Articles de revues : « Patients adherence »

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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 et Yana G. Voronko. « Medication adherence in patients with stable coronary artery disease in primary care ». Research Results in Pharmacology 6, n^o 2 (30 juin 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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Algarni, Majed A., Meznah S. Althobiti, Sarah A. Alghamdi, Huriyyah A. Alotaibi, Ohoud S. Almalki, Adnan Alharbi et Mohammad S. Alzahrani. « Medication Non-Adherence among Patients with Chronic Diseases in Makkah Region ». Pharmaceutics 14, n^o 10 (22 septembre 2022) : 2010. http://dx.doi.org/10.3390/pharmaceutics14102010.

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Background: The Makkah region is the most populated region in Saudi Arabia. Studying medication adherence levels may help to improve general health outcomes and decrease overall health care expenditures. Methods: We used the ARMS scale to assess medication adherence. Bivariable analysis of medication non-adherence was performed. Simple and multiple logistic regression models were built to identify factors associated with medication non-adherence. Results: Participants from the Makkah region were more than two times more likely to be non-adherent to their medications compared to other regions (adjusted OR = 2.58, 95% CI: 1.49–4.46). Patients who dispensed their prescriptions at their own expense were two times more likely to be non-adherents (adjusted OR = 2.36, 95% CI: 1.11–4.98). Patients who had a monthly income ≤6000 SR were almost two times more likely to be non-adherents (unadjusted OR = 1.73, 95% CI: 1.05–2.84). Conclusion: Medication adherence is one of the most important factors to help managing the disease. We found that Makkah chronic patients are more likely to be non-adherent with their medications compared to other regions’ patients. Moreover, we found that lower monthly incomes and paying for medications out-of-pocket were significant predictors of medication non-adherence.

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Volpi, Simiane Salete, Daiana Biduski, Ericles Andrei Bellei, Danieli Tefili, Lynn McCleary, Ana Luisa Sant’Anna Alves et Ana Carolina Bertoletti De Marchi. « Using a mobile health app to improve patients’ adherence to hypertension treatment : a non-randomized clinical trial ». PeerJ 9 (28 mai 2021) : e11491. http://dx.doi.org/10.7717/peerj.11491.

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Poor adherence to hypertension treatment increases complications of the disease and is characterized by a lack of awareness and acceptance of ongoing treatment. Mobile health (mHealth) apps can optimize processes and facilitate access to health information by combining treatment methods with attractive solutions. In this study, we aimed at verifying the influence of using an mHealth app on patients’ adherence to hypertension treatment, also examining how user experience toward the app influenced the outcomes. A total of 49 participants completed the study, men and women, diagnosed with hypertension and ongoing medical treatment. For 12 weeks, the control group continued with conventional monitoring, while the experimental group used an mHealth app. From the experimental group, at baseline, 8% were non-adherent, 64% were partial adherents and 28% were adherent to the treatment. Baseline in the control group indicated 4.2% non-adherents, 58.3% partial adherents, and 37.5% adherents. After follow-up, the experimental group had an increase to 92% adherent, 8% partially adherent, and 0% non-adherent (P < 0.001). In the control group, adherence after follow-up remained virtually the same (P ≥ 0.999). Results of user experience were substantially positive and indicate that the participants in the experimental group had a satisfactory perception of the app. In conclusion, this study suggests that using an mHealth app can empower patients to manage their own health and increase adherence to hypertension treatment, especially when the app provides a positive user experience.

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Martsevich, S. Yu, Yu V. Lukina, N. P. Kutishenko, N. A. Dmitrieva, S. V. Blagodatskikh, O. V. Lerman, T. A. Gomova et al. « Adherence to Statins Therapy of High and Very High Cardiovascular Risk Patients in Real Clinical Practice : Diagnostics and Possible Ways to Solve the Problem (According to the PRIORITY Observational Study) ». Rational Pharmacotherapy in Cardiology 14, n^o 6 (5 janvier 2019) : 891–900. http://dx.doi.org/10.20996/1819-6446-2018-14-6-891-900.

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Aim. To study adherence to treatment with generic statins prescribed to patients with high and very high cardiovascular risk in routine clinical practice, as well as the possible impact of educational training of doctors on compliance with clinical guidelines and changes in patient adherence to treatment. Material and methods. The study was prospective, with educational training for physicians on the main provisions of current clinical guidelines prior to the program. It included 3 visits over 12 weeks: inclusion visit (V0), and visits after 1 and 3 months of follow-up (V1 and V3). The use of generic atorvastatin or rosuvastatin was recommended for all patients. To assess adherence the following surveys were used: medical survey (all visits), the original questionnaire to assess the potential and the actual commitment to taking statins and the causes of non-adherence, and the Morisky-Green 8-question test (visits V0 and V3) to evaluate overall adherence to drug treatment. The patients who started the drug taking according to the medical recommendations and continued it during the study were considered as adherents. Patients who started but stopped taking the drug for 12 weeks were considered as partially non-adherent. Patients who refused to take the recommended statin were considered as non-adherents. The prescribed doses of statins and medical tactics in the titration of doses, as well as the achievement of the target level of low-density lipoprotein cholesterol (LDL cholesterol) were evaluated. Results. 112 (37.5%) of the 298 patients with baseline indications for taking statins did not take these drugs. According to the medical survey at V0 a total of 286 (96%) patients were potential adherents to medical recommendations; at V3 262 (88%) patients were adherent to statin treatment; 34 patients were partially non-adherent, 1 – was non-adherent, and 1 – dropped out of the study immediately after V0. According to the original questionnaire, potential adherence was assessed in 281 patients: 244 (86.8%) were potentially adherent, 37 (13.2%) – partially non-adherent. At V3, out of 294 patients who filled in the original questionnaire, 260 (88.5%) were adherent, 26 (8.8%) – partly non-adherent, 8 (2.7%) – nonadherent. The Morisky-Green questionnaire was filled in by 292 patients: at V0, 106 patients (36.3%) had treatment adherence, non-adherence – 186 patients (63.7%). By V3, an increase in total adherence was found: 159 patients (54.5%) were adherent, and 133 (45.5%) – non-adherent. The lipid profile was evaluated in 231 patients in V1 and in 285 ones – in V3. The target LDL cholesterol level was reached by V1 in 47 (20.3%) patients, and in 184 (79.7%) patients – was not. Dose titration occurred in 56 patients. By V3, 121 (42.4%) patients reached the target level of LDL cholesterol, and 164 – did not. The results of the lipid profile analysis were erroneously interpreted in 21 patients. Conclusion The results of the medical survey and the original questionnaire for assessing adherence predominantly coincided. The Morisky-Green test does not accurately reflect patients' commitment to taking a particular drug. Clinical inertness of doctors in the titration of statin doses and achievement of target LDL cholesterol levels were found as well as erroneous interpretation of the LDL cholesterol level. Educational trainings for doctors had a positive effect on the implementation of clinical guidelines, and also contributed to increasing patient adherence to medical recommendations.

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Prunerová, Anna, Tereza Nováková, Karel Kupka et Petra Reckziegelová. « Patients’ adherence to physiotherapy ». Rehabilitace a fyzikální lékařství 28, n^o 2 (16 juillet 2021) : 89–95. http://dx.doi.org/10.48095/ccrhfl202189.

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Park, Yongwhi, Yong-Hwan Park et Ki-Soo Park. « Determinants of Non-Adherences to Long-Term Medical Therapy after Myocardial Infarction : A Cross-Sectional Study ». International Journal of Environmental Research and Public Health 17, n^o 10 (20 mai 2020) : 3585. http://dx.doi.org/10.3390/ijerph17103585.

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Purpose: Non-adherence to medications can be classified as unintentional and intentional. The aim of this study was to establish the major determinants of each non-adherence in myocardial infarction (MI). We also evaluated the effects of non-adherences on healthy behaviors. Materials and Methods: We enrolled 510 patients >1 year after MI. Nonadherences classified as unintentional or intentional were measured by a self-reported questionnaire. Polynomial and multiple regression analysis were performed to evaluate the determinant of each type of nonadherences. Results: Among patients with nonadherence, 263 (70.7%) patients were unintentionally non-adherent while 109 (29.3%) patients were intentionally non-adherent. Psychological belief and attitude were important in unintentional non-adherence (Exp(β) = 0.917, p = 0.050 for anxiety; Exp(β) = 1.191, p = 0.001 for concerns). Beliefs about medications were the strongest determinant of intentional non-adherence (Exp(β) = 0.812, p < 0.001 for necessity; Exp(β) = 1.421, p < 0.001 for concerns). Anxiety was important determinant of intentional non-adherence (Exp(β) = 0.889, p = 0.015). Conclusion: Psychological factors and beliefs about medication were important determinants of both types of non-adherence. Combined approaches targeting the beliefs about medications and psychological distress are needed to improve drug adherence in patients with MI.

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Kumar, Manan Abhay, Sahana S et Soumya K. N. C. R. Manjunath. « Medication Adherence of TB Patients using IoT ». International Journal of Trend in Scientific Research and Development Volume-2, Issue-4 (30 juin 2018) : 677–83. http://dx.doi.org/10.31142/ijtsrd13049.

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Mohammad Javad Hashemi, Mohammad Manaf, Bhanu Priya HR, Laween Merris Lenos, Prabhu M et Ragunatha S. « A descriptive study of factors associated with anti-fungal medication adherence among patients with dermatophytosis ». International Journal of Research in Pharmaceutical Sciences 11, n^o 4 (20 décembre 2020) : 7027–33. http://dx.doi.org/10.26452/ijrps.v11i4.3806.

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The prevalence of superficial Mycotic infection worldwide is 20–25%. Medication non-adherence in patients leads to worsening of the disease, death and increased health care costs. More than 30% of medicine-related hospital admissions occur due to medication non-adherence. The aim of the study is assessing the factors associated with medication adherence in patients with dermatophytosis. Data were analyzed by using descriptive analysis of 305 patients attending the dermatology department. The period of study was three months. Medication adherence was determined using Morisky Green Levine Scale for dermatophytosis patients who are undergoing treatment. KAP (knowledge, attitude, practice) was used to determine the knowledge gaps, general health practice, and beliefs of the patient towards fungal infection. It was found that 47.86% of the subjects in the study are non- adherent and 49.50% are moderate adherents, and only 2.62% are highly adherent to medications prescribed. In KAP study, it was found that (14.4%) strongly agree that fungal infection does not create hindrance in normal life, while (28.85%) strongly disagree. Practice where analyzed in 305 subjects, (52.13%) share clothing with family members or friends, (50.16%) do not take medication as prescribed. The patient affected with fungal infections had poor adherence to the medicines prescribed. The risk factors affecting medication adherence are poor hygiene, sharing of cloths of friends or family, dosing schedule, complex regimens, access barriers, and cost of the drug. Patient education, in the early stages of fungal infection, can avoid non- adherence.

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Rabba, Abdullah K., Waleed S. Aljiris, Nehad J. Ahmed et Khalid M. Alkharfy. « MEDICATION ADHERENCE ‎IN TYPE 2 DIABETIC PATIENTS : A STUDY IN SAUDI ARABIA‎ ». International Journal of Pharmacy and Pharmaceutical Sciences 9, n^o 10 (1 novembre 2017) : 247. http://dx.doi.org/10.22159/ijpps.2017v9i11.16963.

