Displaying publications 1 - 20 of 229 in total

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  1. AlOmari F, A Hamid AB
    PLoS One, 2022;17(11):e0272057.
    PMID: 36399483 DOI: 10.1371/journal.pone.0272057
    The purpose of this study is to empirically examine the relationships between service quality, patient satisfaction, patient loyalty and medication adherence in the Syrian healthcare setting from a patient's perspective. Based on random sampling technique, data collection was conducted in six hospitals located in the Syrian capital Damascus. The reliability and validity of the theoretical model had been confirmed using quantitative analyses SmartPLS software. The study indicated that our proposed model can significantly explain (35) per cent of patient satisfaction, (55) per cent of patient loyalty and (46) per cent medication adherence in a statistically manner. Our results highlighted that patient satisfaction mediated the relationship between patient loyalty and service quality (assurance, reliability and financial aspect). Besides, patient satisfaction had mediation effect on the relationship between medication adherence and service quality (reliability and financial aspect). Financial aspect had the highest impact on patient satisfaction (β = 0.242) and medication adherence (β = 0.302). In addition, reliability was the only dimension of service quality that had a significant direct impact on patient satisfaction, patient loyalty and medication adherence. To increase patient loyalty in Syrian hospitals, healthcare professionals should place a greater emphasis on the reliability and responsiveness elements of service quality. To the author's knowledge, this is the first study conducted during the COVID pandemic to evaluate the mediating role of patient satisfaction in the relationship between service quality, patient loyalty and medication adherence in the Syrian healthcare sector.
    Matched MeSH terms: Medication Adherence
  2. Collister D, Mbuagbaw L, Guyatt G, Devereaux PJ, Tennankore KK, Reis G, et al.
    Contemp Clin Trials, 2021 08;107:106466.
    PMID: 34098039 DOI: 10.1016/j.cct.2021.106466
    BACKGROUND/AIMS: To examine how measuring adherence at 3 weeks by self-report and pill counts compares to measurements at 7 weeks in a pre-randomization run-in period.

    METHODS: Study within a trial of an international parallel group randomized controlled trial (RCT) that compares spironolactone to placebo. Adults receiving dialysis enter an 8-week active run-in period with spironolactone. Adherence was assessed by both self-report and pill counts in a subgroup of participants at both 3 weeks and 7 weeks.

    RESULTS: 332 participants entered the run-in period of which 166 had complete data. By self-report, 146/166 (94.0%) and 153/166 (92.2%) had at least 80% adherence at 3 and 7 weeks respectively (kappa = 0.27 (95% C.I. 0.16 to 0.38). By pill counts, the mean (SD) adherence was 96.5% (16.1%) and 92.4% (18.2%) at 3 and 7 weeks respectively (r = 0.32) with a mean (SD) difference of 3.1% (17.8%) and a 95% limit of agreement from -31.7% to +37.9%. The proportion of adherent participants by self-report and pill counts at 3 weeks agreed in 87.4% of participants (McNemar's p-value 0.58, kappa 0.11, p = 0.02) and at 7 weeks agreed in 92.2% (McNemar's p-value 0.82, kappa 0.47, p 

    Matched MeSH terms: Medication Adherence*
  3. Megat Kamaruddin PSN, Mohammed Nawi A, Abdul Manaf MR, Yaman MN, Abd Malek AM
    Glob Heart, 2023;18(1):12.
    PMID: 36936248 DOI: 10.5334/gh.1173
    BACKGROUND: Electronic Health (eHealth) interventions as a secondary prevention tool to empower patients' health in decision-making and behaviour.

    OBJECTIVE: With the growing body of evidence supporting the use of eHealth interventions, the intention is to conduct a meta-analysis on various health outcomes of eHealth interventions among ischaemic heart disease (IHD) patients.

    METHODS: Based on PRISMA guidelines, eligible studies were searched through databases of Web of Science, Scopus, PubMed, EBSCOHost, and SAGE (PROSPERO registration CRD42021290091). Inclusion criteria were English language and randomised controlled trials published between 2011 to 2021 exploring health outcomes that empower IHD patients with eHealth interventions. RevMan 5.4 was utilised for meta-analysis, sensitivity analysis, and risk of bias (RoB) assessment while GRADE software for generating findings of physical health outcomes. Non-physical health outcomes were analysed using SWiM (synthesis without meta-analysis) method.

