OBJECTIVE: Psychosocial research in bipolar disorder (BD) has not yet assessed the relative benefits of a short course of psychoeducation (PE), compared with a longer course of cognitive-behavioural therapy (CBT) containing psychoeducational principles. This pilot study evaluated the efficacy and added benefit of adding a course of CBT to a ...

OBJECTIVE: The purpose of the study is to describe allocation of responsibility for illness management in families of children and adolescents perinatally infected with HIV. METHODS: A total of 123 youth (ages 8-18) and caregivers completed family responsibility and medication adherence questionnaires as part of a substudy of Pediatric AIDS ...

BACKGROUND: Prior studies have linked limited literacy to poorer HIV medication adherence, although the precise causal pathways of this relationship have only been initially investigated. OBJECTIVE: To examine whether social stigma is a possible mediator to the relationship between literacy and self-reported HIV medication adherence. DESIGN: Structured patient interviews with ...

BACKGROUND: Although it is important to achieve a good death in Japan, there have been no studies to explore factors associated with a good death. The aim of this study was to explore factors contributing to a good death from the bereaved family members' perspectives, including patient and family demographics ...

Managing heart failure is complex because of the requisite polypharmacy resulting from evidence based care, dietary limitations, lifestyle modifications, and the need for frequent contact and follow-up. Therefore, it is not surprising that adherence to the prescribed medical regimen is frequently suboptimal, serving as the major cause for heart failure ...

BACKGROUND: Low numeracy is pervasive and constrains informed patient choice, reduces medication compliance, limits access to treatments, impairs risk communication, and affects medical outcomes; therefore, it is incumbent upon providers to minimize its adverse effects. PURPOSE: We provide an overview of research on health numeracy and discuss its implications in ...

BACKGROUND: There has been a lack of qualitative research specifically in patients with inflammatory bowel disease relating to reasons for failure to take medication. We aimed to address this gap and also identify factors which might increase adherence. METHODS: Twenty-seven patients from 3 UK hospital sites (Leicester, Norwich, and Cardiff) ...

Treatment adherence is critical in managing chronic disease, but achieving it remains an elusive goal across many prevalent conditions. As part of its care management strategy, BlueCross BlueShield of South Carolina (BCBSSC) implemented the Longitudinal Adherence Treatment Evaluation program, a behavioral intervention to improve medication adherence among members with cardiovascular ...

Medication continues to be the most widely prescribed treatment in the NHS for mental health problems. It has been known for many years that individuals differ in the way they respond to a given pharmaceutical therapy, and one reason for this lies in the genetic variation between individuals. This paper ...

Hypertension may be poorly controlled because patients do not take their medications (poor adherence) or because providers do not increase medication when appropriate (lack of medication intensification, or "clinical inertia"). We examined the prevalence of and relationship between patient adherence and provider treatment intensification. We used a retrospective cohort study ...

Medication adherence in heart failure (HF) is a crucial but poorly understood phenomenon. The purpose of this study was to explore factors contributing to medication adherence in patients with HF by using the World Health Organization's multidimensional adherence model. Patients (N = 134) with HF (70% were male, aged 61 ...

OBJECTIVE: To assess the utility of Leventhal's Self-Regulatory Model (SRM) to predict self-care behavior with regard to dietary, medication, and fluid regimes in end-stage renal disease (ESRD) patients. METHODS: In a prospective study, ESRD patients treated via hospital-based haemodialysis (N=73) were screened for cognitive deficits and completed questionnaires that enquired ...

Health care providers, treating patients with chronic non-malignant pain, often experience that medication is not as effective as expected. It is important to realize that the effectiveness of a pharmacological treatment can be influenced by the way the medication is taken. Medication adherence is a topic that gains more attention, ...

BACKGROUND: Despite being essential to medication adherence, redemption of initial prescriptions (ie, primary adherence) has been investigated only sparsely. OBJECTIVES: The objectives were to determine the frequency and risk factors for primary nonadherence among outpatients with dermatologic conditions. METHODS: Every 15th day during 2006, all patients receiving a prescription for ...

As part of the process of developing cognitive-behavioral therapy (CBT) for medical adherence and depression (Safren, Gonzalez, & Soroudi, 2007), the authors conducted exit interviews among 14 HIV-infected patients who received the intervention, and transcribed, coded, and analyzed these data. The authors concluded that CBT was structured yet flexible, developed ...

Focus group methodology was used to describe the medication adherence experience of 24 HIV-infected gay men who reported being adherent to their medication regimens. A conceptualization of medication adherence as an evolving process consisted of challenges to adherence (learning the diagnosis, starting the medications, struggling with the medications, dealing with ...

Because medication adherence is critical to improving the virologic and immunologic response to therapy and reducing the risk of drug resistance, it is important that we understand the predictors of nonadherence. The goal of the current study is to examine demographic, health behavior and psychosocial correlates (e.g., stressful life events, ...

