Predictors Of Adherence Research Articles

Predictors of adherence to lipid-lowering medications among adult omani patients with hyperlipidemia

Predictors of adherence to lipid-lowering medications among adult omani patients with hyperlipidemia

Improved adherence to hip fracture standards reduces mortality after hip fractures

BackgroundHip fractures are increasing in incidence due to increasing life expectancy. Mortality continues to improve but it is important to explore which factors are responsible for driving improvements. MethodsA cohort of hip fracture patients predating SARS-CoV-2 was examined to determine the predictors of adherence to the six Irish Hip Fracture Standards (IHFS) and the impact of adherence on short (30 day) and long term (1 year) mortality. Our primary aim was assess the impact of a single HFS and cumulative number of HFS on mortality after hip fracture. Our secondary aim was to determine the impact of the HFS which are intrinsically linked to specialist Geriatric care. ResultsAcross 962 patients, over 5 years, the factors which were associated with adherence to HFS were female gender, increasing ASA grade and being nursed on an orthopaedic ward. Patients with increasing ASA were more likely to have met HFS 4–6 (Geriatrician review HFS4, bone health HFS5 & specialist falls assessment HFS6), less likely to have surgery within 48 h are more likely to develop a pressure ulcer. If the patient was not nursed on an orthopaedic ward all HFS were less likely to be met. At 30 days HFS 4–6 were associated with a statistically significant odds ratio (OR) of being alive, while at one year HFS 1 (admitted to an orthopaedic ward within 4 h), 5 and 6 were associated with a statistically significant OR of being alive. As increasing numbers of hip fracture standards were met patients were more likely to be alive at 30 days and one year. ConclusionThis study has identified that improved adherence to hip fracture standards are associated with improved mortality at 30 days and one year.

Comparing Adherence to the Experience Sampling Method Among Patients With Schizophrenia Spectrum Disorder and Unaffected Individuals: Observational Study From the Multicentric DiAPAson Project.

The Experience Sampling Method (ESM) is a valid method of remotely recording activities and mood, but the predictors of adherence to ESM in patients with Schizophrenia Spectrum Disorder (SSD) are not known. Studies on adherence are significant as they highlight the strengths and weaknesses of ESM-based study designs and allow the development of recommendations and practical guidelines for implementing future studies or treatment plans. The aim of this study was to compare the adherence to ESM in patients with SSD and unaffected control individuals, investigate their patterns, and report the predictors of adherence. In total, 131 patients with SSD (74 in residential facilities and 57 outpatients) and 115 unaffected control individuals were recruited at 10 different centers in Italy as part of the DiAPAson project. Demographic information, symptom severity, disability level, and level of function were recorded for the clinical sample. Participants were evaluated for daily time use and mood through a smartphone-based ESM 8 times a day for 7 consecutive days. Adherence was measured by the response rate to ESM notifications. Results were analyzed using the chi-square test, ANOVA, Kruskal-Wallis test, and Friedman test, and a logistic regression model. The overall adherence rate in this study was 50% for residents, 59% for outpatients, and 78% for unaffected control individuals. Indeed, patients with SSD had a lower rate of adherence to ESM than the unaffected control group (P≤.001), independent of time slot, day of monitoring, or day of the week. No differences in adherence rates between weekdays and weekends were found among the 3 groups. The adherence rate was the lowest in the late evening time slot (8 PM to 12 AM) and days 6-7 of the study for both patients with SSD and unaffected control individuals. The adherence rate among patients with SSD was not predicted by sociodemographic characteristics, cognitive function, or other clinical features. A higher adherence rate (ie, ≥70%) among patients with SSD was predicted by higher collaboration skills (odds ratio [OR] 2.952; P=.046) and self-esteem (OR 3.394; P=.03), and lower positive symptom severity (OR 0.835; P=.04). Adherence to ESM prompts for both patients with SSD and unaffected control individuals decreased during late evening and after 6 days of monitoring. Higher self-esteem and collaboration skills predicted higher adherence to ESM among patients with SSD, while higher positive symptom scores predicted lower adherence rates. This study provides important information to guide protocols for future studies using ESM. Future clinical or research studies should set ESM monitoring to waking hours, limit the number of days of monitoring, select patients with more collaborative skills and avoid those with marked positive symptoms, provide intensive training sessions, and improve participants' self-confidence with technologies. RR2-10.1186/s12888-020-02588-y.