    RESULTS: This review included 10 studies, whereby, six studies with 895 participants' data were pooled for physical health outcomes. Overall, the RoB varied significantly across domains, with the majority was low risks, a substantial proportion of high risks and a sizeable proportion of unclear. With GRADE evidence of moderate to high quality, eHealth interventions improved low density lipoprotien (LDL) levels in IHD patients when compared to usual care after 12 months of interventions (SMD -0.26, 95% CI [-0.45, -0.06], I2 = 0%, p = 0.01). Significance appraisal in each domain of the non-physical health outcomes found significant findings for medication adherence, physical activity and dietary behaviour, while half of the non-significant findings were found for other behavioural outcomes, psychological and quality of life.

    CONCLUSIONS: Electronic Health interventions are found effective at lowering LDL cholesterol in long-term but benefits remain inconclusive for other physical and non-physical health outcomes for IHD patients. Integrating sustainable patient empowerment strategies with the advancement of eHealth interventions by utilising appropriate frameworks is recommended for future research.

    Matched MeSH terms: Medication Adherence
  4. Munsour EE, Awaisu A, Ahmad Hassali MA, Dabbous Z, Zahran N, Abdoun E
    Res Social Adm Pharm, 2020 Jun;16(6):793-799.
    PMID: 31542446 DOI: 10.1016/j.sapharm.2019.08.038
    BACKGROUND: The importance of providing accurate medication information that can be easily comprehended by patients to subsequently best use their medication(s) has been widely reported in the literature. Patient information leaflet (PIL) is a supporting tool aiding patients to make decisions about their treatment plan and improve patient-clinician communication and thus medication adherence. PIL is the written document produced by the pharmaceutical manufacturers and packed with the medicine. The available PILs do not consider cultural and behavioral perspectives of diverse populations residing in a country like Qatar. Consumer medication information (CMI) is written information about prescription drugs developed by organizations or individuals other than a drug's manufacturer that is intended for distribution to consumers at the time of drug dispensing.

    OBJECTIVE: To investigate the impact of customized CMI (C-CMI) on health-related quality of life (HRQoL) among type 2 diabetes mellitus (T2DM) patients in Qatar.

    METHODS: This was a randomized controlled intervention study, in which the intervention group patients received C-CMI and the control group patients received usual care. HRQoL was measured using the EQ-5D-5L questionnaire and EQ visual analog scale (EQ-VAS) at three intervals [i.e. baseline, after 3 months and 6 months].

    RESULTS: The EQ-5D-5L index value for the intervention group exhibited sustained improvement from baseline to the third visit. There was a statistically significant difference between groups in the HRQoL utility value (represented as EQ index) at 6 months (0.939 vs. 0.796; p = 0.019). Similarly, the intervention group compared with the control group had significantly greater EQ-VAS at 6 months (90% vs. 80%; p = 0.003).

    CONCLUSIONS: The impact of C-CMI on health outcomes of T2DM patients in Qatar reported improvement in HRQoL indicators among the intervention patients. The study built a platform for health policymakers and regulatory agencies to consider the provision of C-CMI in multiple languages.

    Matched MeSH terms: Medication Adherence
  5. Kassab Y, Hassan Y, Abd Aziz N, Ismail O, AbdulRazzaq H
    Int J Clin Pharm, 2013 Apr;35(2):275-80.
    PMID: 23283596 DOI: 10.1007/s11096-012-9735-y
    BACKGROUND: Secondary prevention pharmacotherapy improves outcomes after acute coronary syndrome (ACS). However, poor medication adherence is common, and various factors play a role in adherence.
    OBJECTIVES: The purpose of this study was to evaluate patients' level of adherence to evidence-based therapies at an average of 6 months after discharge for acs and to identify factors associated with self-reported non-adherence.
    SETTING: This prospective study was conducted in the outpatient cardiac clinics of Hospital Pulau Pinang, located in Penang Island, a northern state in Malaysia.
    METHOD: A random sample of ACS patients (n = 190) who had been discharged on a regimen of secondary preventive medications were included in this study. Six months after discharge and during their scheduled follow-up appointments to cardiac clinics, patients were interviewed using the translated eight-item Morisky Medication Adherence Scale.
    MAIN OUTCOME MEASURE: self-reported patients' adherence to medication.
    RESULTS: Six months following their hospital discharge, only 35 patients (18.4 %) reported high adherence. Medium adherence was reported in majority of patients (51.1 %). Low adherence was reported in 58 patients (30.5 %). Forgetfulness was the most frequently reported reason for patients' non-adherence to their medications (23.2 %). Furthermore, this study identified 5 factors-namely age, employment status, ACS subtypes, number of comorbidities, and number of prescription medications per day-that may influence Patients' level of adherence to the prescribed regimens.
    CONCLUSIONS: Our findings revealed a problem of non-adherence to secondary prevention medications among patients with ACS in Malaysia. Furthermore, this study demonstrates that older patients, unemployed patients, patients with more comorbid conditions, and those receiving multiple medications are less likely to adhere to their prescribed medications 6 months after hospital discharge.

