Therapeutic Compliance Of Patients Research Articles

Impact of negative signs on therapeutic compliance in patients with schizophrenia

IntroductionSchizophrenia is characterized by a heterogeneous clinical expression. Schizophrenic symptoms fall into three main dimensions: positive, negative, and disorganized. Negative symptoms may be primary or secondary to positive symptoms. Therapeutic compliance is essential in the management of mental illnesses and in particular schizophrenia. The associations between poor compliance and negative symptomatology are little studied even though it is found in several patients suffering from schizophrenia and is associated with a poor functional prognosis.ObjectivesThe objective of this study is to evaluate the link between negative symptoms and medication adherence in patients with schizophrenia.MethodsThis is a cross-sectional study with a descriptive and analytical aim carried out among patients in whom a diagnosis of schizophrenia was made according to the diagnostic criteria of the DSM-5.Data will be collected using an anonymous hetero-questionnaire including patients’ personal and sociodemographic data, as well as the negative symptoms subscale of the PANSS and Medication Adherence Rating Scale (MARS) which assesses therapeutic compliance.ResultsIn total, we obtained a sample of 109 patients. The median age of the population is 37 years (+/- 8.2), the age varies between 18 and 64 years. The majority of patients were single, i.e. 79.6%. On average, patients had good compliance with the MARS with a mean score of 6.3 ± 1.9 [0;10]. A negative correlation between the negative symptoms subscale of the PANSS and the MARS was found significant (p=0.003), with a moderate effect.ConclusionsThis study showed that the negative signs of schizophrenia have an impact on therapeutic compliance. Therefore, it would be useful to enlarge the sample and study this association in depth in order to be able to improve these signs to ensure good care and better quality of life for these patients.Disclosure of InterestNone Declared

P403 Therapeutic compliance in patients with chronic inflammatory bowel disease.

Abstract Background The World Health Organization estimates that half of all patients do not take their treatment as agreedwith the prescriber. Thus, the evaluation of compliance is essential in the management of patients withchronic diseases, particularly chronic inflammatory bowel diseases (IBD). This evaluation cansometimes be variable. Hence, it is of clinical significance to develop objective scales unifying compliance assessment methods. The aim of our study was to assess therapeutic compliance in IBD patients and to identify predictivefactors of non compliance. Methods A cross-sectional study over a period of six months (from June to November 2022) including all IBD patients from our department was conducted.The data collection was carried out by one investigator. We used an analytical chart containingdemographic and clinical questions, the Perceived Stress Scale (PSS) questionnaire in its French version to evaluate the degree of stress and the "Morisky medication adherence scale -8 MMAS" and the "Girerd" questionnaires to evaluate compliance to treatment. Results Forty-seven patients were included, with a mean age of 43 years [20-71 years] and a M/F sex ratio of0.59. Forty patients had Crohn's disease and seven had ulcerative colitis. Only 19 patients were recently (less than two years) diagnosed of IBD. Whereas, 20 patients were followed for more than 10years. All were undergoing maintainance therapy with azathioprine in 34%, anti TNF in 19%, combotherapy in 19%, 5 ASA in 8.5%. Among our population, 17% presented a flare and were under corticosteroids during our study.Most of our patients did not have a secondary or a university degree (n= 22). When it comes to patients’ perceptions of the disease, 14 patients showed a good understanding while seven showed poor knowledge. The remaining 26 patients had average knowledge about the disease and its management.Regarding the level of stress caused by their disease, 40% were able to cope with it, while 25.5% had major difficulty in stress management.Fifty-one patients were considered to be well compliant according to the MMAS-8, 32% were moderately compliant and 17% were not compliant. The results were comparable using both scores(Morisky and Girerd). The main predictors of poor compliance were level of education (p=0.042),degree of knowledge of the disease (p=0.011) and poor stress coping (p=0.001). Conclusion Adherence to treatment is the most important predictor of success or failure of therapeutic care. It isimportant to educate patients about the importance of compliance both at treatment initiation andduring periodic visits. It is also important to identify and act on the factors that lead to non-adherence.