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Objective: To assess the extent of antidiabetic drug adherence in patients with type 2 diabetes mellitus, and different factors affecting adherence in outpatient clinics in Alkharj city, Kingdom of Saudi Arabia. Methodology: Type 2 diabetic patients attending two outpatient clinics in Alkharj city, KSA, were randomly selected, and interviewed for information regarding their antidiabetic drug adherence. A six-item questionnaire was used to measure the level of adherence in study participants. Participants scoring six points are categorized as (high adherent), while scores of 4 to 5 puts the participants in the (medium adherence) category, and participants with scores less than 4 are of (Low adherence). Patient’s records were also, reviewed, for relevant lab and clinical data.Results: 68 type 2 diabetic patients participated in this study from April 2014 to September 2014. Majority of participants (73.5%) were of 40 to 60 years old. Hypertension and/or lipid disorders were encountered in majority of patients in this study. 26.5% of patients in this study were categorized as (high adherent), 55.9% as (medium adherent), and 17.6% as (low adherent). 72% of patients had an HbA1c level of ≥7% suggesting poor control of their disease. Patients with a longer history of diabetes, and patients with HbA1c level less than 7% found to achieve better adherence levels (p-value<0.05). Conclusion: Subjective information from patients suggested accepted level of adherence. Nevertheless, objective measurements of HbA1c, suggest poor glycemic control that possibly reflect poor adherence to antidiabetic medications.

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Mukherjee, Dibyendu, Suman Naiya, Suvajit Chakraborty, Rahul D. Chakrabarty et Sucharita Patra. « Adherence to methotrexate therapy among rheumatoid arthritis patients in Eastern India ». International Journal of Advances in Medicine 7, n^o 6 (22 mai 2020) : 899. http://dx.doi.org/10.18203/2349-3933.ijam20202066.

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Background: This study aims to identify adherence rate of methotrexate (MTX) therapy in rheumatoid arthritis (RA) patients of Eastern India and recognize factors contributing to treatment adherence in those patients.Methods: In this cross-sectional observational study, a total of 140 patients (17 males, 123 females; mean age 37.6±7.4 years) with pre-diagnosed RA attending the rheumatology outpatients clinic between February 2019 and January 2020 fulfilling the inclusion and exclusion criteria, were included. The patients were evaluated in terms of sociodemographic factors, clinical and medication details, disease activity score (DAS28-CRP) values and patient - doctor considerations that might contribute to treatment adherence. They filled out a series of standardised present questionnaires including the Morisky 8-item Medication Adherence Scale (MMAS-8). Data was analysed statistically and compounded.Results: Of the patients, 29 (20.7%) were adherent and 111 (79.3%) were non-adherent to medication with MTX. 65% were on MTX monotherapy and 35% on polytherapy with csDMARDs. 45.7% of the non-adherent forgot taking medication, 50.7% skipped during travel, 79.3% intentionally did not comply with strict regimen. The DAS28-CRP scores were much higher amongst non-adherent group and fewer reached remission as compared to adherent participants. Commonest reason for non-adherence being adverse drug reaction and financial constraints. Conclusions: This study showed a significantly higher adherence to MTX treatment compared to most previous studies. Adverse drug reactions, financial constraints, complex treatment regimen, long treatment duration, and frequent travel history significantly affect medication adherence in this patient population. Higher the adherence better the treatment response.

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Tirkey, Mukta Aurelia, et Agnes Elizabeth Jose. « Adherence to Psychotropic Drugs among Patients with Psychiatric Disorders ». RGUHS Journal of Nursing Sciences 12, n^o 2 (2022) : 202–6. http://dx.doi.org/10.26715/rjns.12_2_9.

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Background: Even though psychotropic medication is an effective treatment modality, high rates of nonadherence to these medications is common among patients with psychiatric disorders. One of the biggest challenges in treating psychiatric patients is lack of medication adherence which can lead to relapse, rehospitalisation and poor quality of life. Aims: To assess adherence to psychotropic medications among psychiatric patients. Materials and Methods: The study adopted descriptive cross sectional design. The sample comprised of 300 psychiatric patients who visited the Out Patient Department of Psychiatry at a selected hospital. The Medication Adherence Rating Scale (MARS) was used to assess the level of adherence to medication. Results: A total of 300 patients participated in the study. Majority (62.7%) of the subjects were adherent and 37.3% of the subjects were non-adherent to psychotropic drugs. The mean adherence score was 6.26 (±2.35). The study revealed that there was a significant association of adherence to psychotropic drugs and patients place of living (p=.044). Conclusion: In treating psychiatric patients, non-adherence to medicines is a significant challenge faced by healthcare professionals and it results in poor outcome.

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Egorova, E., N. Nikitina et A. Rebrov. « AB0187 ASSESSMENT OF ADHERENCE TO TREATMENT OF PATIENTS WITH RHEUMATOID ARTHRITIS (RA) ». Annals of the Rheumatic Diseases 79, Suppl 1 (juin 2020) : 1393.1–1393. http://dx.doi.org/10.1136/annrheumdis-2020-eular.1780.

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Background:Rheumatoid arthritis (RA) is the most common chronic immune inflammatory disease. The effectiveness of RA therapy largely depends on adherence to treatment. Non-compliance with the recommendations of the doctor leads to increased disease activity, a greater risk of complications and the increase in the cost of treatment.Objectives:To determine predictors of adherence to treatment of patients with RA.Methods:The study included 82 women with reliable RA according to the criteria of ACR1987 and / or EULAR / ACR2010 (mean age 53.3 ± 10.2 years, the age at the onset of the disease is 42.4 [36;51] years, mean duration of RA - 10.8 [6;14] years, DAS28 - 5.03 [4.3;5.8]). Treatment adherence was assessed according to the questionnaire “Quantitative Evaluation of Adherence to Treatment (KOP - 25)” [1]. The following indicators were calculated: adherence to drug therapy, adherence to medical support, adherence to lifestyle modification and their integral index. For all indicators, the level of values in the range up to 50% is interpreted as “low” («non-adherence to treatment»), from 51 to 75% - as “medium”, more than 75% - as “high”(«adherence to treatment»). The functional ability of patients was assessed by the Health Assessment Questionnaire (HAQ). The severity of pain was determined by VAS. Statistical processing was performing using the program STATISTICA 10.0.Results:Adherence to drug therapy in women with RA was determined: low adherence in 32 (39%) patients, average in 34 (41.5%) patients and high in 16 (19.5%) patients; adherence to medical support: low in 26 (31.7%) patients, average in 40 (48.8%) patients, and high in 16 (19.5%) patients; adherence to lifestyle modification: low in 55 (67%) patients, average in 25 (30.5%) patients and high in 2 (2.5%) patients. According to the integral indicator of adherence to treatment, 34 (41.5%) patients were not adherent to treatment, average adherence was recorded in 42 (51.2%) patients, and high in 6 (7.3%) patients.The HAQ functional impairment was absent in 7 (8.5%) patients, minimal impairment occurred in 26 (31.7%), moderate - in 40 (48.8%) and severe - in 9 (11%) patients.Severe pain in the VAS was noted by 29 (35.4%) patients, moderate - 39 (47.6%), in 14 (17%) patients the pain syndrome was weakly expressed.The relationships of adherence to treatment was established with age (r = -0.29, p <0.05), age at the onset of the disease (r = -0.28, p <0.05), HAQ index (r = -0.27, p <0.05), the number of swollen joints (r = -0.3, p <0.05).Patients under age of 39 years were the most adherence to drug therapy.In patients with medium and high adhering to treatment, the severity of pain according to VAS was significantly lower than in non-adherent patients (50.6 [34;66] and 60.4 [46;73], respectively, p = 0.04), In patients with treatment adherence, activity was significantly lower than in non-treatment adherents (DAS 28 (4.7 [3.5;5.4] and 5.3 [4.7;5.9], respectively, p = 0.04).Conclusion:Low treatment adherence has 41,5% of RA patients. Predictors of adherence to treatment are the young age patients, the onset of the disease before age of 39 years. Non-treatment patients with RA have a higher activity of RA according to DAS28, pain intensity according to VAS, the worst functional status. To increase the effectiveness of treatment, constant interaction between the patient and the physician is necessary, explaining to patients the consequences of non-compliance with recommendations.References:[1]Nikolaev N. A., Skirdenko Yu. P. Russian universal questionnaire for the quantitative evaluation of adherence to treatment (KOP - 25). Clinical pharmacology and therapy. 2018;27(1): 74-78.Disclosure of Interests:None declared

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Guseinova, E. T., Yu V. Lukina, N. P. Kutishenko, S. N. Tolpygina, V. P. Voronina, O. M. Drapkina et S. Yu Martsevich. « Adherence to therapy and the risk of cardiovascular events in patients with heart failure : data from the outpatient registry ». Cardiovascular Therapy and Prevention 21, n^o 10 (3 novembre 2022) : 3389. http://dx.doi.org/10.15829/1728-8800-2022-3389.

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Aim. To determine the adherence to drug therapy and the prevalence of cardiovascular events (CVEs) in patients with heart failure (HF) after a 1-year follow-up in a specialized cardiology unit of a research center.Material and methods. CVEs were analyzed within the prospective observational study COMPLIANCE (Assessment of adherenСe tO Medical theraРy and its infLuence on long-term outcomes In pAtieNts with Chronic hEart failure in the outpatient registry). The study included 72 patients with HF, verified according to clinical guidelines. Patients were divided into 2 groups: adherent and non-adherent to treatment. Overall adherence to therapy and adherence to specific drugs were assessed using the original National Society for Evidence-Based PharmacotherapyAdherence Scale. The study included 2 visits: inclusion in the study and a visit after 1-year follow-up. After a 1-year follow-up, a comparative analysis of the two groups was performed to achieve the primary composite endpoint: death, acute cerebrovascular accident, myocardial infarction, decompensated HF with and without hospitalization.Results. A Kaplan-Meier analysis of 1-year survival showed that the mean time to onset of primary composite endpoint was 10,2 (95% confidence interval: 9,5-10,8) months. A significant relationship was found between the occurrence of composite endpoint and adherence to angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (p=0,001), which was not confirmed for beta-blockers and mineralocorticoid receptor antagonists (p=0,338 and p=0,335, respectively). The risk of composite endpoint was 3,6 times higher in non-adherent patients than in adherent patients (hazard ratio, 3,6; 95% confidence interval, 1,5-8,5 (p=0,003)).Conclusion. A significant relationship was found between nonadherence to treatment and the incidence of CVEs, the risk of which increases by 3,6 times in non-adherent patients compared with adherent patients with HF.

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Permatananda, Pande Ayu Naya, Putu Indah Budi Apsari et Saktivi Harkitasari. « MEDICATION ADHERENCE AND QUALITY OF LIFE AMONG EPILEPSY PATIENTS : A CROSS SECTIONAL STUDY ». International Journal of Research -GRANTHAALAYAH 7, n^o 3 (31 mars 2019) : 1–10. http://dx.doi.org/10.29121/granthaalayah.v7.i3.2019.937.

