Academic literature on the topic 'Effective medication adherence'
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Journal articles on the topic "Effective medication adherence"
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Branham, Ashley, Joseph Moose, and Stefanie Ferreri. "Retrospective Analysis of Medication Adherence and Cost Following Medication Therapy Management." INNOVATIONS in pharmacy 1, no. 1 (June 1, 2010): 12. http://dx.doi.org/10.24926/iip.v1i1.195.
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Objective: To determine if pharmacist-provided medication therapy management (MTM) improves medication adherence in Medicare patients. A secondary objective is to compare the total monthly cost of a patient's prescription medication regimen 6 months before and 6 months following a comprehensive medication review (CMR).
Design: Retrospective analysis of medication adherence, pre-post comparison.
Setting: Three independent pharmacies in North Carolina.
Patients: 97 Medicare Part D beneficiaries with one or more chronic disease states who participated in a comprehensive medication review (CMR).
Intervention: MTM services provided by community pharmacists.
Main outcome measure: Change in adherence as measured by the proportion of days covered (PDC) and change in medication costs for patients and third party payers.
Results: Patients were adherent to chronic disease-state medications before and after MTM (PDC≥ 0.8). Overall, change in mean adherence before and after MTM did not change significantly (0.87 and 0.88, respectively; p = 0.43). However, patients taking medications for cholesterol management, GERD, thyroid and BPH demonstrated improved adherence following a CMR. No change in adherence was noted for patients using antihypertensives and antidiabetic agents. Average total chronic disease-state medication costs for participants were reduced from $210.74 to $193.63 (p=0.08) following the comprehensive medication review. Total costs for patient and third party payers decreased from patients prescribed antilipemics, antihypertensives, GERD and thyroid disorders following a CMR.
Conclusions: Pharmacist-provided MTM services were effective at improving medication adherence for some patients managed with chronic medications. Pharmacist-provided MTM services also were effective in decreasing total medication costs.
Type: Original Research
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Badi, Safaa, Ali Abdalla, Lina Altayeb, Mounkaila Noma, and Mohamed H. Ahmed. "Adherence to Antidiabetic Medications Among Sudanese Individuals With Type 2 Diabetes Mellitus: A Cross-Sectional Survey." Journal of Patient Experience 7, no. 2 (March 13, 2019): 163–68. http://dx.doi.org/10.1177/2374373519831073.
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Background: Adherence to antidiabetic medications is crucial for optimum glycemic control and decreasing complications. This study aimed to assess adherence to antidiabetic medications and the associated factors among individuals with type 2 diabetes attending Jabir Abu Eliz Diabetes Centre in Khartoum state, Sudan. Methods: This was a descriptive cross-sectional study, recruited 213 individuals with type 2 diabetes, and used a pretested questionnaire. Data were analyzed using the Statistical Package of Social Sciences version 21. Logistic regression analysis was used to check for factors that linked to poor adherence to diabetes medication. Results: The median duration of antidiabetic medications use was 8 years; 15.0% were highly adherent to diabetes medications, 44.6% were medium adherent, and 40.4% showed low adherence. Main factors and barriers were medication side effects (18.3%), use of herbal medicine (12.3%), and unavailability of medication (7%). Predictors to nonadherence were gender, and housing status (0.043 and 0.042, respectively). Conclusion: Level of adherence to diabetes medication was unsatisfactory as only 15% showed high adherence. Predictors of nonadherence were gender, and housing status. Effective interventions should be implemented to improve medication adherence, like appropriate patient education and involvement in the treatment plan.
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Zyryanov, Sergey K., Sergey B. Fitilev, Alexander V. Vozzhaev, Irina I. Shkrebniova, Natalya N. Shindryaeva, Dmitry A. Klyuev, Liusine N. Stepanyan, Nikolay N. Landyshev, and Yana G. Voronko. "Medication adherence in patients with stable coronary artery disease in primary care." Research Results in Pharmacology 6, no. 2 (June 30, 2020): 97–103. http://dx.doi.org/10.3897/rrpharmacology.6.54130.
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Introduction: Lack of research targeting non-adherence to cardiovascular medications in Russia prevents from developing effective interventions to improve adherence. The aim was to study medication adherence in patients with stable coronary artery disease in primary care. Material and methods: The study was conducted in a primary care setting of Moscow. Demography, medical history, pharmacotherapy data were obtained retrospectively from 386 coronary patients’ medical records. Medication adherence was measured by 8-item Morisky Medication Adherence Scale (MMAS-8). A statistical analysis was performed using SPSS Statistics V16.0. Results and discussion: According to the results from MMAS-8, 188 (48.7%) coronary patients had high medication adherence, 135 (35.0%) – moderate, and 63 (16.3%) – low. By the dichotomous interpretation: 48.7% (n = 188) – were adherent, 51.3% (n = 198) – were non-adherent. These groups were similar in gender distribution, age, and medical history profile (p > 0.1 for all variables). Smokers prevailed in the non-adherent group (13.6 vs. 5.3%; p = 0.009). Both groups were equally prescribed beta-blockers, antiplatelets, and statins (p > 0.1 for all). Use of fixed dose combinations (11.7 vs. 5.6%; p = 0.048) and the number of pills taken (mean 5.64 ± 1.52 vs. 5.99 ± 1.62; p = 0.029) were associated with better adherence. Higher values of total cholesterol (mean 5.2 ± 1.4 vs. 4.7 ± 1.2 mmol/L; p < 0.001) and low-density lipoprotein cholesterol (mean 2.9 ± 1.2 vs. 2.4 ± 0.9 mmol/L; p < 0.001) were revealed in non-adherents. Subjects with suboptimal adherence visited general practitioners more frequently (median 5 vs. 3 visits; p = 0,003). Conclusion: Medication non-adherence in coronary outpatients exceeded 50%. High adherence was associated with more frequent use of fixed dose combinations and fewer pills taken by patient. Smoking and poorer control of blood lipids prevailed in non-adherents, who also caused higher load on general practitioners.