Updates on Children with Allergic Rhinitis and Asthma during the COVID-19 Outbreak.

Background: During the lockdown period caused by the SARS-CoV-2 pandemic, we monitored via online survey the trend of allergic symptoms and the therapeutic compliance in patients followed at our center. Material and methods: In June 2020, we selected children followed at the Allergy and Immunology Service of Umberto I Hospital, aged between 6 and 16 years old, diagnosed with asthma and/or rhinitis and sensitized to grass pollen or dust mite. We sent an email with 12 multiple-choice questions investigating several areas: type of disease and sensitization, recurrence of symptoms, medication use during lockdown compared to the same period of the previous year. Results: The results of 82 questionnaires showed that 17.8% of patients suffered from asthma, 24.4% from rhinitis, and 57.8% from both. Within the group of asthmatic children, most of them presented an improvement of their symptoms. Likewise, with regard to allergic rhinitis, most of them reported better clinical conditions. Regarding treatment, we observed a global decrease in the use of on-demand therapies (salbutamol, nasal corticosteroid, and antihistamine) for both pathologies. In addition, there was a reduction in the use of basal therapy for asthma and rhinitis from 2019 (23.3%) to 2020 (15.5%). Conclusions: Our data show a general trend of clinical improvement and a reduction in the use of on-demand and basal therapy in allergic children during the lockdown.

Therapeutic Compliance of Patients with Arterial Hypertension in Primary Care

Background and Objectives: Arterial hypertension remains an important cause of cardiovascular morbidity and mortality, despite all the progress made in the methods of diagnosis, monitoring of target organs’ damage and treatment. The main cause of the increased prevalence of uncontrolled blood pressure values is the low compliance to antihypertensive treatment. The objective of our study was to assess the compliance to the treatment of patients diagnosed with arterial hypertension and monitored in a primary care office. Materials and Methods: The cross-sectional, retrospective study included 129 patients, 65.89% (85) women, previously diagnosed with arterial hypertension. Data from the medical files were analyzed, as well as the patients’ answers to a survey of 18 questions regarding arterial hypertension, comorbidities, complications, treatment and awareness of the condition. Results: The study included 129 patients, with a mean age of 66 ± 8 years. The majority of patients were overweight, 55.81% (72 patients), and 10.85% (14 patients) had grade I obesity. Most of the patients, 55.81% (72 patients) were diagnosed with grade III hypertension, while 37.98% (49 patients) were diagnosed with grade II hypertension and 6.2% (8 patients) with grade I hypertension. One third of the surveyed patients answered that they follow the recommendations of a low-sodium diet, 21.7% are adherent to treatment, but 56% think that the total cost of the medication is an impediment for their compliance to treatment. The majority, 82.17% (106 patients), of respondents had an affirmative answer to the questions: ‘Do you think it would be easier to take one pill instead of 2, 3 or 4 pills?’ Conclusion: The increased compliance to the antihypertensive treatment and control of blood pressure values are associated with the degree of awareness of arterial hypertension and the consequences if left untreated, emphasizing the role of the general practitioner in counseling for secondary prevention.

Long-Term Oral Bisphosphonate Compliance Focusing on Switching of Prescription Pattern.