    Study site: outpatient cardiac clinics of Hospital Pulau Pinang
    Matched MeSH terms: Medication Adherence*
  6. Akoi C, Rahman MM, Abdullah MS
    Int J Public Health Res, 2013;3(1):236-240.
    MyJurnal
    Medication adherence is very important for the effective treatment or control of various health problems, including chronic disease like diabetes mellitus (DM). However, medication non-adherence among diabetic patients on follow-up treatment is still a global health problem. This study aimed to identify factors associated with medication adherence and to determine methods on how it could be improved. A cross-sectional study was conducted on medication adherence among Malays, Iban and Melanau ethnic groups in Kota Samarahan and Sarikei, Sarawak using the Health Belief Model framework. Interviews with questionnaires, which were tested for its validity and reliability using the Cronbach’s Alpha, were conducted to collect data on the respondent’s socio-demographic and economic characteristics, and health beliefs of 442 respondents. Data was analyzed using SPSS version 17.0 for frequency distribution, measures of central tendencies, significance testing and logistic regression. The medication adherence rates were low in terms of all the treatment indicators such as amount of medication (31.7%), frequency (38.9%), duration (26%), and follow-up treatment (24.2%). The respondent’s socio-economic and economic characteristics have statistically significant association with medication adherence. The respondents adhered towards medication because they believed in its benefits. They also took their medication because they believed in the severity of DM and their susceptibility to its serious complications. The cues to action (medication taking) such as worrying about their socio-economic well-being, effectiveness of medication, and health campaign on diabetic control have influenced medication adherence. However, forgetfulness, distance of clinic, and costs of transport have caused medication non-adherence. The respondent's health beliefs in the benefits of taking medication, perceived severity and susceptibility to DM and its serious complications have contributed towards medication adherence. Their concerns about the socio-economic well-being, effectiveness of medication, and health campaign on diabetic control were positive cues to medication taking behavior. Therefore, modifying the respondent's related health beliefs and reinforcing the positive cues to actions are the relevant intervention strategies that could be used in improving medication adherence among diabetic patients.
    Matched MeSH terms: Medication Adherence
  7. Chua SS, Lee YK, Chua CT, Abdullah MS
    JUMMEC, 2002;7:100-106.
    Many studies have shown that failure in the control of hypertension with oral antihypertensives could be associated with noncompliance. The present study was conducted to assess the compliance rate to antihypertensive therapies and also to determine factors related to any noncompliance. The study was conducted in a teaching hospital in Kuala Lumpur. Data was collected from patients' medical records and via personal interview using a structured questionnaire. Out of a total of 175 respondents recruited in the study, 49.1% missed at least a dose of their antihypertensive agents during a one·month period. The most common reason given by respondents who were not compliant to their antihypertensive therapies was forgetfulness (91.8%), followed by too busy (20.0%) and insufficient medication supplied to them (18.8%). None of the factors analysed, including the demography of the respondents, their knowledge about hypertension and the types of antihypertensive therapies they were on, had any statistically significant influence on the compliance behaviour of the respondents to their antihypertensive therapies. However, more than 80% of the respondents kept their appointment to see their doctor and only this factor appeared to be related to the medication compliance behaviour although it still did not reach any statistical significance. KEYWORDS: Compliance, antihypertensive agent, blood pressure, knowledge
    Matched MeSH terms: Medication Adherence
  8. Hatah E, Rahim N, Makmor-Bakry M, Mohamed Shah N, Mohamad N, Ahmad M, et al.
    PLoS One, 2020;15(11):e0241909.
    PMID: 33157549 DOI: 10.1371/journal.pone.0241909
    Medication non-adherence remains a significant barrier in achieving better health outcomes for patients with chronic diseases. Previous self-reported medication adherence tools were not developed in the context of the Malaysia population. The most commonly used tool, MMAS-8, is no longer economical because it requires a license and currently every form used is charged. Hence, there is a need to develop and validate a new medication adherence tool. The Malaysia Medication Adherence Assessment Tool (MyMAAT) was developed by a multidisciplinary team with expertise in medication adherence and health literacy. The face and content validities of the MyMAAT was established by a panel of experts. A total of 495 patients with type 2 diabetes were recruited from the Ministry of Health facilities consisting of five hospitals and five primary health clinics. A test-retest was conducted on 42 of the patients one week following their first data collection. Exploratory factor analysis was performed to evaluate the validity of the MyMAAT. The final item for MyMAAT was compared with SEAMS, HbA1c%, Medication Possession ratio (MPR) score, and pharmacist's subjective assessment for its hypothesis testing validity. The MyMAAT-12 achieved acceptable internal consistency (Cronbach's alpha = 0.910) and stable reliability as the test-retest score showed good to excellent correlation (Spearman's rho = 0.96, p = 0.001). The MyMAAT has significant moderate association with SEAMS (Spearman's rho = 0.44, p = < 0.001) and significant relationship with HbA1c (< 8% and ≥ 8%) (χ2(1) = 13.4, p < 0.001), MPR (χ2(1) = 13.6, p < 0.001) and pharmacist's subjective assessment categories (χ2(1) = 31, p < 0.001). The sensitivity of MyMAAT-12, tested against HbA1c% was 72.9% while its specificity was 43%. This study demonstrates that the MyMAAT-12 together with other methods of assessment may make a better screening tool to identify patients who were non-adherence to their medications.
    Matched MeSH terms: Medication Adherence/statistics & numerical data*
  9. Naqvi AA, Hassali MA, Naqvi SBS, Aftab MT
    Trials, 2019 Aug 09;20(1):488.
    PMID: 31399128 DOI: 10.1186/s13063-019-3540-z
    BACKGROUND: The objective of this study is to evaluate the effectiveness of pharmacist intervention in improving disease knowledge, adherence to treatment, health-related quality of life (HRQoL) and direct cost of treatment. The study also documents patient satisfaction with pharmacist counselling as a quality control measure.