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González-Bueno, Javier, Daniel Sevilla-Sánchez, Emma Puigoriol-Juvanteny, Núria Molist-Brunet, Carles Codina-Jané, and Joan Espaulella-Panicot. "Factors Associated with Medication Non-Adherence among Patients with Multimorbidity and Polypharmacy Admitted to an Intermediate Care Center." International Journal of Environmental Research and Public Health 18, no. 18 (September 12, 2021): 9606. http://dx.doi.org/10.3390/ijerph18189606.
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Identifying determinants of medication non-adherence in patients with multimorbidity would provide a step forward in developing patient-centered strategies to optimize their care. Medication appropriateness has been proposed to play a major role in medication non-adherence, reinforcing the importance of interdisciplinary medication review. This study examines factors associated with medication non-adherence among older patients with multimorbidity and polypharmacy. A cross-sectional study of non-institutionalized patients aged ≥65 years with ≥2 chronic conditions and ≥5 long-term medications admitted to an intermediate care center was performed. Ninety-three patients were included (mean age 83.0 ± 6.1 years). The prevalence of non-adherence based on patients’ multiple discretized proportion of days covered was 79.6% (n = 74). According to multivariable analyses, individuals with a suboptimal self-report adherence (by using the Spanish-version Adherence to Refills and Medications Scale) were more likely to be non-adherent to medications (OR = 8.99, 95% CI 2.80–28.84, p < 0.001). Having ≥3 potentially inappropriate prescribing (OR = 3.90, 95% CI 0.95–15.99, p = 0.059) was barely below the level of significance. These two factors seem to capture most of the non-adherence determinants identified in bivariate analyses, including medication burden, medication appropriateness and patients’ experiences related to medication management. Thus, the relationship between patients’ self-reported adherence and medication appropriateness provides a basis to implement targeted strategies to improve effective prescribing in patients with multimorbidity.
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Varshney, Upkar, and Neetu Singh. "A Framework for Studying Patterns of Effective Medication Adherence." International Journal of Interdisciplinary Telecommunications and Networking 5, no. 4 (October 2013): 1–12. http://dx.doi.org/10.4018/ijitn.2013100101.
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Medication adherence has been studied extensively in the healthcare literature. Most of the studies focus on improving medication adherence using interventions, including those based on wireless and mobile technologies, and measure average medication adherence level. This is useful in differentiating between patients with high and low levels of adherence. In practice, the same average medication adherence could be achieved by patients with widely different adherence patterns. In this paper, the authors propose that in addition to average medication adherence level, the patterns of adherence should also be studied. The patterns of adherence can be obtained using wireless medication systems and set of actions/decisions can be communicated to these systems or mobile applications for medication management. The authors present a framework, some metrics including Effective Medication Adherence, and results related to the patterns of adherence. Their results show that pattern of adherence has significant impact on the effective medication adherence. Also, higher levels of effective adherence can be achieved for more flexible medication regimen, such as those with higher values of maximum inter-dose time. It is also possible for a patient with lower average adherence but a desirable pattern of adherence to have higher effective medication adherence than a patient with higher average adherence with less desirable pattern.
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El-Rachidi, Sarah, Joseph M. Larochelle, and Jill A. Morgan. "Pharmacists and Pediatric Medication Adherence: Bridging the Gap." Hospital Pharmacy 52, no. 2 (February 2017): 124–31. http://dx.doi.org/10.1310/hpj5202-124.
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Pediatric medication nonadherence is a major problem in the United States health care system. Age of the child, lack of understanding about the disease or treatment, culture, socioeconomic status, family structure, schedule of medications, and taste can all contribute to this problem. Strategies that target interventions to the individual patient and family can be most effective. Pharmacists are at the forefront of patient care and can help children become more adherent to their medications through counseling and building a trusting relationship with the family. This article highlights some common problems to adherence and some solutions to increase adherence.
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Oh, Seung-Won. "Medication Adherence and Effective Management of Hypertension." Korean Journal of Family Medicine 42, no. 2 (March 20, 2021): 89–90. http://dx.doi.org/10.4082/kjfm.42.2e.
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Claassen, Dirk, Walid K. Fakhoury, Richard Ford, and Stefan Priebe. "Money for medication: financial incentives to improve medication adherence in assertive outreach." Psychiatric Bulletin 31, no. 1 (January 2007): 4–7. http://dx.doi.org/10.1192/pb.31.1.4.
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Aims and MethodAlthough financial incentives to improve treatment adherence have been found effective in various medical specialties, there are few systematic data on their use, ethical background and effectiveness in psychiatry. We explored the practice of and possible ethical problems associated with direct financial incentives to improve adherence in assertive outreach teams in England. We also report clinical observations of a money for medication scheme with five assertive outreach patients in East London.ResultsNone of the assertive outreach teams that responded to the survey (response rate 47%) uses financial incentives. Attitudes of team managers towards the practice were mostly negative, often regarding it as unethical. Specific concerns were related to possible coercion and a negative impact on the therapeutic relationship. Out of five patients studied, four accepted the offer of money and had improved adherence; three remained without hospital admission since entering the scheme.Clinical ImplicationsMoney for medication might be a non-coercive and effective option to achieve medication adherence in otherwise non-adherent assertive outreach patients. However, ethical issues need further exploration and controlled trials are required to establish the effectiveness.