BackgroundFactors determining bisphosphonate compliance are not fully understood. We examined fluctuations in oral bisphosphonate dosing intervals to gauge therapeutic compliance in patients with osteoporosis.Materials and MethodsHospital data accruing between 2010 and 2017 were accessed to retrospectively study patients ≥50 years old (N=1873), each prescribed bisphosphonate at initial diagnosis of osteoporosis. The medication possession ratio (MPR), calculated as total days supplied divided by length of follow-up, served to measure therapeutic compliance. We compared MPRs of various prescription patterns (daily, weekly, monthly, and switch [ie, ≥1 change in pattern] groups). We also analyzed the impact of age, sex, fracture history, surgical history, and comorbidities. Multiple regression analysis was ultimately performed, using MPR as a dependent variable.ResultsIn our cohort (mean follow-up=5.7±2.4 years), once weekly dosing was the most common prescription pattern (1223/1873, 65.3%), as opposed to monthly (366/1873, 19.5%) or daily (164/1873, 8.8%) dosing. A total of 120 patients (6.4%) comprising the switch group changed dosing patterns during the study period. MPR was significantly higher in the switch group (32.8±22.7) than in the other three groups (daily, 21.9±25.9; weekly, 22.7±27.3; monthly, 23.2±27.7). In multiple regression analysis, younger age (P<0.001), female sex (P=0.004), and switching of prescription pattern (decrease or increase frequency) were factors significantly associated with higher MPR, signaling better compliance.ConclusionBetter bisphosphonate compliance was associated with physician-modified dosing patterns. We therefore recommend adjustments of prescription intervals in poorly compliant patients requiring long-term treatment.

Data Collection of Therapeutic Compliance in Patients Receiving Corneal Graft Using a Collection Box for Corticosteroid Eye Drops

Data Collection of Therapeutic Compliance in Patients Receiving Corneal Graft Using a Collection Box for Corticosteroid Eye Drops

Application influence of Maslow's theory of hierarchy of demands on the psychological and therapeutic compliance of patients with psychosis

Objective To explore the application influence of Maslow's theory of hierarchy of demands on the psychological and therapeutic compliance of patients with psychosis. Methods Totally 100 patients with mental disorders who met the requirements of this study were selected from January 2016 to December 2016 in 984 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army. They were randomly divided into 2 groups according to the number table method, 50 cases in each group. The control group adopted the routine nursing mode, while the experimental group followed the intervention mode guided by Maslow's hierarchy of needs theory, and implemented the corresponding nursing and health education. Concise Psychiatric Rating Scale (BPRS) was used to assess the severity of psychiatric symptoms, Self-knowledge and Treatment Attitude Questionnaire (ITAQ) was used to assess patients' compliance with treatment, and Quality of Life Scale (SQLS) was used to assess patients' quality of life. Results After intervention, the symptoms of anxiety, depression, lack of vitality, thinking disorder, activation, hostile suspicion score, and BPRS scores of the control group were (5.84±3.51), (6.24±3.05), (6.49±2.35), (3.72±1.42), (4.34±1.81), (26.14±6.21) points. After the intervention of the study group, they were (3.78±2.07), (4.11±2.28), (5.15±2.36), (3.02±1.23), (3.58±1.07), (23.08±5.95) points. The differences between the two groups were statistically significant (t=2.516-2.845, P<0.05 or 0.01). After the ITAQ score intervention, the control group and the study group were (10.85±3.41) and (12.34±3.89) points. The difference between the two groups was statistically significant (t=-2.037, P<0.05). After the intervention, the quality of life of the control group was compared with psychosocial, motivation/energy, symptom/adverse reaction score, and total score of SQLS (25.34±7.16), (18.69±9.09), (10.54±1.31), (24.00±10.31) points. The study group were (19.06±4.26), (14.75±8.89), (9.56±1.06), (19.36±9.11) points, and the differences between the two groups were statistically significant (t=2.191-5.330, P<0.05). Conclusion Maslow's hierarchy of needs theory can significantly improve mental symptoms, improve treatment compliance and quality of life in psychiatric patients, and is worthy of clinical application. Key words: Schizophrenia; Psychology; Medication adherence compliance; Maslow's demand level theory

Fracción exhalada de óxido nítrico. Recomendaciones clínicas y procedimiento

Measuring the fraction of exhaled nitric oxide makes it possible to quantify «in an indirect, quick and reliable» fashion, the magnitude of airway infl ammation in patients with respiratory diseases; especially in cases of asthma. Because of its simplicity, this technique has also become a useful tool for diagnosing, monitoring and evaluating the therapeutic compliance in patients with asthma, among other conditions. In addition, measuring fraction of exhaled nitric oxide can help prevent exacerbations because it allows increases in infl ammatory activity to be detected and treated immediately. The purpose of this document is to review practical aspects of the fraction of exhaled nitric oxide-measuring technique using a portable device, and to provide clinical physicians with useful instruments that will aid in achieving correct interpretations of results. We consider the fraction of exhaled nitric oxide-measuring technique to be an underutilized test in current respiratory medicine practice, so our motivation is to make practical, summarized information available to readers.

