scholarly journals The association between hypertension self-management and stroke event in male patients at the Badung District Hospital, Bali

2018 ◽  
Vol 6 (2) ◽  
pp. 82
Author(s):  
Ni Kadek Sutini ◽  
Ni Wayan Septarini ◽  
I Made Ady Wirawan ◽  
Anak Agung Sagung Sawitri
Keyword(s):  
Medication Adherence ◽  
Stress Management ◽  
Self Management ◽  
Stroke Event ◽  
Adherence To Medication ◽  
History Of ◽  
Male Patients ◽  
Main Components ◽  
Self Administered Questionnaire ◽  
Poor Management

Background and purpose: Hypertension is a major risk factor for stroke. Despite efforts to control hypertension with pharmacological and non-pharmacological therapies, the prevalence of and death from stroke is reported to be increasing. This study aims to determine the association of hypertension self-management with the incidence of stroke in patients with hypertension.Methods: A case-control study was conducted involving 44 patients suffering from hypertension and who had suffered a stroke as a case, as well as 44 patients with hypertension and no stroke as a control. Data on self-management of diet, physical activity, stress mitigation efforts, alcohol consumption, and medication adherence were collected using self administered questionnaire. Data on the diagnosis of hypertension, stroke and history of comorbidities were obtained from the patient's medical records. Multivariatee analysis using logistic regression was employed to assess the association between hypertension self-management with the incidence of stroke in patients with hypertension.Results: Characteristics of cases and controls did not differ in education, marital and socioeconomic status, but differed in age and employment. Multivariate analysis showed that there were three components of hypertension self-management associated with the incidence of stroke, namely poor adherence to medication (AOR=7.28; 95%CI: 2.19-24.17), poor self-management of stress (AOR=5.45; 95%CI: 1.56-18.99), and poor management of self-regulated diet (AOR=5.28; 95%CI: 1.31-21.32).Conclusions: Medication adherence, diet and stress management are the three main components of self-management that are associated with stroke events among hypertension patients. Efforts to increase medication adherence, diet and stress management should be enhanced.

scholarly journals InspirerMundi—Remote Monitoring of Inhaled Medication Adherence through Objective Verification Based on Combined Image Processing Techniques

2021 ◽  
Author(s):  
Pedro Vieira-Marques ◽  
Rute Almeida ◽  
João F. Teixeira ◽  
José Valente ◽  
Cristina Jácome ◽  
...  
Keyword(s):  
Image Processing ◽  
Medication Adherence ◽  
Remote Monitoring ◽  
Patient Adherence ◽  
Self Management ◽  
Management Decision ◽  
Image Processing Techniques ◽  
Adherence To Medication ◽  
Adherence Assessment ◽  
Processing Techniques

Abstract Background The adherence to inhaled controller medications is of critical importance for achieving good clinical results in patients with chronic respiratory diseases. Self-management strategies can result in improved health outcomes and reduce unscheduled care and improve disease control. However, adherence assessment suffers from difficulties on attaining a high grade of trustworthiness given that patient self-reports of high-adherence rates are known to be unreliable. Objective Aiming to increase patient adherence to medication and allow for remote monitoring by health professionals, a mobile gamified application was developed where a therapeutic plan provides insight for creating a patient-oriented self-management system. To allow a reliable adherence measurement, the application includes a novel approach for objective verification of inhaler usage based on real-time video capture of the inhaler's dosage counters. Methods This approach uses template matching image processing techniques, an off-the-shelf machine learning framework, and was developed to be reusable within other applications. The proposed approach was validated by 24 participants with a set of 12 inhalers models. Results Performed tests resulted in the correct value identification for the dosage counter in 79% of the registration events with all inhalers and over 90% for the three most widely used inhalers in Portugal. These results show the potential of exploring mobile-embedded capabilities for acquiring additional evidence regarding inhaler adherence. Conclusion This system helps to bridge the gap between the patient and the health professional. By empowering the first with a tool for disease self-management and medication adherence and providing the later with additional relevant data, it paves the way to a better-informed disease management decision.