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Aishwaria Jyothi Bhasu, Mangala Susmitha, Rhea Climies, Asmita Clara Baral, Divya Mol E. C., and Nandini Swamy. "Assessment of Health Related Quality of Life and Medication Adherence in the Elderly Population." International Journal of Research in Pharmaceutical Sciences 12, no. 3 (July 5, 2021): 2233–38. http://dx.doi.org/10.26452/ijrps.v12i3.4839.
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The elderly population, aged above 60 years, are prone to various chronic and concurrent diseases. This requires prolonging medication usage, often with complex regimens which affect their medication-taking behavior, compliance, adherence, and overall prognosis of the disease. Thereby, an accurate assessment of adherence behavior and its complimentary factors, prescription analysis are necessary for effective and efficient treatment planning and an overall improvement in the Health Related Quality of Life (HRQOL) of the elderly population. Our study was aimed to comprehend the HRQOL and medication adherence pattern of the elderly. One hundred and thirty-three subjects with a mean age of 66.68 ± 5.49 years were recruited for the study and were assessed for their HRQOL, medication adherence, and the factors influencing medication adherence. Relevant data were collected, questionnaires were administered, and appropriate descriptive and inferential statistics were performed. Our findings demonstrated that there is a noticeable change in the HRQOL of the elderly population. It was also found that subjects were highly adherent to their medications, but certain factors played a major role in influencing medication non-adherence. This implies the importance of determining factors affecting HRQOL, medication adherence, adequate prescription analysis, and promoting and practicing rational use of drugs that can significantly optimize therapy and provide a good prognosis of disease for the elderly population.
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Xu, Shuyin, Bangshan Liu, and Yan Zhang. "Effectiveness of mental therapy for poor medication adherence in depression: A review." Tropical Journal of Pharmaceutical Research 19, no. 8 (November 20, 2020): 1785–92. http://dx.doi.org/10.4314/tjpr.v19i8.30.
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Purpose: To review the effectiveness and underlying mechanism of different types of psychotherapy to improve medication adherence (MA).Methods: In this review, the status and possible factors influencing medication adherence in patients with depression patients based on information obtained from various literature.Results: Although the focus of psychologists' analysis of the causes and solutions of mental illness is different, several of these therapies can improve patient compliance with their medications. An effective psychotherapy can change patients’ attitudes towards disease and help them reduce the disease recurrence rate.Conclusion: Psychotherapy has an irreplaceable role in dealing with the major depressive disorder. This review aimed to provide effective instructions for improving medication adherence and reducing disease relapse and recurrence in the future.
Keywords: Depression, Medication adherence, Psychotherapy
Dissertations / Theses on the topic "Effective medication adherence"
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Hickson, Warren. "An interdisciplinary study exploring how health communication can most effectively explain Antiretroviral Medication (ART) and motivate adherence among young people." Doctoral thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/23044.
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The aim of this study was to explore factors contributing to the success of health communication strategies and supporting visual communication tool(s) designed to explain antiretroviral medication (ART) adherence, and motivate young people who live with HIV to follow an adherence regime. The study drew from the social sciences, including psychology, health sciences and communication. Currently there are an estimated 6.8 million people living with HIV in South Africa, making it the site of the largest HIV epidemic in the world (UNAIDS, 2014). Antiretroviral Therapy (ART) is the only effective treatment for HIV and is one of the most demanding medicine regimes, requiring a 90% compliance. Various studies have documented worryingly poor levels of adherence to ART, especially amongst adolescents and young adults in South Africa. The empirical research consisted of a qualitative case study in Khayelitsha, a periurban township on the edge of Cape Town. It focused on young people from Khayelitsha and health care professionals - doctors, nurses, HIV counsellors and pharmacists. Using grounded theory data collection was carried out during two phases of fieldwork, interspersed with periods for data processing and analysis. The principal methods used were focus groups, semi-structured interviews and participant observation. Two key factors emerged from the data that form the basis of a new theoretical understanding: first, concerning how young people become motivated to learn about treatment and adhere to it, and second, concerning how information about treatment can best be communicated to them. In relation to the first of these, findings showed that young people were traumatised by an HIV diagnosis, fearing both that they would get sick and suffer an early death and also that they would be rejected by their belonging groups. This meant that they could not take in the factual information offered, and in addition, had no motivation to do so because the diagnosis resulted in a loss of hope for their present and future lives. According to young people, motivation was an outcome of re-connecting to one or more trusted significant other(s) from within their belonging group, who accepted and supported them. This in turn affirmed their prior belonging identities of son, daughter, cousin or close friend and then reconnected them to their present and future hopes. This renewed motivation to live was the basis for their becoming motivated to learn about treatment and adhere to it. In relation to the second factor, this study found that current communications about treatment were not effective. Specifically, the use of metaphors, which was seen among clinicians as a method of simplifying the complexity of ART adherence messages, was in fact creating confusion. Also, the use of printed information in isolation was not effective; communication was much more effective when it provided a space for discussion. These two key factors form the basis of a health communication strategy for young people who live with HIV and need to adhere to ART. Following on from these findings the study included the production of a film and animation that were identified as the visual communication media that would best support young people's understanding and motivation to adherence. The film presents a case study of a young person who overcame their initial diagnosis shock and, through the acceptance and support of his family, learned to live a normal life with HIV. Young people had said that they wanted to be able to view a film of this kind soon after their diagnosis. The animation, which was designed using a participatory process, used 'iso-type' as the central visual language. It was piloted, and this showed that the best use of a visual communication tool was in a setting that allowed young people to talk about prior losses to HIV within their families and community and about their confusion about treatment, and to ask questions about the meaning of complex biomedical concepts such as an undetectable viral load. All young people who visited the clinics, irrespective of test results, said that they wanted to learn about ART so that they could support friends and family members who lived with HIV, change perceptions about HIV among peers and better prepare in the case of becoming HIV positive themselves. Therefore it is recommended that communication strategies should target patients, their belonging groups and the wider community. This substantive theory contributes knowledge relevant to how ART adherence is communicated to young people. More broadly, this thesis argues that an interdisciplinary approach is required if communication practitioners are to properly understand the meaning that a population attributes to a health challenge; especially in the context of motivation and understanding. It is only when those meanings are fully identified through consolidated social science research that a communication strategy and supporting visual tools can be successfully designed.