Factors Affecting Therapeutic Compliance in Patients with Chronic Renal Failure: Anxiety, Depression, Illness Perception

Factors Affecting Therapeutic Compliance in Patients with Chronic Renal Failure: Anxiety, Depression, Illness Perception

Stability of results of treatment and therapeutic compliance of patients with organic non-psychotic mental disorders

IntroductionNon-psychotic mental disorders of organic register tend to have protracted progressive course, to respond poorly to treatment. Traditionally it is explained by features of cerebral-organic process. However, affective, behavioural and cognitive disturbances can be complicated by medico-social problems including treatment-related.ObjectiveTo analyse efficiency and stability of results of the therapy of organic mental disorders and propose approaches and means of their improvement.MethodsClinical-psychopathological, epidemiological, clinical-dynamic, catamnestic, experimental-psychological, medical statistics.ResultsThe most frequent causes of decompensations of organic mental disorders in patients with positive results of the therapy were analyzed. Sixty-four percent (58 patients) after 6 months showed partial recurrence of symptoms and after a year the condition practically returned to the initial one. However, only 12.22% (11 patients) passed recommended course of maintenance therapy to sufficiently full extent, 23.33% (21 persons) have discontinued it due to subjective causes during a month after discharge, about 2/3 of patients during the first two months of the therapy. Patients showed low indicators of therapeutic compliance, low level of therapeutic alliance, little familiarity with the illness and treatment and unrealistic expectations about prospects of the therapy. During insignificant difficulties in the therapy, it usually was discontinued and renewed during relapse of symptoms. A medico-social approach with support of psychotherapeutic and psycho-corrective work and information educational programs were developed.ConclusionProposed psychotherapeutic and educational approach heightens efficiency and stability of treatment and can serve a basis for further improvement of psychiatric, psychotherapeutic and medico-social assistance for patients with organic mental disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Analysis of the compliance and affective factors about antiplatelet therapy in patients with coronary heart disease one year after hospitalization

Objective To analyze the compliance of antiplatelet therapy and its affective factors in patients with coronary heart disease one year after hospitalization, which will improve the secondary prevention for coronary heart disease. Methods The study enrolled 398 patients (363 patients completed the study) with first-diagnosed coronary heart disease in a provincial hospital in Anhui province from January to December 2012. The therapeutic compliance of these patients, as well as the affective factors, were evaluated with a self-designed questionnaire either through phone revisit or out-patient interview. The factors influencing therapeutic compliance of patients with coronary heart disease were analyzed by Logistic regression analysis. Results The results showed 301 (83%) patients were in a good therapeutic compliance, while the rest of 62 (17%) patients were not. The affective factors included age, ways of medical payment, whether with PCI treatment or not, and the types of coronary heart disease (stable angina, unstable angina and acute myocardial infarction), χ2 values were 9.425, 6.262, 5.556 and 6.895. The main affective factors were the age [OR=0.471(0.284-0.782)] and whether with PCI therapy or not [OR=2.104(1.123-3.942)]. Conclusions Patients had poor compliance of antiplatelet therapy one year after hospitalization, medical staffs should make treatment protocol and nursing measures according to age and whether with PCI treatment or not of patients, so that the belief and behavior of medication can be intensified, the medication compliance can be elevated and the secondary prevention can be well implemented. Key words: Coronary artery disease; Platelet aggregation inhibitors; Medication adherence

P02-570 - Therapeutic compliance in patients with psychosis in an outpatient setting