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Background: Among the cause of the treatment failure in epilepsy, low adherence to prescribed medication is the principal cause of unsuccessful drug treatment. The aim of this study was to assess the level of adherence and the relations with quality of life among epilepsy patients in Denpasar. Method: Our research based on cross sectional design and conducted in neurology department of tertiary referral hospital in Denpasar. We used Morisky Medication Adherence Scale (MMAS) to measure level of adherence and World Health Organization (WHOQOL-BREF) questionnaire to assess quality of life (QOL) score. Results: On this research, we found 83 epilepsy patients who fulfilled eligibility criteria, there are 43 patients categorized as non-adherent and 39 patients belong to adherent. Based on the cross tabulation between characteristic of participants and adherence, we found that age and duration of therapy influence the adherence level of epilepsy patient (p value < 0.05). Epilepsy patients who adherent to the treatment have higher score of QOL than epilepsy patients who not adherent, especially on physical domain of QOL, the difference was statistically significant (p value < 0.05). Conclusion: Improving adherence is so important to improve the quality of life of epilepsy patients.

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Permatananda, PandeAyuNaya, Putu Indah Budi Apsari et SaktiviHarkitasari. « MEDICATION ADHERENCE AND QUALITY OF LIFE AMONG EPILEPSY PATIENTS : A CROSS SECTIONAL STUDY ». International Journal of Research -GRANTHAALAYAH 7, n^o 4 (30 avril 2019) : 1–10. http://dx.doi.org/10.29121/granthaalayah.v7.i5.2019.865.

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Background: Among the cause of the treatment failure in epilepsy, low adherence to prescribed medication is the principal cause of unsuccessful drug treatment. The aim of this study was to assess the level of adherence and the relations with quality of life among epilepsy patients in Denpasar. Method: Our research based on cross sectional design and conducted in neurology department of tertiary referral hospital in Denpasar. We used Morisky Medication Adherence Scale (MMAS) to measure level of adherence and World Health Organization (WHOQOL-BREF) questionnaire to assess quality of life (QOL) score. Results: On this research, we found 83 epilepsy patients who fulfilled eligibility criteria, there are 43 patients categorized as non-adherent and 39 patients belong to adherent. Based on the cross tabulation between characteristic of participants and adherence, we found that age and duration of therapy influence the adherence level of epilepsy patient (p value < 0.05). Epilepsy patients who adherent to the treatment have higher score of QOL than epilepsy patients who not adherent, especially on physical domain of QOL, the difference was statistically significant (p value < 0.05). Conclusion: Improving adherence is so important to improve the quality of life of epilepsy patients.

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Herrero, María Belén, Silvina Ramos et Silvina Arrossi. « Determinants of non adherence to tuberculosis treatment in Argentina : barriers related to access to treatment ». Revista Brasileira de Epidemiologia 18, n^o 2 (juin 2015) : 287–98. http://dx.doi.org/10.1590/1980-5497201500020001.

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OBJECTIVE: To identify the association between non-adherence to tuberculosis treatment and access to treatment. METHODS: A cross-sectional study was carried out in the Metropolitan Area of Buenos Aires, Argentina. One hundred twenty three patients notified in 2007 (38 non adherent and 85 adherents) were interviewed regarding the health care process and socio-demographic characteristics. Factors associated to non-adherence were assessed through logistic regression analysis. RESULTS: An increased risk of non-adherence with to treatment was found in male patients (OR = 2.8; 95%CI 1.2 - 6.7), patients who had medical check-ups at hospitals (OR = 3.4; 95%CI 1.1 - 10.0) and those who had difficulties with transportation costs (OR = 2.5; 95%CI 1.1 - 5.9). CONCLUSION: Risk of non-adherence increases as a result of economic barriers in accessing health care facilities. Decentralization of treatment to primary health care centers and social protection measures for patients should be considered as priorities for disease control strategies in order to lessen the impact of those barriers on adherence to treatment.

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Martsevich, S. Yu, Yu V. Lukina, N. P. Kutishenko, S. N. Tolpygina, V. P. Voronina, N. A. Dmitrieva, O. V. Lerman et N. A. Komkova. « Adherence to Treatment with New Oral Anticoagulants in Atrial Fibrillation Patients in Real Clinical Practice (Results of the ANTEY Study) ». Rational Pharmacotherapy in Cardiology 15, n^o 6 (3 janvier 2020) : 864–72. http://dx.doi.org/10.20996/1819-6446-2019-15-6-864-872.

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Aim. To study adherence to treatment with new oral anticoagulants (NOAC) and factors associated with it in patients with non-valvular atrial fibrillation (AF) within the outpatient PROFILE registry.Material and methods. ANTEY study included 201 patients with AF from the PROFILE registry (89.3%): 118 males (58.7%) and 83 females (41.3%), aged 71.1Ѓ}8.7 years. The study consisted of two visits half a year apart (V0, V1) and a phone contact (PC) one year after V0. During V0 all patients were recommended to start therapy with one of the NOACs. Adherence to therapy was assessed during all visits with the use of the original questionnaire – National society of evidence-based pharmacotherapy (NSEPh) adherence scale, 8-item Morisky Medical Adherence Scale (MMAS-8) and direct doctors’ questioning.Results. During V0 111 (55.2%) patients were recommended the use of rivaroxaban; 47 (23.4%) – the use of dabigatran and 43 (21.4%) – the use of apixaban. During V1 based on the results of the NSEPh adherence scale 155 (77.5%) patients were completely adherent (strictly followed doctors’ recommendations), 5 patients were partially adherent (violated doctors’ recommendations), 7 patients were partially non-adherent (stopped taking NOACs), and 33 patients were completely non-adherent (did not start taking NOACs). Out of 197 patients who completed MMAS-8 questionnaire 157 (79.7%) patients were partially adherent to treatment and 40 (20.3%) patients were non-adherent. None of the patients were completely adherent to treatment. According to doctors’ questioning, by the time of the PC 15 patients had not started taking the recommended NOAC – were completely non-adherent (CNA). According to the NSEPh adherence scale, by the time of the PC out of 197 patients (4 patients died) 158 patients were completely adherent to treatment, 6 – partially adherent, 18 – partially non-adherent and 15 – CNA. According to MMAS-8, by the time of the PC 153 (77.7%) patients were partially adherent to treatment, and 44 (22.3%) patients – non-adherent (none of the patients were completely adherent). Out of 15 CNA patients MMAS-8 revealed only 4 (27,6%) during B1, and 6 (40%) during the PC. NSEPh adherence scale revealed all CNA patients. The main reason for refusing to start NOAC therapy was their high price. Recently started use of NOACs was stopped mostly due to adverse effects of therapy (bleeding). The most common factors increasing patients’ adherence to NOACs were previous experience of taking this group of drugs and no history of any adverse effects during therapy.Conclusion. The ANTEY study showed relatively high adherence to NOACs prescribed by doctors of the specialized cardiology department of the scientific center. The most common factors associated with early non-adherence to the new drug were high price and adverse effects of therapy, the latter influenced prolonged adherence as well. Previous experience of taking this group of drugs and no history of any adverse effects during therapy increased adherence to NOACs.

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Chung, Misook L., Linda Park, Susan K. Frazier et Terry A. Lennie. « Long-Term Adherence to Low-Sodium Diet in Patients With Heart Failure ». Western Journal of Nursing Research 39, n^o 4 (10 janvier 2017) : 553–67. http://dx.doi.org/10.1177/0193945916681003.

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Although following a low-sodium diet (LSD) for heart failure (HF) has been recommended for decades, little is known about factors related to long-term patient adherence. The purposes of this study were to (a) compare sodium intake and factors affecting adherence in a long-term adherent group and in a non-adherent group and (b) examine predictors of membership in the long-term adherent group. Patients with HF ( N = 74) collected 24-hr urine samples and completed the Dietary Sodium Restriction Questionnaire and the Patient Health Questionnaire-9. Long-term adherence was determined using the Stage of Dietary Behavior Change Scale. The long-term adherent group had lower sodium intake (3,086 mg vs. 4,135 mg, p = .01) and perceived more benefits from LSD than the non-adherent group. Only positive attitudes toward LSD predicted membership in the long-term adherence group (odds ratio [OR] = 1.18, p = .005). Interventions focused on enhancing positive perceptions of the benefits of an LSD may improve long-term dietary adherence in patients with HF.

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Silva, Rui, Joana Bicker, Anabela Almeida, Andreia Carona, Ana Silva, Francisco Sales, Isabel Santana, Amílcar Falcão et Ana Fortuna. « Clinical Application of Pharmacokinetics to Appraise Adherence to Levetiracetam in Portuguese Epileptic Patients ». Biomedicines 10, n^o 9 (30 août 2022) : 2127. http://dx.doi.org/10.3390/biomedicines10092127.

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Adherence to antiseizure drug treatment determines its effectiveness and safety, and consequently affects patients’ quality of life. Herein, we assessed adherence to levetiracetam in Portuguese patients with refractory epilepsy (n = 115), with resort to a pharmacokinetic drug monitoring approach. The pharmacokinetic parameters of levetiracetam in each patient were determined in steady-state while admitted to the hospital. Then, adherence was assessed by comparing the plasma concentration of the drug observed on the first day of hospitalization with the predicted plasma concentration, considering previously determined pharmacokinetic parameters. The rate of adherence was assessed according to gender, age, diagnosis, and antiseizure drug regimen. Among 115 enrolled patients, 49 (42.6%) were identified as non-adherent, 30 (26.1%) classified as under-consumers, and 19 (16.5%) as over-consumers. A relationship between adherence, daily dose and plasma concentrations was herein reported for the first time. Adherent patients received higher daily doses of levetiracetam [2500 (2000–3000) mg] than non-adherent over-consumers [1500 (1000–2000) mg] and non-adherent under-consumers [2000 (1500–3000) mg]. Higher average steady-state plasma concentrations of levetiracetam were found in non-adherent under-consumers [27.28 (15.33–36.36) mg/L], followed by adherent patients [22.05 (16.62–29.81) mg/L] and non-adherent over-consumers [17.50 (10.69–24.37) mg/L]. This study demonstrates that adherence (or lack thereof) influences the plasma concentrations of levetiracetam in steady-state and its pharmacological effects. Moreover, it emphasizes the importance of educating patients to encourage adherence to therapy. Otherwise, the risk of developing toxic and subtherapeutic concentrations is undeniable, compromising the therapeutic effect and safety of treatment.

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El-Missiry, A. « Comparing cognitive functions in medication adherent and non-adherent patients with schizophrenia ». European Psychiatry 33, S1 (mars 2016) : S97—S98. http://dx.doi.org/10.1016/j.eurpsy.2016.01.071.

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BackgroundMedication non-adherence presents a considerable problem in patients with schizophrenia. Cognitive and executive functions can affect adherence. The association between medication non-adherence and cognitive impairment in schizophrenia is under investigated with limited and conflicting research data.Purpose of the studyTo prospectively assess the rate of drug adherence among a sample of patients with schizophrenia and to compare the cognitive and executive functions between adherent and non-adherent patients.Subjects and methodsOne hundred and nine patients with schizophrenia diagnosed according to the DSM-IV classification were initially assessed by the Wechsler Adult Intelligence Scale (WAIS), Wechsler Memory Scale-Revised (WMS-R) and Wisconsin Card Sorting Test (WCST) and six months later by the Brief Adherence Rating Scale (BARS).ResultsAmong the patients, 68.8% were non-adherent to their antipsychotic medication. Adherent patients (31.2%) had significantly higher mean scores for the total, verbal and performance IQ. Moreover, they had significantly higher mean scores in most of WMS subtests (orientation, information, verbal paired association, digit span, visual memory span), and higher mean scores for; total correct, conceptual level response, percentage and categories completed on the WSCT subscales (P < 0.0001). Whereas the non-adherent group had higher mean scores in; trials administered, total errors, perseverative responses, and perseverative errors (P < 0.0001). In a step regression analysis, digit span, conceptualization, total and percentage of errors were putative predictors of non-adherence to antipsychotic medications.ConclusionCognitive deficits, especially verbal memory and executive functions were the strongest patients’ related factors associated with non-adherence to medication. Psychiatrists should consider possible cognitive factors influencing adherence to enable offering proper interventions.Disclosure of interestThe author has not supplied his declaration of competing interest.