scholarly journals A Pilot Study to Evaluate the Acceptability of Using a Smart Pillbox to Enhance Medication Adherence Among Primary Care Patients

2019 ◽  
Vol 16 (20) ◽  
pp. 3964 ◽  
Author(s):  
Choi
Keyword(s):  
Primary Care ◽  
Heart Disease ◽  
Medication Adherence ◽  
Primary Care Clinic ◽  
Care Clinic ◽  
Oral Medications ◽  
Adherence To Medication ◽  
Randomised Control Trials ◽  
Primary Care Patients ◽  
Male Patients

Smart pillboxes that remind patients to take medication may help avoid unintended non-adherence to medication regimens. To better understand the implementation potential of smart pillboxes among patients with chronic diseases, this study aimed to explore patients’ acceptability to use such devices and its associated factors. Five-hundred primary care patients aged 40 years or older were randomly recruited from a government-funded primary care clinic in Hong Kong. Patients were asked (i) if they needed to take medication daily, (ii) how many daily oral medications they needed to take on average, (iii) if they had ever missed a dose by accident, and (iv) if they were willing to use a smart pillbox for free to remind them to take medication. Out of the 344 participants included in the analysis who needed to take daily oral medication, 49.1% reported having previously missed a dose by accident, and 70.6% were willing to use a smart pillbox for free. A multiple logistic regression model found that male patients (adjusted odds ratio (aOR): 0.59) and patients with hypertension (aOR: 0.56) were less likely to have previously missed a dose by accident. Patients who needed to take a greater number of daily medications (aOR: 1.16), who had previously missed a dose by accident (aOR: 2.44), with heart disease (aOR: 3.67) and with a high monthly income (aOR: 2.30) were more willing to use a smart pillbox, while older patients (aOR: 0.95) were less willing to do so. Primary care patients who reported missing a dose by accident were 2.4 times as likely to want to use a smart pillbox while those with heart disease were almost 4 times as likely to want to use a smart pillbox. Further studies such as those evaluating the willingness to pay for smart pillboxes and randomised control trials to evaluate the effectiveness of smart pillboxes in enhancing medication adherence should be conducted to provide more evidence about the implementation potential of such devices.

PENERAPAN TEKNIK SELF MANAGEMENT TERHADAP KEPATUHAN BEROBAT PENDERITA HIV DI YOGYAKARTA

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Yuliati Hasanah
Keyword(s):  
Medication Adherence ◽  
Behavioral Approach ◽  
Self Management ◽  
Single Subject ◽  
Single Subject Design ◽  
Self Monitoring ◽  
Self Evaluation ◽  
Subject Design ◽  
Management Techniques ◽  
The Subject

