-
Indian Heart Journal 2020Medication compliance, an important aspect in the treatment of chronic disease research, is often assessed using pill count method. The patient perception is usually not... (Observational Study)
Observational Study
INTRODUCTION
Medication compliance, an important aspect in the treatment of chronic disease research, is often assessed using pill count method. The patient perception is usually not addressed objectively. The present study was conducted to assess patient cognizance, prevalence and predictors of compliance towards antihypertensive therapy in Indian patients.
METHODS
Adult patients taking antihypertensive medicines were included from the cardiology and geriatric OPDs of a tertiary care hospital in India. Socio-demographic data and disease awareness information was collected. Hill-Bone high blood pressure compliance scale was administered for compliance score.
RESULTS
For the 452 participants, mean age was 54.6 ± 13.7 years with approximate 2:1 ratio of males to females. Cronbach's alpha value of 0.7 for Hill Bone compliance scale showed good internal consistency. More than 80% participants had a score of ≥80%, showing good compliance among Indian patients. Factors that were significantly associated with uncontrolled blood pressure with correlation analysis were age, gender and awareness regarding disease.
CONCLUSION
The study suggests that Hill-Bone high blood pressure compliance scale may be useful for assessing compliance in Indian population. An age appropriate intervention for continued compliance should be considered to improve compliance and hence, reduce long term sequelae of hypertension.
Topics: Antihypertensive Agents; Blood Pressure; Female; Humans; Hypertension; Male; Medication Adherence; Middle Aged; Patient Compliance; Surveys and Questionnaires
PubMed: 32534690
DOI: 10.1016/j.ihj.2020.03.008 -
International Journal of Environmental... Aug 2022This study aimed to explore the subjective experiences of adolescents with scoliosis during brace treatment in order to understand their obstacles and make...
This study aimed to explore the subjective experiences of adolescents with scoliosis during brace treatment in order to understand their obstacles and make recommendations to enhance brace compliance. Using purposive sampling, 15 adolescents (2 males and 13 females) with scoliosis aged from 10 to 16 years old during brace treatment were recruited to participate in semi-structured in-depth interviews. The data were recorded, transcribed, and coded using thematic analysis with the qualitative software NVivo 10. Significant statements and phrases were organized into categories and themes to understand adolescents' experiences during brace treatment for scoliosis. In general, the adolescents acknowledged that compliance with brace treatment was essential to reduce or prevent the progression of spinal curvature and tried their best to comply with the treatment. Regarding their subjective experiences during brace treatment, three themes were identified and emerged as obstacles negatively affecting their brace compliance, including physical discomfort due to brace materials and design, reluctance caused by the brace's visual appearance, and passive patient participation during the treatment process. This study reveals insights into the experiences of adolescents with scoliosis during brace treatment and what they perceive as hindrances to compliance. In order to have better brace compliance, adolescents' feelings and difficulties during brace treatment should be recognized and addressed. Therefore, active patient participation throughout the treatment process, involving the co-design of a customized brace, psychosocial interventions, and personalized appearance style management should be considered and promoted to facilitate a more acceptable bracing experience to achieve better brace compliance.
Topics: Adolescent; Braces; Child; Female; Humans; Male; Patient Compliance; Qualitative Research; Scoliosis; Spinal Curvatures
PubMed: 36078297
DOI: 10.3390/ijerph191710585 -
The Cochrane Database of Systematic... Nov 2015Bronchiectasis is characterised by a widening of the airways, leading to excess mucus production and recurrent infection. It is more prevalent in women and those in... (Review)
Review
BACKGROUND
Bronchiectasis is characterised by a widening of the airways, leading to excess mucus production and recurrent infection. It is more prevalent in women and those in middle age. Many patients with bronchiectasis do not adhere to treatments (medications, exercise and airway clearance) prescribed for their condition. The best methods to change these adherence behaviours have not been identified.
OBJECTIVES
To assess the effects of interventions to enhance adherence to any aspect of treatment in adults with bronchiectasis in terms of adherence and health outcomes, such as pulmonary exacerbations, health-related quality of life and healthcare costs.
SEARCH METHODS
We searched the Cochrane Airways Group Specialised Register (CAGR), which contains trial reports identified through systematic searches of CENTRAL, MEDLINE, EMBASE, CINAHL, AMED and PsycINFO, from inception to October 2015.
SELECTION CRITERIA
We planned to include randomised controlled trials (RCTs) of adults with bronchiectasis that compared any intervention aimed at enhancing adherence versus no intervention, usual care or another adherence intervention. We excluded studies of those who had bronchiectasis due to cystic fibrosis.
DATA COLLECTION AND ANALYSIS
Two review authors (AMcC and ET) independently screened titles, abstracts and full-texts of identified studies.
MAIN RESULTS
Searches retrieved 36 studies reported in 37 articles; no eligible studies were identified.