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Singh, Neetu. "Smart Interventions for Effective Medication Adherence." 2016. http://scholarworks.gsu.edu/cis_diss/61.
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In this research we present a model for medication adherence from information systems and technologies (IS/IT) perspective. Information technology applications for healthcare have the potential to improve cost-effectiveness, quality and accessibility of healthcare. To date, measurement of patient medication adherence and use of interventions to improve adherence are rare in routine clinical practice. IS/IT perspective helps in leveraging the technology advancements to develop a health IT system for effectively measuring medication adherence and administering interventions.
Majority of medication adherence studies have focused on average medication adherence. Average medication adherence is the ratio of the number of doses consumed and the number of doses prescribed. It does not matter in which order or pattern patients consume the dose. Patients with enormously diverse dosing behavior can achieve the same average levels of medication adherence. The same outcomes with different levels of adherence raise the possibility that patterns of adherence affect the effectiveness of medication adherence. We propose that medication adherence research should utilize effective medication adherence (EMA), derived by including both the pattern and average medication adherence for a patient.
Using design science research (DSR) approach we have developed a model as an artifact for smart interventions. We have leveraged behavior change techniques (BCTs) based on the behavior change theories to design smart intervention. Because of the need for real time requirements for the system, we are also focusing on hierarchical control system theory and reference model architecture (RMA). The benefit of using this design is to enable an intervention to be administered dynamically on a need basis. A key distinction from existing systems is that the developed model leverages probabilistic measure instead of static schedule. We have evaluated and validated the model using formal proofs and by domain experts.
The research adds to the IS knowledge base by providing the theory based smart interventions leveraging BCTs and RMA for improving the medication adherence. It introduces EMA as a measurement of medication adherence to healthcare systems. Smart interventions based on EMA will further lead to reducing the healthcare cost by improving prescription outcomes.
Books on the topic "Effective medication adherence"
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Stewart, Jessica Ann, L. Mark Russakoff, and Jonathan W. Stewart. Pharmacotherapy, ECT, and TMS. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199326075.003.0016.
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Physicians’ attention to patients’ concerns and attitudes about taking medication will engender adherence, as will close monitoring of potentially disconcerting side effects. The primary indication for antipsychotic medications is the treatment of psychotic disorders and mania, even in the absence of psychosis. The more troublesome side effects of antipsychotic medications include increased appetite and weight gain; extrapyramidal side effects, tardive dyskinesia, and neuroleptic malignant syndrome. Antidepressants are effective for treating depressive illness, including major depression, persistent depressive disorder (dysthymia) and premenstrual dysphoric disorder. They are also often used effectively in the treatment of anxiety disorders, obsessive-compulsive disorder, bulimia nervosa, and somatic symptom disorders. Selective serotonin reuptake inhibitors (SSRIs) are generally well tolerated. Other important categories of medications include mood stabilizers and anxiolytics.
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Albus, Christian, and Christoph Herrmann-Lingen. Behaviour and motivation. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656653.003.0009.
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Changing one’s lifestyle is difficult and adherence to medication in people at high cardiovascular risk and established cardiovascular disease is low. Lifestyle is usually based on longstanding patterns and is highly determined by social environment and socioeconomic status. Additional factors such as chronic stress, cognitive impairment, and negative emotions (e.g. depression, anxiety) further impede the ability to adopt a healthy lifestyle, as does complex or confusing advice by medical caregivers. In clinical practice, increased awareness of these factors will facilitate empathetic counselling and the provision of simple and explicit advice. Established cognitive-behavioural strategies are important tools to help with behaviour change and medication adherence. Specialized healthcare professionals (e.g. nurses, dieticians, psychologists) should be involved whenever necessary and feasible. Reducing dosage demands to the lowest applicable level is the single most effective means for enhancing adherence to medication.
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Albus, Christian, and Christoph Herrmann-Lingen. Behaviour and motivation. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199656653.003.0009_update_001.
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Changing one’s lifestyle is difficult and adherence to medication in people at high cardiovascular risk and established cardiovascular disease is low. Lifestyle is usually based on longstanding patterns and is highly determined by social environment and socioeconomic status. Additional factors such as chronic stress, cognitive impairment, and negative emotions (e.g. depression, anxiety) further impede the ability to adopt a healthy lifestyle, as does complex or confusing advice by medical caregivers. In clinical practice, increased awareness of these factors will facilitate empathetic counselling and the provision of simple and explicit advice. Established cognitive-behavioural strategies are important tools to help with behaviour change and medication adherence. Specialized healthcare professionals (e.g. nurses, dieticians, psychologists) should be involved whenever necessary and feasible. Reducing dosage demands to the lowest applicable level is the single most effective means for enhancing adherence to medication.