Abstract Self management is a strategy in which the cognitive behavioral approach in the application, subject to the expected full attendance during the intervention process. NAP is an HIV patient and had undergone antiretroviral therapy. Saturation, fatigue experienced by NAP during the ARV therapy, so found some times subject medical leave provisions. Healthy behavior in a sick person (in this case a person suffering from HIV) one of which is adherent to treatment that must be endured. This research aims to gain result the applying of self management techniques against medication adherence of NAP patient with HIV in the Balai Rehabilitasi Sosial Pamardi PutraYogyakarta. This study focuses on the application of self-management techniques that include self-monitoring, self reinforcement and self evaluation of medication adherence that includes aspects of belief, accept and act on the subject. Researchers used quantitative approach by using the method of single subject design N = 1 model A-B-A now where the measurements and observations made in each phase. The subject in this study as many as one person with initials NAP. The purpose of this study is to look at the effect of applying the self management technique against NAP’s medication adherence. The results of this study indicate that the application of self-management techniques have a positive effect in improving NAP’s medication adherence with skor of 2SD smaller than skor of the mean phase difference A2 and A1. Stages through the application of this technique is extracting and determining value, set goals, formulate an action plan, the implementation of self-monitoring, self reinforcement and self evaluation. Based on the analysis of the results of the study concluded that the motivation, participation and discipline will determine the effectiveness of the intervention. Support of family members is also important to support the commitment of the subjects in this therapy.Keywords: behavior modification, HIV, medication adherence, self-management AbstrakManusia dapat memutuskan dan menentukan dirinya sendiri. Berdasarkan asumsi tersebut teknik self management merupakan salah satu teknik modifikasi perilaku yang memfokuskan pada regulasi diri. Self management merupakan salah satu strategi dalam pendekatan perilaku kognitif dimana dalam penerapannya, subjek diharapkan kehadiran penuh selama proses intervensi. NAP adalah seorang penderita HIV dan telah menjalani terapi ARV. Kejenuhan, kelelahan dialami NAP selama mengikuti terapi ARV, sehingga ditemukan beberapa kali subjek meninggalkan ketentuan-ketentuan medis. Perilaku sehat pada orang sakit (dalam kasus ini seseorang yang menderita HIV) salah satunya adalah patuh terhadap pengobatan yang harus dijalani. Penelitian ini bertujuan untuk memperoleh hasil dari penerapan teknik self management terhadap kepatuhan berobat subjek NAP sebagai penderita HIV di Balai Rehabilitasi Sosial Pamardi Putra Yogyakarta. Penelitian ini menitikberatkan pada penerapan teknik self management yang mencakup self monitoring, self reinforcement dan self evaluation terhadap kepatuhan berobat yang mencakup aspek mempercayai (belief), menerima (accept) dan tindakan (act) pada subjek. Peneliti menggunakan pendekatan kuantitatif dengan menggunakan metode single subject design N=1 dengan model A-B-A dinama pengukuran dan pengamatan dilakukan di setiap fase. Subjek dalam penelitian ini sebanyak satu orang dengan inisial NAP. Tujuan penelitian ini adalah untuk melihat pengaruh penerapan teknik self management terhadap kepatuhan berobat subjek NAP. Hasil penelitian ini menunjukkan bahwa penerapan teknik self management mempunyai pengaruh positif dalam meningkatkan kepatuhan berobat subjek NAP dengan nilai 2SD lebih kecil dari selisih mean fase A2 dan A1. Tahapan yang dilalui dalam penerapan teknik ini adalah penggalian dan penentuan value, menetapkan goals, merumuskan rencana tindakan, pelaksanaan self monitoring, self reinforcement dan self evaluation. Berdasarkan analisa hasil penelitian disimpulkan bahwa motivasi, peran serta dan kedisiplinan akan menentukan efektifitas intervensi. Dukungan anggota keluarga juga penting untuk mendukung komitmen subjek dalam terapi ini.Kata kunci:  HIV, kepatuhan berobat, modifikasi perilaku, self management

Gender Differences and Their Influences on T2DM Self-Management Among Spanish-Speaking Latinx Immigrants

2021 ◽  
pp. 154041532110117
Author(s):  
Cheryl A. Smith-Miller ◽  
Diane C. Berry ◽  
Cass T. Miller
Keyword(s):  
Gender Differences ◽  
Health Literacy ◽  
English Language ◽  
Educational Achievement ◽  
Self Management ◽  
Structured Interviews ◽  
Health Promoting Behaviors ◽  
History Of ◽  
Health Promoting ◽  
Excessive Alcohol

Introduction: Evidence suggests that gender may influence many aspects of type 2 diabetes (T2DM) self-management (SM) and we posit that limited English language–proficient Latinx immigrants face additional challenges. Methods: Instruments and semi-structured interviews were used to examine gender differences on health literacy, diabetes knowledge, health-promoting behaviors, diabetes, eating and exercise self-efficacy (SE), and T2DM SM practices among a cohort of limited English language–proficient Latinx immigrants. Statistical and qualitative analysis procedures were performed comparing males and females. Results: Thirty persons participated. Males tended to be older, have higher educational achievement, and more financial security than females. Physiologic measures tended worse among female participants. Health literacy and exercise SE scores were similar, but females scored lower on Eating and Diabetes SE. Forty-seven percent ( n= 9) of the women reported a history of gestational diabetes mellitus and a majority of men ( n = 7) cited difficulty with excessive alcohol. Consumption: Males appeared to receive more SM support compared to females. Females more frequently noted how family obligations and a lack of support impeded their SM. Work environments negatively influenced SM practices. Conclusion: Men and women have unique SM challenges and as such require individualized strategies and support to improve T2DM management.