IntroductionNumerous studies show that patients with psychotic disorders have low rates of adherence, which is the main cause of relapses and hospital admissions. It is fundamental to long-term drug treatment in the management of patients with psychosis, both in preventing relapses and the consequences that flow from them (hospital admissions, clinical deterioration, loss of functionality and quality of life of patients)ObjectivesAssess the benefits to be derived from the use of extended-release injectable antipsychotics in regard to adherence to treatment, the persistent improvement of psychotic symptoms and reducing the number of hospital admissionsMethodsDescriptive study. Sample: 40 patients diagnosed with schizophrenia or schizoaffective disorder treated at a mental health center. Patients are divided into two treatment groups: 20 patients are treated with risperidone in prolonged release of more than one year duration and the other group treated with oral antipsychotics.ResultsAdherence to treatment is higher in the group treated with injectable antipsychotics (90%) than with oral (50%). The age range from 20 to 61 years. The average hospitalization was greater for the group treated with antipsychotic injections in the period prior to treatment (17) compared to post-injection treatment outcome (5). In patients with oral antipsychotics were 20 hospitalizations in total.ConclusionsConfirms the results on adherence and hospitalizations compared to other similar studies. There is a clinical and functional improvement, fewer hospitalizations, shorter average stays and higher outpatient adherence in patients with extended-release injectable antipsychotics compared with the group of patients with oral antipsychotics.

Factors influencing the therapeutic compliance of patients with lung cancer

Factors influencing the therapeutic compliance of patients with lung cancer

Doctors' Opinions on Lung Cancer Treatment

Background : Patients with lung cancer and their relatives often ask the advice of relative or friends who are doctors on the treatment and prognosis of the disease. Therefore a doctor's opinion may play a role in determining the treatment modality and affect therapeutic compliance of patients. The purpose of this study was to find the opinion of general practitioners on lung cancer treatment. Method : A mail survey for general practitioners in Taegu City and Northern Kyungsang Province was performed. Each individual was sent a written questionnaire in which he or she was asked for ten questions about management and prognosis of lung cancer. Results : Two hundred and twenty eight doctors filled in the questionnaire. Of the respondents, 68% had the experience of being asked about lung cancer by their friends or relatives. About 52% replied that it was better to tell the patient of his or her disease. And about 22% considered it better to follow the relatives' opinion. On the question about choosing the treatment modality, following the doctors' plan was most appropriate in 86.9%, showing that most respondents favored actively recommending doctors. Nonsurgical treatment was preferable in patients over 80 years old with resectable lung cancer and with an increase in age, significant increase was observed in respondents recommending nonsurgical treatment. Most respondents said that they would actively recommend or advise following the doctors' plan about radiotherapy and chemotherapy. But a large percent of the respondents had a negative view on the effect of radiotherapy and chemotherapy. Conclusion : The opinions of general practitioners on the treatment and prognosis of lung cancer was variable. And they did not prefer active treatment for patients with old age or advanced lung cancer.