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Berger, Robert H., Robyn J. Wahl, and M. Paul Chaplin. Formulary management/pharmacy and therapeutics committees. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0028.
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While the cost of health care rises in all public healthcare organizations, budgets for that care have remained the same or have decreased. This is most certainly true in correctional settings. Because pharmaceutical expenditures are a substantial percentage of a health care organization’s budget, medication utilization is closely scrutinized. Clinicians must consider the appropriateness, effectiveness, and safety of medications prescribed to incarcerated patients. The abundance of available drugs and the complex issues with respect to their safe and effective use make a sound program for maximizing rational drug use critical. This is a challenging task in jails and prisons that requires a reexamination of the treatments provided. This is not a process of arbitrarily limiting prescriber choices or their decision-making authority solely based on cost-saving incentives. Evidence-based, best practices that inform the development of, and adherence to, disease management guidelines and a preferred, restricted medication formulary enhances the quality, safety, and effectiveness of the care provided. This chapter details the process and procedures to develop, implement, and monitor prescription practice change by establishing an effective Pharmacy & Therapeutics Committee (P & TC). The chapter further addresses: the roles and responsibilities of a P & TC; P & TC decision-making processes; formulary development and modification; formulary process decision-making; medication therapy management guidelines; prescriber education; and data analytics to assist in monitoring outcomes, medication use, and prescriber adherence to P & TC policies.
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Tranter, Bethan, and Simon Noble. Communication in oncology pharmacy. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198736134.003.0051.
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Pharmacists are considered to have a pivotal role in the provision of information in oncology, and in hospice and palliative care. Effective communication is essential for optimal drug safety, timely treatment, medication compliance, and education. The role of the pharmacist has expanded to offer enhanced pharmaceutical care, which serves to improve the communication between healthcare providers and the function of the multidisciplinary team. Furthermore, through optimal communication with patients there will be increased treatment adherence and improved overall care. This chapter focuses on the breadth of communication issues faced by pharmacists involved in cancer care through the full length of the cancer journey, be it curative or palliative.
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Chaudoir, Stephenie R., and Jeffrey D. Fisher. Stigma and the “Social Epidemic” of HIV: Understanding Bidirectional Mechanisms of Risk and Resilience. Edited by Brenda Major, John F. Dovidio, and Bruce G. Link. Oxford University Press, 2017. http://dx.doi.org/10.1093/oxfordhb/9780190243470.013.28.
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HIV/AIDS is one of the most devastating public health threats facing the modern world, and its eradication relies heavily on the performance of individual risk-reduction and treatment behaviors. In this chapter, a bidirectional lens is applied to consider how stigma systematically and synergistically constrains individual ability to perform behaviors critical to the effective prevention and treatment of HIV (e.g., sexual risk reduction and medication adherence), which ultimately compromises physical health. In addition to producing increased stigma, compromised physical health may further inhibit HIV risk-reduction and treatment behaviors. Interventions capable of mitigating these bidirectional effects are then discussed. Finally, the chapter discusses the implications of the conceptual model in illuminating the causes of persistent disparities in HIV incidence and treatment outcomes.
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Kissane, David W., and Matthew Doolittle. Depression, demoralization, and suicidality. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0173.
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The development of clinical depression is common during palliative care, adversely affects quality of life and adherence to medical treatments, yet regrettably can pass unrecognized. Screening for distress as the sixth vital sign is therefore highly recommended. Demoralization is another form of distress where the apparent pointlessness of continued life may lead to suicidal thinking. As the mental condition deteriorates, co-morbid states of anxiety, depression, and demoralization become more likely. Rates of suicide are increased with advanced cancer and poor symptom control. Fortunately, combined treatment with medication and counselling is effective in ameliorating depression, demoralization, and suicidality. Meta-analyses of psychotherapy trials confirm clear benefits, with behavioural activation, supportive, interpersonal, and cognitive behavioural therapies all making contributions. Group, couple, and family therapies optimize support for all involved. All members of the multidisciplinary team contribute to the active treatment of depression, demoralization, and the prevention of suicide.
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Ahn, Woo-kyoung, Nancy S. Kim, and Matthew S. Lebowitz. The Role of Causal Knowledge in Reasoning About Mental Disorders. Edited by Michael R. Waldmann. Oxford University Press, 2017. http://dx.doi.org/10.1093/oxfordhb/9780199399550.013.31.
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Despite the lack of scientific consensus about the etiologies of mental disorders, practicing clinicians and laypeople alike hold beliefs about the causes of mental disorders, and about the causal relations among symptoms and associated characteristics of mental disorders. This chapter summarizes research on how such causal knowledge systematically affects judgments about the diagnosis, prognosis, and treatment of mental disorders. During diagnosis, causal knowledge affects weighting of symptoms, perception of normality of behaviors, ascriptions of blame, and adherence to the DSM-based diagnostic categories. Regarding prognosis, attributing mental disorders to genetic or neurobiological abnormalities in particular engenders prognostic pessimism. Finally, both clinicians and laypeople endorse medication more strongly as an effective treatment if they believe mental disorders are biologically caused rather than psychologically caused. They also do so when considering disorders in the abstract versus equivalent concrete cases. The chapter discusses the rationality, potential mechanisms, and universality of these phenomena.