Affective responses to stretching exercises: Exploring the timing of assessments

Affective responses during exercise have been identified as a predictor of exercise adherence. However, research has been mostly limited to aerobic and resistance exercise. Considering that stretching activities are also an important component of physical fitness, this quasi-experimental study was designed to: 1) compare affective responses during and immediately after stretching exercises in apparently healthy adults, and 2) assess the consistency and repeatability of affect ratings obtained one week apart. For this purpose, we analyzed the Feeling Scale (FS) and Felt Arousal Scale (FAS) ratings using Time (during and after stretching) x Intensity (light, moderate, vigorous) x Stretched Muscle Group (quadriceps, hamstrings, glutes, latissimus dorsi, triceps) with repeated measures analysis of variance (ANCOVA) in 34 participants (21 males; aged 32.8 ± 8.6 years). The repeatability of FS and FAS ratings was assessed using two-way random-effects models, Intraclass Correlation Coefficients (ICC), and Bland-Altman plots. FS scores were higher following the stretching exercises, whereas FAS scores were lower, particularly in the vigorous intensity. In general, the inter-day repeatability for FS and FAS measurements was good across muscle groups. ICC tended to be higher at vigorous intensities. Ratings of core affect can be collected during static passive stretches using the FAS and FAS in ecologically valid settings. These results suggest that an adequate assessment of core affective responses to stretching activities should be performed during the exercises.

Fear of covid-19 and covid-19 anxiety as predictors of adherence to treatment in patients with epilepsy

Background: The study aimed to examine fear of COVID-19 and Coronavirus Anxiety as predictors of adherence to treatment in individuals diagnosed with epilepsy during the COVID-19 pandemic. Method and Material: The study was carried out in a university hospital. The research sample consisted of 154 epilepsy patients. The patient identification form, Coronavirus (Covid-19) Fear Scale, Coronavirus Anxiety Scale, and the Medication Adherence Report Scale (MARS) were used as data collection tools. The data were shown as percentages and mean ± standard deviation (SD), and Pearson/Spearmen correlation and linear regression analyses were used to examine the relationship between the variables. Results: The results of the analysis demonstrated that the model established for medication adherence in epilepsy patients was significant (F: 12,892, p < 0.001). In addition, for medication adherence, COVID-19 anxiety (β = -0.312), regular drug use (β = 0.242), seizure frequency (β = -0.234), and accommodation in the city center (β = -0.173) were found to be statistically significant predictors (p < 0.001). It was found that the variables explained 24% of the total variance. Conclusions: It should be remembered that infectious diseases such as COVID-19 can reoccur and that it is necessary to be prepared for new contagious diseases likely to occur. In case of the recurrence of infectious diseases such as COVID-19, it is important to conduct interventional/experimental studies on how to increase medication adherence of patients and how to reduce COVID-19 anxiety.

Community-based tuberculosis contact management: Caregiver experience and factors promoting adherence to preventive therapy.

Delivery of tuberculosis preventive therapy (TPT) for children with household exposure to tuberculosis is a globally supported intervention to reduce the impact of tuberculosis disease (TB) in vulnerable children; however, it is sub-optimally implemented in most high-burden settings. As part of a community-based household contact management program, we evaluated predictors of adherence to community based TPT in children and performed qualitative assessments of caregiver experiences. The Vikela Ekhaya (Protect the Home) project was a community-based household contact management program implemented between 2019 and 2020 in the Hhohho Region of Eswatini. At home visits, contact management teams screened children for TB, initiated TPT when indicated and performed follow-up assessments reviewing TPT adherence. TPT non-adherence was defined as either two self-reported missed doses or a pill count indicating at least two missed doses, and risk factors were evaluated using multivariate clustered Cox regression models. Semi-structured interviews were performed with caregivers to assess acceptability of home visits for TPT administration. In total, 278 children under 15 years initiated TPT and 96% completed TPT through the Vikela Ekhaya project. Risk factors for TPT non-adherence among children initiating 3HR included low family income (adjusted hazard ratio (aHR) 2.3, 95%CI 1.2-4.4), female gender of the child (aHR 2.5, 95% CI 1.4-5.0) and an urban living environment (aHR 3.1, 95%CI 1.6-6.0). Children with non-adherence at the first follow-up visit were 9.1 fold more likely not to complete therapy. Caregivers indicated an appreciation for community services, citing increased comfort, reduced cost, and support from community members. Our results are supportive of recent World Health Organization (WHO) recommendations for decentralization of TB preventive services. Here, we identify populations that may benefit from additional support to promote TPT adherence, but overall demonstrate a clear preference for and excellent outcomes with community based TPT delivery.

