Predictors Of Adherence Research Articles

Predictors of quality of life (QOL) and treatment adherence among children with nephrotic syndrome.

Any significant changes in the growth and development of any aspect of life will ultimately affect the health-related quality of life (HRQOL) of children with nephrotic syndrome. Various factors can influence treatment adherence, which can promote or decline the child's quality of life (QOL). Objective: To assess the quality of life and adherence to treatment regimen and to identify the predictors of QOL and adherence to treatment regimen among children with nephrotic syndrome. A cross-sectional study was conducted among 59 children with nephrotic syndrome who attended the Paediatric Department of AIIMS, Bhubaneswar, using the PedsQL 4.0 generic core scale to assess the quality of life and adherence response scale. Both descriptive and inferential statistics were performed using the SPSS 20 version. The overall QOL median score was 93.48, with an IQR of 18.48, which indicated good QOL. A median score of treatment adherence was 16 with IQR 5, which indicated that the overall treatment adherence was good. Type of nephrotic syndrome (P = 0.014), developmental stage (P = 0.018), education of mother (P = 0.026), and occupation of mother (P = 0.026) were the variables predicted QOL. Duration of disease (P = 0.006) and duration of therapy (P = 0.005) significantly predicted treatment adherence. Children need continuous reinforcement on treatment adherence strategies to attain and maintain good QOL so that it can help to reduce the disease severity. Controlling the predictors that influence the QOL and treatment adherence has to be counseled among the parents so that their adherence can be sustained throughout the disease process to maintain good QOL.

Impact of Sociodemographic and Psychological Factors on Adherence to Glaucoma Treatment - A Cross-Sectional Study.

Glaucoma is a group of eye diseases characterized by progressive and irreversible damage to the optic nerve. The aim of the study was to examine the impact of sociodemographic and psychological factors on adherence to glaucoma therapy. The study was carried out among 190 adults treated for glaucoma at the Ophthalmology Outpatient Clinic of the University Teaching Hospital in Wroclaw between January 2019 and September 2019. Treatment adherence was measured using the Adherence to Refills and Medications Scale (ARMS). We used the Acceptance of Illness Scale (AIS), the Revised Life Orientation Test (LOT-R) and the Satisfaction with Life Scale (SWLS). 58.9% patients reported low treatment adherence. Educated females aged 68 or under living in cities had higher adherence. The regression analysis showed an association between dispositional optimism and glaucoma treatment adherence. The higher the level of dispositional optimism, the better the adherence. Higher dispositional optimism is directly associated with a sense of self-esteem and self-efficacy and a feeling of internal control. Patients reporting a high level of illness acceptance were found to have 2.5 times higher odds of adhering to glaucoma therapy. Illness acceptance is an indicator of the degree of adaptation to an illness and is positively correlated with a sense of self-esteem and self-efficacy and engagement in healthy behavior. More than half of patients with glaucoma have low adherence. Sociodemographic characteristics (female gender, age 68 or under, tertiary education and living in an urban area) and psychological characteristics (high level of illness acceptance, dispositional optimism and satisfaction with life) are significant predictors of high adherence.

Adherence to wearing prescribed footwear in people at risk of diabetes-related foot ulcers.

Adherence to wearing prescribed footwear is paramount in reducing the risk of developing diabetes-related foot ulcers, but adherence is often lower than optimal. This study aimed to investigate predictors of footwear adherence and variations in adherence and activity in people at risk of diabetes-related foot ulceration. Sixty people at high foot ulcer risk were included. We measured the proportion of weight-bearing acitivity time the prescribed footwear was worn for seven days. Multiple linear regression and analysis of variance were used. Mean overall adherence was 63%. Adherence was lower at home than away from home (59% vs. 74%), while activity was higher at home (2.2 vs. 1.2h/day). Adherence was similar across activities (61%-63%). No variable predicted the overall adherence. Higher Hba1c predicted lower adherence at home (β=-0.34, p=0.045, R2=11.6%). More daily steps predicted lower adherence away from home (β=-0.30, p=0.033, R2=9.3%). Adherence and activity were highest in mornings (71%, 1.1h) and afternoons (71%, 1.5h), and lower in evenings (40%, 0.8h) and at nights (9%, 0.1h). Adherence was similar on weekdays and weekend days (63% vs. 60%), but activity was higher on weekdays (3.4 vs. 3.0h). Adherence levels and predictors thereof differed between adherence at home and away from home, so we suggest to treat them as different concepts. Due to the low explained variance, future studies should focus on other predictors such as psychological variables.

