Therapy Compliance Research Articles

Family education in companion taking medication in patients with diabetes mellitus according to sharia

The prevalence of diabetes mellitus in all age groups continues to increase. One of the problems is medication adherence and blood sugar control. Compliance in drug therapy in patients with diabetes mellitus (DM) aims to control the glycemic index and other clinical outputs and prevent complications. Through educational activities, medication companion cadres (PMO) have increased their knowledge related to DM disease, drug use, and recognition and treatment of drug side effects. Apart from that, PMO families also receive Sharia-based assistance, starting from praying before taking medicine to understanding that only Allah is the healer of all diseases.

Hyperuricemia, gout and comorbidity

Hyperuricemia is most often combined with lipid metabolism disorders, modifiable risk factors for coronary heart disease, stroke, abdominal obesity, type 2 diabetes mellitus, arterial hypertension, urolithiasis, chronic kidney disease. Current data indicate the presence of pro-inflammatory, pro-oxidant and vasoconstrictive effects of uric acid, which may contribute to the development of cardiometabolic disorders. Normal serum uric acid levels are <6 mg / dl (<360 mmol / l) for women and <7 mg / dl (<420 mmol / l) for men. Currently, the role of hyperuricemia as an independent biomarker of the risk of cardiovascular events is emphasized. Both gout and subclinical hyperuricemia are associated with unfavorable cardiovascular outcomes. Patients should be informed about the risk factors of hyperuricemia; the need for lifestyle modification, diet compliance, and correction of drug therapy for comorbid conditions. According to international and domestic recommendations, urate-lowering therapy is indicated for asymptomatic hyperuricemia (>360 mmol / l) and high cardiovascular risk. The data available today allow us to consider the target serum uric acid level <5 mg / dl (<300 mmol / l) for patients with high cardiovascular risk, including at least 2 of the following risk factors: hypertension, diabetes mellitus, dyslipidemia, stroke, heart attack, chronic disease kidneys, and <6 mg / dl for patients who do not have these risk factors. The urate-lowering drug is selected taking into account the concomitant pathology and the presence or absence of liver or kidney dysfunction. Xanthine oxidase inhibitors are still the first-line drugs for the correction of hyperuricemia. The superiority of xanthine oxidase inhibitors is due to the potential inhibition of the production of reactive oxygen species and their antioxidant effect. Treatment of gout is aimed at achieving clinical improvement in acute and chronic arthritis, preventing recurrence of arthritis and damage to internal organs, as well as reducing the risks of negative effects on comorbid pathology. Clinicians are faced with the task of controlling cardiovascular diseases in patients with asymptomatic hyperuricemia and gout. Further studies are needed to investigate the relationship between gout, hyperuricemia and increased risk of cardiovascular diseases, as well as to establish a more complete picture of the prevalence of a wide range of comorbid conditions.

PAP Therapy Compliance in COVID-19: Multifactorial Etiologies to Consider.

PAP Therapy Compliance in COVID-19: Multifactorial Etiologies to Consider.

Клиническая эффективность и переносимость применения миноциклина (Минолексин®) у женщин с хроническими цервицитами, ассоциированными с бактериальной инфекцией