Factors Influencing the Therapeutic Compliance of Patients with Lung Cancer

연구배경: 폐암은 현재 우리나라에서 암사망의 가장 흔한 원인의 하나로 인식되고 있다. 많은 의료인들이 현재 폐암치료에 대해 회의적인 견해를 가지고 있음에도 불구하고 폐암치료의 점진적인 발전과 더불어 폐암환자의 생존률도 조금씩 향상되고 있음은 주지의 사실이다. 그러나 많은 수의 환자들은 여러가지 요인들에 의해 적절한 치료를 거부하거나 포기하는 실정이다. 폐암환자에 있어 치료 순응도에 영향을 미치는 요인을 평가하고 치료순응도를 향상시킬 수 있는 방안을 마련하고자 본 연구를 시행하였다. 방 법: 1989년 1월부터 1996년 12월까지 경북대학교 병원에서 원발성 폐암으로 진단된 환자 1141명 가운데 비교적 의무기록이 충실하고 활도도가 ECOG기준으로 grade 0-III인 903명을 대상으로 하였다. 나이, 성별, 흡연력, 음주력, 종교유무, 배우자유무, 직업과 학력등의 인구학적 특성 및 사회경제적 특성과 증상유무, 조직형, 병기, 수행상태 등의 병적특성에 따른 치료순응도를 후향적으로 분석하였다. 결 과: 치료순응률은 1989-1990년 57.3-61.3%에서 1995-1996년 64.2-67.5%로 연도에 따라 증가하는 경향이 있었다. 치료순응도는 연령, 교육수준, 직업과 유의한 상관관계가 있었으며, 성별, 배우자유무, 흡연력에 따른 치료순응도의 차이는 없었다. 증상을 가진 경우보다 무증상인 환자의 치료순응도가 유의하게 높았으며, 수행상태가 양호할수록 치료순응도가 유의하게 높았다. 소세포암에 비해 비소세포암에서 치료순응도가 유의하게 높았으나, 비소세포암가운데 병기 I기와 II기를 제외하였을 경우 조직형에 따른 치료순응도의 차이는 없었다. 소세포암과 비소세포암 모두에서 진행된 병기일수록 치료순응도가 유의하게 낮았다. 결 론: 폐암환자들의 치료순응도는 64%로 매우 낮았으며, 특히 교육수준과 병기가 치료순응도와 가장 밀접한 관계가 있었다. 따라서 이와같은 요인들이 있는 환자들의 경우 폐암과 치료과정에 대한 교육이 필요할 것으로 생각된다. 본 연구에서는 인적 사회경제적 특성과 병적 특성을 중심으로 치료순응도를 조사하였으나 향후 치료에 대한 환자의 인식도와 치료의 부작용과 같은 치료 특성과 환자-의사관계 풍이 순응도에 미치는 영향과 순응도가 낮은 환자들을 대상으로 교육프로그램을 실시하여 순응도의 향상을 가져올 수 있는지에 관한 전향적인 연구가 필요할 것으로 생각된다. 【Background : In recent years, lung cancer has been one of most common cause of death in Korea. Despite many physician's high degree of pessimism about the gains made in treatment, progressive improvement in the survival of lung cancer by treatment has occurred, particulary in the early stages of the disease. However, a lot of patients refuse treatment or give up in the fight against the disease. This study was done to evaluate factors influencing the compliance to therapy and to lead in the establishment of special programs to enhance compliance in patients with lung cancer. Methods: The medical records of 903 patients, whose ECOG(Eastern Cooperative Oncology Group) performance status was 3 or less and whose medical record was relatively satisfactory, among 1141 patients diagnosed with lung cancer between January 1989 and December 1996 were reviewed retrospectively. Compliance was classified into three groups based on the degree of compliance with physicians practice guideline: (a) compliants; (b) patients who initially complied but gave up of themselves midway during the course of treatment; (c) noncompliants who refused the treatment. Results: The overall compliance rate was 63.9%, which was progressively increased from 57.3-61.3% in 1989 and 1990 to 64.2-67.5% in 1995 and 1996. Age, education level and occupation of patients bore statistically significant relationship with the compliance but sex, marital status and smoking history did not. The compliance was significantly higher in patients without symptoms than with, and was also significantly higher in patients with good performance status. The compliance was significantly high in patients with NSCLC(non-small cell lung cancer) compared to SCLC(small cell lung cancer), but after exclusion of stage I and II, among NSCLC, which had higher compliance to surgery there was no significant difference of compliance by histology. The compliance was significantly lower in advanced stage. Conclusion: To enhance the compliance, special care including education programs about therapy including complication and prognosis are necessary, especially for educationally and economically disadvantaged patients.】

Family support, health beliefs, and therapeutic compliance in patients with rheumatoid arthritis

Compliance with recommendations about aspirin, exercise, and splints was evaluated in 40 patients with rheumatoid arthritis to determine the relationship of compliance to two variables: family support and belief in benefit. Interventions to enhance family support were effective in two cases, but belief in the benefit of the recommendation was the critical variable in all types of compliance.