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Choudhary, Ranju, et Ravikant Nirankari. « Study of Factors Affecting the Adherence to HAART in HIV Infected Children ». Journal of Evolution of Medical and Dental Sciences 11, n^o 3 (21 février 2022) : 415–19. http://dx.doi.org/10.14260/jemds/2022/80.

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BACKGROUND Adherence to medication, also known as compliance with medication, is the extent to which patients follow medical instruction.1,2 Adherence level of 90% or more is commonly cited as essential for HIV infected patients for maximum benefit of treatment. This level of adherence is also difficult to attain given that average adherence rate of 70-75% are found in primary care setting.3We wanted to evaluate the factors that affect the adherence to highly active antiretroviral therapy (HAART) in children and counselling of attendant, parents, or caregivers for better adherence to HAART. METHODS The children who were HIV positive (confirmed by ELISA for HIV-I/or HIV-II) had been the part of this study. Follow up questionnaire method was followed in this study for total 30 patients who were enrolled in this study. RESULTS >95% adherence level was found in 63% of patients in all six visits and all these patients had a better health status. Over all drug adherence level of >95% in all age group was found in 60% of patients. Adolescent patients were found to be of fluctuating nature. 71% male patients found to be >95% adherent while only 44% female patients were >95% adherent to HAART. Some patients were found to be 100% adherent and multiple factors were present. Adherence program and counselling was the most important factor that increases adherence level after regular visits. CONCLUSIONS Multiple factors affect the adherence to treatment and this is very difficult in children. KEY WORDS HIV, ART, ARV, HAART, Adherence, HIV Infected Children, STD.

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Murru, A., C. M. Bonnin, A. M. Nivoli, I. Pacchiarotti, E. Vieta et F. Colom. « Treatment non-adherence amongst schizoaffective bipolar patients : An unsolved question ». European Psychiatry 26, S2 (mars 2011) : 235. http://dx.doi.org/10.1016/s0924-9338(11)71945-9.

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IntroductionNon adherence to treatment is especially common in patients with chronic relapsing disorders. Schizoaffective disorder is a chronic, severe and disabling illness consisting of the concurrent presentation of symptoms of schizophrenia and affective disorders. Its course and prognosis has been found to be intermediate to those two conditions.ObjectivesTo evaluate treatment adherence in a schizoaffective sample and to which demographical and clinical variables it may be associated.MethodsAdherence to treatment and its clinical correlates were assessed in 69 patients meeting DSM-IV-TR diagnosis of schizoaffective disorder, bipolar type, by means of adherence-focused interviews, measurements of plasma concentrations of mood stabilizers.Adherent and poorly adherent patients were compared with respect to several clinical and treatment variables.ResultsPoorly adherent patients were 40% of the total sample. Demographic variables (i.e.: gender, marital status, cultural level, employment) were not associated to treatment adherence, nor were clinical variables (age at onset, polarity of the first episode, lifetime history of seasonal pattern, rapid cycling, atypical depression, melancholia, catatonia) or family history for generic psychiatric, affective disorders and suicide. No pharmacological treatment (atypical antipsychotic, mood stabilizer and antidepressant) was associated to adherence in our sample.ConclusionsClinical and demographical factors are not related to medication adherence in our sample. Coherently with the general severity of this condition, and since there does not seem to be any clinical predictor of poor adherence, in clinical practice all schizoaffective patients should be monitored and treated as potentially non-adherent.

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Boo, Sunjoo. « Factors Affecting Medication Adherence in Patients with Rheumatoid Arthritis ». Korean Journal of Health Promotion 20, n^o 4 (30 décembre 2020) : 203–10. http://dx.doi.org/10.15384/kjhp.2020.20.4.203.

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Background: Adherence to medication in patients with rheumatoid arthritis has been associated with decreased disease activity and morbidity in prior reports. However, adherence in this population remains suboptimal. This study evaluated the levels of medication adherence and determined the factors thereof in patients with rheumatoid arthritis.Methods: We analyzed cross-sectional data from 345 rheumatoid arthritis outpatients at a university-affiliated hospital. The level of medication adherence was then determined. Lastly, a multivariate logistic regression analysis was used to identify the predictors significantly associated with medication adherence.Results: Approximately 65% of the subjects were categorized as medication-adherent. In univariate analysis, educational level, perceived health, attitude toward medication, and level of learned helplessness all differed significantly between the adherent and nonadherent groups. When controlling for other factors, higher levels of learned helplessness significantly lowered the likelihood of patients’ adherence to medication in our cohort.Conclusions: Given that learned helplessness is modifiable, the results of this study suggest that interventions to decrease the degree of learned helplessness should be developed and implemented in order to increase the levels of medication adherence in patients with rheumatoid arthritis and improve clinical outcomes

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Camejo, Natalia, Cecilia Castillo, Clara Tambasco, Noelia Strazzarino, Nicolás Requena, Silvina Peraza, Anna Boronat et al. « Assessing adherence to adjuvant hormone therapy in breast cancer patients in routine clinical practice. » Journal of Clinical Oncology 40, n^o 16_suppl (1 juin 2022) : e12532-e12532. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e12532.

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e12532 Background: Adjuvant hormone therapy (HT) in patients with hormone receptor-positive breast cancer (BC) increases overall survival (OS). Adherence to HT in routine clinical practice is still poorly reported. Many BC patients are treated for other diseases and experience polypharmacy. Methods: Objective To assess adherence to HT in routine clinical practice.Materials and Methods: Adjuvant hormone therapy (HT) in patients with hormone receptor-positive breast cancer (BC) increases overall survival (OS). Adherence to HT in routine clinical practice is still poorly reported. Many BC patients are treated for other diseases and experience polypharmacy. Results: A total of 118 patients were included; 65.2% were treated with aromatase inhibitors (AI) and the rest with tamoxifen, with 36% presenting polypharmacy. Treatment adherence was observed in 81% of the patients, and it was associated with age (p=0.03, OR=0.96 for non-adherence), with adherent and non-adherent patients having a median age of 66 and 61.5 years, respectively; however, adherence was not associated with polypharmacy, territory of origin, marital status, living alone, level of education, occupation, or stage. The adherence profile was similar for both drugs, but homemakers and retired women showed greater adherence to AI. Conclusions: Adherence to HT was assessed in real life, with 19% of the patients not adhering to the treatment, despite the known benefit for OS, being a well-tolerated treatment, and being provided free of charge. The most adherent patients were the oldest. The results show the need to investigate the reasons for discontinuing HT, with Pharmacy and Medical Oncology fields combining efforts to develop coordinated strategies and interventions to increase adherence, given the impact that this may have on patients' OS.

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Camejo, Natalia, Cecilia Castillo, Clara Tambasco, Noelia Strazzarino, Nicolás Requena, Silvina Peraza, Anna Boronat et al. « Assessing adherence to adjuvant hormone therapy in breast cancer patients in routine clinical practice. » Journal of Clinical Oncology 40, n^o 16_suppl (1 juin 2022) : e12532-e12532. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e12532.

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e12532 Background: Adjuvant hormone therapy (HT) in patients with hormone receptor-positive breast cancer (BC) increases overall survival (OS). Adherence to HT in routine clinical practice is still poorly reported. Many BC patients are treated for other diseases and experience polypharmacy. Methods: Objective To assess adherence to HT in routine clinical practice.Materials and Methods: Adjuvant hormone therapy (HT) in patients with hormone receptor-positive breast cancer (BC) increases overall survival (OS). Adherence to HT in routine clinical practice is still poorly reported. Many BC patients are treated for other diseases and experience polypharmacy. Results: A total of 118 patients were included; 65.2% were treated with aromatase inhibitors (AI) and the rest with tamoxifen, with 36% presenting polypharmacy. Treatment adherence was observed in 81% of the patients, and it was associated with age (p=0.03, OR=0.96 for non-adherence), with adherent and non-adherent patients having a median age of 66 and 61.5 years, respectively; however, adherence was not associated with polypharmacy, territory of origin, marital status, living alone, level of education, occupation, or stage. The adherence profile was similar for both drugs, but homemakers and retired women showed greater adherence to AI. Conclusions: Adherence to HT was assessed in real life, with 19% of the patients not adhering to the treatment, despite the known benefit for OS, being a well-tolerated treatment, and being provided free of charge. The most adherent patients were the oldest. The results show the need to investigate the reasons for discontinuing HT, with Pharmacy and Medical Oncology fields combining efforts to develop coordinated strategies and interventions to increase adherence, given the impact that this may have on patients' OS.

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Pilon, Dominic, Joyce Lamori, Carmine Rossi, Isabelle Ghelerter, Xuehua Ke, Marie-Hélène Lafeuille, Lorie Ellis et Patrick Lefebvre. « Medication adherence among prostate cancer patients using advanced oral therapies. » Journal of Clinical Oncology 39, n^o 6_suppl (20 février 2021) : 44. http://dx.doi.org/10.1200/jco.2021.39.6_suppl.44.

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44 Background: Prostate cancer (PC) is associated with a high clinical and economic burden. Advanced oral (AO) therapies have become the standard of care for patients with advanced PC, but real-world data on treatment patterns and their impact on healthcare resource utilization (HRU) are lacking. This study aims to describe treatment adherence, factors associated with adherence, and its impact on HRU in patients with PC initiated on AOs. Methods: Adults with a PC diagnosis initiated on apalutamide, enzalutamide, or abiraterone acetate were identified using Symphony Health Solutions Patient Transactional Databases (10/01/2014-09/30/2019). Patients were included if they had ≥6 months of continuous clinical activity before and after AO initiation (index date) and no other cancer diagnoses. Adherence was defined using the proportion of days covered (PDC) by AOs during the 6-month period following the index date. Patients with a PDC≥80% were considered adherent. Multivariable logistic regression was used to evaluate baseline characteristics associated with AO adherence. All-cause and PC-related HRU was assessed from 6 to 18 months post-index and compared between adherent and non-adherent patients using multivariable Poisson regression. Results: A total of 27,322 patients initiated on an AO were identified. Most patients were aged ≥65 years (81%), were white (60%), had Medicare coverage (48%), and had metastatic PC (56%). At 6 months, 57% of patients were adherent to AOs. Patients aged 55-64 and 65-74 years had greater odds of being adherent versus those aged ≥75 years (24% and 22%, respectively), while Black patients had 17% lower odds of being adherent relative to white patients (all p<0.01). Medicare coverage was associated with 23% greater odds of being adherent relative to commercial insurance (p<0.01). Patients with a below median primary insurer paid amount for their first AO claim had 13% greater odds of being adherent relative to the above median amount (p<0.05). Adherent patients generally had fewer HRU compared to non-adherent patients. More specifically, adherent patients had 25% fewer all-cause inpatient days, 16% fewer all-cause emergency room (ER) visits, 18% fewer all-cause other non-outpatient services use, as well as 30% fewer PC-related inpatient days and 24% fewer PC-related ER visits (all p<0.01) relative to non-adherent patients. Conclusions: In this study, non-adherence over a 6-month period following AO initiation was associated with substantially higher HRU, including inpatient and ER visits. Moreover, non-adherence was widely observed, impacting over 40% of advanced PC patients in the first 6 months after AO initiation. Identifying factors linked to lower adherence and defining strategies to improve adherence may improve patient outcomes and associated medical resource utilization. (1)Abiraterone acetate plus prednisone is the approved therapy although the combination was not imposed.

