilities of the health provider. Factors that neither patient nor clinician can control are the social determinants of health, such as poverty, easy access to healthcare, and cultural variables. There has been little investigation of factors that influence adherence in the target population, e.g., women with DD. Preliminary results of this literature search indicate that solutions from outside the field of DD may apply to this population. Overall, a solid therapeutic alliance appears to be the best hedge against nonadherence.

When COVID-19 Met Families Living in Armed-Conflict Zones: The Importance of Maternal Trauma and Child Self-Regulation.

The COVID-19 outbreak began in Israel at the end of February 2020, and on March 17, 2020, a general lockdown was announced. Families were instructed to stay at home and schools and non-essential businesses were closed. Aiming to understand how families who were already living in areas of high exposure to armed conflict would be affected by another external stressful condition, data were collected before and after the outbreak. Mothers and children (aged 10–45 months) were recruited from areas with high (n = 40) and low (n = 78) exposure to armed conflict. Mothers reported on their posttraumatic stress symptoms (PTSS) and on their child's effortful control tendencies prior to the outbreak. Toward the end of the first lockdown, mothers were interviewed regarding adverse effects of the outbreak on their family. No group differences were found for maternal perceptions of adverse effects of COVID-19. However, a moderation model was revealed, indicating that maternal PTSS as well as child effortful control predicted adverse effects of COVID-19 only in the high-exposure group. Results are discussed considering cumulative stress and risk factors.

Epidemiological Survey on the Perception of Adverse Effects in Women Using Contraceptive Methods in Brazil.

The present study aimed to understand patient perception of the adverse effects of contraceptives to improve health care and adherence to treatment. An online questionnaire was available for women in Brazil to respond to assess their perception of adverse effects and their relationship with contraceptive methods. Of all 536 women who responded, 346 (64.6%) reported current contraceptive use. One hundred and twenty-two (122-34.8%) women reported having already stopped using contraception because of the adverse effects. As for the contraceptive method used, the most frequent was the combined oral contraceptive (212-39.6%). When we calculated the relative risk for headache, there was a relative risk of 2.1282 (1.3425-3.3739; 95% CI), suggesting that the use of pills increases the risk of headache, as well as edema, in which a relative risk of 1.4435 (1.0177-2.0474; 95% CI) was observed. For low libido, the use of oral hormonal contraceptives was also shown to be a risk factor since its relative risk was 1.8805 (1.3527-2.6142; 95% CI). As for acne, the use of hormonal contraceptives proved to be a protective factor, with a relative risk of 0.3015 (0.1789-0.5082; 95% CI). The choice of a contraceptive method must always be individualized, and the patients must be equal participants in the process knowing the expected benefits and harms of each method and hormone, when present.

Satisfaction and attitude of bipolar patients regarding electroconvulsive therapy: modified or unmodified

Objective: Ministry of Health of Turkey issued a legislation to use only modified electroconvulsive therapy (ECT) in 2005, and this study aimed to assess satisfaction and attitude of bipolar patients regarding modified and unmodified electroconvulsive therapy.Methods: A total of 100 patients (50 treated with modified electroconvulsive therapy (M-ECT) and 50 treated with unmodified ECT (UM-ECT) with a diagnosis of Bipolar Disorder (depressive or manic episode) were invited to participate in this study. Patients with euthymic mood were included. Satisfaction and attitude towards ECT were evaluated with a structured attitude questionnaire, and M-ECT and UM-ECT patients, and their subgroups (depressive vs. manic) were compared.Results: No significant differences were found between M-ECT and UM-ECT groups regarding age, sex, marital status and occupation. The majority of all patients (78%) were satisfied from treatment with ECT and with the outcome (88%), without significant differences between modified and unmodified groups. Forgetfulness (70%) and headaches (57%) occurred in all groups, with the only significant difference in forgetfulness being reported by more manic patients treated with UM-ECT. Depressive and manic patients treated with UM-ECT reported concerns of brain damage and physical harm significantly more frequently. While 86% of patients treated with M-ECT consented to a future treatment, this was significantly less in patients treated with UM-ECT (50%).Conclusions: Bipolar patients report a high degree of satisfaction treated either with modified or unmodified ECT but there was a significant difference in perception of adverse effects and willingness for receiving ECT in future.