OBJECTIVE: Partial compliance with antipsychotic medication increases relapse and rehospitalization rates in patients with schizophrenia. The aim of the present study was to assess the frequency of and factors contributing to partial compliance. METHOD: During a 10 day period in June 2004 psychiatrists working in hospitals or in private practices ...

This study examines the psychometric properties and tests the concurrent and predictive validity of a structured, self-reported medication adherence measure in patients with hypertension. The authors also assessed various psychosocial determinants of adherence, such as knowledge, social support, satisfaction with care, and complexity of the medical regimen. A total of ...

BACKGROUND: Some people take the disease label "hypertension" literally; leading to the belief that increasing relaxation instead of medication is the best treatment for this condition. We experimentally tested the effect of such underlying beliefs on ratings of interventions for hypertension and compared alternative communication strategies to increase medication effectiveness ...

BACKGROUND: Medication regimens are constantly modified and updated during a patient's hospitalization. These modifications and those made after discharge might increase the risk for nonadherence, polypharmacy, and poor outcomes among elderly patients. OBJECTIVES: To investigate the extent of in-hospital modification of medication regimens of elderly patients and its relationship to ...

Glaucoma is initially asymptomatic, but untreated can result in progressive visual field loss and eventual blindness. With adequate therapy progression can be halted, but poor adherence with medical therapy is a significant issue requiring further research. The aim of the present study was to gain a better understanding of the ...

The aim of this study was to identify barriers to medication adherence in adolescent transplant recipients. Eighty adolescent transplant recipient families reported in an open-ended manner about barriers to medication adherence. These responses were then coded to reflect potentially important themes associated with medication adherence. The themes derived included: forgot/distracted, ...

This study was conducted to clarify whether the brachial-ankle pulse wave velocity (baPWV) might serve as a marker of target organ damage in middle-aged hypertensive subjects. Multivariate linear regression analysis demonstrated that while the baPWV showed a significant relationship to the intima-media thickness of the carotid artery (IMT), no such ...

Arthrocentesis is a method of flushing out the temporomandibular joint (TMJ) that is currently performed by providing a double access to the joint space. Several studies have shown that arthrocentesis of the upper compartment of the TMJ may be a highly effective method to restore normal maximal mouth opening and ...

BACKGROUND AND OBJECTIVE: Adherence with preventive asthma medication by young children is an important factor when evaluating a suboptimal response to treatment. However, few data exist regarding the accuracy of subjective measures of adherence and factors associated with adherence in young children. METHODS: Fifty-one asthmatic children aged 18 months to ...

BACKGROUND: Electronic monitoring devices (EMDs) are regarded as the gold standard for assessing medication adherence in clinical research. However, little is known about the effect of patients' acceptance of EMDs on medication adherence in African Americans with hypertension who are followed in primary care practices OBJECTIVE: To assess patients' perceptions ...

Measuring medication adherence in patients with schizophrenia is difficult and lacks a gold standard. Consequently, a great number of different methods and instruments have been proposed. Although it has been assumed that they all measure medication adherence, this study demonstrates that instruments differ significantly. Using data from an international multisite ...

The effects of implementation intentions and posthypnotic suggestion were investigated in 2 studies. In Experiment 1, participants with high levels of hypnotic suggestibility were instructed to take placebo pills as part of an investigation of how to best enhance compliance with medical instruction. In Experiment 2, participants with high, medium, ...

BACKGROUND: Little is known about the effect of nonadherence among patients with coronary artery disease (CAD) on a broad spectrum of outcomes including cardiovascular mortality, cardiovascular hospitalizations, and revascularization procedures. METHODS: This was a retrospective cohort study of 15,767 patients with CAD. Medication adherence was calculated as proportion of days ...

BACKGROUND: Significant number of patients with ulcerative colitis (UC) fail to comply with treatment. AIMS: To review issues surrounding medication non-adherence in inflammatory bowel disease (IBD), including the clinical and health service implications in the UK, and discuss strategies for optimizing medication adherence. METHODS: Articles cited were identified via a ...

The research study aimed to identify the factors contributing to premature termination of treatment for substance addiction. The investigation took the form of a differential research design based on archival data obtained from patient files at an inpatient drug rehabilitation centre in Gauteng. One independent variable (treatment adherence) and five ...

This study examined the medication compliance of people with schizophrenia in relation to their self-stigma, insight, attitude towards medication, and socio-demographic status via a cross-sectional observational design. Eighty-six Chinese adults with schizophrenia were recruited from the psychiatric hospitals and community settings for this study. The findings suggested that stereotype agreement ...

BACKGROUND: A bioterrorism attack with an agent such as anthrax will require rapid deployment of medical and pharmaceutical supplies to exposed individuals. How should such a logistical system be organized? How much capacity should be built into each element of the bioterrorism response supply chain? METHODS: The authors developed a ...