    METHODS/DESIGN: This is a randomized, single-blind, two-arm, controlled trial in patients with rheumatoid arthritis visiting outpatient rheumatology clinics in Karachi, Pakistan. We will enroll patients with established diagnosis of rheumatoid arthritis over 3 months. The patients would be randomized through a computer-generated list into the control group, i.e., usual care or into the intervention group, i.e., pharmaceutical care, in a ratio of 1:1, after providing signed written consent. The study will take place in two patient-visits over the course of 3 months. Patients in the intervention group would receive intervention from the pharmacist while those in the control group will receive usual care. Primary outcomes include change in mean score from baseline (week 0) and at follow up (week 12) in disease knowledge, adherence to medications and rehabilitation/physical therapy. The secondary outcomes include change in the mean direct cost of treatment, HRQoL and patient satisfaction with pharmacist counselling.

    DISCUSSION: This is a novel study that evaluates the role of the pharmacist in improving treatment outcomes in patients with rheumatoid arthritis. The results of this trial could set the foundation for future delivery of care for this patient population in Pakistan. The results of this trial would be published in a peer-reviewed journal.

    TRIAL REGISTRATION: ClinicalTrials.gov, NCT03827148 . Registered on February 2019.

    Matched MeSH terms: Medication Adherence
  10. Damulak PP, Ismail S, Abdul Manaf R, Mohd Said S, Agbaji O
    PMID: 33802322 DOI: 10.3390/ijerph18052477
    Optimal adherence to antiretroviral therapy (ART) remains the bedrock of effective therapy and management of human immunodeficiency virus (HIV). This systematic review examines the effect of interventions in improving ART adherence in sub-Saharan Africa (SSA), which bears the largest global burden of HIV infection. In accordance with PRISMA guidelines, and based on our inclusion and exclusion criteria, PUBMED, MEDLINE, and Google Scholar databases were searched for published studies on ART adherence interventions from 2010 to 2019. Thirty-one eligible studies published between 2010 to 2019 were identified, the categories of interventions were structural, behavioral, biological, cognitive, and combination. Study characteristics varied across design, intervention type, intervention setting, country, and outcome measurements. Many of the studies were behavioral interventions conducted in hospitals with more studies being randomized controlled trial (RCT) interventions. Despite the study variations, twenty-four studies recorded improvements. Notwithstanding, more quality studies such as RCTs should be conducted, especially among key affected populations (KAPs) to control transmission of resistant strains of the virus. Reliable objective measures of adherence should replace the conventional subjective self-report. Furthermore, long-term interventions with longer duration should be considered when evaluating the effectiveness of interventions.
    Matched MeSH terms: Medication Adherence*
  11. Abas SA, Ismail N, Zakaria Y, Yasin SM, Ibrahim K, Ismail I, et al.
    BMC Public Health, 2024 Jan 22;24(1):249.
    PMID: 38254065 DOI: 10.1186/s12889-023-17561-z
    BACKGROUND: Finding innovative methods to enhance Tuberculosis treatment adherence in Malaysia is imperative, given the rising trend of non-adhere TB patients. Direct Observed Therapy (DOTS) has been used to ensure Tuberculosis (TB) drug compliance worldwide. However, due to its inconvenience, digitalizing this system into a virtual monitoring system via a mobile app can help deliver a more efficient tuberculosis management system. A gamified video-observed therapy is developed that connects three users the patient, supervisor, and administrator, allowing drug monitoring and patient loss to follow up with the patient tracking system. Thus, the objective of this study is to determine the impact of Gamified Real-time Video Observed Therapy (GRVOTS) mobile apps on patient medication adherence rates and motivation.