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Wawruch, Martin, Jan Murin, Tomas Tesar, Martina Paduchova, Miriam Petrova, Denisa Celovska, Petra Matalova, Beata Havelkova, Michal Trnka et Emma Aarnio. « Adherence to Antiplatelet Medications among Persistent and Non-Persistent Older Patients with Peripheral Arterial Disease ». Biomedicines 9, n^o 12 (30 novembre 2021) : 1800. http://dx.doi.org/10.3390/biomedicines9121800.

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Secondary prevention of peripheral arterial disease (PAD) includes administration of antiplatelet agents, and adherence to medication is a requirement for an effective treatment. The aim of this study was to analyse adherence measured using the proportion of days covered (PDC) index separately in persistent and non-persistent patients, and to identify patient- and medication-related characteristics associated with non-adherence in these patient groups. The study cohort of 9178 patients aged ≥ 65 years in whom PAD was diagnosed in 1/–12/2012 included 6146 persistent and 3032 non-persistent patients. Non-adherence was identified as PDC < 80%. Characteristics associated with non-adherence were determined using the binary logistic regression model. In the group of persistent patients, 15.3% of subjects were identified as non-adherent, while among non-persistent patients, 26.9% of subjects were non-adherent to antiplatelet medication. Administration of dual antiplatelet therapy (aspirin and clopidogrel) and a general practitioner as index prescriber were associated with adherence in both patient groups. Our study revealed a relatively high proportion of adherent patients not only in the group of persistent patients but also in the group of non-persistent patients before discontinuation. These results indicate that most non-persistent PAD patients discontinue antiplatelet treatment rapidly after a certain period of adherence.

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Park, Sulki, Hye-Chung Kum, Michael A. Morrisey, Qi Zheng et Mark A. Lawley. « Adherence to Telemonitoring Therapy for Medicaid Patients With Hypertension : Case Study ». Journal of Medical Internet Research 23, n^o 9 (6 septembre 2021) : e29018. http://dx.doi.org/10.2196/29018.

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Background Almost 50% of the adults in the United States have hypertension. Although clinical trials indicate that home blood pressure monitoring can be effective in managing hypertension, the reported results might not materialize in practice because of patient adherence problems. Objective The aims of this study are to characterize the adherence of Medicaid patients with hypertension to daily telemonitoring, identify the impacts of adherence reminder calls, and investigate associations with blood pressure control. Methods This study targeted Medicaid patients with hypertension from the state of Texas. A total of 180 days of blood pressure and pulse data in 2016-2018 from a telemonitoring company were analyzed for mean transmission rate and mean blood pressure change. The first 30 days of data were excluded because of startup effects. The protocols required the patients to transmit readings by a specified time daily. Patients not transmitting their readings received an adherence reminder call to troubleshoot problems and encourage transmission. The patients were classified into adherent and nonadherent cohorts; adherent patients were those who transmitted data on at least 80% of the days. Results The mean patient age was 73.2 (SD 11.7) years. Of the 823 patients, 536 (65.1%) were women, and 660 (80.2%) were urban residents. The adherent cohort (475/823, 57.7%) had mean transmission rates of 74.9% before the adherence reminder call and 91.3% after the call, whereas the nonadherent cohort (348/823, 42.3%) had mean transmission rates of 39% and 58% before and after the call, respectively. From month 1 to month 5, the transmission rates dropped by 1.9% and 10.2% for the adherent and nonadherent cohorts, respectively. The systolic and diastolic blood pressure values improved by an average of 2.2 and 0.7 mm Hg (P<.001 and P=.004), respectively, for the adherent cohort during the study period, whereas only the systolic blood pressure value improved by an average of 1.6 mm Hg (P=.02) for the nonadherent cohort. Conclusions Although we found that patients can achieve high levels of adherence, many experience adherence problems. Although adherence reminder calls help, they may not be sufficient. Telemonitoring lowered blood pressure, as has been observed in clinical trials. Furthermore, blood pressure control was positively associated with adherence.

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V., Rakshitha B., Nalini G. K., Sahana G. N., Deepak P., Jayashree V. Nagaral, Mohith N. et Divyashree C. R. « Adherence to treatment in patients undergoing dialysis ». International Journal of Basic & ; Clinical Pharmacology 8, n^o 5 (23 avril 2019) : 1024. http://dx.doi.org/10.18203/2319-2003.ijbcp20191595.

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Background: Chronic Kidney Disease (CKD) is a silent disease that is frequently diagnosed in advanced stages. The prevalence and incidence of chronic kidney disease (end-stage renal disease) are continuously increasing, particularly in elderly patients. Poor adherence to complex multimodal therapies is a widely recognized problem in the daily care of dialysis patients, contributing to excess morbidity and mortality of this population. Aims and objectives was to assess the adherence to medications among patients undergoing haemodialysis and to explore the factors affecting non adherence.Methods: After obtaining approval from Institutional Ethics Committee, a prospective observational study was carried out among 150 patients, who were on dialysis in a tertiary care hospital, Hassan. An eight item Morisky Medication adherence questionnaire was used to assess medication adherence. Chi-square test applied to assess statistics.Results: Adherence levels were 28%, 42% and 30% for high, medium and poor adherence respectively. The overall prevalence of non-adherence among respondents was 30%. Among them 77.77% were males, 44.44% belonged to age group of 41-60 years, 40% illiterate, 60% employed, 51.11% of patients with smoking and alcoholic habits were not adherent to Dialysis. Other reasons contributing to non-adherence to treatment were forget fullness (86.66%), inadequate knowledge about side effects (80%), unhappy clinical visits (71.11%) and lack of assistance (48.88%).Conclusions: In this study patient showed moderate adherence. This emphasizes the need for constant motivation and education at frequent intervals to ensure better adherence.

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Nikitina, N. M., E. V. Egorova, I. F. Melehina, S. N. Grigoryeva et A. P. Rebrov. « Problems of treatment adherence in patients with rheumatoid arthritis and comorbidity ». Russian Archives of Internal Medicine 10, n^o 5 (9 octobre 2020) : 372–81. http://dx.doi.org/10.20514/2226-6704-2020-10-5-372-381.

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Aim of the study. Evaluation of treatment adherence in patients with rheumatoid arthritis (RA) and comorbidity.Materials and methods. One hundred thirty-two women (mean age: 55.5 ± 10.5 years) with proven RA (mean duration of disease: 10.2 [4; 14] years) were included in this study. Patients with moderate and high disease activity were prevalent (average DAS28: 5.0 [4.3; 5.8]). All patients had comorbidities. All patients underwent clinical examination, laboratory evaluation and imaging. Functional capacity was assessed using the Steinbroker classification (functional class — FC) and Stanford Health Assessment Questionnaire (HAQ). Pain severity was evaluated using visual analog scale (VAS). Patients’ social status was assessed. Baseline adherence to treatment was evaluated using two questionnaires. Morisky-Green questionnaire was used to evaluate general adherence to treatment among 132 (100%) patients. Quantitative evaluation of treatment adherence was performed in 82 (62.1%) patients using N.A. Nikolaev questionnaire.Results. Analysis of adherence to treatment as assessed by Morisky-Green questionnaire has established that 68 (52.3%) of patients are non-adherent to treatment. Low treatment adherence as assessed by Nikolaev questionnaire was found in 33 (40.3%) of patients. Lifestyle modification was characterized by lowest adherence. Young age, lower duration of disease and lower income were predictive of higher adherence to treatment. Non-adherent patients had higher RA activity index and lower functional capacity.Conclusion. Simultaneous use of several methods to assess treatment adherence is a reasonable way to get more information about the patient and to implement therapy as planned. Evaluation of baseline adherence to treatment among patients with rheumatoid arthritis allows to develop an optimal plan for follow-up and treatment control.

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Liquori, Gloria, Aurora De Leo, Emanuele Di Simone, Sara Dionisi, Noemi Giannetta, Elvira Ganci, Sherly Pia Trainito, Giovanni Battista Orsi, Marco Di Muzio et Christian Napoli. « Medication Adherence in Chronic Older Patients : An Italian Observational Study Using Medication Adherence Report Scale (MARS-5I) ». International Journal of Environmental Research and Public Health 19, n^o 9 (25 avril 2022) : 5190. http://dx.doi.org/10.3390/ijerph19095190.

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Background: the world population is aging, and the prevalence of chronic diseases is increasing. Chronic diseases affect the quality of life of patients and contribute toward increased healthcare costs if patients do not adhere to treatment. This study defines the medication adherence levels of patients with chronic diseases. Methods: an observational cross-sectional study was carried out. Patients aged 65 years and older with chronic diseases were included in this study. The medication adherence report scale was used. Results: overall, 98 patients aged 65 years and older were included. The mean age of responders was 78.65 years. Study population: 71.43% were always adherent; 9.79% often adherent; 14.89% sometimes adherent; 3.87% rarely adherent; and 1% never adherent. The internal consistency of the MARS-5I was good: Cronbach’s alfa value of 0.77. Conclusions: the MARS-5I is an effective self-report instrument to measure the medication adherence of patients. However, further studies are needed to explore factors affecting medication adherence to avoid clinical consequences for patients and high healthcare costs for healthcare facilities. Healthcare communication could be improved to ensure better transitional care.

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Liquori, Gloria, Aurora De Leo, Emanuele Di Simone, Sara Dionisi, Noemi Giannetta, Elvira Ganci, Sherly Pia Trainito, Giovanni Battista Orsi, Marco Di Muzio et Christian Napoli. « Medication Adherence in Chronic Older Patients : An Italian Observational Study Using Medication Adherence Report Scale (MARS-5I) ». International Journal of Environmental Research and Public Health 19, n^o 9 (25 avril 2022) : 5190. http://dx.doi.org/10.3390/ijerph19095190.

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Background: the world population is aging, and the prevalence of chronic diseases is increasing. Chronic diseases affect the quality of life of patients and contribute toward increased healthcare costs if patients do not adhere to treatment. This study defines the medication adherence levels of patients with chronic diseases. Methods: an observational cross-sectional study was carried out. Patients aged 65 years and older with chronic diseases were included in this study. The medication adherence report scale was used. Results: overall, 98 patients aged 65 years and older were included. The mean age of responders was 78.65 years. Study population: 71.43% were always adherent; 9.79% often adherent; 14.89% sometimes adherent; 3.87% rarely adherent; and 1% never adherent. The internal consistency of the MARS-5I was good: Cronbach’s alfa value of 0.77. Conclusions: the MARS-5I is an effective self-report instrument to measure the medication adherence of patients. However, further studies are needed to explore factors affecting medication adherence to avoid clinical consequences for patients and high healthcare costs for healthcare facilities. Healthcare communication could be improved to ensure better transitional care.

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Cho, Juno, Leslie Niziol, Paul Lee, Michele Heisler, Kenneth Resnicow, David C. Musch et Paula Anne Newman-Casey. « 44190 Comparing the Accuracy of Different Tools in Identifying Glaucoma Medication Non-adherence ». Journal of Clinical and Translational Science 5, s1 (mars 2021) : 127. http://dx.doi.org/10.1017/cts.2021.725.

