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Singh, Paramjit, Kanchan Gupta, Gagandeep Singh, and Sandeep Kaushal. "Simultaneous Use of Two Different Tools to Assess Compliance with Antiepileptic Drugs: Experience in A Community-Based Study." Journal of Neurosciences in Rural Practice 11, no. 04 (2020): 636–39. http://dx.doi.org/10.1055/s-0040-1715991.
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Abstract Objective Antiepileptic drug (AED) therapy remains the primary form of treatment for epilepsy, noncompliance to which can result in breakthrough seizure, emergency department visits, fractures, head injuries, and increased mortality. Various tools like self-report measures, pill-counts, medication refills, and frequency of seizures can assess compliance with varying extent. Thus, assessment of compliance with AEDs is crucial to be studied. Materials and Methods Compliance was assessed using pill-count and Morisky medication adherence scale (MMAS) during home visits. A pill-count (pills dispensed–pills remaining)/(pills to be consumed between two visits) value of 0.85 to ≤1.15 was recorded as appropriate compliance. Underdose (<0.85) and overdose (>1.15) was labeled as noncompliance. Score of 1 was given to each positive answer in MMAS. Score of ≥1 was labeled as noncompliance.Statistical analysis: Relationship of demographic factors between compliant and noncompliant patients was analyzed using Chi-square test (SPSS version 21.0, IBM). Rest of the data was analyzed with the help of descriptive statistics using Microsoft Excel. p< 0.05 was considered statistically significant. Results Out of 105 patients, 54 patients were noncompliant with both pill-count and MMAS. 10 patients were noncompliant with pill-count only, while 10 were noncompliant with MMAS. Conclusion Both tools complement each other when used in combination, as use of a single tool was not able to completely detect compliance.
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Appelgren, Kristie E., Paul J. Nietert, Thomas C. Hulsey, Bruce W. Hollis, and Carol L. Wagner. "Analyzing Adherence to Prenatal Supplement: Does Pill Count Measure Up?" International Journal of Endocrinology 2010 (2010): 1–8. http://dx.doi.org/10.1155/2010/631971.
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Objective. To determine if adherence as measured by pill count would show a significant association with serum-based measures of adherence.Methods. Data were obtained from a prenatal vitamin D supplementation trial where subjects were stratified by race and randomized into three dosing groups: 400 (control), 2000, or 4000 IU vitaminD3/day. One measurement of adherence was obtained via pill counts remaining compared to a novel definition for adherence using serum 25-hydroxy-vitamin D (25-OH-D) levels (absolute change in 25(OH)D over the study period and the subject's steady-state variation in their 25(OH)D levels). A multivariate logistic regression model examined whether mean percent adherence by pill count was significantly associated with the adherence measure by serum metabolite levels.Results. Subjects' mean percentage of adherence by pill count was not a significant predictor of adherence by serum metabolite levels. This finding was robust across a series of sensitivity analyses.Conclusions. Based on our novel definition of adherence, pill count was not a reliable predictor of adherence to protocol, and calls into question how adherence is measured in clinical research. Our findings have implications regarding the determination of efficacy of medications under study and offer an alternative approach to measuring adherence of long half-life supplements/medications.
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Krezanoski, Joseph D., Kidwell Matshotyana, Nkosinathi Nxumalo, Alison B. Comfort, Phinda Khumalo, and Paul J. Krezanoski. "The impact of pill counting on resource-limited health facilities: a thematic qualitative analysis in eSwatini." Health Policy and Planning 35, no. 4 (2020): 452–60. http://dx.doi.org/10.1093/heapol/czaa007.
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Abstract Research on health systems in resource-limited settings has garnered considerable attention, but the dispensing of individual prescriptions has not been thoroughly explored as a specific bottleneck to effective delivery of care. The rise of human immunodeficiency virus/tuberculosis prevalence and non-communicable diseases in the Kingdom of eSwatini has introduced significant pressures on health facilities to meet patient demands for lifelong medications. Because automated pill counting methods are impracticable and expensive, most prescriptions are made by means of manually counting individual prescriptions using a plastic dish and spatula. The aim of this work was to examine the perceptions of health providers of causes for pill counting errors, and pill counting’s impact on clinic workflow. Our study took place in 13 randomly selected public health facilities in eSwatini, stratified by three groups based on monthly patient volumes. Thirty-one participants who count pills regularly and 13 clinic supervisors were interviewed with semi-structured materials and were audio-recorded for later transcription. Interviews were thematically analysed with inductive coding and three major themes emerged: workflow, counting error causes and effect on clinic function. Findings demonstrate large variety in how facilities manage pill counting for prescription making. Due to patient demands, most facilities utilize all available personnel, from cleaners to nurses, to partake in prescription making. Major causes for pill counting errors were distractions, exhaustion and being hurried. Participants mentioned that patients said that they had initially received the wrong quantity of pills and this affected medication adherence measurements based off pill counts. Most participants described how efforts put into pill counting detracted from their work performance, wasted valuable time and increased patient wait times. Future research is needed to quantify prescription accuracy, but our data suggest that interventions directly alleviating the burden of pill counting could lead to improved clinic quality and possibly improve patient outcomes.
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Sentat, Triswanto. "HUBUNGAN PELAYANAN INFORMASI OBAT TERHADAP KEPATUHAN MINUM OBAT PASIEN HIPERTENSI DI RSUD PENAJAM PASER UTARA." Jurnal Ilmiah Manuntung 3, no. 1 (2017): 7. http://dx.doi.org/10.51352/jim.v3i1.85.
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The Drug Information Service or Pelayanan Informasi Obat (PIO) is indispensable for improving patient compliance with their treatment. With the PIO can change the knowledge and compliance of patients, especially hypertensive patients. This study was conducted to determine whether PIO can influence adherence to medication hypertension patients in RSUD Penajam Paser Utara. Sampling was done by purposive sampling and analyzed using Spearman Rank Correlation Test where the compliance aspect was assessed using validity and reliability tested questionnaire method, given before PIO and after PIO, and Pill Count method (calculating the remaining pills for 4 weeks) . Samples were obtained by 50 people, the results showed no improvement in adherence before and after PIO administration, and there was a relationship of compliance measurement results with questionnaire method after counseling and Pill Count method. The percentage of patient adherence after PIO administration was based on a high-compliance 70% (35 person) questionnaire method and based on the Pill Count method with a high adherence rate of 60% (30 persons), the compliance data obtained from both methods indicated that the provision of PIO can not improve compliance to take medication of hypertension patient of RSUD Penajam Paser Utara
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Singh, Paramjit, Kanchan Gupta, Gagandeep Singh, and Sandeep Kaushal. "A prospective observational study to assess compliance and factors influencing compliance with antiepileptic drugs among patients with epilepsy." International Journal of Basic & Clinical Pharmacology 8, no. 8 (2019): 1838. http://dx.doi.org/10.18203/2319-2003.ijbcp20193187.
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Background: The primary treatment for epilepsy is Antiepileptic drug (AED) therapy. Non-compliance to AEDs can result in break-through seizure, emergency department visits, hospitalizations, fractures, head injuries and increased mortality. Thus, compliance to AEDs is crucial to be studied. Objective is to study compliance and factors influencing compliance with AEDs among patients with epilepsy.Methods: This observational study was conducted in 105 patients with epilepsy on AED therapy in community in Ludhiana (Punjab) after approval from Institutional Ethics Committee. Demographic data and drug history was collected. Monthly follow up for 6 months was done by paying home visits and data regarding type, dose, frequency of administration of AED was recorded on a semi-structured performa. Pill count was done by recording number of pills dispensed and number of pills remaining with patient. Response to Morisky’s Medication Adherence Scale (MMAS) was also recorded. Results were correlated with patient demographics, type, frequency and number of AEDs.Results: Out of 105 patients, 65 were males and 40 were females. Fifty-four patients were non-compliant with both pill-count and MMAS. Non-compliance was high in first month and decreased gradually. Poly-therapy, lower socio-economic status and multiple dosing regimens were most commonly associated with non-compliance.Conclusions: Under-dosing was more common among non-compliers, which explains the high reporting of forgetfulness to take medicine in MMAS. Both pill count and MMAS are effective non-invasive tools to study compliance.
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Woodcock, Barry G. "Pill-count and the arithmetic of risk." Int. Journal of Clinical Pharmacology and Therapeutics 56, no. 12 (2018): 571. http://dx.doi.org/10.5414/cp203373.