    METHODS: 71 patients from 18 facilities participated in the 8-week single-arm intervention study. GRVOTS mobile apps were installed in their mobile apps, and patients were expected to fulfill tasks such as providing Video Direct Observe Therapy (VDOTS) daily as well as side effect reporting. At 3-time intervals of baseline,1-month, and 2-month intervals, the number of VDOT taken, the Malaysian Medication Adherence Assessment Tool (MyMAAT), and the Intrinsic Motivation Inventory (IMI) questionnaire were collected. One-sample t-test was conducted comparing the VDOT video adherence to the standard rate of 80%. RM ANOVA was used to analyze any significant differences in MyMAAT and IMI scores across three-time intervals.

    RESULTS: This study involved 71 numbers of patients from 18 healthcare facilities who showed a significantly higher treatment adherence score of 90.87% than a standard score of 80% with a mean difference of 10.87(95% CI: 7.29,14.46; p 

    Matched MeSH terms: Medication Adherence*
  12. Ibrahim IR, Ibrahim MI, Al-Haddad MS
    Int J Clin Pharm, 2012 Oct;34(5):728-32.
    PMID: 22744843 DOI: 10.1007/s11096-012-9667-6
    BACKGROUND: Beyond the direct pharmacological effect of medicines, preferences and perceptions toward a particular oral solid dosage form (OSDF) play a crucial role in recovery and may reduce adherence to the prescribed treatment.

    OBJECTIVES: This study conducted to investigate the most preferred OSDF and the degree to which swallowing solid medication is an issue, to assess perceptions of the therapeutic benefits of the OSDF, and to find predictors of the most preferred OSDF.

    METHOD: A cross-sectional study, through convenience sample method, was conducted to survey consumers visiting community pharmacies in Baghdad, Iraq. Data was collected by self-administered and pre-piloted questionnaires, and analyzed using Statistical Package for Social Science. Multiple logistic regression analysis and Chi-square tests were used at alpha level = 0.05.

    RESULTS: A total of 1,000 questionnaire were included in the analysis. Of all respondents, 52.9 % preferred capsule among other OSDF and this preference varied significantly with a number of socio-demographic factors. Ease of swallowing solid medication was the main issue which resulted in preferences for a particular form. A negative perception of the therapeutic benefits of the OSDF was found among 89.1 % of the consumers. Multiple logistic regression analysis indicated that gender, ease of swallowing, and perceptions of the therapeutic benefits of the OSDF were significant predictors of capsule preferences.

    CONCLUSIONS: Given the fact that consumers are the end users of medicines and their preferences may influence response to the treatment, efforts are worthwhile by the prescribers and medicines' manufactures to understand consumers' preferences of a particular dosage form in order to achieve successful therapy outcomes.

    Matched MeSH terms: Medication Adherence/psychology*
  13. Khan AH, Iqbal MZ, Syed Sulaiman SA, Ibrahim A, Azmi NSBY, Iqbal MS, et al.
    J Pharm Bioallied Sci, 2020 12 21;13(1):108-115.
    PMID: 34084056 DOI: 10.4103/jpbs.JPBS_475_20
    Objective: Diabetes mellitus (DM) is a chronic metabolic disorder that can initiate organ damage inside the body if not treated appropriately. Apart from tight glycemic control, a suitable educational intervention is also needed from health-care providers to stop or decrease the progression of organ damage in diabetic patients. This study intended to measure the impact of pharmacist-led educational intervention on improvement in predictors of diabetic foot in two different hospitals in Malaysia.

    Materials and Methods: In two tertiary care selected hospitals, the included diabetic patients were randomly divided into two study arms. In the control group, 200 patients who were receiving usual treatment from hospitals were included. However, in the intervention group, those 200 patients who were receiving usual treatment along with counseling sessions from pharmacists under the Diabetes Medication Therapy Adherence Clinic (DMTAC) program were included. The study continued for 1 year, and there were four follow-up visits for both study arms. A prevalidated data collection form was used to measure the improvement in predictors of diabetic foot in included patients. Data were analyzed by using the Statistical Package for the Social Sciences (SPSS) software program, version 24.0.