AUTHORS' CONCLUSIONS
We did not identify any studies that assessed the effect of interventions to enhance adherence to treatment in bronchiectasis. Adequately powered, well-designed trials of adherence interventions for bronchiectasis are needed.
Topics: Adult; Bronchiectasis; Humans; Patient Compliance
PubMed: 26576499
DOI: 10.1002/14651858.CD011023.pub2 -
Journal of Neuromuscular Diseases 2021To optimize care for patients with DMD, it is essential to know to what extent current care complies with the recommended monitoring frequencies suggested by the DMD...
BACKGROUND AND OBJECTIVE
To optimize care for patients with DMD, it is essential to know to what extent current care complies with the recommended monitoring frequencies suggested by the DMD care considerations. The objective of this study was to investigate the current care for patients with DMD in the Netherlands and to what extent the care complies with the international care considerations.
METHODS
A cross-sectional questionnaire was carried out among the Dutch DMD patients and caregivers about the patients' functional and health status, visits to healthcare professionals, clinical tests and assessments, therapy, medication use and access to medical aids and devices. Compliance to guidelines was defined by comparing the frequency of visits to health care providers and clinical tests with the recommended frequencies derived from the care considerations of 2010.
RESULTS
Eighty-four participants completed the questionnaire. The majority of participants met the recommended visit frequencies to a neuromuscular specialist and cardiologist. Compliance was suboptimal for respiratory assessments in the non-ambulatory phase, monitoring of side effects of corticosteroid use and neuromuscular assessments. Disease specific information supply was perceived as sufficient and participants were satisfied with the received care.
CONCLUSIONS
This study identifies areas in which compliance is lacking. Countries, such as the Netherlands, working according to a shared care system require easy and low-threshold communication between health care centers and a clear division of roles and responsibilities to reach optimal compliance. In the Netherlands the Duchenne Center Netherlands has the coordinating role.
Topics: Adolescent; Adult; Caregivers; Child; Cross-Sectional Studies; Health Personnel; Humans; Male; Muscular Dystrophy, Duchenne; Netherlands; Patient Compliance; Surveys and Questionnaires; Young Adult
PubMed: 34120911
DOI: 10.3233/JND-210670 -
Cleveland Clinic Journal of Medicine Sep 2019Positive airway pressure (PAP) devices deliver a pressurized column of air to open the airway in patients with sleep apnea. For patients with moderate to severe sleep... (Review)
Review
Positive airway pressure (PAP) devices deliver a pressurized column of air to open the airway in patients with sleep apnea. For patients with moderate to severe sleep apnea, PAP therapy is the gold standard for treatment, with demonstrated improvements in daytime sleepiness and cardiovascular measures that are superior to conservative treatments. For a variety of reasons, adherence to PAP therapy is a challenge for many patients, resulting in deficits in the frequency and duration of use. To improve use and compliance to therapy, several advanced features are available to enhance comfort, pressure, and humidification factors associated with PAP devices. Patient motivation strategies such as motivational interviews, desensitization protocols, and PAP "NAPs" are also being employed to improve adherence to therapy.
Topics: Continuous Positive Airway Pressure; Humans; Motivation; Patient Compliance; Sleep Apnea Syndromes
PubMed: 31509501
DOI: 10.3949/ccjm.86.s1.05 -
International Archives of Allergy and... 2021Subcutaneous allergen immunotherapy (SCIT) is an effective treatment for allergic rhinitis, asthma, and venom allergy. Compliance is essential for SCIT to obtain maximal...
BACKGROUND
Subcutaneous allergen immunotherapy (SCIT) is an effective treatment for allergic rhinitis, asthma, and venom allergy. Compliance is essential for SCIT to obtain maximal benefit as it is a long-term treatment.
OBJECTIVES
This study aimed to determine the level of real-life SCIT compliance in pediatric patients and the associated factors. Additional aims were to determine how SCIT compliance was affected by the COVID-19 pandemic and why some patients dropped out SCIT.
METHOD
Pediatric patients diagnosed with allergic rhinitis, allergic asthma, or venom allergy that received SCIT between September 2012 and July 2020 were analyzed.
RESULTS
The study included 201 children (66.7% male) with a median (interquartile range) age of 12.8 years (9.4-15.2) at the time of the first SCIT injection. The overall compliance rate before COVID-19 pandemic was 86.1%. Short SCIT follow-up time and venom anaphylaxis were found to be risk factors for drop out. The leading causes of drop outs were moving to another city/country (32.1%), symptom improvement (17.8%), treatment ineffectiveness (14.2%), and adverse reactions (14.2%). Among the 108 patients that were still receiving SCIT during the COVID-19 pandemic, 31 (28.7%) dropped out the therapy. The most frequent reasons for drop-out were fear of being infected with COVID-19 (35.4%) and thinking that the AIT practise stopped due to COVID-19 pandemic (29%). Male gender and older age were found to be the independent risk factors for drop-out of SCIT.
CONCLUSIONS
Real life compliance in children was found 13.9% and it was higher than adults. Nearly one-third of children dropped out during the CO-VID-19 pandemic. Male gender and older age are associated with SCIT drop-out during the COVID-19 pandemic.