Background: bacterial-associated chronic cervicitis (CC) occupies a leading place in the cervical pathology structure. At the same time, the disease recurrence rate reaches 59–68% in the setting of resistance to antibacterial therapy, which determines the need to find new effective drugs. Aim: to evaluate the clinical efficacy, safety and compliance of therapy with minocycline in patients with bacterial-associated CC. Patients and Methods: a multicenter prospective observational clinical study was conducted in women's health clinics and medical centers in Yekaterinburg. The study included 60 female patients with a confirmed diagnosis of bacterial-associated CC. Group 1 (n=31) received the antibacterial drug minocycline (Minolexin®) 100 mg twice a day in the morning and evening, 10 days + antimycotic prebiotic 1 suppository once a day intravaginally for 6 days, starting from the 3rd day of antibiotic therapy. Group 2 (n=29) received doxycycline 100 mg twice a day for 10 days + antimycotic prebiotic 1 suppository once a day intravaginally for 6 days, starting from the 3rd day of antibiotic therapy. Clinical and laboratory efficacy (cervicitis signs, results of laboratory microbiome research methods) and drug tolerability were evaluated 10 and 30 days after the treatment initiation. Results: as a result of CC antibacterial therapy with minocycline, pathogen eradication was observed in 83.9% of female patients (group 2 — in 69.9%, p=0.0001), the original squamous epithelium 30 days after the minocycline was detected in 27 (87.1%) female patients (group 2 — in 19 (65.5±5.8%) female patients, p=0.0001), which indicates a higher efficacy of minocycline versus doxycycline. Patients of the minocycline group had more therapy adherence — 96.8% vs. 82.9% in the doxycycline group (p=0.0001) due to the minimal number of side effects (3.2% vs. 17.2%, respectively; p=0.0001). Conclusion: minocycline is a systemic antibiotic of the tetracycline group, which can be considered as the front-line drug for antibacterial therapy of patients with CC due to its high clinical efficacy, minimal risk of side effects and high compliance. KEYWORDS: chronic cervicitis, antibacterial therapy, tetracyclines, minocycline, efficacy. FOR CITATION: Dobrokhotova Yu.E., Kononova I.N., Kareva E.N., Shmakova N.A., Graban I.V., Ogurtsova T.A. Minocycline (Minolexin®) clinical efficacy and tolerability evaluation in women with bacterial-associated chronic cervicitis. Russian Journal of Woman and Child Health. 2023;6(4):340–346 (in Russ.). DOI: 10.32364/2618-8430-2023-6-4-3.

Clinical efficacy and compliance of dupilumab therapy in adolescent and adult patients with atopic dermatitis in real clinical practice: An analysis of data from a single allergy clinic in Korea

Clinical efficacy and compliance of dupilumab therapy in adolescent and adult patients with atopic dermatitis in real clinical practice: An analysis of data from a single allergy clinic in Korea

Usability of a wearable device for home-based upper limb telerehabilitation in persons with stroke: A mixed-methods study.

The use of wearable technology offers a promising home-based self-directed option for upper limb training. Although product usability is a crucial aspect of users' acceptance of a wearable device, usability studies in wearable devices are rare, with most studies focusing primarily on clinical validity. This study aimed to explore the usability of a wristwatch device called "Smart reminder" for home-based upper limb telerehabilitation for persons with stroke. Eleven stroke participants used the proposed wristwatch for at least two weeks and underwent a home-based telerehabilitation program. A mixed-methods design was used to explore the usability of the wristwatch. Quantitative data were collected through the System Usability Scale (SUS) questionnaire, and the participants' rate of therapy compliance (gathered from the device) was reported descriptively. In addition, qualitative data were collected through semi-structured interviews with the participants and were analyzed using thematic analysis. The results demonstrated that the usability of the proposed wristwatch and telerehabilitation system was rated highly by the participants, with a high SUS mean score of 84.3 (12.3) and high therapy compliance rate (mean = 91%). Qualitatively, all participants reported positive experiences with the wristwatch and indicated keenness to use it again. Participants reported physical improvements and felt motivated to exercise after using the wristwatch. They found the device easy and convenient and appreciated the remote monitoring function. Meanwhile, they highlighted critical considerations for the design of the device and program, including technical support, a wearable design of the device, graded exercise content according to ability, and flexibility in exercise schedules. Finally, they suggested that an interim review with the therapist on their progress might help them continue using the wristwatch. This study's results supported the proposed wearable device's usability and showed strong acceptance by the participants for using it as a home-based upper limb telerehabilitation intervention.