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Grymonpre, Ruby E., Cathy D. Didur, Patrick R. Montgomery, and Daniel S. Sitar. "Pill Count, Self-Report, and Pharmacy Claims Data to Measure Medication Adherence in the Elderly." Annals of Pharmacotherapy 32, no. 7-8 (1998): 749–54. http://dx.doi.org/10.1345/aph.17423.
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OBJECTIVE: To compare medication adherence calculated from four different data sources including a pill count and self-report obtained during a home medication history, as well as calculations based on refill frequency derived from a provincial prescription claims database (manual and electronic). DESIGN: Baseline medication adherence was collected as part of a prospective, randomized, controlled study. Mean medication adherence results obtained from the four data sources were compared using repeated-measures ANOVA followed by a Tukey's multiple range test. SETTING: A pharmacy consultation service located at an interdisciplinary wellness center for noninstitutionalized elderly. PATIENTS: 65 years or older, noninstitutionalized, taking one or more prescribed or nonprescribed medications. Clients would either present to the wellness center or be referred by the Provincial Home Care program. RESULTS: When calculated from self-report or manual or electronic prescription claims data, mean percent adherence by drug was high and not statistically different (95.8% ± 17.1%, 107.6% ± 40.3%, and 94.6% ± 24.0%, respectively), whereas the pill count adherence was significantly lower at 74.0% ± 41.5% (p < 0.0001). CONCLUSIONS: An unexpected finding was that the pill count technique used in this study of elderly clients using chronic, repeat medications appeared to underestimate medication adherence. Numerous other limitations of pill count, self-report, and a province-wide prescription claims database in estimating medication adherence are presented. When using medication adherence as a process measure, the researcher and practitioner should be aware of the limitations unique to the data source they choose, and interpret data cautiously.
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Welsh, MD, Christopher. "Acceptability of the use of cellular telephone and computer pictures/video for “pill counts” in buprenorphine maintenance treatment." Journal of Opioid Management 12, no. 3 (2016): 217. http://dx.doi.org/10.5055/jom.2016.0334.
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Objective: As part of a comprehensive plan to attempt to minimize the diversion of prescribed controlled substances, many professional organization and licensing boards are recommending the use of “pill counts.” This study sought to evaluate acceptability of the use of cellular phone and computer pictures/video for “pill counts” by patients in buprenorphine maintenance treatment.Setting and intervention: Patients prescribed buprenorphine/naloxone were asked a series of questions related to the type(s) of electronic communication to which they had access as well as their willingness to use these for the purpose of performing a “pill/film count.”Results: Of the 80 patients, 4 (5 percent) did not have a phone at all. Only 28 (35 percent) had a “smart phone” with some sort of data plan and Internet access. Forty (50 percent) of the patients had a phone with no camera and 10 (12.5 percent) had a phone with a camera but no video capability. All patients said that they would be willing to periodically use the video or camera on their phone or computer to have buprenorphine/naloxone pills or film counted as long as the communication was protected from electronic tampering.Conclusions: With the advent of applications for smart phones that allow for Health Insurance Portability and Accountability Act of 1996-compliant picture/video communication, a number of things can now be done that can enhance patient care as well as reduce the chances of misuse/diversion of prescribed medications. This could be used in settings where a larger proportion of controlled substances are prescribed including medication assisted therapy for opioid use disorders and pain management programs.
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Jimenez, Humberto R., Kayla M. Natali, and Jin S. Suh. "2502. Impact of Pharmacist-Led Antiretroviral Therapy Simplification Initiative in Heavily Treatment-Experienced Patients on Virologic Control." Open Forum Infectious Diseases 6, Supplement_2 (2019): S868. http://dx.doi.org/10.1093/ofid/ofz360.2180.
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Abstract Background It is well established that antiretroviral therapy (ART) with a lower pill burden are associated with better virologic suppression. However, many HIV providers are cautious when considering ART changes in heavily treatment-experienced patients for a variety of reasons: accumulation of complex resistance patterns, intolerance concerns with new agents, drug-interaction concerns, and a paucity of data on ART simplification in this population. The objective of our study was to evaluate the impact of pharmacist-led initiative to simplify ART among heavily treatment-experienced patients with high pill burdens on virologic control. Methods This was a prospective, observational cohort at a clinic in Paterson, NJ, USA. Patients were eligible if: heavily treatment experienced (≥10 years on ART with history of failure or resistance), ART with ≥ 4 pills daily, ≥ 48 weeks of data, and at clinic from September 2016 to present. The primary endpoint was to measure the effect of ART simplification (decrease of ≥ 2 pills daily) on virologic response (HIV RNA < 200 copies/mL) compared with continuation of regimens with a high pill burden. Secondary endpoints included difference in antiretroviral pill burden and monthly cost, based on average wholesale price (AWP). Results There were 94 patients eligible for the analysis. Most patients were male (65%), and either Black (53%) or Latinx (35%). The simplification and continuation groups had similar baseline characteristics: mean age (50 vs. 50 years old), daily pill burden (4.77 vs. 4.95), virologic response (82% vs. 87%), CD4 count (459 ± 265 vs. 528 ± 273), monthly ART cost ($4,585 vs. $4,159). M184V (50.0%) and K103N (23.4%) were the most commonly documented mutations. Thymidine-analog, atazanavir-associated, and darunavir-associated mutations were documented in 28.7%, 24.5%, and 11.7% of patients, respectively. Patients with ART simplification were more likely to have virologic response than patients continued on the baseline regimen (97% vs. 76%, P = 0.0126), and had a significantly lower daily pill burden (2.05 vs. 4.95, P = 0.001). Conclusion Pharmacist-led ART simplification in heavily treatment experienced patients can dramatically reduce pill burden while achieving better virologic success. Disclosures All authors: No reported disclosures.
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Kayseri, Gonca Özçelik, and Erhan Kirtay. "Part 1. Predicting the Pilling Tendency of the Cotton Interlock Knitted Fabrics by Regression Analysis." Journal of Engineered Fibers and Fabrics 10, no. 3 (2015): 155892501501000. http://dx.doi.org/10.1177/155892501501000305.
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This study, it was aimed to determine the equations and models for estimating the pilling propensity of interlock knitted fabrics. Seven different cotton blends supplied from different spinning mills, yarns in 3 different yarn counts (Ne 20, Ne 30 and Ne 40) and in 3 different twist coefficients (αe=3.2, 3.6 and 4.0) were produced. Interlock knitted fabrics were manufactured in three different fabric tightness values from each of the produced yarns. The pilling tendencies of the fabrics were tested according to EN ISO 12945–2 standard by a Martindale pilling and abrasion device. The PillGrade Objective Pilling Grading System, based on the image analysis principle, was used for evaluating the pilling propensity of the fabrics. By using this system, the pilling degree of the fabrics, total pill number, total weighted pill number, average pill area, and average pill height of the fabrics were measured. Fiber features determined by an AFIS PRO 2 instrument with the samples taken from the cotton roving were used as independent variables for the regression analysis. Moreover, yarn unevenness, yarn twist, yarn count, yarn hairiness, and fabric cover factor values were included in the equations as independent variables; and by considering each of the pilling features measured by PillGrade as a dependent variable, multivariate linear regression equations were determined and the availability of the equations was investigated in detail statistical analyses.
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Kunutsor, Setor, John Walley, Elly Katabira, et al. "Clinic Attendance for Medication Refills and Medication Adherence amongst an Antiretroviral Treatment Cohort in Uganda: A Prospective Study." AIDS Research and Treatment 2010 (2010): 1–8. http://dx.doi.org/10.1155/2010/872396.
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Background. Regular clinic attendance for antiretroviral (ARV) drug refills is important for successful clinical outcomes in HIV management.Methods. Clinic attendance for ARV drug refills and medication adherence using a clinic-based pill count in 392 adult patients receiving antiretroviral therapy (ART) in a district hospital in Uganda were prospectively monitored over a 28-week period.Results. Of the 2267 total scheduled clinic visits, 40 (1.8%) were missed visits. Among the 392 clients, 361 (92%) attended all appointments for their refills (regular attendance). Clinic attendance for refills was statistically significantly associated with medication adherence with regular attendant clients having about fourfold greater odds of achieving optimal (≥95%) medication adherence [odds ratio(OR)=3.89, 95% CI: 1.48 to 10.25, exactP=.013]. In multivariate analysis, clients in age category 35 years and below were less likely to achieve regular clinic attendance.Conclusion. Monitoring of clinic attendance may be an objective and effective measure and could be a useful adjunct to an adherence measure such as pill counting in resource-constrained settings. Where human resource constraints do not allow pill counts or other time-consuming measures, then monitoring clinic attendance and acting on missed appointments may be an effective proxy measure.