Exploring the impact of subjective well-being on medication adherence: A cross-sectional study among individuals with multiple chronic diseases

BackgroundMedication non-adherence is a significant barrier to optimal treatment goals. The study explores the association between subjective well-being (SWB) and medication adherence among Lebanese individuals with multiple chronic diseases and identifies additional factors that may influence adherence in this population. MethodsAn exploratory, cross-sectional study was conducted for three months at six community pharmacies. Adherence was assessed using the Adherence to Refills and Medication Scale Arabic Lebanese Version (ARMS-A). The SWB was measured using the Arabic Scale of Happiness (ASH), Love of Life Scale (LLS), Arab Hope Scale (AHS), and Satisfaction with Life Scale (SWLS). Spearmen's Rho correlation analyzed the association between ARMS-A and SWB constructs. Binary logistic regression identified predictors of adherence among individuals with chronic diseases and on multiple chronic medications. ResultsOf 400 participants, 106 (26.5 %) with a 95 % CI, 0.22–0.31, were adherent. Lower medication adherence (reflected in higher ARMS-A scores) was associated with lower SWB (p = 0.01). Multivariate analysis showed that lower education (OR=2.21, 95 % CI, 1.01–4.81), lack of a specific diet (OR = 1.64, 95 % CI, 1.01–2.69), and frequent hospital and/or emergency visits (OR=3.29, 95 % CI, 1.75–6.17 for 2 visits; OR = 2.71, 95 % CI, 1.43–5.14 for ≥3 visits) significantly increased the odds of non-adherence to chronic treatment. However, higher income (OR = 0.06, 95 % CI, 0.01–0.38), healthcare provider occupation (OR = 0.42, 95 % CI, 0.21–0.48), and having diabetes mellitus (OR = 0.59, 95 % CI, 0.36–0.96) correlated with better adherence. ConclusionA significant portion of participants failed to adhere to their prescribed chronic medications, influenced by multicomplex socioeconomic, psychological, and health-related factors. These findings demonstrate the need for culturally-tailored, pharmacist-led interventions to improve medication adherence and overall health outcomes.

The Management of Depression and Anxiety in Primary Care: Examining Predictors of Adherence to a Psychopharmacological Collaborative Care Management Program for Veterans.

Collaborative care management (CoCM) is an evidenced based approach to psychiatric treatment in primary care, yet literature examining factors associated with program adherence is lacking. This study analyzed predictors of adherence to a CoCM model of psychopharmacological treatment of depression and anxiety in primary care by conducting a retrospective cohort analysis on Veterans referred to a large VA Medical Center's CoCM program over an 18-month period. Baseline characteristics, symptomatic assessments, and covariates of interest were collected. For the primary outcome, the association between covariates and programmatic completion were analyzed. Secondary analyses assessed improvements in psychiatric symptoms. A total of 757 Veterans with depressive or anxiety disorders were included, and 256 completed the CoCM program. Baseline covariates associated with differences in completion rates included the following: age, contact with psychology prior to referral, baseline PHQ-9, baseline GAD-7, and a number of comorbid psychiatric/substance abuse covariates. After controlling for baseline differences, age remained a significant positive predictor of completion (OR 1.019, 95% CI 1.008‒1.030) and cannabis use a significant negative predictor (OR 0.507, 95% CI 0.275‒0.934). Both early improvement in PHQ-9 (OR 1.864, 95% CI 1.210‒2.872) and GAD-7 (OR 1.762, 95% CI 1.154‒2.691) scores were positive predictors. Secondary analyses showed that programmatic completion was associated with greater reductions in psychiatric symptoms. Results identified a number of modifiable parameters associated with differences in completion rates and greater symptomatic reduction for those who complete the program. Additional studies should be conducted examining interventions to optimize CoCM programs by supporting positive predictors while minimizing negative predictors.