Nonadherence with medication treatment has been found to occur in large proportions of patients with a broad range of chronic conditions. Our aim was to perform a systematic review of the literature examining adherence with treatments for inflammatory rheumatic conditions to assess the magnitude of the problem in this patient ...

OBJECTIVE: To examine the relationship between medication adherence and quality of life (QOL) in adolescent patients with inflammatory bowel disease (IBD) utilizing a multimethod adherence assessment approach. METHODS: Medication adherence in 36 adolescents with IBD was assessed via interviews, pill counts, and biological assays. QOL was assessed via patient and ...

OBJECTIVE: To use multiple data sources to determine drivers of patient adherence to topical ocular hypotensive therapy. DESIGN: Retrospective database and chart reviews in combination with prospective patient surveys. Diverse medical environments where insured patients in the research database seek care. PARTICIPANTS: Three hundred patients with a new claim diagnosis ...

OBJECTIVES: To determine treatment compliance and how compliance was perceived by patients, parents and by a multidisciplinary team in Cystic Fibrosis (CF) patients. Also to analyse the relative importance given to each of the prescribed treatments, reasons for non-adherence and to investigate possible predictors of therapeutic compliance. PATIENTS AND METHODS: ...

The purpose of this research was to examine the impact of HIPAA compliance on the Battlefield Medical Evacuation process. Specifically, this thesis sought to answer three research questions addressing the current Battlefield Medical Evacuation process and current HIPAA considerations for each step of the process. The research questions were answered ...

Lifestyle modification should be an important part of therapy when hypertension is first diagnosed, with or without starting antihypertensive medication. The objective of the present study was to determine the extent to which recently diagnosed hypertensive Canadians modify their lifestyles and to examine how lifestyle modification relates to antihypertensive medication ...

Clinicians aim to establish trust during medical encounters because, without it, health consumers may not seek medical care, consider their diagnoses legitimate, or adhere to treatment regimens. This paper examines the identification and treatment of memory loss within two specialty clinics to understand how cultural dynamics, such as organizational ethos ...

OBJECTIVE: To explore the experiences and perceptions of postmenopausal women regarding strategies to improve adherence to osteoporosis therapy. DESIGN: Qualitative, mixed phenomenologic study using focus groups. SETTING: Family physicians' and specialists' practices and community pharmacies in Hamilton, Ont. PARTICIPANTS: A total of 37 postmenopausal women currently taking at least 1 ...

OBJECTIVE: Poor adherence to a low-sodium diet (LSD) and prescribed medications increases rehospitalization risk in patients with heart failure (HF). Clinicians have difficulty assessing adherence objectively, so they depend on patients' self-report. The degree to which self-reported adherence reflects actual adherence is unclear. We examined patients' ability to self-monitor adherence ...

Data indicate that nonadherence plays a major role in preventable rehospitalizations. The first step to improving adherence is determining the affecting factor. This article critically reviews the literature on factors affecting medication adherence in heart failure patients. Findings about effects of age, gender, race, and living status on adherence are ...

OBJECTIVE: To investigate whether patients' expectations influence how they take their medications by looking at the expectations patients have of their medications and the factors that affect these expectations. DESIGN: Qualitative study using in-depth interviews and a grounded-theory approach. SETTING: A large city in Ontario. PARTICIPANTS: A total of 18 ...

OBJECTIVE: Federal regulations governing transportation safety disqualify commercial drivers with persistent uncontrolled hypertension. We sought to determine whether a hypertension management and health promotion program designed for commercial drivers improved blood pressure (BP) outcomes among drivers employed by a self-insured utility company. METHODS: This retrospective study examined the employment-related medical ...

BACKGROUND: British Columbia's central prescription database, PharmaNet, is often used for both clinical and research applications. However, PharmaNet details prescription transactions, not actual medication consumption, resulting in many potential sources of inaccuracy when the information is assumed to reflect population or individual drug utilization. OBJECTIVE: To assess the accuracy of ...

AIMS/HYPOTHESIS: Structured exercise is considered a cornerstone in type 2 diabetes treatment. However, adherence to combined resistance and endurance type exercise or medical fitness intervention programmes is generally poor. Group-based brisk walking may represent an attractive alternative, but its long-term efficacy as compared with an individualised approach such as medical ...

BACKGROUND: The inverse correlation between the complexity of a drug regimen and medication adherence is well established. Fixed-dose combination (FDC) therapies are hypothesized to enhance compliance by decreasing the number of required pills. OBJECTIVE: The objective of the study is to compare adherence of a FDC [Glucovance, a FDC of ...

OBJECTIVE: The current study quantitatively synthesized the adherence intervention literature for two common acute childhood illnesses and examined the magnitude of change in adherence as indicated by different outcome measures and the relationship between type of intervention and adherence outcome. METHODS: Meta-analysis was used to synthesize the results of 12 ...