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Krikorian, Susan, Susan Pories, Gary Tataronis, et al. "Adherence to oral chemotherapy: Challenges and opportunities." Journal of Oncology Pharmacy Practice 25, no. 7 (2018): 1590–98. http://dx.doi.org/10.1177/1078155218800384.
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Purpose There is very little data on the effect of combining methods to better predict and improve oral antineoplastic adherence in cancer patients. The goal of this study was to evaluate the effectiveness of an intensive pharmacist intervention at the beginning of oral antineoplastic therapy versus nurse-led control group on adherence. Methods This was a prospective, randomized, open-label controlled trial performed in a single center hematology/oncology outpatient service to compare the effectiveness of repetitive pharmacist educational intervention on adherence rates measured at four and eight weeks after prescribing oral antineoplastic medication compared to a nurse-led control group. Both groups included investigator pill counts and self-report adherence questionnaires. Results Two-hundred patients were enrolled between 2009 and 2015. Fourteen of the 101 (14%) patients in the pharmacist group and 7 (7%) of the 99 patients in the nurse-led control group dropped out ( p = 0.166). The majority of patients who remained in the study were 90–100% adherent to oral antineoplastic therapy in both groups. The pharmacist group slightly underperformed at Pill Count 2, possibly due to barriers for non-adherence. Statistically significant correlations associated with non-adherence were forgetfulness ( p = 0.009), wanting to avoid side effects ( p = 0.02), feeling depressed or overwhelmed ( p = 0.032), or falling asleep before taking medication ( p = 0.048) in both groups. Conclusion The combination of pill count and patient self-report adherence is a way of improving oral antineoplastic adherence. However, significant barriers to adherence were identified such as forgetfulness, wanting to avoid side effects, feeling depressed or overwhelmed, and falling asleep before taking medications.
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Peng, Annie R., Bernard Le Foll, Mark Morales, Caryn Lerman, Robert Schnoll, and Rachel F. Tyndale. "Improvement of the association between self-reported pill count and varenicline levels following exclusion of participants with misreported pill count: A commentary on Peng et al. (2017)." Addictive Behaviors 79 (April 2018): 14–16. http://dx.doi.org/10.1016/j.addbeh.2017.11.032.
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Rudd, P., R. L. Byyny, V. Zachary, et al. "Pill Count Measures of Compliance in a Drug Trial: Variability and Suitability." American Journal of Hypertension 1, no. 3 Pt 1 (1988): 309–12. http://dx.doi.org/10.1093/ajh/1.3.309.
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Dunbar-Jacob, Jacqueline, Lora E. Burke, Jeffrey M. Rohay, et al. "A73 Comparability of self-report, pill count, and electronically monitored adherence data." Controlled Clinical Trials 17, no. 2 (1996): S80—S81. http://dx.doi.org/10.1016/0197-2456(96)84604-6.
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Turcotte, PhD, MBA, Justin, Kevin Crowley, MBA, MS, PT, Stephanie Adams, MEd, et al. "The impact of opioid prescribing reduction interventions on prescribing patterns across orthopedic subspecialties." Journal of Opioid Management 17, no. 2 (2021): 169–79. http://dx.doi.org/10.5055/jom.2021.0626.
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Objective: To date, the majority of studies have focused on the adverse effect of opioid overutilization on outcomes, risk factors for overutilization and dependence, and the development of procedure-specific guidelines. We present the results of a multiphased approach to reducing opioid prescribing.Design: A retrospective pre-post study of opioid prescriptions across 386,393 patient encounters was conducted. The preintervention cohort included patient encounters from November 2016 to March 2017, and the post-intervention cohort included encounters from April 2017 to October 2019.Setting: Single-institution orthopedic practice.Patients, participants: 386,393 patient encounters.Intervention: Multiple prescribing reduction interventions were implemented from April 2017 to July 2018.Main outcome measure: Average morphine milligram equivalent (MME) per patient encounter.Results: Implementation of the interventions resulted in an average reduction of 15.2 MME per encounter (54.5 percent) compared to the preimplementation cohort (pre: avg. MME = 27.9, SD 113.6; post: avg. MME = 12.7, SD 66.1; p 0.001). The number of pills per opioid prescription was reduced by 13.4 (29.5 percent) (pre: avg. pill count = 45.5, S.D. 25.1; post: avg. pill count = 32.1, SD 21.1; p 0.001), and the percent of patients receiving opioids was reduced from 8.3 percent to 5.8 percent (p 0.001). Prescribing compliance was evaluated for 7,664 surgical encounters, with 98.2 percent of prescriptions meeting stated guidelines; 5.5 percent of these encounters required second prescriptions.Conclusions: The use of a multiphase approach effectively reduced the opioid prescribing patterns of a large orthopedic practice and was successful across subspecialties. This approach provides a template that other institutions may use to reduce opioid overprescribing in orthopedic practices.
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van Lierde, Marie-Anne, Filipo Serra, Larissa De Rop, et al. "Multimethod Clinical Assessment of Patterns and Prevalence of Nonadherence (NA) to Imatinib Treatment (IMRx) in Patients (Pts) with Chronic Myeloid Leukemia (CML): Results from the ADAGIO Study." Blood 110, no. 11 (2007): 5163. http://dx.doi.org/10.1182/blood.v110.11.5163.5163.
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Abstract BACKGROUND. ImRx for CML is a long-term treatment. Patterns and prevalence of NA to ImRx remain largely unknown. Short-term NA trends may be indicative of long-term NA. Methods for clinical NA assessment vary in reliability. A multimethod approach is indicated. OBJECTIVE. Multimethod estimation of patterns and prevalence of ImRx NA in CML pts at baseline (BL) and follow-up (FU) at 90 days (90d), incl. BL to 90d changes. DESIGN AND PATIENTS. Data subset from prospective, 90d observational, open-label, multicenter study. 169 evaluable pts on ImRx for minimum 30d at enrollment [1]. METHODS OF NA ASSESSMENT. At BL (NA with prior ImRx) and 90d (NA during study): visual analog scale (VAS) for physicians (phs; mVAS), pts (pVAS), cos (cVAS); Basel Assessment of Adherence Scale for pts (pBAAS; structured interview re NA in past 4 weeks [4wks]); pts reported persistence (pPST); % clinic appointments (%CAPPTS) kept (if any scheduled). At 90d also: % of ImRx taken per pill count (%pts@ImRx). RESULTS. See Table 1. CONCLUSIONS. Intuitive adherence ratings (VAS) by phs, pts, and cos are very high and differ from those from structured interview, where about one-third of patients exhibited NA behavior in 4wks prior to BL and FU - despite high persistence. Pill count suggests patterns of under- and overtaking, with only 1 out 7 patients being perfectly adherent. Rate of clinic appointments may be affected by physician scheduling practices and collateral input is a function of availability of collateral person. Consenting to participate in the ADAGIO study did not reduce NA. Though patient self-reports in structured interview (pBAAS) and pill counts have inherent biases, both indices suggest that NA with ImRx may be similar to NA rates in other disease categories. Especially pBAAS and pill count may be useful rapid clinical assessment tools, with pBAAS having the benefit of validated categorical assessment (vs. continuous in other methods). Determinants of NA and the impact of NA on treatment outcomes must be examined. Table 1 - Multimethod Assessment of Non-Adherence with Imatinib Method BL 90d n M±SD/Min-Max M±SD/Min-Max P mVAS 164 95.0±7.6/60–100 94.9±9.9/0–100 ns pVAS 169 95.3±8.5/25–100 95.7±6.1/75–100 ns cVAS 56 97.1±5.1/80–100 97.4±5.1/75–100 ns %pts@ImRx 162 - 91.0±21.1/29.5–2002.2 71.0% @ < 100% ImRx 14.2% @ 100% ImRx n % NA % NA P pBAAS 163 36.2% 32.5% ns %CAPPTS 51 94.1% 88.2% 0.001 pPST 163 98.8% 100.0% ns
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Sammulia, Suci Fitriani, Fita Rahmawati, and Tri Murti Andayani. "PERBANDINGAN PILL BOX DAN MEDICATION CHART DALAM MENINGKATKAN KEPATUHAN DAN OUTCOME KLINIK GERIATRI KOTA BATAM." JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) 6, no. 4 (2016): 288. http://dx.doi.org/10.22146/jmpf.358.