Predictors of Poor Adherence to Antiretroviral Treatment among HIV Positive Patients at Tamale West Hospital, Ghana

Background: Adherence to Antiretroviral therapy is necessary to reduce the viral load of people diagnosed with HIV and help boost the persons’ immunity against opportunistic infections due to the virus. Therefore, this study aimed to assess the level of adherence to ART and its associated factors among HIV clients at the Tamale west hospital. Methods: The current study employed a descriptive study design, and sampled a total of 104 clients receiving ART in the Tamale West Hospital in the Northern Region of Ghana. Results: The results showed that weekly adherence was 94.2%, monthly adherence (76%), quarterly adherence (71%), half yearly adherence (51.9%) and only 33.7% have religiously adhered to ART medication from the initiation of their treatment. The treatment profile of the clients revealed that the majority of them (44.7%) had been receiving antiretroviral therapy (ART) for a duration of 5 years. Additionally, 25.2% had been on ART for 1 year, while 22.3% had been on the treatment for a period ranging from 6 to 10 years. Educational level [(CI: -0.101, 0.001), p<0.052], forgetfulness [(CI: 0.186, 0.581), p<0.001], side effects [(CI: 0.072, 0.400), p<0.005], education on medication [(CI: 0.015, 0.540), p<0.038], confidentiality of services [(CI: 0.012, 0.543), p<0.041], and cost of transportation to treatment centre [(CI: 0.006, 0.167), p<0.035] were significantly associated with treatment adherence to ART among the clients. Conclusions: The adherence rate as determined in the current study did not meet the expected target set by the Ghana National AIDS control programme. A continuous friendly ART services and an intervention to cater for the transport cost of clients would have helped improve adherence among the study clients.

Big five personality traits and resilience as predictors for self-isolation adherence during COVID-19 pandemic

Background & Aim: Results of previous studies on the role of personality traits and resilience in explaining health-oriented behaviors such as social/physical distance and self-isolation were inconsistent. The present study was conducted to determine the role of the five big personality traits and resilience in adherence to self-isolation during the COVID-19 pandemic. Methods & Materials: A prospective longitudinal cohort study tracked 112 healthcare providers who tested positive for SARS-CoV-2. Using GPS data from their cell phones, researchers assessed self-isolation adherence over 14 days. Participants completed NEO-Five-Factor Inventory (NEO-FFI) and Connor–Davidson Resilience Scale (CD-RISC) questionnaires. Results: Sixty-one (58.7%) of the subjects violated their self-isolation, and 43 (41.3%) did not violate it during the 14 days after PCR positivity for COVID-19. After adjustment for potential confounders, results showed that only two of the five big personality traits included, conscientiousness (AOR=1.37; 95%CI: 1.15–1.63) and neuroticism (AOR=0.85; 95%CI: 0.74–0.98), were significantly related to the self-isolation adherence. This means a one-unit increase in conscientiousness is associated with 37% higher odds of self-isolation adherence, while a one-unit increase in neuroticism reduces self-isolation adherence by 15%. Resilience was the main predictor for self-isolation adherence in which a one-unit increase in resilience score, the odds of adherence to self-isolation significantly increased by 18% (AOR=1.18, 95%CI: 1.07–1.30) (P<0.001). Conclusion: The study suggests that fostering conscientiousness and resilience among individuals may enhance self-isolation commitment during pandemics. Further research is needed to explore the influence of agreeableness, extraversion, and openness to experience on self-isolation adherence.

Does the type of pharmacy used influence medication adherence? A retrospective observational study in Aotearoa, New Zealand.

Community pharmacies in New Zealand have varying ownership and operational structures. Unlike independent pharmacies, corporate and hybrid pharmacies do not charge prescription copayments. This research aimed to determine whether people receiving free prescriptions from corporate and hybrid pharmacies (via copayment waiver) have greater medication adherence than the users of independent pharmacies. A nationwide, retrospective, observational study linked 1 year of dispensing data (1/05/2022 to 30/04/2023) from the Pharmaceutical Collection to patient enrollment data using a National Health Index number to identify demographics of different pharmacy-type users. People were assigned to a particular type of pharmacy if they collected at least 70% of their prescriptions from there; if they did not meet this threshold, they were defined as mixed users. People were classified as adherent if dispensing data showed they collected their supply of medication to cover at least 80% of the study period. The sample captured 218,080 people taking at least 1 diabetes medication, with a total of 360,079 unique medications being included in the analysis. The majority, 156,893, used independent pharmacies. The type of pharmacy used was shown to be a significant predictor of adherence. Corporate and hybrid pharmacy users were 0.90 (95% CI 0.88 to 0.93) and 0.93 (95% CI 0.90 to 0.96) times as likely be adherent than the users of independent pharmacies. Mail order pharmacy users were the most likely to be adherent, whereas mixed pharmacy users were the least likely to be adherent. Our findings suggest that prescription copayments provided by corporate and hybrid pharmacies are not the most significant barrier to medication adherence. Further research may identify more efficient ways of improving medication adherence than removing prescription copayments for all.