Evaluation of Experiences with Immunosuppressive Drugs in Transplantation: Validation of the MESI Scale in French

Patients’ experiences of immunosuppressive treatment, including their perception of adverse effects, influences their quality of life and may be a trigger for poor adherence. The Medication Experience Scale for Immunosuppressants (MESI) questionnaire was designed in German to evaluate patients’ experiences of immunosuppressive drugs. The objective of this study was to validate the MESI in French. The MESI was transculturally adapted and validated in French-speaking transplant recipients according to international guidelines. Statistical analysis was performed using R version 3.2.3, and the psychometric properties of the MESI were determined using the psy R package. Validation was performed in 164 kidney, liver, lung, and heart transplant recipients (aged 55.4 ± 13.1 years, 62.8% males, years since transplantation 7.5 ± 7.9). The MESI displayed good psychometric characteristics (intra-class correlation coefficient 0.854, Cronbach’s α 0.79 (95% confidence interval 0.74–0.83, Kappa coefficient 0.30–0.76). There was an association between the MESI score, family status, and the transplanted organ (p < 0.05). Almost half of the patients believed that adverse events would always persist. The good psychometric properties of the French version of the MESI allow evaluation of French-speaking patients’ experiences and attitudes towards their immunosuppressive treatment and, therefore, identification of patients at risk of poor adherence. This simple tool could help healthcare providers screen patients for the risk of poor adherence before any adherence issues appear.

Adverse effects of carbamazepine monotherapy among patients in Nigeria: a pilot study and implications.

Antiepileptic drugs do cause adverse effects, affecting patients' quality of life, adherence and seizures. Consequently, there is a need to study this among Nigerian patients. Descriptive cross-sectional study assessing the extent of adverse effects with carbamazepine monotherapy and potential factors. 54 patients (64.3%) reported no adverse effects, while 30 did. The most common adverse effects were memory problems followed by headaches, restlessness, tiredness and depression. Adverse effects were significantly higher in females, with females with low educational levels having significantly higher rates. Dose, co-medications, seizure control and comorbid conditions did not significantly affect adverse effects. Perception of adverse effects was common in patients on carbamazepine monotherapy, more common in women than men. Educational status was important in women.

Estudio RN4CAST en Murcia: características organizacionales de los hospitales y perfiles enfermeros

ObjectiveTo determine the profile of nurses in public hospitals in Murcia and to assess how they perceive their work environment, the quality of care and their level of burnout (the RN4CAST project repetition). Material and methodsA cross-sectional descriptive study was carried out in 8 hospitals in Murcia. Data were collected between 2009 and 2010 from 687 nurses (stratified by the type of unit) using a self-completed questionnaire with 149 items covering variables related to sociodemographics; work; perception of the work place (PES-NWI); burnout (Maslach Burnout Inventory); and the quality of patient care, and patient safety. Analysis: Non parametric tests, for two samples or k samples according to the comparison. ResultsA total of 495 questionnaires were collected (72%). Most respondents were female (80.4%) having a mean age of 34.1 (SD=7.1) years, and they had been working for 9.4 (SD=7.4) years. Just over one-quarter (25.7%) had carried out more than 300hours of training in the previous 24 months. The patient/nurse ratio was 11.7 (SD=3.6), varying between hospitals. The nurses reported 25% of hospitals as having an unfavorable work environment, whereas 37.5% had favorable ones; large hospitals were less highly valued. Few respondents intended to give up their jobs (16.8%). Burnout levels revealed emotional exhaustion in 18.4% of respondents; depersonalization in 7.5%, and personal fulfillment in 28.8%. Perception of quality varied between centers and the perception of adverse effects was more favorable in small hospitals. ConclusionsOur professionals were generally satisfied, but given the unfavorable work environment, measures should be adopted for improving well-being and reducing weaknesses.

Aripiprazole Versus Haloperidol in Combination With Clozapine for Treatment-Resistant Schizophrenia in Routine Clinical Care

This multisite study was conducted to compare the efficacy and tolerability of combination treatment with clozapine plus aripiprazole versus combination treatment with clozapine plus haloperidol in patients with schizophrenia who do not have an optimal response to clozapine. Patients continued to take clozapine and were randomly assigned to receive daily augmentation with aripiprazole or haloperidol. Physicians prescribed the allocated treatments according to usual clinical care. Withdrawal from allocated treatment within 3 months was the primary outcome. Secondary outcomes included severity of symptoms on the Brief Psychiatric Rating Scale and antipsychotic subjective tolerability on the Liverpool University Neuroleptic Side Effect Rating Scale. A total of 106 patients with schizophrenia were randomly assigned to treatment. After 3 months, we found no difference in the proportion of patients who discontinued treatment between the aripiprazole and haloperidol groups (13.2% vs 15.1%, P = 0.780). The 3-month change of the Brief Psychiatric Rating Scale total score was similar in the aripiprazole and haloperidol groups (-5.9 vs -4.4 points, P = 0.523), whereas the 3-month decrease of the Liverpool University Neuroleptic Side Effect Rating Scale total score was significantly higher in the aripiprazole group than in the haloperidol group (-7.4 vs -2.0 points, P = 0.006). These results suggest that augmentation of clozapine with aripiprazole offers no benefit with regard to treatment withdrawal and overall symptoms in schizophrenia compared with augmentation with haloperidol. However, an advantage in the perception of adverse effects with aripiprazole treatment may be meaningful for patients.