Topics: Adolescent; COVID-19; Child; Desensitization, Immunologic; Female; Humans; Hypersensitivity, Immediate; Injections, Subcutaneous; Logistic Models; Male; Patient Compliance; Patient Dropouts; Turkey
PubMed: 33887728
DOI: 10.1159/000514587 -
Saudi Medical Journal Apr 2022To recognize and assess treatment compliance in children and adolescents with growth hormone deficiency during the cronavirus disease-2019 (COVID-19) pandemic along with...
OBJECTIVES
To recognize and assess treatment compliance in children and adolescents with growth hormone deficiency during the cronavirus disease-2019 (COVID-19) pandemic along with other lifestyle factors that might have been affected by the pandemic, such as diet, physical activity, sleep pattern, and screen time.
METHODS
This descriptive, cross-sectional study was carried out between March 2020-2021 at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Data were collected through clinical interview questions.
RESULTS
The total sample size was 130 patients, 54 (41.5%) of whom were males and 76 (58.5%) were females. The mean age of the patients was 12.56±3.44 years. Comparisons of before and during the COVID-19 pandemic revealed significant changes in growth hormone therapy compliance (=0.007), dietary changes (=0.002) with an increase in vegetables and fruit consumption, a significant decrease in physical activity time (<0.001), an increase in sleep time (<0.001), and screen time (<0.001).
CONCLUSION
The COVID-19 crisis had an impact on growth hormone therapy compliance, with a significant impact on other lifestyle factors such as dietary habits, physical activity, sleep time, and leisure screen time.
Topics: Adolescent; COVID-19; Child; Cross-Sectional Studies; Female; Growth Hormone; Humans; Life Style; Male; Pandemics; Patient Compliance; SARS-CoV-2
PubMed: 35414621
DOI: 10.15537/smj.2022.43.4.20210877 -
Journal of Medical Ethics Sep 2006Compliance is a key concept in health care and affects all areas of health care including diabetes. Non-compliance has previously been a label attached to many patients... (Review)
Review
Compliance is a key concept in health care and affects all areas of health care including diabetes. Non-compliance has previously been a label attached to many patients without much thought having been given to the causes of poor compliance. Over the last few decades there has been a large volume of research focusing on compliance that has exposed the multitude of factors affecting compliance. Even the definition is not clear cut and so comparability between studies is not without difficulties. A better understanding of the factors affecting compliance, including the doctor/patient relationship, has allowed the evolution of "concordance". Concordance views the patient as being the equal of the healthcare provider and as having a right to make informed decisions. In a condition such as diabetes, which has many potential long term complications, it is vital that concordance is embraced in the healthcare system in order to improve care.
Topics: Attitude of Health Personnel; Communication; Diabetes Mellitus; Health Knowledge, Attitudes, Practice; Humans; Patient Compliance; Physician-Patient Relations; Treatment Outcome
PubMed: 16943329
DOI: 10.1136/jme.2005.012138 -
Physical Therapy Dec 2008
Topics: Health Behavior; Humans; Motivation; Outpatients; Patient Compliance; Patient Dropouts; Physical Therapy Modalities; Professional-Patient Relations
PubMed: 19047072
DOI: 10.2522/ptj.20070076.ic -
Respirology (Carlton, Vic.) Apr 2020Continuous positive airway pressure (CPAP) is highly effective in treating sleep-disordered breathing (SDB). However, unlike surgical interventions, this treatment... (Review)
Review
Continuous positive airway pressure (CPAP) is highly effective in treating sleep-disordered breathing (SDB). However, unlike surgical interventions, this treatment modality relies heavily on patient acceptance and adherence. The current definition of adherence is largely arbitrary and is mainly used by third-party payers to determine CPAP reimbursement but CPAP adherence remains sub-optimal. Strategies to augment adherence, especially early in the course of a CPAP trial, are needed in the management of SDB. An understanding of the basis for observed differences in CPAP and oral appliance (OA) use is necessary in developing these strategies, but to date no single factor has been consistently identified. Consequently, a multidimensional approach using educational, behavioural, technological and potentially pharmacological strategies to target (i) disease characteristics, (ii) patient characteristics including psychosocial factors, (iii) treatment protocols and (iv) technological devices and side effects that may influence adherence, is likely required to augment the complex behaviour of CPAP and OA use. In the near future, we envision a personalized medicine approach to determine the risk of non-adherence and set individualized adherence goals aimed at treating specific symptoms (e.g. excessive daytime sleepiness) and reducing the risk of patient-specific SDB consequences (e.g. atherosclerosis). Resources for interventions to improve adherence such as educational programmes and telemedicine encounters could then be more efficiently allocated.
Topics: Continuous Positive Airway Pressure; Humans; Patient Compliance; Sleep Apnea Syndromes
PubMed: 31270925
DOI: 10.1111/resp.13589