    Results: With the average decrease of 1.97% of HbA1c values in the control group and 3.43% in the intervention group, the univariate and multivariate analysis showed a statistically significant difference between both of the study arms in the improvement of predictors belonging to the diabetic foot (P < 0.05). The proportion of patients without any signs and symptoms of the diabetic foot in the intervention group was 91.7%, which increased from 42.3% at baseline (P < 0.05). However, this proportion in the control group was 76.9% at the fourth follow-up, from 48.3% at baseline (P < 0.05).

    Conclusion: A statistically significant reduction in the signs and symptoms of diabetic foot was observed in the intervention group at the end of 1 year. The progression of diabetic foot was significantly decreased in the pharmacist intervention group.

    Matched MeSH terms: Medication Adherence
  14. Mohd Isa NA, Cheng CL, Nasir NH, Naidu V, Gopal VR, Alexander AK
    Med J Malaysia, 2020 07;75(4):331-337.
    PMID: 32723990
    INTRODUCTION: As the first point of contact for those presenting with asthma symptoms, primary healthcare plays a crucial role in asthma management. This is a nationwide study of assessment of asthma symptom control and adherence to asthma medication among outpatients in public health clinics in Malaysia.

    METHODS: This is a prospective, observational multicentre study (ASCOPE; NCT03804632). Data on asthma control, assessment of control symptoms, and adherence to treatment were collected from medical records and interviews of patients. The level of asthma control was assessed using the Global Initiative for Asthma (GINA) Assessment of Symptom Control. Adherence of patient to medication for asthma was assessed through interview of patients using four questions adapted from the Malaysian Medication Adherence Scale.

    RESULTS: Among the 1011 patients recruited, 416 (41%) had well controlled asthma, 388 (38%) were partly controlled, and 207 (21%) had uncontrolled asthma. Majority (81%) had mild asthma and all patients were on asthma medication. Most patients did not have spirometry data (97%) but underwent peak flow rate measurements (98%). Poor adherence occurred at all levels of asthma control but was worst among those with uncontrolled asthma. This was statistically significant across all four questions on adherence (p<0.05). For example, more patients with uncontrolled asthma forgot doses (56%) or stopped treatment (39%) than those with well-controlled asthma (44% and 27%respectively).

    CONCLUSIONS: Among Malaysian primary care patients with asthma, less than 50% had well-controlled asthma, and low adherence to treatment was common. More effort is needed to improve asthma control among patients in Malaysia, including those with mild asthma.
    Matched MeSH terms: Medication Adherence*
  15. Munsour EE, Awaisu A, Hassali MAA, Abdoun E, Dabbous Z, Zahran N, et al.
    Int J Clin Pract, 2020 Aug;74(8):e13527.
    PMID: 32386077 DOI: 10.1111/ijcp.13527
    INTRODUCTION: In patients with diabetes, better health communication is associated with better health outcomes including medication adherence and glycaemic control. The conventional patient information leaflet does not consider the cultural and behavioral perspectives of diverse patient populations. Consumer medicine information (CMI) is a written information about the prescription drugs developed by organisations or individuals other than a drug manufacturer that is intended for distribution to consumers at the time of medication dispensing.

    OBJECTIVE: This study aimed to evaluate the impact of CMI on medication adherence and glycaemic control among patients with type 2 diabetes in Qatar.

    METHODS: We developed and customised CMI for all the anti-diabetic medications used in Qatar. A randomised controlled trial in which the intervention group patients (n = 66) received the customised CMI with usual care, while the control group patients (n = 74) received usual care only, was conducted. Self-reported medication adherence and haemoglobin A1c (HbA1c ) were the primary outcome measures. Glycaemic control and medication adherence parameters were measured at baseline, 3 months, and 6 months in both groups. Medication adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS-8).

    RESULTS: Although the addition of CMI resulted in better glycaemic control, this did not reach statistical significance, possibly because of the short-term follow-up. The median MMAS-8 score improved from baseline (6.6 [IQR = 1.5]) to 6-month follow-up (7.0 [IQR = 1.00]) in the intervention group. In addition, there was a statistically significant difference between the intervention and the control groups in terms of MMAS-8 score at the third visit (7.0 [IQR = 1.0]) vs 6.5 (IQR = 1.25; P-value = .010).

    CONCLUSION: CMI for anti-diabetic medications when added to usual care has the potential to improve medication adherence and glycaemic control among patients with type 2 diabetes. Therefore, providing better health communication and CMI to patients with diabetes is recommended.