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ABSTRACT IMPACT: Medication non-adherence is a widespread problem in glaucoma care, and this abstract shows that a free and easy to implement tool can be used to accurately screen and identify patients who are not adherent to their glaucoma medication. OBJECTIVES/GOALS: To compare the accuracy of pharmacy refill data and five measures of self-reported adherence in identifying patients with poor electronically monitored glaucoma medication adherence. METHODS/STUDY POPULATION: Glaucoma patients (age ≥40, poor self-reported adherence, and ≥1 medication) recruited at the University of Michigan completed five surveys of adherence and 3-months of electronically monitored medication adherence; pharmacy refill data were obtained. Electronically monitored adherence was summarized monthly as percent of doses taken on time. Median monthly adherence ≤80% was considered non-adherent. Pharmacy refill data were reported as the proportion of days covered. The accuracy of the measures in predicting ≤80% adherence was assessed with receiver operating characteristic curves such as estimation of area under the curve (AUC), sensitivity, specificity, and accuracy. RESULTS/ANTICIPATED RESULTS: 95 patients completed electronic monitoring with a median monthly adherence of 74% (±21%); 53 patients (56%) were non-adherent. Pharmacy refill adherence was not significantly correlated with electronically monitored medication adherence (r=0.12, p=0.2). A single-item adherence question (‘Over the past month, what percentage of your drops do you think you took correctly?’) had the largest correlation with electronically monitored adherence (r=0.47, p<0.0001), the largest AUC for predicting non-adherence (AUC= 0.76, [95% Confidence Interval = 0.66, 0.87]), best accuracy (71%, [61, 82]), and good sensitivity (84%, [73, 96]). DISCUSSION/SIGNIFICANCE OF FINDINGS: A free, single-item screening question ('Over the past month, what percentage of your drops do you think you took correctly?') offers an easy-to-implement tool for identifying glaucoma patients with poor medication adherence in clinical practice.

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Homętowska, Henryka, Natalia Świątoniowska-Lonc, Jakub Klekowski, Mariusz Chabowski et Beata Jankowska-Polańska. « Treatment Adherence in Patients with Obstructive Pulmonary Diseases ». International Journal of Environmental Research and Public Health 19, n^o 18 (14 septembre 2022) : 11573. http://dx.doi.org/10.3390/ijerph191811573.

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COPD is the third most common cause of death globally. Adherence rates in patients with obstructive pulmonary diseases usually range between 10% and 40%. The aim of the study was to evaluate the level of treatment adherence to inhaled therapy in patients with obstructive pulmonary diseases. A total of 325 patients, of mean age 63.04 ± 11.29, with COPD or asthma, were included into the study between 2020 and 2021. The following questionnaires were used: Beliefs about Medicines Questionnaire, Test of Adherence to Inhalers and Adherence to Refills and Medications Scale. The respondents tended to be convinced of the necessity of their medication (3.87 points per question). The patients reported moderate levels of overall adherence (21.15 ± 6.23). A total of 74% of patients demonstrated sporadic non-compliance. We conclude that patients with obstructive pulmonary diseases are moderately adherent to their medication. Beliefs about medicines have a significant impact on adherence to medications. Being unemployed, being a non-smoker and belief in the necessity of medication are independent determinants of better medication adherence. The number of hospital admissions due to exacerbations of the disease over the last year and belief that medicines are harmful are independent determinants of poorer medication adherence.

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Gavrilova, Bandere, Rutkovska, Šmits, Mauriņa, Poplavska et Urtāne. « Knowledge about Disease, Medication Therapy, and Related Medication Adherence Levels among Patients with Hypertension ». Medicina 55, n^o 11 (28 octobre 2019) : 715. http://dx.doi.org/10.3390/medicina55110715.

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Background and Objectives: A particular problem in cardiology is poor adherence to pharmacological treatment among patients with hypertension. It is known that approximately half of these patients do not use their medications as prescribed by their doctor. Patients may choose not to follow the doctor’s recommendations and regularly do not control their blood pressure, owing to many factors. A convenient method for measuring the level of adherence is the Morisky Medication Adherence Scale, which also provides insight into possible remedies for low adherence. We investigated their therapy, knowledge about the disease and its control, and demographic differences to assess the adherence of patients with hypertension. Materials and Methods: This was a cross-sectional observational study. Data were collected through a survey of 12 pharmacies in Latvia. The study involved 187 participants with hypertension. Results: The prevalence of non-adherence was 46.20% in Latvia. The oldest patients were the most adherent (p = 0.001, β = 0.27). The higher the self-rated extent from 0 to 10, to which the patient takes their antihypertensives exactly as instructed by their physician, the higher the level of adherence (p < 0.0001, β = 0.38), where at “0”, the patient does not follow physician instructions at all, and at “10”, the patient completely follows the physician’s instructions. Non-adherent patients tend to assess their medication-taking behavior more critically than adherent patients. The longer the patient is known to suffer from hypertension, the more adherent he or she is (p = 0.014, β = 0.19). Conclusions: Medication non-adherence among patients with hypertension is high in Latvia. Further investigations are needed to better understand the reasons for this and to establish interventions for improving patient outcomes.

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Musa, Fauzia, Nathan Shaviya, Fidelis Mambo, Collins Abonyo, Erick Barasa, Philemon Wafula, George Sowayi, Mustafa Barasa et Tom Were. « Cytokine profiles in highly active antiretroviral treatment non-adherent, adherent and naive HIV-1 infected patients in Western Kenya ». African Health Sciences 21, n^o 4 (14 décembre 2021) : 1584–92. http://dx.doi.org/10.4314/ahs.v21i4.12.

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Background: Cytokines play an important role in signaling the immune system to build an adequate immune responseagainst HIV. HIV distorts the balance between pro and anti-inflammatory cytokines causing viral replication. Highly active antiretroviral treatment (HAART) acts by trying to restore pro and anti-inflammatory cytokine balance. It is not clear how HAART non-adherence influences circulating cytokine levels. This study therefore determined cytokine levels in HAART non-adherent individuals. Methods: This cross-sectional study recruited 163 participants (51 controls, 23 HIV-1+ HAART naive, 28 HAART-adherent6 months, 19 HAART-adherent 12 months and 42 HAART non-adherent). Cytokines were analyzed by ELISA while CD4 T cells determined in 3.0 μl of whole blood using BD FACSCaliburTM and viral load in 0.2ml plasma sample using Abbott Molecular m2000sp sample preparation and m2000rt real-time amplification and detection systems (Abbott MolecularInc., Illinois, USA) according to the manufacturer’s methods. Results: IL-4, IL-6, IL-10, TNF-α and TGF-β were significantly elevated in HIV-1 HAART non-adherent compared withHIV-1 HAART adherent and healthy controls P<0.01. IFN- γ was significantly decreased in HIV-1 HAART non-adherentcompared with HIV-1 HAART adherent and healthy controls P<0.01. TNF-α and TGF-β were significantly reduced in HIV-1 HAART adherent patients at 12 months compared to those at 6 months P<0.01. IL-4 and IL-10 correlated positively withviral load. IL-4, IL-6, IL-10, TNF-α and TGF- β associated inversely with CD4 T cell counts and body mass index (BMI). Conclusion: This study established that HAART adherence is immunologically beneficial to the pro and anti-inflammatory cytokine balance milieu while non-adherence appears to cause alterations in pro and anti-inflammatory cytokines warping the balance in this dichotomy. Keywords: Cytokines; non-adherence; HAART.

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Zyryanov, S. K., S. B. Fitilev, A. V. Vozzhaev, I. I. Shkrebneva, N. N. Shindryaeva, D. A. Klyuev, L. N. Stepanyan, A. M. Lutsenko, A. T. Tsai et A. A. Danilova. « Adherence to Medical Treatment in Elderly Patients with Coronary Artery Disease in the Settings of Primary Outpatient Care ». Rational Pharmacotherapy in Cardiology 17, n^o 2 (7 mai 2021) : 178–85. http://dx.doi.org/10.20996/1819-6446-2021-03-03.

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Aim. To study medication adherence in elderly patients with coronary artery disease (CAD) in primary care practice.Material and methods. The study conducted in out-patient clinic of Moscow city. 293 elderly (≥65 years) patients with established CAD included. The following patient data obtained via electronic medical record system: demography, medical history, modifiable risk factors and prescribed pharmacotherapy. Level of medication adherence measured by Morisky scale (MMAS-8) via telephone survey.Results. According to Morisky scale high adherence was identified in 146 (49.8%) elderly patients, moderate adherence – in 99 (33.8%) patients, low adherence – in 48 (16.4%) patients. Analysis of specific questions of the scale done in non-adherent patients revealed signs of unintentional non-adherence due to forgetfulness (45.9%) and signs of intentional non-adherence due to patients feeling worse (35.8%) or better (28.4%). By means of dichotomic interpretation of Morisky scale results the population under research was divided into two groups: 147 (50.2%) non-adherent patients and 146 (49.8%) – totally adherent patients. These groups were comparable in terms of sex (female 71.2 vs 68.0%; p>0.05) and age (median 73.5 vs 73.0 years; p>0.05) distribution, and medical history: myocardial infarction (39.0% vs 38.8%), atrial fibrillation (37.0 and 41.5%), chronic heart failure (90.4% vs 91.2%), diabetes (26.7% vs 24.5%). There were fewer smokers in adherent group (0.7% vs 6.5%; p<0.05). As primary antianginal pharmacotherapy adherent and non-adherent patients were equally prescribed beta-blockers (75.3% vs 75.5%; p>0.05). Drugs that improve prognosis were also prescribed comparably: antiplatelets (66.4% vs 61.9%; p>0.05), anticoagulants (36.3% vs 44.9%; p>0.05), statins (82.2% vs 79.6%; p>0.05), renin-angiotensin system inhibitors (89.0 and 87.8%; p>0.05). Adherent patients had lower mean values of lipids: total cholesterol (4.7±1.2 vs 5.2±1.4 mmol/l; p<0.05) and low density cholesterol (2.4±0.9 vs 2.8±1.2 mmol/l; p<0.05). Non-adherent elderly patients made more visits to general practitioner (median 5 vs 3 visits; p<0.05). Share of patients receiving drugs within supplementary pharmaceutical provision program was comparable in both groups (53.7% vs 50.7%; p>0.05).Conclusion. Half of elderly patients with CAD are non-adherent to treatment in primary care setting. Medical history and structure of pharmacotherapy do not influence level of adherence in this population. Among adherent patients fewer individuals smoke and mean values of lipids are lower. Non-adherent elderly patients cause higher load on general practitioner, supplementary pharmaceutical provision program provided no better adherence in the population under research.

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Ungari, Andrea Queiróz, et Amaury Lelis Dal Fabbro. « Adherence to drug treatment in hypertensive patients on the Family Health Program ». Brazilian Journal of Pharmaceutical Sciences 46, n^o 4 (décembre 2010) : 811–18. http://dx.doi.org/10.1590/s1984-82502010000400024.