Drivers and Barriers Influencing Adherence to the Mediterranean Diet: A Comparative Study across Five Countries.

Given the global decline in adherence to the Mediterranean Diet (MD), even within its native region, it is key to identify the factors influencing this trend to mitigate the negative health outcomes associated with westernized diets. To this end, 4025 individuals (49.6% women, 42.6 ± 14.2 y/o) from Greece, Italy, Morocco, Slovenia, and Tunisia remotely completed a series of measures assessing motives, attitudes, and psychosocial factors related to MD adherence, which was evaluated using the MEDAS questionnaire. The results suggested medium-to-low adherence across all countries, with the highest adherence in Italy and Morocco and the lowest in Slovenia. Structural equation modeling revealed that positive attitudes toward the healthiness of food were the strongest predictors of adherence, whereas picky eating was a significant negative predictor in all countries except Greece. Adherence to the MD was positively influenced by health motivations in Morocco and weight control in Slovenia and Greece, while sensory appeal negatively influenced adherence in Italy. Additionally, price and convenience were significant barriers in Tunisia and Greece, whereas a preference for local and seasonal foods promoted adherence in Morocco and Greece. Overall, our findings underscore the need for country-specific interventions and policies that address distinct local factors and motivations to ease favorable shifts in dietary patterns toward MD principles.

HIV and intersectional stigma among people living with HIV and healthcare workers and antiretroviral therapy adherence in the Dominican Republic.

HIV-related stigma, discrimination, and social marginalization undermines optimal HIV care outcomes. More research examining the impact of HIV-related stigma, discrimination, other interlocking forms of oppression, and antiretroviral therapy (ART) adherence is needed to optimize HIV treatment programming. This study uses data from two clinics in the Dominican Republic to examine client and healthcare worker (HCW) perceptions of HIV and intersectional stigmas among people living with HIV. Surveys exploring demographics, HIV-related stigma, various dimensions of discrimination (race/ethnicity, HIV status, sexual orientation), healthcare engagement, and medication adherence were collected from 148 clients and 131 HCWs. Analysis of variance was conducted to examine differences in stigma by clinic and logistic regressions were used to determine predictors of optimal client medication adherence. Perceived discrimination in healthcare facilities due to clients' sexual orientation retained significance in crude and multivariable logistic regression models and was negatively associated with ART adherence (aOR:0.79; 95% CI:0.66, 0.95). Findings highlight the importance of implementing strategies to address stigma, discrimination, and social marginalization, particularly within healthcare facilities.

Predictors of methotrexate adherence and patient's awareness of it in rheumatoid arthritis and its effect on quality of life.

Adherence studies among rheumatoid arthritis (RA) patients, in Egypt and throughout the Middle East region, are lacking. This study aimed to evaluate methotrexate (MTX) adherence in Rheumatoid arthritis (RA) patients and to identify specific non-adherence predictors. A cross-sectional observational study included 300 RA patients who were administered MTX for at least one year. The survey was completed through direct interviews. The demographic patient data were collected (age, education, sex, work status, disease duration, duration of MTX administration and current dose). Patients' adherence to MTX predictors for non-adherence, MTX side effects and functional disability were assessed in the study. Majority of respondents showed good MTX adherence, and more than 50% of patient's experienced MTX side effects. A large percentage of participants showed low knowledge about MTX nature and side effects. Most participants reported no or some difficulty in quality of life-related activities and functional disability. MTX adherence and awareness were positively correlated to many variables, including, age, educational level and disease duration, which in turn has its positive impact on the patient's quality of life. Still, more research is needed to determine the impact of non-adherence on the patient's health outcomes.

Predictors of medical adherence following a bowel management program for youth and young adults with Spina Bifida.