Are Prior Sexual Risk Behaviors Associated With Adherence to COVID-19 Preventative Behaviors Among Young Black Men?

Behavioral clustering is a phenomenon in which several risk or protective behaviors co-occur in an individual. We sought to determine if prior sexual risk behaviors among young Black men who have sex with women could predict subsequent nonadherence to COVID-19 prevention behaviors. Young Black men who have sex with women aged 15 to 24 years previously enrolled in a community-based Chlamydia trachomatis (Ct) screening program were enrolled in a substudy between May and June 2020 and asked about adherence to 4 COVID-19 recommended nonpharmaceutical prevention behaviors (handwashing, mask wearing, social distancing, and following stay at home orders). Data from the original study were used to elicit the follow prepandemic behaviors including having multiple sex partners, inconsistent condom use, prior sexually transmitted infection testing behaviors, and substance use. Wilcoxon rank sum tests were used to assess the association between historic risk behaviors and COVID-19 behavior score. There were 109 men included in the analysis, with a mean (SD) age of 20.5 (2.0) years. Inconsistent condom use, multiple sex partners, and prior HIV/sexually transmitted infection testing status were not associated with fewer COVID-19 preventive behaviors, but men who used any nonprescription drugs ( P = 0.001) or marijuana only ( P = 0.028) had a lower median COVID-19 preventative score compared with those who did not engage in those activities. Although none of the sexual risk behavior variables were associated, self-reported nonprescription drug and marijuana use were both significant predictors of lower adherence to COVID-19 preventative behaviors among young Black men. Young men who use drugs may need additional support to promote COVID-19 preventative behavior uptake.

Testing Assumptions of the Physical Activity Adoption and Maintenance Model: A Longitudinal Perspective of the Relationships Between Intentions and Habits on Exercise Adherence.

In this study, we aimed to examine empirically the Physical Activity Adoption and Maintenance model (PAAM). We collected data on these variables at baseline (T0) and 6-months later (T1). We recruited 119 participants (42 male, 77 female) aged 18-81years old (Mage = 44.89, SD = 12.95). who reported, at baseline, that they exercised an average of 3.76days per week (SD = 1.33) in training periods lasting 15-60minutes (M = 38.69; SD = 23.28). We conducted hierarchical multiple regression analysis to test the association between each determinant (intentions, habits, and frequency) and future exercise adherence. We tested four models by entering blocks of predictors according to PAAM assumptions. The variance change (R2) between the first and fourth models (ΔR2 = .391) was statistically significant, showing that the fourth model accounted for 51.2% of variance for future exercise adherence, F (6, 112) = 21.631, p < .001, R2 = .73, adjusted R2 = .512. Exercise intention at T1 maintained its significant association (p = .021) with exercise frequency at T1 in all tested models. Exercise frequency at T0 was the most significant predictor (p < .01) of future exercise adherence, with past experience the second most significant predictor (p = .013). Interestingly, exercise habits at T1 and T0 did not predict exercise frequency at T1 in the fourth model. Among the variables we studied, having constantly high exercise intentions and high regular exercise frequency are significantly associated with maintaining or increasing regular future exercise behavior.

Predictors of Adherence to Personal Preventive Behaviors Among Nursing Students Based on Health Belief Model: Cross Sectional Study During the Second Wave of COVID-19 Pandemic in Indonesia