    Matched MeSH terms: Medication Adherence/statistics & numerical data*
  16. Nazir SU, Hassali MA, Saleem F, Bashir S, Aljadhey H
    Value Health, 2015 Nov;18(7):A613.
    PMID: 26533439 DOI: 10.1016/j.jval.2015.09.2128
    Objectives: Diabetes mellitus is a serious health problem. Medication adherence is a key determinant of therapeutic success in patients with diabetes mellitus. The purpose of this study was to assess medication adherence and its potential association with diabetes related knowledge in patients with type 2 diabetes mellitus.
    Methods: This study was carried out at the outpatient clinics of a public sector teaching hospital in Sargodha, Pakistan. Besides demographic and disease-related questions, previously validated questionnaires, Morisky Medication Adherence Scale and Michigan diabetes knowledge test was used to assess the medication adherence and diabetes related knowledge, respectively. Descriptive statistics were used to determine the demographic and disease characteristics of the patients while Spearman rank correlation was employed to measure the association between medication adherence and knowledge.
    Results: Three hundred and ninety two patients were interviewed. Out of 392 patients, 245 (62.5%) of the patients had average knowledge about diabetes while 282 (71.9 %) were categorized as poor adherent. Only 13 patients (3.3 %) were considered as good adherent in the study. The correlation coefficient between total scores of knowledge and total medication adherence score was 0.036 (p< 0.05), indicating a weak correlation between knowledge scores and adherence level.
    Conclusions: Knowledge of diabetes mellitus among these patients was average; however, adherence to drug therapy was also poor. Patients’ knowledge about diabetes had positive association with medication adherence. Improving diabetes knowledge of people can result in better adherence, which may result in better control of diabetes.
    Matched MeSH terms: Medication Adherence*
  17. Nazir SU, Hassali MA, Saleem F, Bashir S, Aljadhey H
    Prim Care Diabetes, 2016 Apr;10(2):136-41.
    PMID: 26476867 DOI: 10.1016/j.pcd.2015.09.004
    AIMS: The purpose of this study was to investigate the association of diabetes-related knowledge and treatment adherence with glycaemic control among patients with type 2 diabetes mellitus (T2DM) in Pakistan.
    METHODS: The study was designed as a questionnaire-based, cross-sectional analysis. T2DM patients attending a public outpatient clinic in Sargodha, Pakistan, were targeted for the study. In addition to the demographic information, the Urdu version of Michigan Diabetes Knowledge Test and Morisky Medication Adherence Scale was used for data collection. Patients' medical records were reviewed for glycated haemoglobin levels (HbA1c). Descriptive statistics were used to elaborate sociodemographic characteristics. The Spearman's Rho correlation was used to measure association of disease-related knowledge and treatment adherence with glycaemic control. SPSS V 20.0 was used for data analysis and p<0.05 was taken as significant.
    RESULT: In total, 392 T2DM patients were included in the study. The mean age (SD) of these patients was 50.77±9.671 years, 56.6% were males and 90% (n=353) of respondents were married. The mean (SD) duration of disease was 5.58 (4.09) years with median HbA1c of 9.00 (IQR=8.20-10.40). The median knowledge score was 8.0 (IQR=6.0-10.0), while the median adherence score was 4.7 (IQR=3.0-6.0). HbA1c had non-significant and weak negative association with diabetes-related knowledge (r=-0.036, p=0.404) and treatment adherence (r=-0.071, p=0.238).
    CONCLUSION: There was negative association reported between HbA1c, treatment adherence and diabetes-related knowledge. Greater efforts are clearly required to investigate other factors affecting glycaemic control among T2DM patients in Pakistan.
    KEYWORDS: Adherence; Correlation; Diabetes-related knowledge; Glycaemic control; Type 2 diabetes
    Matched MeSH terms: Medication Adherence
  18. Nazir SR, Hassali MA, Saleem F, Bashir S, Aljadhey H
    Pak J Pharm Sci, 2017 Nov;30(6):2159-2165.
    PMID: 29175785
    Patient adherence with a therapeutic regimen predicts successful treatment and reduces the severity of negative complications. The purpose of this work was to find the relationship between general Health Related Quality of Life (HRQoL) and compliance to the treatment among type 2 diabetes mellitus patients (T2DM) in Sargodha, Pakistan. The research was planned as a cross-sectional survey. T2DM patients attending a tertiary care institute in Sargodha, Pakistan were targeted for the study. The Urdu version of the Morisky Medication Adherence Scale (MMAS-Urdu) and EuroQol Quality of Life Scale were employed to evaluate adherence to treatment regimen and HRQoL correspondingly. Descriptive statistics were used for the elaboration of socio-demographic characteristics. The Spearman rank order test was employed to determine the relationship between medicine adherence and HRQoL. P<0.05 was considered statistically significant. A total of 392 patients were selected for the survey. Most participants were males (n=222, 56.6%) with 5.58±4.09 years of history of T2DM. Majority of respondents (n=137, 34.9%) were categorized in age group of 51 to 60 years with mean age of 50.77±9.671 years. The present study highlighted that individuals with type 2 diabetes mellitus had decreased HRQoL (0.4715±0.3360) and poor medication adherence (4.44±1.8). Significant, yet weak positive correlations were observed between medication adherence and HRQoL (r=0.217 and 0.136 for EQ-5D and EQVAS respectively). Although the association between adherence to therapeutic regimen and HRQoL in the present study cohort was significant, it was rated as weak, hence failed in producing an overall impression on quality of life. The study highlights the need of identifying other individual factors affecting HRQoL among T2DM patients in Pakistan.
    Matched MeSH terms: Medication Adherence*
  19. Kamarulzaman A, Altice FL
    Curr. Opin. Infect. Dis., 2015 Feb;28(1):10-6.
    PMID: 25490106 DOI: 10.1097/QCO.0000000000000125
    HIV management in people who use drugs (PWUD) is typically complex and challenging due to the presence of multiple medical and psychiatric comorbidities as well as social, physical, economic and legal factors that often disrupt the HIV continuum of care. In this review, we describe the individual, health systems and societal barriers to HIV treatment access and care retention for PWUD. In addition, the clinical management of HIV-infected PWUD is often complicated by the presence of multiple infectious and noninfectious comorbidities.
    Matched MeSH terms: Medication Adherence/psychology*
  20. Loeliger KB, Meyer JP, Desai MM, Ciarleglio MM, Gallagher C, Altice FL
    PLoS Med, 2018 10;15(10):e1002667.
    PMID: 30300351 DOI: 10.1371/journal.pmed.1002667
    BACKGROUND: Sustained retention in HIV care (RIC) and viral suppression (VS) are central to US national HIV prevention strategies, but have not been comprehensively assessed in criminal justice (CJ) populations with known health disparities. The purpose of this study is to identify predictors of RIC and VS following release from prison or jail.