To evaluate individual and community sociodemographic factors that predict bowel regimen adherence in youth and young adults with Spina Bifida (SB) following participation in a bowel management program (BMP). Participants were drawn from clinical cases seen through an International Center for Colorectal and Urogenital Care. Area deprivation index (ADI) scores were extracted from participant addresses and bowel regimen adherence data were collected from the electronic medical record (EMR). Participants' mean age was 8.06years old, 51.7% were male, 72.4% white, 37.9% Hispanic, 56.9% government insurance, 89.7% myelomeningocele, 15.5% non-adherent. Average neighborhood disadvantage was 5.19 (SD:2.83, range:1-10). After controlling for variables correlated with adherence (p < .20), every one decile higher neighborhood disadvantage score was associated with a 48% decrease in the odds of being adherent (OR = 0.52, p = .005, 95% CI: -101.90, -0.21). Our results suggest that neighborhood disadvantage is a strong predictor of medical adherence following a BMP, more so than other sociodemographic and health-related variables. These results may assist with identifying which individuals may be at higher risk for poor health outcomes due to neighborhood socioeconomic disadvantage and help health care systems intervene proactively.

The Relationship between Self-Efficacy and Adherence to Drug Therapy in Hypertension Patients at the Medan Freight Health Center

This study examines the relationship between self-efficacy and medication adherence among 83 hypertensive patients at the Sering Community Health Center in Medan. Using a cross-sectional design, self-efficacy was assessed using the General Self-Efficacy Scale, and adherence was measured through self-reported medication adherence. The findings reveal a significant positive correlation between self-efficacy and medication adherence, highlighting that patients with higher self-efficacy are more likely to adhere to prescribed treatment regimens. Duration of hypertension emerged as a significant predictor of adherence. These findings underscore the importance of psychological factors in chronic disease management and suggest that interventions aimed at enhancing self-efficacy could improve adherence and health outcomes among hypertensive patients. Future research should explore longitudinal designs to establish causal relationships and consider cultural factors in intervention strategies.

Longitudinal changes in Mediterranean diet adherence and perceived benefits and barriers to its consumption in US university students.

The Dietary Guidelines for Americans has recommended consumption of a Mediterranean diet (MD) for overall health and wellbeing, and the US News & World Report has ranked the MD as the top diet overall for the past six consecutive years. However, it is uncertain if university students in the United States (US) have increased their adoption of this dietary approach over these past six years. Longitudinal cross-sectional survey conducted in three cohorts (2018, 2020, 2022) utilizing regression models to assess MD Adherence and other relevant outcomes variables. University in the southern US. Students (n = 761) enrolled in undergraduate introductory nutrition course. Survey respondents were 83% female, 91% white, and 97% ages 18-24. Predictors of MD adherence were older age, female gender, and health-related qualifications. MD adherence was lowest in 2022. The 2022 group perceived less MD health benefits, weight loss, ethical concerns, natural content, and sensory appeal compared to the 2018 group. During the COVID-19 pandemic, changes in eating behavior were examined in the 2020 and 2022 groups. We observed that participants in the 2022 group had a greater frequency of snacking and a lower frequency of eating out compared to 2020 group. MD adherence did not increase over time in US university students. These findings underscore the need for targeted interventions and education to promote healthier eating habits in university students.

Risk factors determining adherence to tyrosine kinase inhibitors in chronic myeloid leukaemia.

Tyrosine kinase inhibitors (TKIs) have successfully changed the natural course of chronic myeloid leukaemia (CML). Although they are highly effective drugs, their clinical benefit is conditioned by adherence. This study aims to analyse the adherence of CML patients treated with TKIs and to identify the main factors influencing their adherence to TKIs treatment. An 8-month prospective, observational, multicentre study which included patients diagnosed with CML on treatment with TKIs attending the outpatient departments (OPD) of the Pharmacy Services of the participating hospitals. Adherence was assessed using two methods: the Simplified Medication Adherence Questionnaire (SMAQ) and the register of treatment dispensations from the OPDs. To analyse the predictors of adherence, a questionnaire was developed to report demographic and socio-economic information on the patients. A total of 130 patients enrolled in this study. Adherence rate was 56.9% (n = 74) among individuals, not conditioned by the type of drug used: imatinib (54.8%), nilotinib (63.6%) or dasatinib (54.3%) (p = 0.67). The patient educational level (p = 0.047) and employment status (p = 0.028) were predictors of non-adherence to treatment. Adherence is one of the most relevant parameters affecting the effectiveness of highly effective chronic treatments. Approximately half of our patients showed inadequate adherence to treatment with TKIs, with employment status and the individual's level of education emerging as the determining factors.

Adherence of SARS-CoV-2 Seroepidemiologic Studies to the ROSES-S Reporting Guideline During the COVID-19 Pandemic.