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The aim of the present study was to analyze adherence to drug treatment in hypertensive patients enrolled on the Family Health Program in Ribeirão Preto, São Paulo State. This transversal study was conducted between August and December 2006, in which 109 patients were interviewed using the Morisky and Green Test to measure adherence level to pharmacotherapy. Variables that may be related to adherence level were also investigated, such as demographic characteristics, health care team and health service related factors, and pharmacotherapy related factors. The test scores were analyzed by two criteria: patients were categorized as "more adherent" if they had a score from 3 to 4 (criterion 1) or a score of 4 (criterion 2); patients with other scores were categorized as less adherent. Of all patients, 79.8% and 43.1% were classified as "more adherent" according to criterion 1 and criterion 2, respectively. With regard to the possible causes of non-adherence to treatment, statistically significant (p<0.05) associations were identified between "trust in the doctor" or "number of antihypertensive drugs used" and the level of adherence, according to criterion 2. These results indicated adequate adherence levels to drug treatment by the patients, and highlighted the importance of professional/patient interaction, trust in the doctor and the attitude by health professionals toward users.

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Carrieri, Maria Patrizia, François Raffi, Charlotte Lewden, Alain Sobel, Christian Michelet, Valérie Cailleton, Geneviève Chêne et al. « Impact of Early versus Late Adherence to Highly Active Antiretroviral Therapy on Immuno-Virological Response : A 3-Year Follow-Up Study ». Antiviral Therapy 8, n^o 6 (1 août 2002) : 585–94. http://dx.doi.org/10.1177/135965350300800606.

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Objective To assess the impact of different patterns of adherence to highly active antiretroviral therapy (HAART), in particular, the relative impact of early and late adherence, on long-term immuno-virological response in HIV-infected individuals started on a protease inhibitor-containing regimen. Design Clinical, immuno-virological and self-reported adherence data were collected at 4 (M4), 12 (M12), 20 (M20), 28 (M28) and 36 (M36) months after HAART initiation in the French APROCO cohort. Methods A standardized self-administered questionnaire classified patients as non-adherent, moderately or highly adherent at each visit. Stable viral suppression at both M28 to M36, and a CD4 cell increase >200 between M0 and M36 were used as outcome measures. Results Of the 582 patients followed regularly through M36, 360 patients had complete adherence data. Although 59.2% were highly adherent at M4, only 25.8% maintained consistent high adherence throughout the follow-up. High adherence at M4 was independently associated with both stable viral suppression at M28–M36 [OR (95% CI): 2.8 (1.4–5.5)] and a CD4 cell increase >200 during the same period [OR (95% CI): 3.9 (1.7–9.7)]. However, ‘moderately adherent’ patients between M12 and M36 had the same likelihood [OR (95% CI): 1.9 (1.1–3.2)] as patients who were always high adherent [OR (95% CI): 1.9 (1.1–3.2)] of achieving stable viral load suppression, relative to those who reported non-adherence episodes. Conclusion Optimizing adherence in the early months of treatment is crucial to ensure long-term immuno-virological success. Moderate deviations from high adherence during follow-up have a less negative impact. Priority should be given to interventions aimed to improve adherence in the early months of HAART.

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Ajrouche, Aya, Candice Estellat, Yann De Rycke et Florence Tubach. « Trajectories of Adherence to Low-Dose Aspirin Treatment Among the French Population ». Journal of Cardiovascular Pharmacology and Therapeutics 25, n^o 1 (24 juillet 2019) : 37–46. http://dx.doi.org/10.1177/1074248419865287.

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Background: Previous studies have shown that adherence to low-dose aspirin (LDA) is suboptimal. However, these studies were based on an average measure of adherence during follow-up, ignoring its dynamic process over time. We described the trajectories of adherence to LDA treatment among the French population over 3 years of follow-up. Methods: We identified a cohort of 11 793 new LDA users, aged ≥50 years in 2010, by using the French national health-care database. Patients included had at least 3 years of history in the database before study entry to exclude prevalent aspirin users and to assess baseline comorbidities. They were followed from the first date of LDA supply (the index date) until the first date among death, exit from the database, or 3 years after the index date. Adherence to LDA was assessed every 3 months by using the proportion of days covered (PDC) and dichotomized with a cutoff of PDC of 0.8. We used group-based trajectory modeling to identify trajectories of LDA adherence. Predictors of LDA adherence trajectory membership were identified by multinomial logistics regression. Results: We identified 4 trajectories of adherence among new LDA users: the not-adherents (4737 [40.2%]), the delayed not-adherents (gradual decrease in adherence probability, 1601 [13.6%]), the delayed adherents (gradual increase in adherence probability, 1137 [9.6%]), and the persistent adherents (4318 [36.6%]). The probability of belonging to the not-adherent group was increased with female sex, low socioeconomic status, and polymedication and was reduced with a secondary indication for LDA use, such as diabetes, hypertension, and dementia, at least 4 consultations in the previous year, or 1 hospitalization or a cardiologist consultation in the 3 months before the index date. Conclusion: This study provides a dynamic picture of adherence behaviors among new LDA users and underlines the presence of critical trajectories that intervention could target to improve adherence.

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Piragine, Eugenia, Davide Petri, Alma Martelli, Vincenzo Calderone et Ersilia Lucenteforte. « Adherence to Oral Antidiabetic Drugs in Patients with Type 2 Diabetes : Systematic Review and Meta-Analysis ». Journal of Clinical Medicine 12, n^o 5 (2 mars 2023) : 1981. http://dx.doi.org/10.3390/jcm12051981.

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Poor adherence to oral antidiabetic drugs (OADs) in patients with type 2 diabetes (T2D) can lead to therapy failure and risk of complications. The aim of this study was to produce an adherence proportion to OADs and estimate the association between good adherence and good glycemic control in patients with T2D. We searched in MEDLINE, Scopus, and CENTRAL databases to find observational studies on therapeutic adherence in OAD users. We calculated the proportion of adherent patients to the total number of participants for each study and pooled study-specific adherence proportions using random effect models with Freeman–Tukey transformation. We also calculated the odds ratio (OR) of having good glycemic control and good adherence and pooled study-specific OR with the generic inverse variance method. A total of 156 studies (10,041,928 patients) were included in the systematic review and meta-analysis. The pooled proportion of adherent patients was 54% (95% confidence interval, CI: 51–58%). We observed a significant association between good glycemic control and good adherence (OR: 1.33; 95% CI: 1.17–1.51). This study demonstrated that adherence to OADs in patients with T2D is sub-optimal. Improving therapeutic adherence through health-promoting programs and prescription of personalized therapies could be an effective strategy to reduce the risk of complications.

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TING, TRACY V., DEEPA KUDALKAR, SHANNEN NELSON, SANDRA CORTINA, JOSHUA PENDL, SHAAISTA BUDHANI, JENNIFER NEVILLE et al. « Usefulness of Cellular Text Messaging for Improving Adherence Among Adolescents and Young Adults with Systemic Lupus Erythematosus ». Journal of Rheumatology 39, n^o 1 (15 novembre 2011) : 174–79. http://dx.doi.org/10.3899/jrheum.110771.

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Objective.In a cohort of 70 patients with childhood-onset systemic lupus erythematosus (cSLE): to determine the baseline adherence to medications and visits; to investigate the effects of cellular text messaging reminders (CTMR) on adherence to clinic visits; and to study the influence of CTMR on adherence to use of hydroxychloroquine (HCQ).Methods.CTMR were sent to 70 patients prior to clinic visits for 14 months. A subgroup of patients were evaluated for medication adherence to HCQ: 19 patients receiving CTMR prior to each scheduled HCQ dose were compared to 22 patients randomized to standard of care education about HCQ. Visit adherence was measured using administrative databases. Pharmacy refill information, self-report of adherence, and HCQ blood levels were utilized to monitor medication adherence to HCQ. Sufficient adherence to visits or HCQ was defined as estimates > 80%. Disease activity was primarily monitored with the Systemic Lupus Erythematosus Disease Activity Index.Results.At baseline, 32% of patients were sufficiently adherent to HCQ, and 81% to clinic visits. Visit adherence improved significantly by > 80% among those who were nonadherent to clinic visits at the baseline CTMR (p = 0.01). CTMR did not influence adherence to HCQ over time.Conclusion.Patients with cSLE were only modestly adherent to HCQ and clinic visits. CTMR may be effective for improving visit adherence among adolescents and young adults with cSLE, but it does not improve adherence to HCQ.

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Podzolkov, V. I., A. E. Bragina, L. V. Vasil’eva, Yu P. Grintsevich et Yu N. Rodionova. « Adherence to statin therapy in patients with high and very high cardiovascular risk in real clinical practice ». Sechenov Medical Journal 11, n^o 1 (23 septembre 2020) : 38–48. http://dx.doi.org/10.47093/2218-7332.2020.11.1.38-48.

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Despite the proven efficacy of lipid-lowering therapy, adherence to long-term statin therapy in patients with cardiovascular disease remains low.Aim. To study adherence to long-term statin therapy and factors associated with adherence in patients with high and very high cardiovascular risk (CVR) in real clinical practice.Materials and methods. The single-center cohort study included 53 patients (mean age 68.1 ± 10.2 years) with high or very high CVR on the SCORE scale and have been taking statins for at least 3 months prior to inclusion in the study. The level of low-density lipoprotein cholesterol (LDL-C), cognitive impairment (MoCA test), anxiety and depression (HADS scale), presence of senile asthenia (FRAIL scale), M. Charlson comorbidity index were assessed. Adherence to statin therapy was assessed using the original questionnaire. The correlation between patient adherence and ordinal variables for the scores of the studied scales was studied.Results. Completely adherent to statin therapy were only 12 (22%) patients, 14 (26%) were insufficiently adherent, 27 (51%) were non-adherent. The target level of LDL-С was achieved in 13 (25%) patients. 38 (72%) patients showed a decrease in cognitive functions; a positive correlation was found between adherence and the MoCA test (r = 0.44, p = 0.04). Clinical and subclinical depression and anxiety were noted in 12 (23%) and 14 (26%) patients, respectively. A statistically significant negative correlation was found between adherence and depression (r = –0.32; p = 0.04) and a positive correlation between adherence and anxiety (r = 0.44; p = 0.04). There was no statistically significant correlation between adherence and the FRAIL fragility scale, as well as the M. Charlson comorbidity index.Conclusions. Depression and cognitive decline are associated with decreased adherence to statin therapy.

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Mattam, Bheemesh Naidu, Mounika Akurathi, B. M. S. G. Krishna et Haritha Reddy Tumati. « Evaluation of factors influencing drug adherence to anti retroviral therapy (ART) in a tertiary care hospital, Guntur Andhra Pradesh, India ». International Journal of Basic & ; Clinical Pharmacology 6, n^o 6 (23 mai 2017) : 1323. http://dx.doi.org/10.18203/2319-2003.ijbcp20172030.

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Background: Antiretroviral therapy (ART) adherence is a primary determinant of the effectiveness of Human immunodeficiency virus/Acquired immune deficiency syndrome (HIV/AIDS) treatment and is also considered a major predictor of survival among patients living with HIV/AIDS. The present study measures the level of adherence to antiretroviral drug therapy in Guntur district using Morisky medication adherence scale-8 (MMAS-8) and various factors influencing the degree of adherence.Methods: This was a cross sectional, semi structured questionnaire based study conducted over a period of 13 months at KMCH. MMAS-8 was used to assess the degree of adherence. A semi-structured questionnaire was designed to assess the factors influencing adherence.Results: A total of 354 patients participated in the study. 126 (36%) patients were highly adherent, 126 (36%) patients were moderately adherent and 102 (29%) patients were low adherent according to MMAS-8 score. Statistical analysis has shown that patients using the reminder tools, patients living with family had shown significant adherence to ART (p value <0.001).Conclusions: People who are taking ART in Guntur district are found to be moderate to high adherent according to MMAS-8. Degree of adherence to ART is found to be influenced by simplified treatment regimen, patient counselling and family support.