Introduction: Personal preventive behaviors was cited as effective strategy to prevent the SARS-CoV-2 transmissions. When vaccine become available, preventive behavior must still be implemented to significantly decreased the COVID-19 infection risk in the emergence of novel SARS-CoV-2 variants of concern with immune escape phenotype. The Health Belief Model (HBM) is the most widely recognized behaviour theory, but its capacity to predict the preventive behaviours have been inconsistent. This study aimed to assess predictors adherence to COVID-19 preventive behaviour among nursing students based on HBM during the second wave of COVID-19 in Indonesia. Methods: An online cross-sectional study was conducted from May to September 2021. Undergraduate nursing students (n=1,413) from 10 universities in Indonesia was recruited using consecutive sampling. Online self-administered questionnaire was used to collect the data. Binary logistic regression was employed to analyse the association between sociodemographic and HBM construct with adherence to preventive behaviors. Results: Most of the students (n=804; 56.9 %) had poor adherence to COVID-19 preventive behaviors, and poor physical distancing identified as the most dominant non-adherence type (n=774; 54.8 %). First year students (AOR=1.313; 95%CI: 1.020-1.690), low perceived susceptibility (AOR=1.530; 95%CI: 1.193-1.962), low perceived severity (AOR= 1.756; 95%CI: 1.337-2.307), low perceived effectiveness (AOR=1.910; 95%CI: 1.315-2.777), and low self-efficacy (AOR=4.795; 95%CI: 3.566-6.447) significantly associated with poor adherence (p&lt;0.05). Nagelkerke R square value was 0.313 suggesting that the whole model explained 31.3% of variance in adherence. Conclusion: Intervention that targeting health belief model could be useful to increased adherence level to COVID-19 preventive measures among nursing students.

Medication adherence in leukemia children receiving home-based treatment and its related factors

ABSTRACTObjectives:This study aimed to investigate home-based medication adherence in children with acute leukemia and its related factors.Methods:We examined 132 children with acute leukemia in a tertiary pediatric hospital in Chongqing. A general questionnaire, the MMAS-8 (the eight-item Morisky Medication Adherence Scale), SEAMS (Self-efficacy for Appropriate Medication Use Scale), and a multifactorial logistic regression model were used to analyze the factors related to drug adherence of the children.Results:54.55% of patients showed good medication adherence, while 50.76% either forgot a dose or administered an incorrect dose. The average score on the Self-Efficacy for Appropriate Medication Use Scale (SEAMS) was 32.47.61. The logistic regression analysis revealed that a SEAMS score, the occupation of caregivers, and the patient’s age were predictors of medication adherence among pediatric leukemia patients (P < 0.05).Conclusions:The home-based medication adherence in children with acute leukemia was not favorable. Patients with low SEAMS scores, farmers serving as caregivers, and children under the age of three should arouse more attention. It is expected to strengthen the confidence of patient families in medication by emphasizing the development of their relationships with healthcare professionals. Awareness of breakthroughs in leukemia home-based medication management systems by utilizing Internet technology.

Demographic, Clinical, and Psychosocial Predictors of Exercise Adherence: The STRRIDE Trials.

To identify baseline demographic, clinical, and psychosocial predictors of exercise intervention adherence in the Studies of a Targeted Risk Reduction Intervention through Defined Exercise (STRRIDE) trials. A total of 947 adults with dyslipidemia or prediabetes were enrolled into an inactive control group or one of ten exercise interventions with doses of 10-23 kcal/kg/week, intensities of 40-80% of peak oxygen consumption, and training for 6-8-months. Two groups included resistance training. Mean percent aerobic and resistance adherence were calculated as the amount completed divided by the prescribed weekly minutes or total sets of exercise times 100, respectively. Thirty-eight clinical, demographic, and psychosocial measures were considered for three separate models: 1) clinical + demographic factors, 2) psychosocial factors, and 3) all measures. A backward bootstrapped variable selection algorithm and multiple regressions were performed for each model. In the clinical and demographic measures model (n=947), variables explained 16.7% of the variance in adherence (p<0.001); lesser fasting glucose explained the greatest amount of variance (partial R2 = 3.2%). In the psychosocial factors model (n=561), variables explained 19.3% of the variance in adherence (p<0.001); greater 36-Item Short Form Health Survey (SF-36) physical component score explained the greatest amount of variance (partial R2 = 8.7%). In the model with all clinical, demographic, and psychosocial measures (n=561), variables explained 22.1% of the variance (p<0.001); greater SF-36 physical component score explained the greatest amount of variance (partial R2 = 8.9%). SF-36 physical component score was the only variable to account for >5% of the variance in adherence in any of the models. Baseline demographic, clinical, and psychosocial variables explain approximately 22% of the variance in exercise adherence. The limited variance explained suggests future research should investigate additional measures to better identify participants who are at risk for poor exercise intervention adherence.

Adherence to therapy among liver transplant patients as related to depression, anxiety, acceptance of the disease, and social support.