    METHODS AND FINDINGS: This is a retrospective cohort study of all adult people living with HIV (PLWH) incarcerated in Connecticut, US, during the period January 1, 2007, to December 31, 2011, and observed through December 31, 2014 (n = 1,094). Most cohort participants were unmarried (83.7%) men (77.0%) who were black or Hispanic (78.1%) and acquired HIV from injection drug use (72.6%). Prison-based pharmacy and custody databases were linked with community HIV surveillance monitoring and case management databases. Post-release RIC declined steadily over 3 years of follow-up (67.2% retained for year 1, 51.3% retained for years 1-2, and 42.5% retained for years 1-3). Compared with individuals who were not re-incarcerated, individuals who were re-incarcerated were more likely to meet RIC criteria (48% versus 34%; p < 0.001) but less likely to have VS (72% versus 81%; p = 0.048). Using multivariable logistic regression models (individual-level analysis for 1,001 individuals after excluding 93 deaths), both sustained RIC and VS at 3 years post-release were independently associated with older age (RIC: adjusted odds ratio [AOR] = 1.61, 95% CI = 1.22-2.12; VS: AOR = 1.37, 95% CI = 1.06-1.78), having health insurance (RIC: AOR = 2.15, 95% CI = 1.60-2.89; VS: AOR = 2.01, 95% CI = 1.53-2.64), and receiving an increased number of transitional case management visits. The same factors were significant when we assessed RIC and VS outcomes in each 6-month period using generalized estimating equations (for 1,094 individuals contributing 6,227 6-month periods prior to death or censoring). Additionally, receipt of antiretroviral therapy during incarceration (RIC: AOR = 1.33, 95% CI 1.07-1.65; VS: AOR = 1.91, 95% CI = 1.56-2.34), early linkage to care post-release (RIC: AOR = 2.64, 95% CI = 2.03-3.43; VS: AOR = 1.79; 95% CI = 1.45-2.21), and absolute time and proportion of follow-up time spent re-incarcerated were highly correlated with better treatment outcomes. Limited data were available on changes over time in injection drug use or other substance use disorders, psychiatric disorders, or housing status.

    CONCLUSIONS: In a large cohort of CJ-involved PLWH with a 3-year post-release evaluation, RIC diminished significantly over time, but was associated with HIV care during incarceration, health insurance, case management services, and early linkage to care post-release. While re-incarceration and conditional release provide opportunities to engage in care, reducing recidivism and supporting community-based RIC efforts are key to improving longitudinal treatment outcomes among CJ-involved PLWH.

    Matched MeSH terms: Medication Adherence/statistics & numerical data*
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