Possibilities of achieving target levels of arterial pressure and atherogenic lipids in patients with arterial hypertension with obesity at the outpatient stage (results of a 12-week follow-up)

The aim: To study the possibility of achieving target levels of blood pressure (BP) and atherogenic lipids’ levels in patients with arterial hypertension with abdominal obesity (AO) using combined antihypertensive and lipid‑lowering therapy against the background of recommendations for lifestyle correction at the outpatient stage.
 Materials and methods. The study involved 54 patients with AH of 2 and 3 degrees with AO of I — II degrees, who were examined in the polyclinic of the GI «L. T. Malaya Therapy National Institute of the NAMS of Ukraine». The investigated group included 30 (56 %) men and 24 (44 %) women, aged 47 to 59 years (the mean age — (50.6 ± 5.2) years). All patients underwent general clinical laboratory and instrumental examinations. After the initial examination, all patients were prescribed a three‑component fixed combination (FC) of antihypertensive drugs: an angiotensin‑converting enzyme inhibitor (ACE inhibitor) perindopril, a thiazide‑like diuretic (TPD) indapamide and a long‑acting dihydropyridine calcium channel blocker (CCB) amlodipine in optimal daily doses, considering blood pressure levels. Atorvastatin was administered as a lipid‑lowering drug in a daily dose, defined depending on the initial blood levels of low‑density lipoprotein cholesterol (LDL cholesterol). Achievement of the target levels of blood pressure and LDL‑cholesterol was assessed after 6 and 12 weeks of the study. Doses of antihypertensive drugs and atorvastatin were adjusted during the study.
 Results. It has been established that 6 weeks of treatment of AH patients with AO in outpatient settings with the use of three‑component fixed combination of antihypertensive drugs (ACE inhibitors, TPD and CCBs of the dihydropyridine series) and statins’ lipid‑lowering therapy against the background of recommendations for lifestyle correction, resulted in the achievement of the target “office” BP levels of in only 57 % of patients and target levels of LDL‑cholesterol in only 32 %. Insufficient efficacy of antihypertensive therapy in the examined patients was associated with a greater severity of obesity, increased heart rate (HR) and a higher incidence of left ventricular hypertrophy (LVH), while the low efficacy of statin therapy was primarily associated with the low therapy compliance. The addition of nebivolol, cardioselective beta‑adrenoblocker (BAB) with a vasodilatory effect, to the fixed combination of ACE inhibitors, TPD and BCC significantly increased the effectiveness of antihypertensive therapy. At the same time, intensification of statin therapy did not result in the significant increase of the frequency of achieving target levels of LDL cholesterol in the blood.
 Conclusions. The standard three‑component fixed combination of antihypertensive drugs in combination with medium‑dose statin therapy and recommendations for the normalization of lifestyle was not enough effective in a significant part of AH patients with AO at the outpatient stage, which indicates the need for timely correction of drug therapy and implementation of healthy lifestyle.

Current Trends in the Management of Helicobacter pylori Infection in Serbia: Preliminary Results from the European Registry on H. pylori Management

Background: Helicobacter pylori (H. pylori) is the most common chronic bacterial infection. Treatment effectiveness remains a subject of debate considering bacterial antimicrobial resistance. Our aim was to analyze the diagnostic methods and eradication treatments for H. pylori infection in Serbia. Methods: An observational multicenter prospective study was conducted in Serbia, as part of the European Registry on H. pylori Management (Hp-EuReg). Demographics, treatment indication, diagnostic methods, previous eradication attempts, and treatment were collected at AEG-REDCap e-CRF. Modified intention-to-treat (mITT) and per-protocol (PP) effectiveness analyses were performed. Safety, compliance, and bacterial antimicrobial resistance rates were reported. Data were quality checked. Results: Overall, 283 patients were included, with a mean age of 55 ± 15 years. Dyspepsia (n = 214, 77%) was the most frequent treatment indication, and histology (n = 144, 51%) was the most used diagnostic method. Overall eradication rate was 95% (PP) and 94% (mITT). Most prevalent first-line therapy was quadruple PPI + clarithromycin + amoxicillin + metronidazole, with a 96% effectiveness (p < 0.001). Second-line main treatment choice was triple amoxicillin + levofloxacin, with a 95% effectiveness (p < 0.05). Single-capsule Pylera® was the most prescribed third-line therapy, with 100% effectiveness (p < 0.05). Longer treatment duration was associated with a higher eradication rate in first-line therapy (p < 0.05). Clarithromycin and quinolone resistance rates in first-line were 24% and 8.3%, respectively. The overall adverse events’ incidence rate was 13.4%, and therapy compliance was 97%. Conclusions: Considering the high eradication rate, 14-day non-bismuth quadruple concomitant therapy is a reasonable first-line choice, while quinolone-based therapy and single-capsule Pylera® should be considered as rescue therapy options.