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Banyaknya obat yang dikonsumsi oleh pasien geriatri dengan penyakit kronis meningkatkan penurunan kepatuhan. Ada beberapa cara dalam meningkatkan kepatuhan diantaranya dengan menggunakan Pill box dan Medication reminder chart. Penelitian ini bertujuan untuk mengetahui perbandingan efektifitas penggunaan Pill box dengan Medication reminder chart dalam meningkatkan kepatuhan pasien geriatri dengan hipertensi di Kota Batam. Rancangan Penelitian ini adalah studi experimental; Randomized Controlled Trial dengan desain penelitian pre test dan post test control group. Pengambilan sampel pada penelitian ini dilakukan dengan teknik random alokasi sampling. Pasien akan dikelompokkan menjadi dua kelompok subjek yang berbeda, yaitu kelompok yang mendapat intervensi berupa Pill box dan Medication reminder chart. Data dikumpulkan secara prospektif sesuai dengan kriteria inklusi padap asien geritri rawat jalan, dengan diagnosa penyakit hipertensi di dua rumah sakit Kota Batam, penelitian dilakukan pada bulan Januari sampai April 2016. Pengukuran tingkat kepatuhan menggunakan kuesioner MMAS-8 dan pill count dan outcome klinik pasien diukur dengan melihat tekanan darah sistolik dan diastolik yang disesuaikan dengan diagnosa dokter yang tertera di rekam medik. Pengukuran dilakukan sebelum dan sesudah perlakuan. Data dianalisis secara statistik menggunakan deskripitif, uji bivariat. Hasil penelitian ini menunjukkan bahwa Pill box dapat meningkatkan kepatuhan (P=0,000) dan menurunkan tekanan darah sistolik dan diastolik secara signifikan (P=0,000 dan P=0,002), sedangkan pada Medication reminder chart hanya efektif dalam meningkatkan kepatuhan (P=0,000). Terdapat perbedaan yang signifikan antara Pill box dan Medication reminder chart dalam meningkatkan kepatuhan (P=0,008) dan pada penurunan tekanan darah sistolik dan diastolik (P=0,006 dan P= 0,016).
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Allam, Ramesh R., Mayuko Takamiya, Rashmi Pant, et al. "Factors associated with non-adherence to antiretroviral therapy among female sex workers living with HIV in Hyderabad, India." International Journal of STD & AIDS 31, no. 8 (2020): 735–46. http://dx.doi.org/10.1177/0956462420920145.
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We determined factors associated with non-adherence (consuming <90% of monthly antiretroviral therapy) among female sex workers (FSWs). An interviewer-administered questionnaire was used in a sample of 100 South Indian FSWs living with HIV. We examined demographics, food insecurity, side effects, stigma, alcohol/substance use and self-efficacy. Non-adherence was assessed by self-report, pill-count and combined measures. Prevalence ratios and 95% confidence intervals (CIs) were calculated at p-value <0.1. Thirty-seven percent (33/90) of FSWs were non-adherent by pill-count, 29% (28/95) by self-report and 52% (51/99) by the combined measure. Seventy-six percent (76/100) of FSWs reported experience of at least one form of food insecurity in the past six months. In the regression analysis, arrest in the past year was independently associated with the combined measure of non-adherence (crude prevalence ratios 1.7, 95% CI 1.0–2.8). A successful combination adherence intervention should consider several of the socio-behavioral factors identified in this study including arrest and food insecurity.
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Lam, Y. F., D. I. Velligan, M. DiCocco, et al. "Comparative assessment of antipsychotic adherence by concentration monitoring, pill count and self-report." Schizophrenia Research 60, no. 1 (2003): 313. http://dx.doi.org/10.1016/s0920-9964(03)80256-6.
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Elm, Jordan J., Cornelia Kamp, Barbara C. Tilley, et al. "Self-reported adherence versus pill count in Parkinson's disease: The NET-PD experience." Movement Disorders 22, no. 6 (2007): 822–27. http://dx.doi.org/10.1002/mds.21409.
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Young, J., C. Smith, R. Teira, et al. "Antiretroviral pill count and clinical outcomes in treatment-naïve patients with HIV infection." HIV Medicine 19, no. 2 (2017): 132–42. http://dx.doi.org/10.1111/hiv.12562.
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Jasti, Sunitha, Anna Maria Siega-Riz, Mary E. Cogswell, Abraham G. Hartzema, and Margaret E. Bentley. "Pill Count Adherence to Prenatal Multivitamin/Mineral Supplement Use among Low-Income Women." Journal of Nutrition 135, no. 5 (2005): 1093–101. http://dx.doi.org/10.1093/jn/135.5.1093.
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Obeng-Kusi, Mavis, Karen MacDonald, Marie-Anne van Lierde, and Ivo Abraham. "Novel application of Kaplan-Meier methods to model tolerance for nonadherence to imatinib in patients with chronic myeloid leukemia (CML) in the ADAGIO study." Journal of Clinical Oncology 39, no. 15_suppl (2021): 7038. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.7038.
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7038 Background: Although adherence to imatinib treatment has been shown to be critical for attaining treatment response among patients with CML, some studies have suggested a 7.3-9.9% nonadherence tolerance margin before loss of treatment effects. We aimed to model probabilistically the margin of tolerance required to ensure treatment response among patients prescribed imatinib and the margin, if any, before treatment response is at risk. Methods: We performed a post hoc analysis of the ADAGIO study conducted in Belgium on 169 evaluable patients ( Blood 2009). Using the pill count ratio as, what in conventional survival analysis would be, the time variable, we modeled the cumulative likelihood of treatment response as a function of increasing pill count adherence. We applied Kaplan-Meier methods to model the likelihood of complete cytogenetic (CCyR), complete hematological (CHR), major molecular (MMR) and optimal (OR) (as defined by the European Leukemia Net) response as a function of 90-day pill count adherence. Kaplan-Meier methods thus estimated the tolerance for nonadherence to imatinib by calculating the 1 minus Kaplan-Meier estimate for treatment response. Results: Analyses (see Table) showed that ̃100% adherence of prescribed dose is associated with probabilities (rounded) of 0.84 for CHR, 0.83 for CCyR, 0.82 for OR, and 0.77 for MMR; compared to, 0.37 (CHR and CCyR), 0.35 (OR), and 0.39 (MMR) at 90% adherence. (of 0.7698 (MMR). Increasing the intake of imatinib from 90% to 100% of the prescribed dose increased the likelihood of the various treatment responses by 1.95 to 2.35-fold. Conclusions: Our findings challenge any previously estimated tolerance for nonadherence. There is virtually no margin for nonadherence if the objective is to optimize the likelihood of treatment response, and only a minimal margin to avoid impaired treatment response. Under such adherence, response rates similar to those in the pivotal IRIS trial can be obtained. Clinicians must assess and promote patient adherence, and patients must be perfectly adherent.[Table: see text]
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Acmaz, G., L. Cınar, B. Acmaz, et al. "The Effects of Oral Isotretinoin in Women with Acne and Polycystic Ovary Syndrome." BioMed Research International 2019 (April 7, 2019): 1–5. http://dx.doi.org/10.1155/2019/2513067.
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Introduction. Many patients who were diagnosed as polycystic ovary syndrome- (PCOS-) related acne were not capable of sustaining or beginning oral contraceptive pills (OCPs) due to pill scaring, contraindications of OCP use, migraine, or smoking. In this situation, oral isotretinoin treatment may become an important option for PCOS-related acne. The aim of the study was to determine the effects of isotretinoin treatment on PCOS patients who were complicated with severe cystic acne. Materials and Methods. This study consisted of 40 female patients diagnosed as PCOS complicated with severe cystic acne. These patients were not eligible candidates for OCP use due to migraine, thrombophilia, heavy smoking, or pill scare. To establish baseline values of hormone levels, on days 2–5 of the menstrual cycle, venous blood samples were obtained. Moreover Modified Ferriman-Gallwey (mFG) score, acne score (AS), follicle count, and bilateral ovarian volumes were evaluated both before and after isotretinoin treatment. Results. Isotretinoin treatment significantly decreased Ferriman-Gallwey score, free testosterone, insulin level, hemoglobin level, acne score, and ovarian volume. Increased triglyceride and cholesterol levels were detected after treatment. Conclusion. Isotretinoin treatment may have beneficial effects on free testosterone, insulin, acne score, and Ferriman-Gallwey score. Solely isotretinoin administration may supply adequate healing in PCOS patients’ symptoms complicated with severe cystic acne who is not eligible candidates for OCP use. This trial is registered with Clinicaltrials.gov NCT02855138.