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Ntatsaki, E., V. S. Vassiliou, A. Velo-Garcia, A. D. Salama et D. A. Isenberg. « Renal transplantation for lupus nephritis : non-adherence and graft survival ». Lupus 28, n^o 5 (avril 2019) : 651–57. http://dx.doi.org/10.1177/0961203319842641.

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Objectives Poor adherence to immunosuppressive treatment is common in patients with systemic lupus erythematosus and may identify those with lupus nephritis (LN) who have a poorer prognosis. Non-adherence has also been reported to be a potential adverse outcome predictor in renal transplantation (rTp). We investigated whether non-adherence is associated with increased rTp graft rejection and/or failure in patients with LN. Methods Patients with LN undergoing rTp in two major London hospitals were retrospectively included. Medical and electronic records were reviewed for documented concerns of non-adherence as well as laboratory biochemical drug levels. The role of non-adherence and other potential predictors of graft rejection/failure including demographics, comorbidities, age at systemic lupus erythematosus and LN diagnosis, type of LN, time on dialysis prior to rTp and medication use were investigated using logistic regression. Results Out of 361 patients with LN, 40 had rTp. During a median follow-up of 8.7 years, 17/40 (42.5%) of these patients had evidence of non-adherence. A total of 12 (30.0%) patients experienced graft rejection or failure or both. In the adherent group 2/23 (8.7%) had graft rejection, whilst in the non-adherent this rose to 5/17 (29.4%, p = 0.11). Graft failure was seen in 5/23 (21.7%) patients from the adherent group and 4/17 (23.5%) in the non-adherent group ( p = 0.89). Non-adherent patients had a trend towards increased graft rejection, hazard ratio 4.38, 95% confidence interval = 0.73–26.12, p = 0.11. Patients who spent more time on dialysis prior to rTp were more likely to be adherent to medication, p = 0.01. Conclusion Poor adherence to immunosuppressive therapy is common and has been shown to associate with a trend towards increased graft failure in patients with LN requiring rTp. This is the first paper to report that shorter periods on dialysis prior to transplantation might lead to increased non-adherence in lupus patients.

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Golshan, Shabnam, Tahereh Feizy, Sanaz Tavasoli et Abbas Basiri. « Service quality and urolithiasis patient adherence ». International Journal of Health Care Quality Assurance 32, n^o 1 (11 février 2019) : 2–10. http://dx.doi.org/10.1108/ijhcqa-08-2017-0140.

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Purpose Adherence to preventive recommendations improves clinical outcomes and is compulsory for long-term prevention in urolithiasis patients. Service quality can affect patients’ adherence to treatment and care. The purpose of this paper is to compare perceived service quality, using the SERVQUAL model, between urolithiasis patients who were nonadherent to their follow-up visits and those who were adherent, in a stone prevention clinic, Tehran, Iran. Design/methodology/approach This was a cross-sectional study on patients with urolithiasis referred to the Shahid-Labbafinejad Hospital stone prevention clinic between 2010 and 2014. All patients withdrawing from follow-up visits were selected as the nonadherent group. Patients with follow-up visits were randomly selected and appointed as the adherent group. Data included demographic, service quality (assessed using the SERVQUAL) and a questionnaire about the reason for withdrawal from follow-up visits. Man–Whitney U test, χ2 and binary logistic regression were used for data analyses. Findings In total, 531 nonadherent and 51 adherent patients entered the study. SERVQUAL results revealed that patients’ expectations were significantly higher than their perceptions in all five service quality dimensions in both groups. The adherent group had better-quality scores. Responsibility, assurance and empathy scores significantly increased patient adherence odds. Research limitations/implications Uni-center design; missing data, such as socioeconomic status and disease severity, which may influence treatment adherence; and missing data regarding adherence to medication and dietary advice were limitations. Practical implications Service quality needs to be improved in all dimensions. Originality/value Since responsiveness, assurance and empathy dimensions determined patients’ adherence, giving special attention to these dimensions could improve patient adherence.

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Shrestha, Pragya, Neelam Shrestha et Ikshaya Rana. « Treatment Adherence Among Patients Undergoing Hemodialysis of Selected Hospitals of Rupandehi ». Journal of Universal College of Medical Sciences 8, n^o 02 (31 décembre 2020) : 68–72. http://dx.doi.org/10.3126/jucms.v8i02.34297.

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INTRODUCTION Chronic kidney disease (CKD) is a major public health problem in Nepal. Adherence is the crucial factor in determining the morbidity and mortality of hemodialysis patients. MATERIAL AND METHODS A cross-sectional study was conducted to find out the hemodialysis adherence among 125 hemodialysis patients of Universal College of Medical Sciences-Teaching Hospital and Crimson Hospital, Rupandehi. The data was collected by enumerative sampling using semi-structured interview schedule. The duration of the study was from June 16, 2019 to August 2, 2019. The data was analyzed by using descriptive and inferential statistics with SPSS software version 16.0. RESULTS The study revealed 56.8% were adherent to haemodialysis in general. Likewise 62.7%, 77.1%, 74.6% and 48.3% were adherent to haemodialysis schedule, diet restriction, fluid restriction and medication respectively. There was statistically significant association between level of adherence to haemodialysis and education level (p=0.020), adequacy of family monthly income for haemodialysis (p=0.007), presence of care taker to haemodialysis centre (p=0.057) and haemodialysis hours in a session (p=0.002). CONCLUSION It is concluded that the haemodialysis adherence among patients is good in general but poor adherence to medicine. The adherence is influenced by education, family monthly income, presence of care taker and haemodialysis hours in a session. Hence it emphasizes on need for educating patients to enhance adherence to haemodialysis.

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Bhattarai, B., B. Bista, S. Shrestha, B. Budhathoki et B. Dhamala. « Contributing Factors of Non-Adherence to Treatment among the Patients with Type II Diabetes Mellitus ». Journal of Manmohan Memorial Institute of Health Sciences 5, n^o 1 (14 mai 2019) : 68–78. http://dx.doi.org/10.3126/jmmihs.v5i1.24075.

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Background: The Multiple therapeutic component and need for life long treatment makes diabetic adherence a difficult task. We took this study to identify the Non adherence Patient to the Diabetic treatment, and to assess the contributing factors for non adherence. Methods: A four questions preformed questionnaire -the Morisky medication adherence scale (MMAS) and Structured questionnaire were used to assess the contributing factors of Non adherence to diabetic treatment in 214 patient with type 2 diabetes mellitus which was carried out on Kathmandu Diabetic and Thyroid Center, Alka Hospital and Endocrine Care Center, Kupandol following Probability simple random sampling technique. Results: A total of 55.14% of diabetic client were non adherent. Major contributing factor of non-adherence to diabetic treatment were ignorance for life style modification i.e. 83.78%. Among them, 59.48% didn't take the prescribed medicine in time ,most of them 85.71% didn't follow diabetic diet and less than half (46.61%) didn’t monitored blood glucose level regularly due to poor self discipline. Gender, occupation and educational status were the significant contributors to Non adherence. Conclusion: The findings showed high percentage of non adherent diabetic client and enlighten the various factors causing non adherence. It focuses the need for one to one counselling and constant motivation frequently to ensure better adherence.

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Piotrowicz, Ewa, Michael Pencina, Grzegorz Opolski, Wojciech Zaręba, Maciej Banach, Ilona Kowalik, Piotr Orzechowski et al. « Heart Failure Patients’ Adherence to Hybrid Comprehensive Telerehabilitation and Its Impact on Prognosis Based on Data from TELEREH-HF Randomized Clinical Trial ». Applied Sciences 12, n^o 5 (2 mars 2022) : 2595. http://dx.doi.org/10.3390/app12052595.

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(1) Background Adherence to treatment guidelines in heart failure (HF) patients is of major prognostic importance, but thorough implementation of guidelines in routine care remains insufficient. Introducing hybrid comprehensive telerehabilitation (HCTR) consisting of telecare, telerehabilitation, and remote monitoring of implantable devices might be an option to improve adherence to recommendation and can affect the prognosis. The purpose is to investigate the association of adherence to HCTR with mortality and hospitalization. (2) Methods This analysis formed part of TELEREH-HF multi-center, randomized trial that enrolled 850HF patients (NYHA I-III;LVEF ≤ 40%). Patients were randomized 1:1 to 9-week HCTR (1 week in hospital and 8 weeks at home) plus usual care or usual care only and followed-up for 14 to 26 months. This analysis focuses on the HCTR group. Adherent patients were those who adhered both to the number of training sessions prescribed and to the duration of the prescribed cycle by at least 80%; non-adherent patients were those who adhered<20% to the prescribed number of training sessions and their duration. The remaining patients were classified as partially adherent. (3) Results There were 350 (88.4%) adherent patients, 39 (9.8%) partially adherent patients, and 7 (1.8%) non-adherent patients. There were 46 deaths during follow-up. Non-adherence or partial adherence was associated with higher risk of cardiovascular (CV) mortality (hazard ratio (HR) = 2.62, p = 0.021); all-cause mortality or HF hospitalization (HR = 1.71, p = 0.038); CV mortality or HF hospitalization (HR = 1.89, p = 0.014). (4) Conclusions The adherence to HCTR was high. Adherence to HCTR was associated with improved prognosis for CV mortality and the reduction in the combined outcome of CV mortality or HF hospitalization.

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Zukin, Mauro, Marcos Coelho Simões Travassos Soares, Nathalia Fonseca Gamboa, Fabiano Hosken Pombo et Lucyana Carvalho. « Oral chemotherapy follow up on a Brazilian private health care unit. » Journal of Clinical Oncology 37, n^o 15_suppl (20 mai 2019) : e18311-e18311. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e18311.

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e18311 Background: Oral antineoplastic therapy is a growing reality, and ensures greater comfort and better quality of life for patients. However, this modality of treatment requires greater attention of the professionals to avoid dispensing errors and to guarantee adherence to the treatment. The goal of this study is to present a method to follow up cancer patients to reduce percentage of problems related to medication and improve oral antineoplastic adherence. Methods: The study was conducted at a private oncology clinic in Rio de Janeiro during the year 2018. In the first dispensation, patients received verbal and written pharmaceutical advice on posology, proper storage, safe handling requirements and strategies to avoid adverse side effects and food and drugs interactions. There were also given nutrition, sexuality, rights and duties guidelines. To improve adherence and to avoid forgetfulness or duplicity of dosing, patients received a medication calendar. Pharmacist made dispensing, managed adverse side effects and assessed adherence of patient using a model based on Morisky Medication Adherence Scale. Patients that answered "yes" to any questions were considered non-adherents. All information was registered in medical record. Non-compliances were considered: wrong medicine, incorrect dose and delays of any administrative reason. Results: In 2018, on average 1487 dispensings were made and 1053 patients’ adherence behavior were measured. 94.37% were considered adherent. Monthly percentage of non-compliance was 1.5% of dispensings. Conclusions: The present study demonstrates that with education and pharmaceutical follow-up since the first dispensation, it is possible to guarantee a safer and more effective treatment for patients using oral cancer medication. It is imperative to maintain the objective of developing better techniques for dispensing, guiding and guaranteeing high adherence.

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