This study aimed to assess the patients' adherence to therapeutic regimens after liver transplantation, taking into account the levels of depression and anxiety, acceptance of the disease, and social support. The study group included N = 112 patients selected from 669 patients after liver transplantation. The Delphi method was used to develop a tool to assess the level of adherence to treatment regimens. The sources of data for this study were recommendations and the work of an expert panel. The next method used in the study was a diagnostic survey based on the following standardized research instruments: Inventory of Socially Supportive Behaviors (ISSB), Acceptance of Illness Scale (AIS), Beck Depression Inventory-II (BDI-II) and State-Trait Anxiety Inventory (STAI). The study group showed a medium level of adherence to therapeutic recommendations (6.8 ± 1.85). We observed a statistically significant positive correlation between acceptance of the disease and adherence to therapeutic recommendations (r = -0.20, t = -2.040, p = 0.044). Among the factors analyzed, six predictors were identified that significantly affect the level of adherence to therapeutic recommendations in a group of liver transplant patients. 1. Patients who accept their disease are a group of people who significantly worse adhere to therapeutic recommendations. 2. The main positive predictors of treatment adherence in the group of transplant patients are the search for various sources of information and declarative adherence to treatment recommendations. Negative predictors include the duration of the disease, side effects of the applied treatment, and comorbidities. 3. The patients who were informed that results depend on regular medication intake significantly more often followed therapeutic recommendations.

Predictors of Medication Adherence among Patients with Bipolar I Disorder

The present study aimed to determine predictors of medication adherence among patients diagnosed with Bipolar I Disorder (BP-I). Another aim was to estimate differences with different marital status in perceived social support, internalized stigmatization and medication adherence. Correlational research design was used and a sample of 103 participants was gathered using purposive sampling method. Data was collected by administering Multidimensional Scale of Perceived Social Support (MSPSS), Internalized Stigma of Mental Illness (ISMI), and General Medication Adherence Scale (GMAS). Results illustrated perceived social support (R2 = .46, F (3, 99) = 28.52, p&lt;0.001) and internalized stigmatization R2 = .49, F (8, 94) = 11.40, p&lt;0.001) to be significant predictors of medication adherence. Furthermore, it was found that married individuals with bipolar I disorder received more support [F (1, 101) = 4.08, p = .04] and were more adherent to medication [F (1, 101) = 6.35, p = .01] as compared to single individuals with bipolar I disorder. However, no significant difference was found between married and single patients in their experience of internalized stigmatization. Present study highlights the need for awareness campaign where individuals are informed regarding the importance of their support and also the need for educational workshops for skill building in patients with Bipolar I disorder.

Influence of depression and interpersonal support on adherence to antiretroviral therapy among people living with HIV

BackgroundPoor adherence and under-utilization of antiretroviral therapy (ART) services have been major setbacks to achieving 95-95-95 policy goals in Sub-Saharan Africa. Social support and mental health challenges may serve as barriers to accessing and adhering to ART but are under-studied in low-income countries. The purpose of this study was to examine the association of interpersonal support and depression scores with adherence to ART among persons living with HIV (PLWH) in the Volta region of Ghana.MethodsWe conducted a cross-sectional survey among 181 PLWH 18 years or older who receive care at an ART clinic between November 2021 and March 2022. The questionnaire included a 6-item simplified ART adherence scale, the 20-item Center for Epidemiologic Studies Depression Scale (CES-D), and the 12-item Interpersonal Support Evaluation List-12 (ISEL-12). We first used a chi-squared or Fisher’s exact test to assess the association between these and additional demographic variables with ART adherence status. We then built a stepwise multivariable logistic regression model to explain ART adherence.ResultsART adherence was 34%. The threshold for depression was met by 23% of participants, but it was not significantly associated with adherence in multivariate analysis(p = 0.25). High social support was reported by 48.1%, and associated with adherence (p = 0.033, aOR = 3.45, 95% CI = 1.09–5.88). Other factors associated with adherence included in the multivariable model included not disclosing HIV status (p = 0.044, aOR = 2.17, 95% CI = 1.03–4.54) and not living in an urban area (p = 0.00037, aOR = 0.24, 95% CI = 0.11–0.52).ConclusionInterpersonal support, rural residence, and not disclosing HIV status were independent predictors of adherence to ART in the study area.