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Carrico, Adam W., and Michael H. Antoni. Psychoneuroimmunology and HIV. Edited by Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding, and Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0021.
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Psychoneuroimmunology (PNI) examines the biological and behavioral pathways whereby psychosocial factors may influence the course of chronic medical conditions, including HIV/AIDS. This chapter summarizes PNI research conducted examining the possible role of negative life events (including bereavement), stress reactivity, personality factors, cognitive appraisals, and affective states (depression) in HIV illness progression. Because much of this research was conducted in the era prior to the advent of effective antiretroviral therapy, important questions remain regarding whether there the associations of psychosocial factors with HIV illness progression are independent of medication adherence and persistence. There is also increasing recognition that chronic viral infections such as HIV have neuropsychiatric effects, and more recent PNI research has focused on studying the bidirectional communication between the immune system and central nervous system in HIV. Future research should focus on obtaining definitive answers to these questions to inform the development of novel approaches for reducing psychiatric symptoms and optimizing health outcomes among persons with HIV.
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Suls, Jerry, and Karina W. Davidson. Depression and Cardiovascular Diseases. Edited by C. Steven Richards and Michael W. O'Hara. Oxford University Press, 2013. http://dx.doi.org/10.1093/oxfordhb/9780199797004.013.006.
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This chapter provides a selective review of empirical studies concerning the relationship between depression and depressive symptomatology as risk factors for cardiovascular diseases. Depression appears to confer a twofold risk for both cardiac disease incidence and cardiac disease progression. Several factors appear to contribute to this risk, including the effects of depression on immune activity, endothelial function, SNS and HPA activity, and medical adherence. However, it remains unclear whether depression is only marking risk of some unmeasured third variable responsible for increased heart disease. Although antidepressant medication and cognitive behavioral therapy produce some reduction of depression in cardiac patients, there are no definitive clinical trial data showing medical or behavioral treatment reduce cardiac deaths. Only large-scale randomized clinical trials can fill this gap. The chapter concludes with a series of critical questions requiring resolution to decide what treatment would work most effectively for the cardiac patient with depression.
Book chapters on the topic "Effective medication adherence"
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Singh, Neetu, and Upkar Varshney. "An Artifact for Improving Effective Medication Adherence." In Advancing the Impact of Design Science: Moving from Theory to Practice, 304–11. Cham: Springer International Publishing, 2014. http://dx.doi.org/10.1007/978-3-319-06701-8_20.
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Rokni, Seyed Ali, Hassan Ghasemzadeh, and Niloofar Hezarjaribi. "Smart Medication Management, Current Technologies, and Future Directions." In Handbook of Research on Healthcare Administration and Management, 188–204. IGI Global, 2017. http://dx.doi.org/10.4018/978-1-5225-0920-2.ch012.
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Medication non-adherence is a major healthcare challenge with irreversible consequences in terms of healthcare costs and quality of care. While recent years have seen some effort in developing sensor-based technologies to detect medication adherence and provide interventions, the community lacks a comprehensive study on the clinical utility, reliability, and effectiveness of such medication intake monitoring solutions. Furthermore, many opportunities inspired machine learning algorithms have largely remained unexplored. In an effort to highlight these knowledge gaps, in this paper, we take an interdisciplinary approach to (1) review and compare existing engineering products for medication intake monitoring; (2) discuss clinical applications where such technologies have demonstrated to be effective; (3) explore research gaps and shed light on unmet needs and future research opportunities in the area of medication management from both clinical and technology development points of view. The results of this paper may open several new avenues in the area of technology-based medication.
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Holstad, Marcia M. "Integration of Motivational Interviewing with Other Intervention Modalities in HIV Care." In Motivational Interviewing in HIV Care, edited by Antoine Douaihy and K. Rivet Amico, 141–48. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190619954.003.0015.
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Motivational interviewing (MI) has been effective in promoting HIV self-management behaviors in people (both adolescents and adults) living with HIV. The most frequently studied behaviors are medication adherence, safer sex, alcohol use, and substance use. MI has also been effectively used to reduce smoking and depression/anxiety. Often MI is combined with other modalities such as cognitive behavior therapy, health education techniques, group methods, and emerging technology. This chapter discusses MI in combination with other modalities and provides examples for providers to incorporate MI into patient communication to promote self-management behaviors.
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Feliz, José Manuel, and Marta Barroca. "Importance of Medication Reconciliation as a Strategy for Health Literacy." In Handbook of Research on Assertiveness, Clarity, and Positivity in Health Literacy, 224–37. IGI Global, 2022. http://dx.doi.org/10.4018/978-1-7998-8824-6.ch013.
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Health literacy depends on communication skills of health professionals. Assertiveness, clarity, and positivity (ACP) are a communication model/technique very useful to improve the patient-health professional relationship, adherence to treatment, health literacy, and quality of life. This model can be used in medication reconciliation (MR) – the identification of the most precise list of medication that a patient has been taking and should take, which requires a multidisciplinary participation and a better communication between health professionals and between them and the patient. When the guidance from healthcare professionals is clear and effective, patients and caregivers are more compliant to the recommended drug regimen, resulting in better health outcomes.
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Henderson, David C. "Psychopharmacology and refugees, asylum seekers, and migrants." In Oxford Textbook of Migrant Psychiatry, edited by Dinesh Bhugra, Oyedeji Ayonrinde, Edgardo Juan Tolentino, Koravangattu Valsraj, and Antonio Ventriglio, 483–92. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198833741.003.0057.