2217. Sexually Transmitted Infection (STI) Therapy Compliance Pre and Post Centers for Disease Control and Prevention (CDC) STI Treatment Guideline Update

Abstract Background In December 2020, an update to the CDC STI Guidelines was published for the treatment of uncomplicated Neisseria gonorrhoeae (GC) and the common co-infection of Chlamydia trachomatis (CT). These prescribing changes reflect goals of antimicrobial stewardship and antimicrobial susceptibility. Previous studies assessed guideline prescribing adherence; however, there is no current literature to assess the impact of these updates. The results will be used to further evaluate the impact of the 2021 CDC STI Treatment Guidelines on prescribing patterns in the Emergency Department (ED). Methods This study was a single-center, retrospective cohort study which included patients treated for an STI (GC/CT) in the ED at an academic medical center between February 1, 2020 and August 31, 2021, &amp;gt; 19 years of age, and discharged from the ED. The primary endpoint is to determine if the updated guidelines contributed to a reduced incidence of appropriate guideline directed therapy for ED treatment of STIs. Secondary endpoints include ED patients still in need of STI treatment 30-days post-ED discharge, ED patients lost to follow-up within 30 days post-ED discharge and repeat ED visit for STI within 30 days. Results A total of 1049 patient encounters were screened for inclusion with 338 patient encounters in the Pre-CDC update cohort (PRE) and 346 patient encounters in the Post-CDC update cohort (POST). Results for the primary outcome indicate a statistically significantly reduced incidence of appropriate guideline directed therapy for ED treatment of STIs (PRE = 98.2% vs POST = 62.7%, p&amp;lt; 0.0001). Results for the secondary outcomes were not statistically significant. Conclusion The update to the CDC STI Treatment Guidelines led to decreased guideline directed therapy prescribing in an academic medical center ED. There was no difference in ED patients still needing treatment, lost to follow-up, or repeat ED visits for STI within 30 days post ED discharge. Disclosures All Authors: No reported disclosures.

Facts and ideas on statins with respect to their lipophilicity: a focus on skeletal muscle cells and bone besides known cardioprotection.

Statins are known to block cholesterol synthesis in the liver. They also exhibit non-lipid pleiotropic effects due to the inhibition of protein prenylation, thereby modulating various signaling pathways of cellular homeostasis and integrity. Both lipid control and pleiotropic action of statins are clinically used, mainly for treatment of hypercholesterolemia and primary and secondary prevention of cardiovascular diseases. Because the prescription of statins is increasing and statin therapy is often lifelong, in particular in patients with other risk factors, safety issues being associated with polymorbidity and polypragmasia as well as the persistence with and adherence to statins are specific points of attention of clinicians and clinical pharmacologists. Furthermore, because skeletal myocytes have a cholesterol inhibitory sensitivity greater than hepatocytes, a choice of an appropriate statin based on its lipophilicity and the associated likelihood of its side effects on skeletal muscle cells and bone is warranted in such polymorbid patients. These approaches can effectively modulate the risk: benefit ratio and highlight a need for personalized therapy as much as possible, thereby minimizing risk of discontinuation of therapy and poor compliance.