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Brinkerhoff, AJ, S. Pinto, and R. Bechtol. "Analysis of Metabolic Syndrome Patients’ Self-Reported Medication adherence Barriers affect on Pill Count." Value in Health 18, no. 3 (2015): A66. http://dx.doi.org/10.1016/j.jval.2015.03.386.
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Fatiha, Chilmia Nurul, and Farroh Bintang Sabiti. "Peningkatan Kepatuhan Minum Obat Melalui Konseling Apoteker pada Pasien Diabetes Mellitus Tipe 2 di Puskesmas Halmahera Kota Semarang." JPSCR: Journal of Pharmaceutical Science and Clinical Research 6, no. 1 (2021): 41. http://dx.doi.org/10.20961/jpscr.v6i1.39297.
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Ketidakpatuhan obat merupakan salah satu permasalahan dalam pengobatan Diabetes Mellitus (DM). Kepatuhan minum obat pasien DM berperan penting dalam menjaga kadar gula darah dalam rentang normal dan mencegah komplikasi. Peran apoteker diperlukan untuk meningkatkan pengetahuan dan perilaku pengobatan sehingga tingkat kepatuhan dikatakan baik. Tujuan penelitian ini adalah untuk mengetahui pengaruh konseling pada kepatuhan obat dan kadar gula darah pada pasien DM tipe 2 di Puskesmas Halmahera Semarang. Penelitian ini merupakan penelitian pre-eksperimental dengan rancangan <em>The One Group Pretest-Posttest</em>. Pengambilan data dilakukan pada periode April-Mei 2019 di Puskesmas Halmahera Semarang dan di rumah pasien. Kepatuhan obat diukur menggunakan instrument <em>Morisky, Green, and Levine Medication Adherence Questionnaire </em>(MGL MAQ) dan <em>pill count</em>. Kepatuhan berdasarkan MGL MAQ dianalisis menggunakan uji<em> Wilcoxon</em><em>, </em>dan didapatkan<em> p-value</em> 0,000 sehingga dapat dikatakan kepatuhan minum obat sebelum dan sesudah konseling apoteker berbeda signifikan. Kepatuhan obat menggunakan <em>pill count</em> didapatkan hasil patuh 62,80% dan tidak patuh 37,14%. Dapat disimpulkan bahwa konseling apoteker di Puskesmas Halmahera Semarang berpengaruh pada kepatuhan minum obat pasien DM tipe 2.
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Detry, J.-M. R., P. Block, G. De Backer, J.-P. Degaute, and R. Six. "Patient Compliance and Therapeutic Coverage: Amlodipine versus Nifedipine (Slow-Release) in the Treatment of Angina Pectoris." Journal of International Medical Research 22, no. 5 (1994): 278–86. http://dx.doi.org/10.1177/030006059402200505.
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Patient compliance with therapy is often poor and overestimated by the treating physician; it is particularly important in cardiovascular diseases such as hypertension and angina pectoris. Compliance was studied in an open parallel study in out-patients with stable angina pectoris, given either amlodipine (5 mg, once daily) or slow-release nifedipine (20 mg, twice daily) for 12 weeks. Compliance was assessed using pill counting and using an electronic device, the medication event monitoring system, to record the time and date of each opening and closure of the pill container. There was no difference between the two groups in pill count or taking ‘in compliance’ (the percentage of prescribed doses taken as indicated by the monitoring system). Compliance was significantly better ( P < 0.001) with amlodipine, however, for ‘correct dosing’ (the percentage of days on which the correct dose was taken) and for ‘timing compliance’ (the percentage of doses taken at the prescribed time interval after the last dose). ‘Therapeutic coverage’ (the estimated proportion of treatment time for which the drug was active) was also significantly better for amlodipine ( P < 0.001). There was no difference in reported side-effects between the two therapies.
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Seu, Merry M. V., Johanes C. Mose, Ramdan Panigoro, and Edhyana Sahiratmadja. "Anemia Prevalence after Iron Supplementation among Pregnant Women in Midwifes Practice of Primary Health Care Facilities in Eastern Indonesia." Anemia 2019 (October 22, 2019): 1–8. http://dx.doi.org/10.1155/2019/1413906.
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Background. Iron deficiency anemia (IDA) in pregnant women is common, and iron supplementation is given during pregnancy to reduce birth complication. This study aimed to explore the prevalence of anemia and type of anemia after iron supplementation among pregnant women in the eastern part of Indonesia. Methods. A cross-sectional study design was conducted between January and March 2019 in three Primary Health Care (PHC) facilities at Kupang, West Timor. After consent, pregnant women who had taken their iron supplementation for at least 3 months were asked for iron pills intake by using a self-designed questionnaire and by counting the pills leftover. Complete blood count examination was performed, and the type of anemia was assessed using Shine and Lal index (SLI; MCV ∗ MCV ∗ MCH/100) to determine whether anemia was due to iron deficiency or β-thalassemia trait (β-TT). In a subset of iron tablets distributed in the PHCs, Fe-concentration was measured. Results. Of 102 pregnant women included, only 25.5% had taken the pills with a pill count of >80%. Interestingly, Fe-concentration in the pills from three different PHC facilities varied between 75% and 100%. After iron supplementation, however, anemia was detected in 34.3%, and based on SLI, 14.7% was suspected because of iron deficiency and 19.6% was suspective of β-TT. Of note, nonanemic pregnant women (17.6%) had also low SLI, suggesting β-TT or other hemoglobinopathies. Conclusion. Assessment of Shine and Lal index as the first step to screen the type of anemia in pregnant women from a limited area is of potential value, especially because Indonesia is located in the thalassemia belt area. An integrative approach and counseling among pregnant women with β-TT and their partners will increase thalassemia awareness and optimal birth management.
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Suharsono, Tony. "Comparative Study of Medication Notification Booklet and Text Messaging In Maintaining Medication Adherence Among Hypertention Patient In Public Health Center Kendalsari of Malang." Elevate The International Journal of Nursing Education, Practice and Research 1, no. 1 (2018): 33–39. http://dx.doi.org/10.25077/elevate.1.1.33-39.2018.
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Hypertension patient’s drug consumption adherence was very important because hypertension was a condition that cannot be cured, but can be controlled or maintained, one of the factor behind patient’s nonadherence anti-hypertension drug consumption is because patients forget to take their drug. The purpose of this study was to know the difference in drug consumption adherence using drug consumption reminder card and text messages on hypertension patients in the work area of Puskesmas Kendalsari. Research design used was Quasi experimental with pretest – posttest design. Total sample of this research are 53 people using purposive sampling technique. The number of sample then divided into 2 groups, 27 respondents are given the remainder card and 26 respondents are given text messages. Instrument of research used MMAS-8 questionnaire and pill count to measure respondents’ adherence. Adherence level difference between the groups are analyzed using Mann Whitney test resulted in 0.321 p-value for MMAS-8 score and 0.534 for pill count, which means there are no difference in drug consumption adherence between remainder card group and text messages group in the work area of Puskesmas Kendalsari Malang. Based on this research it was suggested giving counseling about hypertension drugs to be taken as prescribed and safe for the body.
Keywords: Drug Consumption Adherence, Hypertension, Text Messages, Reminder Cards.
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Cheng, Caroline W. R., Kam-sang Woo, Juliana C. N. Chan, Brian Tomlinson, and Joyce H. S. You. "Assessing adherence to statin therapy using patient report, pill count, and an electronic monitoring device." American Journal of Health-System Pharmacy 62, no. 4 (2005): 411–15. http://dx.doi.org/10.1093/ajhp/62.4.0411.
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Cheng, Caroline W. R., Kam-sang Woo, Juliana C. N. Chan, Brian Tomlinson, and Joyce H. S. You. "Assessing adherence to statin therapy using patient report, pill count, and an electronic monitoring device." American Journal of Health-System Pharmacy 62, no. 4 (2005): 411–15. http://dx.doi.org/10.1093/ajhp/62.4.411.
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Holstad, Marcia M., Melinda Higgins, Maya Bauman, et al. "Picture Pill Count: An Innovative, Reliable, Valid and Feasible Method to Measure Adherence to ART." AIDS and Behavior 23, no. 8 (2019): 2210–17. http://dx.doi.org/10.1007/s10461-019-02513-9.
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Vaughn, Jennifer, Chesley Ammerman, and Jeffrey Stein. "Delay discounting as a predictor of adjuvant endocrine therapy adherence among breast cancer survivors." Journal of Clinical Oncology 38, no. 15_suppl (2020): e24172-e24172. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e24172.