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Refugee, asylum seeker, and migrant populations may have experienced many adverse life events during time in their country and during the time of migration. As a result, many will experience common mental health problems, including anxiety, post-traumatic stress disorder, and depression. This chapter reviews the genetic and environmental factors that impact pharmacological interventions for the common mental health problems of these groups. Cultural and explanatory models may play a role in help-seeking, as well as therapeutic alliances and adherence. Cultures may carry different explanations for the use of medication. Pharmacodynamics and pharmacokinetic properties will vary across cultures. These will be affected by dietary factors, as well as genetic and biological factors. Recommendations are also included regarding the safe and effective approaches for treating these groups of patients with psychotropic medications.
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"HIV and palliative care." In Oxford Handbook of Palliative Care, edited by Max Watson, Rachel Campbell, Nandini Vallath, Stephen Ward, and Jo Wells, 561–78. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198745655.003.0019.
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Since the discovery of HIV in 1983, there have been dramatic advances in the management of people living with the virus due to the availability of effective antiretroviral medication (ARV). Prior to this, acquisition of the virus would lead to the development of AIDS and eventual death within ten years for the majority. By 1996, a regime of triple therapy antiretroviral medication was developed which could sustainably suppress HIV viral replication and viral load in the blood. People living with HIV now have near-normal life expectancies, and opportunistic infection rates have reduced in the UK. Despite these advances, people living with HIV experience a high level of symptoms. Symptoms can be direct effects of the HIV virus, side effects of HIV treatment, or consequences of advanced disease. In the UK, advanced disease is still seen with late presentation of infection and poor adherence to ARV medication. Advanced HIV disease is associated with an impaired immune system, leading to high risk of developing opportunistic infections and HIV-associated malignancies. Painful peripheral neuropathy occurs at all stages of HIV infection and is resistant to many neuropathic pain treatments.
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Brack, Graham, Penny Franklin, and Jill Caldwell. "The Nurse’s Role in Promoting Concordance." In Medicines management for nursing practice. Oxford University Press, 2013. http://dx.doi.org/10.1093/oso/9780199697878.003.0015.
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● To support an understanding of the theory of concordance ● Working in partnership with your patient, to relate this knowledge to the achievement of concordance in the consultation process. The NMC code states that when caring for your patient: you must work with others to protect and promote the health and wellbeing of those in your care, their families and carers, and the wider community (NMC, 2008). In the past, nurses would give medicines to patients, and the patients would usually do as they were told and take the medicine without questioning the doctor or health professional. The word used to explain this interaction in the world of medicines management is compliance. This term originates from a traditional biomedical model of care where the patient is viewed as a list of symptoms and it implies that in the act of giving medicines nurses were doing something active to treat the patient’s illness and symptoms. It also implies that the patient was receiving medicines from the nurse; the act of receiving is a passive concept whereby the patient is having something done to them. If they passively followed the instructions that they had been given and took their medicines correctly, then they would get better. The traditional biomedical model of compliance has not proved very effective in terms of patient treatment. If the patient is not given reasons why their treatment is important, or feels that they have not been involved in the decision, the common result is non-compliance. Sometimes this is intentional (the patient decides not to take their medication), and sometimes unintentional (the patient does not know what they need to take, or when). This has cost implications for the National Health Service. If prescribed drugs, often paid for by the NHS, remain unused the patient’s illness may not improve, resulting in the supply of another prescription (or other treatment) that might have been avoided if they had taken the medicine which was initially prescribed. Indeed the World Health Organization identified that less than 50% of patients adhere to their medicines’ regimens (WHO 2003). An American study identified that 33–69% of hospital admissions with ensuing expense to health care delivery are due to poor adherence to medication (Osterberg and Blaschke, 2005).
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Miklowitz, David J., and W. Edward Craighead. "Psychosocial Treatments for Bipolar Disorder." In A Guide to Treatments that Work, 309–22. Oxford University Press, 2007. http://dx.doi.org/10.1093/med:psych/9780195304145.003.0011.
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Whereas pharmacological interventions remain the primary treatment for bipolar disorder, adjunctive psychosocial interventions have the potential to increase adherence to medication regimens, decrease hospitalizations and relapses, improve quality of life, and enhance mechanisms for coping with stress. Controlled studies have established that individual, family, and group psychoeducation, designed to provide information to bipolar patients and their families about the disorder, its pharmacological treatment, and the treatments’ side effects, leads to lower rates of recurrence and greater adherence to pharmacological treatment among bipolar patients. Type 1 and 2 studies have evaluated cognitive behavioral therapy (CBT) as an ancillary treatment. These studies indicate that CBT is associated with better medication adherence and significantly fewer recurrences and/or rehospitalizations. One Type 1 study has evaluated the effectiveness of IPSRT (interpersonal and social rhythm therapy) for bipolar disorder. IPSRT demonstrated its greatest symptomatic effects during a maintenance treatment period, especially if bipolar patients had been successful in stabilizing their daily and nightly routines during an acute treatment period. Finally, four Type 1 studies in adult and pediatric patients have shown that marital/ family therapy may be effectively combined with pharmacotherapy to reduce recurrences and improve medication adherence and family functioning.
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Lyketsos, Constantine G. "Nonpharmacologic Interventions Other Than Psychotherapy." In Psychiatric Aspects of Neurologic Diseases. Oxford University Press, 2008. http://dx.doi.org/10.1093/oso/9780195309430.003.0031.