Cross-sectional survey assessment of physical activity level and frequency of performing pelvic floor muscle exercises

Pelvic floor muscle (PFM) exercises are a non-invasive and effective treatment option for female pelvic floor disorders, but patient adherence is often poor, and predictors of adherence are limited. Our objective was to evaluate the relationship between physical activity level in women and self-reported frequency of performing PFM exercises. Women who responded to a cross-sectional survey through Research Match, a national online volunteer registry, were stratified into low, moderate, and high activity categories based on the International Physical Activity Questionnaire (IPAQ) Short Form. The Pearson Chi-square test was used to evaluate the association between activity level and the self-reported frequency of performing Kegels or PFM exercises. Multivariable logistic regression was used to assess the impact of physical activity level, demographic characteristics (including age, race, ethnicity, insurance status), and urinary symptoms (assessed by the Lower Urinary Tract Research Network-Symptom Index, LURN-SI 29) on performing PFM exercises several times a month or more. A total of 1,720 women were classified as having low (47.4%), moderate (26.3%), and high (26.3%) activity. More women in the high IPAQ category reported performing PFM exercises several times a month or more (17.0%, vs. 10.7% for moderate activity and 12.0% for low activity; P < 0.01). Women most commonly reported doing PFM exercises to improve sex (25.9%), to prevent getting a problem (17.8%), and because they were instructed to start doing them after childbirth (18.0%). Of women who provided a reason for not doing PFM exercises, those in the low and moderate activity groups were more likely to cite laziness as a reason compared to women in the high activity group (47.6% and 51.2%, respectively, vs. 38.7%; P = 0.02). On multivariable logistic regression, physical activity level and lacking insurance coverage were significant predictors of performing PFM exercises several times a week or more. Interventions aimed at increasing PFM exercise participation may benefit from linking to motivation, self-efficacy, and physical activity. The relationship between insurance coverage and frequency of performing PFM exercises warrants further exploration.

Disparities in adherence and emergency department utilization among people with epilepsy: A machine learning approach

PurposeWe used a machine learning approach to identify the combinations of factors that contribute to lower adherence and high emergency department (ED) utilization. MethodsUsing Medicaid claims, we identified adherence to anti-seizure medications and the number of ED visits for people with epilepsy in a 2-year follow up period. We used three years of baseline data to identify demographics, disease severity and management, comorbidities, and county-level social factors. Using Classification and Regression Tree (CART) and random forest analyses we identified combinations of baseline factors that predicted lower adherence and ED visits. We further stratified these models by race and ethnicity. ResultsFrom 52,175 people with epilepsy, the CART model identified developmental disabilities, age, race and ethnicity, and utilization as top predictors of adherence. When stratified by race and ethnicity, there was variation in the combinations of comorbidities including developmental disabilities, hypertension, and psychiatric comorbidities. Our CART model for ED utilization included a primary split among those with previous injuries, followed by anxiety and mood disorders, headache, back problems, and urinary tract infections. When stratified by race and ethnicity we saw that for Black individuals headache was a top predictor of future ED utilization although this did not appear in other racial and ethnic groups. ConclusionsASM adherence differed by race and ethnicity, with different combinations of comorbidities predicting lower adherence across racial and ethnic groups. While there were not differences in ED use across races and ethnicity, we observed different combinations of comorbidities that predicted high ED utilization.

Behind closed doors: Protective social behavior during the COVID-19 pandemic.

The success of personal non-pharmaceutical interventions as a public health strategy requires a high level of compliance from individuals in private social settings. Strategies to increase compliance in these hard-to-reach settings depend upon a comprehensive understanding of the patterns and predictors of protective social behavior. Social cognitive models of protective behavior emphasize the contribution of individual-level factors while social-ecological models emphasize the contribution of environmental factors. This study draws on 28 waves of survey data from the Understanding Coronavirus in America survey to measure patterns of adherence to two protective social behaviors-private social-distancing behavior and private masking behavior-during the COVID-19 pandemic and to assess the role individual and environmental factors play in predicting adherence. Results show that patterns of adherence fall into three categories marked by high, moderate, and low levels of adherence, with just under half of respondents exhibiting a high level of adherence. Health beliefs emerge as the single strongest predictor of adherence. All other environmental and individual-level predictors have relatively poor predictive power or primarily indirect effects.