The Impact of Ocular Adverse Effects in Patients Treated With Topical Prostaglandin Analogs: Changes in Prescription Patterns and Patient Persistence

To document patient/physician perceptions of adverse effects and their relationship to medication changes among patients prescribed prostaglandin analogs. Medical/pharmacy claims (private U.S. health network) identified patients filling initial topical ocular hypotensive prescriptions from 2001 to 2004; 300 open-angle glaucoma patients prescribed a prostaglandin analog and 103 ophthalmologists were selected by algorithm for telephone interviews. Medical charts for 225/300 interviewed and 75 non-interviewed patients were abstracted. Medication patterns were assessed in pharmacy claims data. Frequency of adverse effects noted by physicians and associations with medication change decisions were examined in charted data. Patients' experiences with adverse effects were compiled from surveys. In patients treated with latanoprost (N = 4,071), bimatoprost (N = 1,199), or travoprost (N = 1,001), continuous refill of medication through 1 year was seen in 11%, 9%, and 5% of patients, respectively (P = 0.0001; retrospective pharmacy claims). Adverse effects were the second most common reasons noted by physicians for switching medications after lack of efficacy (19% vs. 43%, respectively). Adverse effects were noted in 65% of patient charts. Hyperemia was the most common adverse effect occurring with at least one other adverse effect in 48% of patients with the condition. Ocular adverse effects, particularly hyperemia, negatively affect patient continuation with therapy and switching.

Patient reporting of adverse drug reactions: useful information for pain management?

Background. Patients’ perceptions of adverse effects caused by the medicines they are prescribed may influence how they use these medicines. Little is known about patients’ perceptions of the adverse effects of specific drugs in everyday use and whether these differ from those identified by clinical trials and standard post-marketing surveillance methods. Aim. To compare reports of perceived adverse drug reactions (ADRs) obtained directly from patients taking tramadol to those found in clinical trials and two methods of post-marketing surveillance. Method. Postal questionnaire distributed to 1048 patients who had a prescription for tramadol dispensed over a 3-month period. Results. Most (84%) of the 344 respondents reported at least one symptom perceived as an ADR to tramadol. Dry mouth, light-headedness and constipation were most commonly reported. Almost half (48%) rated their most bothersome symptom as at least moderate and 43% claimed to have reported symptoms to their doctor. Perceived problems had led 38 respondents to stop taking tramadol. The 10 most frequently reported symptoms were all previously reported ADRs to tramadol. Although relatively minor, all 10 also appeared in reports to the UK Committee on the Safety of Medicines (CSM) and in prescription event monitoring. For many symptoms, the estimated range of frequency was in line with published reports, but considerably higher than that of post-marketing surveillance methods. Conclusions. Symptoms were reported by the majority of respondents and for many symptoms the frequency was high. Many patients did not report symptoms they perceived to be adverse effects to their doctor. The results indicate that patient perceptions of potential ADRs are relevant and should be an integral part of a pain management strategy.

Peer support, perceptions of adverse effects, and the hallucinogenic drug experience

The relationship between peer support and perceived effects of hallucinogenic drug use is examined, informed by Howard Becker's (1967) hypothesis that peers may provide benign interpretive contexts for drug induced experiences that reduce the psychologically threatening effects that would ordinarily accompany hallucinogenic drug use. Using data from a sample of 995 subjects who reported ever using hallucinogens, the effects of three separate measures of peer support on three different measures of perceptions of adverse effects as consequences of initial drug use were estimated in logistic regression models, controlling for demographic background characteristics of race/ethnicity, father's education, and a tendency to over-endorse statements. The results of these analyses show partial support for Becker's hypothesis in one model predicting perceptions of adverse psychological effects. Subjective distress interacts with peer support to predict reports of psychological effects. Subjects who report subjective distress and who report initiating drug use because their friends were doing it are significantly less likely to report adverse psychological effects of drug use. Additionally, differences in perceptions of unpleasant effects from initial drug use were found across racial/ethnic categories.

Factors contributing to preservice teachers' management of children's problem behaviors

The purpose of this study was to assess factors that contribute to preservice teachers' choice of a helping or a restrictive strategy to manage social immaturity and social defiance behaviors among children. Levels of tolerance, opinions as to the causes of behavior, perceptions of adverse effects or costs of problem behaviors, and choice of strategy were measured in response to hypothetical samples of problem behavior. Regression analyses indicated that the costs of problem behavior significantly predicted the type of strategy that would be chosen. Training preservice teachers to manage these costs was the main implication for teacher training programs.