Pharmacist intervention in cardiovascular disease prevention: lipid modifying treatment optimisation in type 2 diabetes within hastings primary care network

Abstract Introduction Cardiovascular disease (CVD) leads to 1 in 4 premature deaths with higher likelihood in the most deprived population1. Consistent data demonstrated efficacy of statins in CVD prevention and mortality reduction through modifying lipid profile1,2. NICE:CG181 recommends high-intensity statin, namely atorvastatin 20mg daily in type 2 diabetes (T2DM) with high risk of developing CVD1, whilst the European Society of Cardiology suggests LDL-C target below 1.4mmol/L, the lower the better 2. In contrast, 30% of patients in Hastings Primary Care Network (PCN) are prescribed sub-optimal statin therapy3 with scope to promote medicine optimisation through modification of CVD risk factor in one of the England’s most deprived areas. Aim Lowering patient’s CVD risk through optimising statin therapy and improving practice’s compliance with NICE:CG181. Methods NHS Health Research Authority Decision tool was followed, ethics approval was not required. Statin prescribing data were obtained through OpenPrescribing database. This pilot study focused on the prescribing of simvastatin at one surgery within the PCN where patients were identified using the surgery medical information system with the inclusion clinical codes of: “T2DM”, “QRISK2&amp;gt;10%”, “latest LDL-C&amp;gt;1.4mmol/L” and “current simvastatin 10/20/40mg prescription”. Systematic review of patient medical records was followed, including medical history, latest lipid profile and liver function, allergies, history of statin intolerance, previous lipid therapy and frailty status determined using the electronic frailty index, Rockwood score and medical notes. Patients with heterozygous familial hypercholesterolaemia diagnosis, confirmed statin intolerance and moderately-to-severely frail were excluded. Patients were contacted to exercise shared decision-making. Once intervention agreed, prescription was initiated for prescriber authorisation. Blood test 3 months post-intervention monitored for liver function and lipid profile. Results Search in February 2022 identified 44 patients with 39 suitable for intervention after exclusion. Thirty-six contactable patients were all switched to high-intensity statin. Thirty-four were switched to atorvastatin 20 mg whilst two with prior atorvastatin intolerance were switched to rosuvastatin 10 mg. At baseline, 32 patients (88%) had cholesterol profile done within a year as per NICE:CG181. Three-month post-intervention blood tests were completed for 21, with 15 pending; 33% (7/21) had a reduction of LDL-C. In February 2022, 28.9% of the practice’s statin prescriptions were of low and medium intensity and was reduced to 25.6% post intervention. Discussion/Conclusion All contactable patients had statin therapy optimised after exercising shared decision-making with improvement of prescribing compliance to NICE:CG181 demonstrated in this practice. Findings were inconclusive whether the intensification of statin therapy demonstrated cholesterol lowering effect in this cohort. Study limitations due to small sample size, currency of baseline profile at time of intervention and patient compliance not measured. Raised LDL-C observed could have been influenced by lifestyle changes such as poor diet and lack of exercise1. The limitations of this study will be reviewed for future roll out across Hastings PCN. Further exploration of therapy compliance, lifestyle education and the barriers to regular blood test would facilitate such medicine optimisation intervention. In conclusion, patients prescribed with sub-optimal lipid therapy should be reviewed and managed through healthy lifestyle recommendations and aggressive pharmacological intervention.

Use of physiotherapeutic methods in treatment of acne vulgaris

Acne vulgaris is a chronic inflammatory disease that not only reduces the quality of life of patients, but also leaves persistent consequences in the form of scars and hyperpigmentation. Early and effective acne treatment is the main method of prevention in scar formation. Today, both topical and systemic medications are used in the treatment of acne, but the development of resistance to antibacterial drugs, the presence of contraindications to drugs, low compliance or ineffectiveness of therapy are pushing for the search for combined treatments. Even though little attention is paid to physiotherapeutic methods in domestic and foreign recommendations, these methods as part of combination therapy reduce the duration of acne treatment, help reduce the severity of cicatricial changes, and ultimately lead to more satisfactory cosmetic results. This article discusses the efficacy and safety of the most popular physiotherapy methods such as laser therapy, light therapy and chemical peels in the treatment of acne.