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e24172 Background: Despite the demonstrated mortality benefit, 30-70% of hormone-responsive breast cancer (BC) survivors struggle to adhere to adjuvant endocrine therapy (ET). Little is known about patient-specific behavioral traits and their role in ET non-adherence. To gain a survival benefit, patients must adhere to ET for years. In contrast, the benefits of discontinuing ET (i.e., avoiding toxicity) are immediate. Thus, adherence requires one’s behavior to be guided by future outcomes, rather than immediate gratification. We therefore hypothesized that ET adherence may be related to the behavioral economic process of delay discounting (DD; i.e. devaluation of delayed outcomes), which provides a measure of how individuals value the future. Methods: BC survivors (age 18-80) prescribed adjuvant ET within the last 5 years were recruited. ET adherence was measured by pill count and self-report. DD was measured using two methods: monetary DD was measured using a validated task in which participants made repeated, hypothetical choices between a larger amount ($100 or $1000) available after a time delay or half of this amount ($50 or $500) available now. Across trials, the delay to the larger amount is titrated based on previous choices until reaching a delay at which the participant becomes indifferent to waiting for the larger reward. Cancer DD was measured using an investigational task adapted from the adjusting-delay task described above. This task presented repeated, hypothetical choices between preventing BC recurrence after varying time delays and avoiding ET side effects immediately. Results: Eighty nine BC survivors participated. Average pill count adherence was near 50%, but self-reported adherence was near 100%. Monetary DD was significantly associated with pill counts; adherence improved with increasing log indifference delays (standardized b 0.328, p = 0.005). Self-report adherence (categorized as discontinued/never started, suboptimal, and perfect) was significantly associated with Cancer DD and income (OR 3.764, p < 0.001 and OR 1.01, p = 0.04, respectively) but not monetary DD (OR 0.978, p = 0.951). No association was found between ET non-adherence and medication type, side effect severity, menopausal status, age, education or minority status. Conclusions: DD may promote ET non-adherence among BC survivors. Behavioral therapies which reduce DD may provide a targeted strategy to improve adherence. More research is needed to develop tools that reliably assess ET adherence and that tailor DD assessments to the cancer survivor population.
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Wang, Hui, Yao Huang, Pan Shen, et al. "Modified Si-Miao Pill for Rheumatoid Arthritis: A Systematic Review and Meta-Analysis." Evidence-Based Complementary and Alternative Medicine 2020 (May 22, 2020): 1–12. http://dx.doi.org/10.1155/2020/7672152.
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Objective. The aim of this review and meta-analysis was to assess the effects and safety of modified Si-Miao pill (mSMP) in treatment of rheumatoid arthritis. Design. A systematic literature search was carried out in eight databases from their available dates of inception to April 2020. After screening, fifteen randomized, controlled trials (RCTs) comparing the effects and safety of mSMP in combination with western medicine (including disease-modifying antirheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs (NSAIDs)) in treating rheumatoid arthritis patients were included after screening. Results. In comparison with DMARDs, or coadministration of DMARDs and NSAIDs, mSMP in combination with western medicine significantly lowered erythrocyte sedimentation rate (mean difference (MD) = -10.61, 95% confidence interval (CI) [−12.19, −9.03]), C-reactive protein (MD = −6.50, 95% CI [−8.43, −4.56]), rheumatoid factors (MD = −17.31, 95% CI [−24.34, −10.27]), swollen joint count (MD = −1.63, 95% CI [−2.29, −0.97]), tender joint count (MD = −1.98, 95% CI [−2.34, −1.62]), and morning stiffness time (MD = −24.37, 95% CI [−29.41, 19.33]) and ameliorated the condition of patients (odds ratio (OR) = 3.69, 95% CI [2.64, 5.14]). Additionally, mSMP in combination with western medicine seemed safer (OR = 0.49, 95% CI [0.30, 0.81]). Conclusion. The results of the meta-analysis study have shown that mSMP in combination with western medicine therapies appears to be more effective and safer than western medicine alone in the treatment of rheumatoid arthritis including reducing inflammatory markers and adverse events and improving symptoms. Howbeit, more high-grade, large-scale RCTs of mSMP in various countries and regions are still needed.
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Narayana Goruntla, Vijayajyothi Mallela, and Devanna Nayakanti. "Impact of pharmacist directed counseling on knowledge, attitude, practices and medication adherence among hypothyroidism patients: a quasi-experimental design." International Journal of Research in Pharmaceutical Sciences 10, no. 3 (2019): 1891–99. http://dx.doi.org/10.26452/ijrps.v10i3.1388.
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The pharmacist plays an important role in providing counseling services to patients suffering with various chronic disorders and to improve health outcomes. The study aims to evaluate the effect of pharmacist mediated counseling on Knowledge, Attitude, and Practice (KAP) and medication adherence (MA) among hypothyroidism patients attending outpatient department of a secondary care referral hospital. This is a Quasi-Experimental design without control. A total of 403 patients were enrolled and subjected for KAP assessment by pre-validated questionnaire, and medication adherence levels by pill count and visual analogue scale methods. All patients were counselled by the pharmacist regarding hypothyroidism and its management. After three months, post-KAP and medication adherence levels were measured. Chi-square test was used to compare the adequacy of KAP levels. The paired t-test was used to compare mean medication adherence and mean KAP percentage levels. The mean KAP percentage levels were significantly improved after counselling (80.5±16.4; 86.2±15.7; 67.5±13.8) compared to before (34.1±21.7; 33.8±22.9; 24.5±20.9) with a P value less than <0.0001. There was a significant improvement in mean medication adherence levels measured by visual analogue scale method and pill count method after counselling (92.4±4.8, 97.4±3.2) compared to before counselling (76.8±6.8, 80.3±6.4). The study illustrates how pharmacist plays an integral part in improving medication adherence and KAP towards hypothyroidism management. Improving KAP and medication adherence levels will promote positive clinical outcomes and prevents complications associated with hypothyroidism.
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SHIOMI, MEGUMI, YOICHI TANAKA, MOMOKA KUROBUCHI, TESSHU TAKADA, and KATSUYA OTORI. "815-P: Medication Adherence by Pill Count Using Medical Reconciliation in Patients with Type 2 Diabetes." Diabetes 69, Supplement 1 (2020): 815—P. http://dx.doi.org/10.2337/db20-815-p.
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Kavanagh, Janet, Tiffany Bishop, Claire Chiang, Alyssa M. DePasquale, Helen C. Kales, and Jo Anne Sirey. "Simplifying the assessment of antidepressant adherence through automated pill count calculation: experience from the TIP studies." American Journal of Geriatric Psychiatry 22, no. 3 (2014): S138—S139. http://dx.doi.org/10.1016/j.jagp.2013.12.162.
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Kedir Obsa, Aman, Yadesse Tegene, and Achamyelesh Gebretsadik. "Iron and Folic Acid Supplementation Compliance and Associated Factors among Pregnant Women Attending Antenatal Clinic in Shalla District, Southwest Ethiopia: A Cross-Sectional Study." Journal of Nutrition and Metabolism 2021 (March 27, 2021): 1–7. http://dx.doi.org/10.1155/2021/6655027.
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Background. Iron-folate supplementation for a pregnant mother is a cost-effective intervention to reduce iron deficiency anemia during pregnancy. The aim of this study was to assess the iron-folic acid supplements and associated factors among pregnant women attending antenatal clinics in the public health center of Shalla district, Southwest Ethiopia. Methods. Institutional-based cross-sectional study design was conducted among 402 randomly selected pregnant mothers between February and April 2019. Data were collected using an interviewer-administered structured questionnaire from pregnant mothers attending antenatal care and using iron-folate supplements. Descriptive and multivariate logistic regression analyses were employed. Results. Pill count compliance rate was found to be (154) 38.3%. Pregnant mothers who had anemia in their previous pregnancy [(AOR = 11.35, 95% CI: 4.76–27.03)], counseling on iron-folate supplements [(AOR = 11.39, 95% CI: 5.09–27.03)], awareness of the benefit of the iron-folate supplements [(AOR = 2.22, 95% CI: 1.18–3.92)], and being a member of the Health Development Army [(AOR = 2.11, 95% CI: (1.2, 3.9)] were significantly associated with compliance with iron-folate supplement. Conclusion. Compared to the World Health Organization cut-off point, the pill count compliance rate of iron-folate supplementation among pregnant women in the study area was very low. Previous history of anemia and lack of knowledge about its benefit were some of the factors associated with it. Therefore, the healthcare providers should give continuous awareness creation and counseling services focusing on the benefit of iron-folate supplementation for pregnant mothers and their neonates.