Complete reporting of seroepidemiologic studies is critical to their utility in evidence synthesis and public health decision making. The Reporting of Seroepidemiologic studies-SARS-CoV-2 (ROSES-S) guideline is a checklist that aims to improve reporting in SARS-CoV-2 seroepidemiologic studies. Adherence to the ROSES-S guideline has not yet been evaluated. This study aims to evaluate the completeness of SARS-CoV-2 seroepidemiologic study reporting by the ROSES-S guideline during the COVID-19 pandemic, determine whether guideline publication was associated with reporting completeness, and identify study characteristics associated with reporting completeness. A random sample from the SeroTracker living systematic review database was evaluated. For each reporting item in the guideline, the percentage of studies that were adherent was calculated, as well as median and interquartile range (IQR) adherence across all items and by item domain. Beta regression analyses were used to evaluate predictors of adherence to ROSES-S. One hundred and ninety-nine studies were analyzed. Median adherence was 48.1% (IQR 40.0%-55.2%) per study, with overall adherence ranging from 8.8% to 72.7%. The laboratory methods domain had the lowest median adherence (33.3% [IQR 25.0%-41.7%]). The discussion domain had the highest median adherence (75.0% [IQR 50.0%-100.0%]). Reporting adherence to ROSES-S before and after guideline publication did not significantly change. Publication source (p < 0.001), study risk of bias (p = 0.001), and sampling method (p = 0.004) were significantly associated with adherence. Completeness of reporting in SARS-CoV-2 seroepidemiologic studies was suboptimal. Publication of the ROSES-S guideline was not associated with changes in reporting practices. Authors should improve adherence to the ROSES-S guideline with support from stakeholders.

Adherence to The Mediterranean Dietary Pattern and Associated Factors Among Adolescents: a Cross-sectional Study from Portugal

INTRODUCTION: The Mediterranean Dietary Pattern is one of the healthiest dietary models, being associated with several health benefits. However, in recent years, this pattern has been abandoned by adolescents in Mediterranean countries. OBJECTIVES: To determine and analyze the adherence to the Mediterranean Dietary Pattern and its associated factors in a sample of adolescents from a city in the north of Portugal. METHODOLOGY: Cross-sectional study. The data was collected via a stratified one-stage cluster sampling of adolescents (10 to 19 years old) from a city in the north of Portugal. The Mediterranean Diet Quality Index (KIDMED Index) was self-administered to evaluate the adherence to the Mediterranean Dietary Pattern among adolescents. Participants self-reported information about sociodemographic, anthropometric and lifestyle characteristics. Logistic regression was performed to identify the predictors of high adherence to the Mediterranean Dietary Pattern. RESULTS: Most adolescents had a low/moderate adherence to the Mediterranean Dietary Pattern (63.2%). Logistic regression modelling indicated that age and parents’ educational level were the utmost factors positively related to the possibility of high Mediterranean Dietary Pattern adherence. Sex, school location, body mass index and number of household members did not significantly predict high Mediterranean Dietary Pattern adherence. CONCLUSIONS: These results highlight the importance of the parents’ education level in adolescents’ Mediterranean Dietary Pattern adherence, allowing the identification of the priority groups for a possible intervention, namely, younger adolescents and those whose parents have lower educational level.

Awareness and Knowledge of the Physical Activity Guidelines and Their Association with Physical Activity Levels.

Physical activity guidelines recommend that adults engage in aerobic exercise and activities that preserve or increase muscle mass. The primary aim of this study was to assess the awareness and knowledge of these guidelines among adults in the Jazan region of Saudi Arabia. A secondary objective was to examine the role of awareness and knowledge in the adherence to physical activity guidelines. In this cross-sectional observational study, 1018 participants were recruited through a self-administered online survey. Participants' awareness and knowledge about physical activity guidelines were assessed using a prompted questionnaire. Physical activity levels and weekly energy expenditures were evaluated using the International Physical Activity Questionnaire. The proportion of the participants who reported being aware of the guidelines was approximately 48%, whereas the proportion of the participants who correctly identified the guidelines for moderate-intensity physical activity was 38%. However, only 23% correctly identified the muscle strength guidelines. Those who were aware of the guidelines were most likely to meet the physical activity recommendations (OR = 2.03; 95% CI = 1.55-2.65). Participants who reported being aware of the guidelines exhibited a significantly higher energy expenditure, measured in MET minutes per week (p < 0.01). Similarly, participants who correctly identified the guidelines had greater energy expenditure (p = 0.03). We found that adults in Jazan have a moderate level of awareness and knowledge of PA guidelines and that awareness is a predictor of adherence to these guidelines. Individuals who are aware of PA guidelines or have knowledge of them tend to have higher levels of physical activity. These findings suggest that public health campaigns that promote awareness and knowledge of the physical activity guidelines may accelerate the progress in engaging the Saudi population with these guidelines.