A cross-sectional questionnaire-based study of medication adherence in children suffering from epilepsy attending pediatric out-patient department at a tertiary care teaching hospital

Background: Epilepsy is a common chronic disease presenting during childhood that requires long-term treatment. Rates of adherence to antiepileptic drugs are variable in children ranging from 25% to 75%. Non-adherent patients are more likely to experience frequent and recurrent seizures which drastically impact the health of the patient. This study was therefore conducted in order to assess the medication adherence of children suffering from epilepsy to the prescribed anti-epileptic drug therapy. Methods: Children diagnosed with epilepsy aged 6-18 years were enrolled in the present cross-sectional questionnaire-based study after prior written informed consent and written informed assent. Children with co-morbidities were excluded from the study (as diagnosed by the Paediatrician). The case record form was filled after interviewing the patients. A questionnaire based on the Morisky medication adherence scale-8 (MMAS) was used to evaluate the quality of life of children. Results: Total 243 patients got enrolled in the study. GTCS was found to be the most common type of epilepsy. Valproate was the most commonly used agent. Out of the 243 patients in total, 201 patients (83%) showed high adherence, 24 patients (10%) showed medium adherence and 18 patients (7%) showed poor adherence to the treatment prescribed. Patients on monotherapy showed higher adherence rates than patients on polytherapy. Medication adherence was highest with Valproate among monotherapy and valproate + carbamazepine among poly-therapy. Conclusions: We conclude that monotherapy with anti-epileptic agents and patient satisfaction is positive predictors of medication adherence leading to a lesser impact of the disease on the child and improved health.

Preventive Measures and Potential Risk Factors for Toxoplasmosis among ART Clients in Sunyani Municipality.

This current study looked at the risk factors and preventive measures among persons living with HIV who access ART care at the Sunyani Bono Regional Hospital. A cross-sectional study was used because it simultaneously assesses both outcome and exposure variables. 340 people out of the projected 5430 in the municipality were sampled. Convenience sampling was used to select currently well PLWHA attending the ART clinic in the Bono Regional Hospital for the study. The most prevalent potential risk factors identified were lack of purification of drinking water (88.5%), farming and gardening activities (42.9%), handling cat feces without personal protection (21.0%), not washing fruits before eating (3.1%), not washing vegetables before cooking (1.2%), and an unquantified consumption of undercooked meat. The preventive measures assessed were the use of co-trimoxazole preventive therapy (CPT) and antiretroviral therapy (ART), adherence to which was tested for their relationships with socio-demographic characteristics and challenges to adherence at the first four levels of the social-ecological model. Strong predictors of adherence were occupation and satisfaction with ARVs. However, in this study, no significant relationship was found with the multivariate analysis. Similarly, no significant relationship was identified between age and adherence to CPT at any stage of the analysis in this research study. It is recommended that clinicians who are involved in ART care encourage patients in all categories of occupations to make their treatment a priority since their health is vital to all other pursuits in their lives.

Level Of ART Adherence and associated factors among People Living with HIV in the Context of Early Antiretroviral therapy initiation In Wolaita Sodo Town, Ethiopia: Cross-sectional study.

Early antiretroviral therapy initiation is WHO recommendation for fasten viral suppression and for prevention of further viral transmission sexually. There is no evidence showing the level of adherence to antiretroviral therapy (ART) after initiation of the universal test and treat (UTT) strategy in Ethiopia, including study area. This study was aimed to determine the level of ART adherence and associated factors among HIV/AIDS patients in context of Universal test and treat strategy. A Health facility-based study was conducted on 352 people living with HIV who started their ART follow-up after application of universal test and treat strategy in Ethiopia from 15 April to 5 June 2020. Systematic random sampling method was used to select the study participants. Interviewer administered questionnaire was used to collect data and collected data were entered directly in to SPSS version 21 and analyzed. Both bivariate and multivariate logistic regression analyses were done. Strength and direction of association was determined by using AOR with 95%CI. The total 352 participants included the study. The overall level of adherence was 290 (82.4%). Commonly used ART regimen was TDF+3TC+EFV, 201(57.1%). In bivariate analysis, type of health institutions COR 2.934(1.388, 6.200), age level of 18-27 COR .357(.133, .959), current viral load in log scale COR= .357(.133, .959) and change of ART medication COR= 8.088(1.973, 33.165) were associated with medication adherence. Health institution type AOR = 2.615(1.147, 5.9600) and change of ART medication AOR= 7.267 (1.683, 31.384) were independent predictors of ART adherence. Low level of ART adherence was detected in this study. It was below the recommended good adherence standard and 90-90-90 target strategy. Therefore, patients should get adequate and comprehensive ART adherence counseling before initiation ART treatment and during the follow-up time.