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Mas Ulfa, Ninik, and Rizky Darmawan. "Analysis Of The Effect Of Age On Medication Adherence With Oral Antidiabetes And Oral Antihypertension Drugs Using Pill Count Method." Journal of Pharmacy and Science 6, no. 2 (2021): 63–68. http://dx.doi.org/10.53342/pharmasci.v6i2.216.
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Compliance with taking medication is a problematic patients who get polypharmacy prescribing, this is because of the many drugs that must be consumed. As a result of the consumption of many drugs that cause sufferers of degenerative diseases are not compliant to take medication and health awareness decreases. This is not only experienced in elderly and geriatric patients but in adulthood also experience non-compliance with taking medication due to the many activities, lazy to take medication and also forget. This study was conducted to analyze the effect of age on adherence to taking oral antidiabetic drugs and oral antihypertensive drugs using the pill count method at the Regional Hospital of South Surabaya. The Pill Count method was chosen in this study with the aim of analyzing patient compliance in taking medication by calculating the remaining drug based on the rules of use and dosage when the patient returns to control. In addition, this study also aims to determine the effect of age on patient compliance in taking oral antidiabetic drugs and oral antihypertensive drugs. This research is descriptive observational with prospective data collection. Data analysis used descriptive and continued with statistical analysis using Chi-Square. The results of this study that adherence to take medication for elderly patients who received oral antidiabetic drug therapy obtained as much as 96.7% and 90% in adult patients. Compliance to oral antihypertension drugs in adult patients are 90% and 83.3% in elderly patients. Age does not effect compliance patients with Chi-Square analysis with p value = 0,301 and 0,448 > 0.05.
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van Onzenoort, H. A. W., W. J. Verberk, A. G. H. Kessels, et al. "Assessing Medication Adherence Simultaneously by Electronic Monitoring and Pill Count in Patients With Mild-to-Moderate Hypertension." American Journal of Hypertension 23, no. 2 (2010): 149–54. http://dx.doi.org/10.1038/ajh.2009.207.
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Zellweger, J. P., C. L. Fallab-Stuby, A. Sauty, et al. "248-PA12 Assessment of adherence to preventive chemotherapy — a comparison between MEMS, pill count and urine tests." Tubercle and Lung Disease 76 (October 1995): 107–8. http://dx.doi.org/10.1016/0962-8479(95)90404-2.
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Pinto, Sharrel, Angela Simon, Feyikemi Osundina, Matthew Jordan, and Diana Ching. "Study to Measure the impact of Pharmacists and Pharmacy Services (STOMPP) on Medication Non-Adherence: Medication Adherence and Clinical Outcomes." INNOVATIONS in pharmacy 9, no. 1 (2018): 11. http://dx.doi.org/10.24926/iip.v9i1.1104.
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Objective: To compare the impact of various pharmacy-based services on medication adherence and clinical outcomes.
Design: Prospective, randomized control trial
Setting: A local endocrinology group (clinic setting) and community pharmacies belonging to a regional integrated delivery network (IDN) in Toledo, OH
Population: Subjects included within this study had type 2 diabetes, were prescribed a minimum of five medications, at least 18 years of age, having the ability to self-administer medications as prescribed, and be able to speak and understand English. Subjects were required to have Paramount health insurance, must be willing and able to provide informed consent, actively participate in the assigned MTM sessions, and have adequate transportation to attend the sessions at a participating pharmacy.
Methods: Patients were recruited through flyers at practice sites, referrals from physicians and pharmacists, and direct mailers. Members of the research team would screen patients to assess their eligibility to participate in the study. Patients who fit the inclusion criteria were randomized into one of the following four different groups: Pill Bottle (PB), Blister Pack (BP), Pill Bottle + Medication Therapy Management (PB+MTM), and Adherence Pharmacy (BP+MTM). Patients enrolled in the BP groups had their medications synchronized. Patients in the AP group were given the option to have their medications delivered, if needed.
Practice innovation: We partnered with a regional integrated delivery network (IDN) with multiple community pharmacy practice sites and a practice group of endocrinologists. A new practice model called Adherence Pharmacy was conceptualized and implemented within the community setting and was accessible to patients.
Main Outcomes Measures: Medication adherence, measured using proportions of days covered (PDC) and pill count scores at baseline, 3 months, 6 months, 9 months, and 12 months; Hemoglobin A1c (HbA1c), body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressures (DBP) were collected at baseline, 6 months, and 12 months
Results: A mixed-model ANOVA was used to study the impact of these services on medication adherence, using PDC and pill count scores. Results of the 61 patients in the study revealed that there was a statistically significant difference between the PB and BP groups (p=0.008); between the PB and BP+MTM groups (p=0.023); and between the PB+MTM and the BP+MTM groups (p=0.041). Except at baseline, adherence scores at all time points (0, 3, 6, 9, and 12 months) were significant with the patients in the BP and BP+MTM groups having higher adherence compared to those in the PB and PB+MTM groups. Pill count scores had similar results to the PDC measures. Insert data from HBA1c, BMI, SBP and DBP. Clinical outcomes were also analyzed using the mixed between-within ANOVA and were measured at baseline, 6, and 12 months. Patients in the MTM groups reached the American Diabetes Association goal of 7%, whereas the patients in the PB group did not reach a goal at 12 months. All groups, except for the PB only group, indicated a statistically significant change from baseline to 12 months. When comparing body mass index (BMI) scores across groups over time, patients in the BP+MTM group showed the lowest BMI at 12 months. There were not any significant differences across the groups, but patients in the two MTM groups saw greater improvement in their BMI scores than patients in the other two groups. There were no significant differences between groups in SBP and DBP reduction. However, patients in the two BP groups reached a SBP goal sooner (per the Eighth Joint National Committee) than patients in the PB+MTM and PB groups.
Conclusion: Patients had improved clinical outcomes and adherence rates when using blister packaging and medication therapy management services, individually and in combination. Blister packaging seemed to have a greater impact on medication adherence while MTM services helped improve clinical endpoints. However, patients who received the combination of services offered within the AP demonstrated higher improved clinical outcomes and adherence rates when compared to patients who did not. While each of these services was found to be more impactful that dispensing medications in pill bottles, combining them can provide a greater benefit to patients.
Type: Original Research
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Moon-Soo, L., Y. Jae-Won, A. Hyonggin, and K. Seung-Hyun. "Evaluation of Factors Influencing Antidepressant Medication Compliance in Outpatient Treatment of Depressive Disorders in Korea." European Psychiatry 24, S1 (2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70743-6.
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Objective:Medication compliance is associated with the treatment outcomes. The reported consequences of non-compliance are chronification, poor psychosocial outcomes and increased suicide rates. We measured the drug compliance using medication event monitoring system (MEMS) and several compliance measures in the outpatients with depressive disorders. In addition, we tried to find out the relationship of antidepressant compliance with other clinical correlates including insight in depressive disorders.Method:This study was performed in Korea university medical center, Guro hospital. Outpatients diagnosed as having depressive disorders were enrolled. Monitoring was performed in 76 depressive patients who were taking the mono-antidepressant therapy during the at least 4-week evaluation period. 17 item Hamilton Rating Scale for Depression (HRSD), Multidimensional Scale of Perceived Social Support (MSPSS) and the mood disorders insight scale (MDIS) were investigated. Compliance was measured using MEMS, clinician rating scale of antidepressant compliance, pill count, and patient's self-report.Results:A total of 76 outpatients were enrolled in this study. As the severity of depression increases, patients tended to perceive poor social support from others in the correlation analysis. Level of depression by HRSD was significantly correlated with MDIS scores. Compliance rates for MEMS, pill count, clinician rating scale of compliance and self-report were 51.9%, 71.4%, 79.2% and 75.3% respectively. We did not find any statistical significance between compliance variables and other clinical scale scores (MDIS, HRSD, and MSPSS).Conclusion:More severely depressed patients have higher scores of insight in case of depression. However, increased perception of insight in depressive patients was not directly related with the increase in treatment compliance. Further investigation is needed to understand other factors affecting the drug compliance especially in depressive patients..
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Ong, Angel M., Hope A. Weiler, Michelle Wall, et al. "Feasibility of a clinical trial to assess the effect of dietary calciumv.supplemental calcium on vascular and bone markers in healthy postmenopausal women." British Journal of Nutrition 116, no. 1 (2016): 104–14. http://dx.doi.org/10.1017/s0007114516001677.