Impact of treatment compliance in chronic hepatitis B

The incidence rate of chronic hepatitis B remains high in China. Antiviral therapy can significantly reduce the risk of progressive liver disease and hepatocellular carcinoma in patients with chronic hepatitis B. However, all current antiviral treatments can only inhibit HBV replication and not completely eliminate the hepatitis B virus, so antiviral therapy for chronic hepatitis B is probably a long-term or even lifelong treatment. Antiviral therapy compliance is essential for achieving long-term clinical benefits and preventing nucleot(s)ide drugs resistance. Herein, we analyzed the relevant factors of antiviral therapy compliance and their impact on CHB treatment and explored feasible programs that can improve compliance with nucleot(s)ide drug treatment by conducting a literature search using PubMed and Scopus with search terms including hepatitis B, compliance, nucleot(s)ide drugs, antiviral therapy, viral suppression, and drug resistance.

Influence of the personalities and adherence to therapy on the metabolic control type 1 diabetes in adolescents

Introduction. Diabetes mellitus type 1 (T1DM) in children and adolescents occupies a leading place in the structure of chronic diseases of childhood. Despite modern advances in the treatment and control of CT 1, adolescents have problems with glycemic control in comparison with other age groups.Aim. Is to estimate the correlation between the degree of compensation for diabetes in adolescents and the features of the personality profile, emotional and behavioural characteristics and environmental factors.Materials and methods. The study included 101 children aged 11 to 17 years, treated to pump insulin therapy or multiple injections of insulin. Adherence and compliance to therapy was assessed using the Medication Adherence Questionnaire (MAQ) and the Self Care Inventory-Revised Version (SCI-R). Emotional and behavioral problems were evaluated using the Youth self-report for ages 11-18. Characterization of personality profile was assessed using the The Sixteen Personality Factor Questionnaire». Results. Diabetes was compensated in 25% of children (HbA1c &lt; 7,0%). A statistically significant relationship was established between the degree of patient compliance and the level of HbA1c. The predictive role of individual psychological characteristics on compliance has been determined. Factors such as realism and acceptance of moral norms have a positive impact on compliance.Conclusions. The therapy compliance indicator is the most significant indicator of better compensation for type 1 diabetes in adolescents. The personality traits of adolescents, such as acceptance of moral norms and realism — sensitivity have a predictive effect on the therapy compliance.

P002 CPAP therapy compliance and changes in cognitive function in patients with obstructive sleep apnoea

Abstract Aims Obstructive sleep apnoea (OSA) has been implicated in the pathophysiology of Alzheimer’s disease (AD). Intermittent hypoxia and arousals may contribute to mechanisms leading to accumulation of amyloid beta plaques and intraneuronal neurofibrillary tangles seen in AD. Treatment with Continuous Positive Airway Pressure (CPAP) improves symptoms and cardiovascular sequalae of OSA, and may also mitigate the progression of AD. We investigated, in patients with moderate to severe OSA, whether CPAP compliance altered cognitive test scores. Methods Cognitive testing with the Addenbrooke’s Cognitive Examination-Revised Version (ACE-R) was performed before commencing CPAP and repeated after 3 to 5 years. Student’s independent t-test was used to compare changes in ACE-R between compliant and non-complaint groups based on usage greater than 4 hours/day. Results 30 subjects, mean age 67 years (SD=6.4), had baseline ACE-R of 90 (SD=4.75). At follow up, treatment compliant subjects demonstrated improvement in cognitive test scores in the memory and visuospatial cognitive domains with a mean improvement in memory of 1.5 points p=0.01 95% CI [0.33, 2.67], and mean improvement in visuospatial cognition of 0.95 points p=0.01 95% CI [0.23, 1.7]. Scores for CPAP non-compliant subjects showed no significant difference over time. Conclusion Sustained use of CPAP over time results in a statistically significant improvement in ACE-R test scores, in the subdomains of memory and visuospatial cognition. However, the clinical significance of these findings is unclear and requires further research, as the scores remained in the normative range.