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Several nonpharmacologic interventions are available to the physician for the management of psychiatric disturbances in patients with neurologic disease. These include education, providing day-to-day structure, and caregiver interventions. They are discussed individually in this chapter. Patient education is a critical aspect of management that can reassure patients, help them better understand what is happening to them, reduce distress, promote a stronger clinician– patient relationship, and enhance adherence to treatment.When treating psychiatric symptoms in a patient with neurologic disease, it is important to set aside time to provide such education. Several approaches to patient education might be incorporated. For the patient who has limited insight into his or her psychiatric symptoms, it is important to approach education delicately and nonjudgmentally, emphasizing treatment options without directly confronting the patient about the lack of insight. For example, a man might be told that his symptoms of anxiety, irritability, and trouble sleeping represent a ‘‘mood disorder’’ for which effective treatment is available to reduce his suffering. By focusing on doing something to help, the physician avoids conflict and preserves the clinician–patient relationship while asking the patient to keep an open mind about diagnosis and therapy. For the patient who has better insight, education involves more detailed explanation of the psychiatric diagnosis and the physician’s best judgment about its cause. For example, ‘‘you are seeing things that are very real to you but that others do not see. I have no doubt that these are real to you, and that they are troubling. Many patients with Parkinson’s disease develop such symptoms that we call hallucinations. They may be caused by some of the medication you take for your condition or by the brain damage caused by the Parkinson’s disease. I think we might be able to make them better.’’ Sometimes, and commonly in the context of dementia care, a patient’s condition precludes constructive discussion of diagnosis. The patient may be incapable of understanding or may not even recognize that anything is wrong with him. In some cases, the patient may become upset and agitated if a diagnosis is discussed.
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Hughes, Dyfrig. "Health and economic impact of non-adherence to preventative cardiovascular medicines." In ESC CardioMed, edited by Lorenzo Mantovani, 3131–33. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0760.
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Suboptimal adherence to prescribed cardiovascular medicines is highly prevalent, associated with increased morbidity and mortality, and costly to manage. Adherence is defined by the three phases of initiation, implementation, and discontinuation. Up to one in six patients prescribed a statin do not initiate treatment and less than 60% of patients persist with therapy at 2 years. Even among patients who engage with the dosing regimen, about 10% of scheduled doses are missed on any given day. There is no evidence of significant differences in persistence across different classes of cardiovascular medicines, but persistence is worse in the context of primary prevention, compared with secondary prevention. The relative risk of development of cardiovascular disease in patients with good versus poor adherence is 0.85 and 0.81 for statins and antihypertensive medications, respectively. The consequences of variable dose implementation may be tempered by the use of drugs which are forgiving to variable dosing, that is, drugs whose pharmacological activity persists despite the occasional late or missed dose. The use of specific interventions that involve electronic reminders, pharmacist-led interventions, and healthcare professional education of patients may be an effective strategy to improve adherence to statins, and to achieve corresponding decreases in low-density lipoprotein cholesterol. Improving adherence to preventative cardiovascular medicines could result in savings of over £109 million (€126 million) per year in the United Kingdom alone, and could lead to a 35% reduction in the risk of all-cause mortality.
Conference papers on the topic "Effective medication adherence"
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"Patterns of effective medication adherence: The role of wireless interventions." In 2014 Wireless Telecommunications Symposium (WTS). IEEE, 2014. http://dx.doi.org/10.1109/wts.2014.6835015.
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Kaviski, Mariane, Verônica Isabela Quandt, Pedro Felipe Taveira dos Santos, Wilian Galezzi, and Eduardo Juliano Alberti. "Gerenciador de Pílulas Inteligente." In Computer on the Beach. São José: Universidade do Vale do Itajaí, 2021. http://dx.doi.org/10.14210/cotb.v12.p255-258.
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In Brazil, as in other countries in the world, the percentage of elderlypeople has been increasing in recent decades. This fact ismainly caused by the drop in the birth rate and the increase in theaverage life span. As a result, health care for the elderly becomesincreasingly important. Adherence to drug treatment is a clinicalchallenge for doctors who serve this population. Very old peoplehave multiple illnesses and, consequently, they use multiple medications.Some also have impaired cognitive or sensory functions,such as visual pathologies or decreased motor skills. However, nonadherenceto drug treatment can lead to the emergence of newdiseases, hospitalizations or even death. This article presents the developmentof an intelligent device that has the function of assistingdrug management, seeking the well-being of the elderly. The deviceallows the registration of the time and interval of medication intakethrough a list of products, regulated by Anvisa, pre-registeredin the system and selected according to its format. After audibleand visual warnings, the medication is dispensed automatically,allowing the medication to be ingested at the appropriate time. Itis also possible to view a drug consumption report and registrationtimes. After testing, the developed prototype was effective for thepurpose for which it was designed. The encoder system, responsiblefor monitoring and controlling the position of the medicationcompartment disc, presented an average deviation of 0.0263 mm,which prevents the overlapping of pills. At the same time, samplesof medication availability at the scheduled times showed a zeroerror rate.
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Raza, Syed. "93 Improving awareness and adherence to medications amongst heart failure patients is the most cost effective way of reducing healthcare costs." In British Cardiovascular Society Annual Conference ‘Digital Health Revolution’ 3–5 June 2019. BMJ Publishing Group Ltd and British Cardiovascular Society, 2019. http://dx.doi.org/10.1136/heartjnl-2019-bcs.91.
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