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AbstractWhether supplemental Ca has similar effects to dietary Ca on vascular and bone markers is unknown. The present trial investigated the feasibility of applying dietary and supplemental interventions in a randomised-controlled trial (RCT) aiming to estimate the effect of supplemental Ca as compared with dietary Ca on vascular and bone markers in postmenopausal women. In total, thirteen participants were randomised to a Ca supplement group (CaSuppl) (750 mg Ca from CaCO3+450 mg Ca from food+20 µg vitamin D supplement) or a Ca diet group (CaDiet) (1200 mg Ca from food+10 µg vitamin D supplement). Participants were instructed on Ca consumption targets at baseline. Monthly telephone follow-ups were conducted to assess adherence to interventions (±20 % of target total Ca) using the multiple-pass 24-h recall method and reported pill count. Measurements of arterial stiffness, peripheral blood pressure and body composition were performed at baseline and after 6 and 12 months in all participants who completed the trial (n9). Blood and serum biomarkers were measured at baseline and at 12 months. Both groups were compliant to trial interventions (±20 % of target total Ca intake; pill count ≥80 %). CaSuppl participants maintained a significantly lower average dietary Ca intake compared with CaDiet participants throughout the trial (453 (sd187) mg/dv.1241 (sd319) mg/d;P<0·001). There were no significant differences in selected vascular outcomes between intervention groups over time. Our pilot trial demonstrated the feasibility of conducting a large-scale RCT to estimate the differential effects of supplemental and dietary Ca on vascular and bone health markers in healthy postmenopausal women.
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Samsunnahar, Qazi Shamima Akhter, Atiquzzaman, Najneen Akhter, US Naima Begum, and Farhana Rahman. "Assessment of Coagulation Disorder in Women Taking Oral Contraceptives." Journal of Bangladesh Society of Physiologist 9, no. 1 (2015): 1–5. http://dx.doi.org/10.3329/jbsp.v9i1.22786.
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Background: Oral contraceptive pill (OCP) is related to development of hypercoagulability and the risk of thromboembolic effects in women. Objectives: To assess the coagulability status in women taking oral contraceptives by estimation of plasma fibrinogen level and total count of platelets. Methods: This cross sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka, during the period of January 2012 to December 2012 on sixty apparently healthy female subjects aged 25 to 45 years taking OCPs for 1 to 10 years. Thirty subjects were 1 to 5 years user group and another 30 subjects were >5 to 10 years user group. They were collected from family planning clinics of Dhaka city. In addition, age matched 30 apparently healthy women of OCP nonusers were also studied as control. For assessment of coagulability state, plasma fibrinogen and total counts of platelet levels were estimated by automated coagulation analyzer and automated hematology analyzer. Statistical analysis was done by unpaired Students t test. Results: The mean (±SE) total count of platelet level was significantly higher (P<0.001) in contraceptive user group and plasma fibrinogen level was higher in users but it was not significant. Conclusion: This study concludes that OCP users had more tendency of hypercoagulability and therefore these women are at higher risk of thromboembolic effects. DOI: http://dx.doi.org/10.3329/jbsp.v9i1.22786 Bangladesh Soc Physiol. 2014, June; 9(1): 1-5
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Kumar, Anand, Rohit Bhatia, Gautam Sharma, et al. "Effect of yoga as add-on therapy in migraine (CONTAIN)." Neurology 94, no. 21 (2020): e2203-e2212. http://dx.doi.org/10.1212/wnl.0000000000009473.
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ObjectiveTo evaluate the effectiveness of yoga as an adjuvant to conventional medical management on clinical outcomes in patients with migraine.MethodsCONTAIN was a prospective, randomized, open-label superiority trial with blinded endpoint assessment carried out at a single tertiary care academic hospital in New Delhi, India. Patients enrolled were aged 18–50 years with a diagnosis of episodic migraine and were randomized into medical and yoga groups (1:1). Randomization was computer-generated with a variable block size and concealed. A predesigned yoga intervention was given for 3 months. Outcomes were recorded by a blinded assessor. The primary endpoint was a decrease in headache frequency, headache intensity, and Headache Impact Test (HIT)–6 score. Secondary outcomes included change in Migraine Disability Assessment (MIDAS) score, pill count, and proportion of headache free patients.ResultsBetween April 2017 and August 2018, 160 patients with episodic migraine were randomly assigned to medical and yoga groups. A total of 114 patients completed the trial. Baseline measures were comparable except for a higher mean headache frequency in the yoga group. Compared to medical therapy, the yoga group showed a significant mean delta value reduction in headache frequency (delta difference 3.53 [95% confidence interval 2.52–4.54]; p < 0.0001), headache intensity (1.31 [0.60–2.01]; p = 0.0004), HIT score (8.0 [4.78–11.22]; p < 0.0001), MIDAS score (7.85 [4.98–10.97]; p < 0.0001), and pill count (2.28 [1.06–3.51]; p < 0.0003).ConclusionYoga as an add-on therapy in migraine is superior to medical therapy alone. It may be useful to integrate a cost-effective and safe intervention like yoga into the management of migraine.Clinicaltrials.gov identifierCTRI/2017/03/008041.Classification of evidenceThis study provides Class III evidence that for patients with episodic migraine, yoga as adjuvant to medical therapy improves headache frequency, intensity, impact, and disability.
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Buchanan, Taneisha S., Carla J. Berg, Lisa Sanderson Cox, et al. "Adherence to Varenicline Among African American Smokers: An Exploratory Analysis Comparing Plasma Concentration, Pill Count, and Self-report." Nicotine & Tobacco Research 14, no. 9 (2012): 1083–91. http://dx.doi.org/10.1093/ntr/ntr333.
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El Zubier, A. G., A. A. Husain, I. A. Suleimati, and Z. A. Hamid. "Drug compliance among hypertensive patients in Kassala, Eastern Sudan." Eastern Mediterranean Health Journal 6, no. 1 (2000): 100–105. http://dx.doi.org/10.26719/2000.6.1.100.
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A cross-sectional study of hypertensive patients was conducted and drug compliance was estimated. Factors associated with compliance, status of blood pressure control and occurrence of complications were assessed. Compliance was 59.6% as measured with the pill count method. We found 92% of compliant patients had controlled blood pressure in comparison with 18% of non-compliant patients, and 30.1% of the compliant patients had complications in comparison with 46.3% of the non-compliant patients. While the compliance rate was reasonable, 36.8% of patients were non-compliant because they could not afford to buy antihypertensive drugs. Inability to buy drugs was negatively and significantly associated with compliance. These patients experienced uncontrolled blood pressure and other complications
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Mariana, N., V. Lisdawati, S. Maemun, et al. "Evaluation of Adherence, Virology and Imunology Response in HIV Patients Treated with a Once Daily Fixed Dose Combination (FDC) and a Free Combination of Antiretroviral." Advanced Science Letters 24, no. 8 (2018): 6143–46. http://dx.doi.org/10.1166/asl.2018.12656.
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A once daily FDC is a treatment strategy to reduce both the pill burden and the dosing frequency. This study to evaluate the adherence, virology and immunology response in patients treated with a once daily FDC (single pill) and free combination of antiretroviral (more than one pill). A cross sectional study on adults HIV–infected (aged >18 years old) in Sulianti Saroso Hospital, ARV–naïve patients for 12 months of treatment, receiving the first line ARV bases on Tenovofir and Efavirenz in the form of once daily FDC and a free combination of ARV. Ninety eight patients (a once daily FDC group consist of 78 patients and a free combination group consist of 20 patients) were recruited during the period of July to October 2017. The proportion of patients with good adherence (≥95%) after 12 months of once daily FDC treatment group was 98,7%, and a free combination group was 100%. The proportion of patients with an undetectable viral load to a once daily FDC treatment group was 80%, and a free combination group was 85,5%. The viral load and adherence were not significantly different statistically in two groups (Fisher Exact, p value >0,05) at 12 months of treatment and there was no significant difference in the increase in CD4 cell count at 6 months between those 2 groups at 6 months of treatment (Chi-Square p = 0,723). A once daily FDC treatment strategy and a free combination of ARV have the same benefits toward adherence, immunology response at 6 months therapy and virology response in HIV patients during 12 months of therapy. Confirmatory studies with similar proportion of patients between the two groups are needed to clarify the benefits of adherence, immunology and virology response.