The Impact of Temperament and Character on Treatment Compliance of Opioid Agonists

Background: Opioid agonist treatment, as the most effective treatment for opioid dependency, requires patient adherence for its effectiveness over the long run. Previous studies on psychiatric and non- psychiatric patients indicated that the patient`s temperament has had effect on their treatment compliance. Some studies on different types of addiction have attributed special temperament and character traits to these patients. Introduction: This study aims to investigate the impact of temperament and characteristics on opioid treatment compliance. In this study, the relationship between demographic variables, type of medication therapy, and temperament and characteristics scales of patients against opioid agonists therapy compliance was examined Methods: In this cross-sectional study, 150 patients who had initiated the course of opioid agonist maintenance therapy underwent TCI 125-item test and were followed-up for 2 months regarding compliance. The data were inputted into SPSS 24. K-S and Mann-Whitney U tests were employed to explore the relationship between quantitative and qualitative variables, while for examining the relationship between qualitative variables with each other, Chi-square test was utilized. The significance level in the tests was considered p&lt;0.05. Result: The treatment compliance in this study was 67.2%. In patients who did not have treatment compliance, scores of novelty-seeking (16.7±7versus11.7±4, p&lt;0.001), harm avoidance (16.5±5versus 11.8±5, p&lt;0.0001), reward dependence (12.4±3 versus 10.2±3, p=0.005) and self-transcendence (10.6±2 versus 8.7±2 p=0.002) were higher, but in those who had suitable treatment compliance, scores of persistence (3.5±1 versus 2.3±1, p=0.004) and cooperativeness (17.6±3 versus14.8±4, p=0.004) were higher. Further, some temperament traits were different among patients undergoing treatment with buprenorphine versus methadone (scores of persistence, self-directedness and self-transcendence were higher in the group receiving buprenorphine, while scores of harm avoidance and cooperativeness were higher in the group under methadone treatment). There was also a significant relationship between gender (good compliance: female 100%, male 65%, poor compliance female 0%, male 35%; p=0.04), level of education (higher), as well as type of medication (buprenorphine) and treatment compliance. Conclusion: The results of this study can help to identify high-risk individuals for withdrawing opioid addiction. These people can be a target for pharmacological and non-pharmacological interventions to have their personality traits modified. Investigation of the effect of performing these interventions on treatment compliance can be a subject of future study in this area. Also while there are differences in personality characteristics among cultures, this study investigated Iranian culture more precisely.

Gender Factor Effects on Compliance of Statin Therapy in Hyperlipidemia Patients

Background: The biggest cause of death worldwide is cardiovascular disease (CVD), which accounts for 31% of all fatalities that are officially reported each year. Hyperlipidemia is thought to be a key risk factor for CVD. Due to the lack of symptoms associated with hyperlipidemia, many patients do not feel the need to take medication. Undoubtedly, treating and managing the hypercholesterolemia and other diseases with no symptoms has been difficult for both patients and medical professionals. Methodology: Study was conducted in co-operation of department of Cardiology &amp; Medicine PMC Hospital Nawabshah. 100 patients were registered having hyperlipidemia, included through convenience sampling technique. Two groups were made age from 31-50 years and other age from 51 to 70 years. Drug compliance was measured by using Morisky scale and detailed history by using the pre-formed proforma. Results: Result showed there was compliance of statin therapy in both genders PDC was more than 80%, but in comparison of both groups statin therapy compliance was statistically non-significant p value-0.726. Conclusion: The majority of the participants in this study who had hyperlipidemia adhered to their statin medication. The factors determining compliance revealed good adherence in the high-risk population, especially in people over 50 years old. Keywords: Gender, compliance. Statin therapy. Hyperlipidemia.

Bedside medication review with cognitive and depression screening by a clinical pharmacist as part of a comprehensive geriatric assessment in hospitalized older patients with polypharmacy: A pilot study.