Factors Influencing Adherence to Treatment in Adult Patients with Hypertension

Introduction Adherence to treatment including medication and lifestyle modification is crucial for improving health outcomes in patients with hypertension. However, there is limited research investigating the factors influencing adherence to medication and lifestyle modification, particularly among adult patients diagnosed with hypertension. Objective To investigate adherence to treatment and the predictive power of work status, comorbidity, complexity of medication regimens, perceived severity and risk of hypertension complications, and quality of care affecting adherence to treatment in adult patients with hypertension. Design Cross-sectional correlational predictive research using the multidimensional adherence model as the conceptual framework. Methodology The sample included 156 adult patients with essential hypertension aged 18 to 59 years old who had received antihypertensive medication and lifestyle modification treatment for at least six months at a super-tertiary hospital’s hypertension clinic. Data were collected between April and July 2023. The research instruments consisted of a general profile questionnaire, a treatment adherence questionnaire for patients with hypertension, a perceived severity and risk of hypertension complications questionnaire, a patient assessment of chronic illness care, the Charlson Comorbidity Index, a medication regimen complexity index, and an illness record form. These instruments were examined for content validity by experts and tested for reliability prior to use in data collection. The reliability ranged from .77-1.00. The data were analyzed using descriptive statistics and multiple linear regression. Results The sample had an average age of 46.50 years (SD = 9.65); 63.46% were female. The average score for adherence to treatment was 87.97 (SD = 9.02), with the highest score for average medication adherence of 34.37 (SD = 2.52) and the lowest score for average exercise adherence of 4.33 (SD = 1.89). Additionally, 14.74% were overweight, and 71.80% were obese. The majority were employed (83.33%), without any comorbidities (62.82%), and had a low level of medication regimen complexity (68.59%). Furthermore, they demonstrated a high level of perceived severity and risk of hypertension complications (96.15%) and reported a high level of quality of care (61.54%). In the Multiple linear regression, 30.9% of the variance in adherence to treatment was explained (Adjusted R2 = .309 F(5,150) = 14.858, p &lt; .001). Work status (β = -.262, p &lt; .001), comorbidity (β = -.184, p = .020), perceived severity and risk of hypertension complications (β = .466, p &lt; .001), and quality of care (β = .165, p = .017) together were significant predictors of adherence to treatment in adult patients with hypertension. Recommendation To promote adherence to treatment in adult patients with hypertension, nurses should develop strategy to improve quality of care within hypertension clinics and enhance the perceived severity and risk of hypertension complications as well as enhance lifestyle modifications particularly regarding diet and exercise for overweight and obese adults with hypertension.

Adherence to a lifestyle intervention – just a question of self-efficacy? Analysis of the AgeWell.de-intervention against cognitive decline

BackgroundAim of this study was to detect predictors of better adherence to the AgeWell.de-intervention, a two-year randomized multi-domain lifestyle intervention against cognitive decline.MethodsData of 317 intervention group-participants comprising a risk group for dementia (Cardiovascular Risk Factors, Ageing and Dementia (CAIDE) score of ≥ 9; mean age 68.9 years, 49.5% women) from the AgeWell.de intervention study were analysed. Regression models with four blocks of predictors (sociodemographic, cognitive and psychosocial, lifestyle factors and chronic conditions) were run on adherence to the components of nutrition, enhancement of social and physical activity and cognitive training. Adherence to each component was operationalised by assessing the degree of goal achievement per component at up to seven time points during the intervention period, measured using a 5-point Likert scale (mean score of goal achievement).ResultsIncreasing age was negatively associated with adherence, while higher education positively predicted adherence. Participants with better mental state (Montreal Cognitive Assessment (MoCA)-score > 25) at baseline and higher self-efficacy adhered better. Diabetes and cardiovascular conditions were not associated with adherence, whereas smoking negatively affected adherence. Highest education and quitting smoking in the past were the only predictors associated with all four intervention components.ConclusionResults identified predictors for better and worse adherence. Particularly self-efficacy seems to be of considerable influence on adherence. This should be considered when designing future intervention trials.Trial registrationGerman Clinical Trials Register (ref. number: DRKS00013555).