BackgroundPolypharmacy is highly prevalent in older patients with multimorbidity and is associated with increased risk of adverse drug events. This pilot study investigated the added value of a bedside medication review with cognitive and depression screening by a clinical pharmacist to identify potentially inappropriate medications (PIMs) and medication use issues in older patients with polypharmacy.Methods and resultsIn the period from September 2018 to March 2019, a clinical pharmacist took part in the comprehensive geriatric assessment of 37 older patients hospitalized at Antwerp University Hospital and conducted a medication review consisting of a record review, a bedside interview questionnaire covering medication use, evaluation of cognitive function (abbreviated MMSE), depression (GDS-4), and systematic check for possible PIMs (STOPP/START criteria).Patients were 83±4 years old and on a median of 12 home medications (range 5–20). The clinical pharmacist formulated an average of 7.7 recommendations to optimize medication use per patient, of which 89.9% were considered clinically relevant by the geriatrician. Only 2 out of 286 PIMs were discovered during routine electronic validation of medication prescriptions. Supervision of medication intake was absent in 75% of cognitively impaired patients, but advice to do so was implemented in 86.4% of cases. The multidisciplinary geriatric advice was communicated to the treating physician, who fully implemented 33.8% of the recommendations.ConclusionsBedside medication review with cognitive and depression screening by a clinical pharmacist is useful to discover polypharmacy related problems and medication intake issues in a population of geriatric patients. Systematic screening for cognitive impairment and depression are needed to detect patients in need of support for correct medication use and therapy compliance.

Full Compliance of Adjuvant Endocrine Therapy Is Associated with Higher Disease-Free Survival in Hormone Receptor-Positive and HER2-Negative Chinese Breast Cancer Patients with First Tumor Recurrence

To characterize the compliance status of adjuvant endocrine therapy (aET) and its relationship with disease-free survival (DFS) in hormone receptor-positive (HR+) and HER2-negative (HER2-) in Chinese breast cancer (BC) patients with first tumor recurrence. All women with primary unilateral stage I - III HR+HER2- BC and first tumor recurrence in 2008 - 2018 at our institution were identified. Full (vs. none/partial) compliance of aET was classified from records. Multivariate Cox regression estimated the hazard ratio (HR), its 95% confidence interval (CI), and p value. DFS. Covariates included age, T stage, N stage, pathology, tumor grade, LVI, chemotherapy, radiotherapy. Results: A total 258 patients had average age 47.4 years at BC diagnosis and median DFS 31.7 months. Patients with ipsilateral (contralateral) region and organ recurrence were 47.7% (19.8%) and 71.9%. Compared to the patients with none/partial compliance of aET, the full compliance patients (54.3% ) had a higher DFS (median 35.0 vs. 25.2 months, p=0.009). Multivariate analysis showed that the full compliance of aET was associated with a lower HR 0.614 (95%CI 0.467 - 0.807, p<0.001) on recurrence. Early discontinuation (67.5%, 56/83) due to the drug side effects was the top reason for partial compliance of aET. Full compliance of aET was quite low in Chinese HR+HER2- BC patients. However, it was associated with a 38.6% lower risk of first tumor recurrence. To search for effective tools to improve the compliance of aET in this population should be stressed.

Study of Compliance, Pattern of Treatment Interruption and Adverse Events Reported by Anaemic Pregnant Women Receiving the Parenteral Iron Sucrose Therapy

Background: In spite of many efforts by the government since independence anaemia in pregnant women has shown resistance to improvement. Aim: The main aim was to study the compliance of parenteral iron sucrose therapy in pregnant woman along with an additional objective which was to study the pattern of treatment interruption and adverse events observed by them. Methods: This study was conducted by the Department of Community Medicine in the rural and urban field practice area of district Nuh. A list of three hundred and eighty four anaemic pregnant females put on IVIS therapy, fetched from the health centre and relevant details were documented. Result: Out of total of 384 study participants, 291 (75.8%) were compliant with IVIS therapy i.e., they received all four doses. Out of total 93 either non-compliant or partially compliant subjects, most of them (51.6%, n=48) missed 3 doses whereas 22 participants (23.7%) missed 2 doses of the IVIS therapy. Ten study participants (10.7%) showed non-compliance to the therapy. Multigravida subjects were either non or partial compliant compared to primigravida. The three most common adverse events recorded at the time of infusion of 1st dose of IVIS therapy were swelling at injection site, pruritus, and muscle pain or joint pain experienced by 32 (8.3%), 17 (4.4%) and 16 (4.2%) study participants respectively. Conclusion: IVIS therapy is relatively safe therapy and well tolerated by anaemic pregnant females when given as slow infusion. Multigravida subjects were either non or partial compliant compared to primigravida females for IVIS therapy.