scholarly journals Postoperative Urinary Retention Following General Anesthesia for Endoscopic Nasal Surgery in Men Aged Older Than 60 Years: A Retrospective Study

2021 ◽  
pp. 014556132110331
Author(s):  
Yong Won Lee ◽  
Bum Sik Kim ◽  
Jihyun Chung
Keyword(s):  
General Anesthesia ◽  
Incidence Rate ◽  
Urinary Retention ◽  
Nasal Surgery ◽  
Prostate Hyperplasia ◽  
Postoperative Urinary Retention ◽  
Asa Classification ◽  
History Of ◽  
Male Patients ◽  
Endoscopic Nasal Surgery

Objectives: Postoperative urinary retention (POUR) is influenced by many factors, and its reported incidence rate varies widely. This study aimed to investigate the occurrence and risk factors for urinary retention following general anesthesia for endoscopic nasal surgery in male patients aged >60 years. Methods: A retrospective review of medical records between January 2015 and December 2019 identified 253 patients for inclusion in our study. Age, body mass index (BMI), a history of diabetes/hypertension, American Society of Anesthesiologists (ASA) classification, and urologic history were included as patient-related factors. Urologic history was subdivided into 3 groups according to history of benign prostate hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and current medication. The following was analyzed as perioperative variables for POUR development: duration of anesthesia and surgery; amount of fluid administered; rate of fluid administration; intraoperative requirement for fentanyl, ephedrine, and dexamethasone; postoperative pain; and analgesic use. Preoperatively measured prostate size and uroflowmetry parameters of patients on medication for symptoms were compared according to the incidence of urinary retention. Results: Thirty-seven (15.7%) patients developed POUR. Age (71.4 vs 69.6 years), BMI (23.9 vs 24.9 kg/m2), a history of diabetes/hypertension, ASA classification, and perioperative variables were not significantly different between patients with and without POUR. Only urologic history was identified as a factor affecting the occurrence of POUR ( P = .03). The incidence rate among patients without urologic issues was 5.9%, whereas that among patients with BPH/LUTS history was 19.8%. Among patients taking medication for symptoms, the maximal and average velocity of urine flow were significantly lower in patients with POUR. Conclusions: General anesthesia for endoscopic nasal surgery may be a potent trigger for urinary retention in male patients aged >60 years. The patient’s urological history and urinary conditions appear to affect the occurrence of POUR.

scholarly journals 83 A Medication Self-Management Intervention to Improve Medication Adherence For Older People with Multimorbidity: A Pilot Study

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
C Yang ◽  
Z Hui ◽  
S Zhu ◽  
X Wang ◽  
G Tang ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Pilot Study ◽  
Older People ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Medication Knowledge ◽  
Management Intervention ◽  
Patient Reported

Abstract Introduction Medication self-management support has been recognised as an essential element in primary health care to promote medication adherence and health outcomes for older people with chronic conditions. A patient-centred intervention empowering patients and supporting medication self-management activities could benefit older people. This pilot study tested a newly developed medication self-management intervention for improving medication adherence among older people with multimorbidity. Method This was a two-arm randomised controlled trial. Older people with multimorbidity were recruited from a community healthcare centre in Changsha, China. Participants were randomly allocated to either a control group receiving usual care (n = 14), or to an intervention group receiving three face-to-face medication self-management sessions and two follow-up phone calls over six weeks, targeting behavioural determinants of adherence from the Information-Motivation-Behavioural skills model (n = 14). Feasibility was assessed through recruitment and retention rates, outcome measures collection, and intervention implementation. Follow-up data were measured at six weeks after baseline using patient-reported outcomes including medication adherence, medication self-management capabilities, treatment experiences, and quality of life. Preliminary effectiveness of the intervention was explored using generalised estimating equations. Results Of the 72 approached participants, 28 (38.89%) were eligible for study participation. In the intervention group, 13 participants (92.86%) completed follow-up and 10 (71.42%) completed all intervention sessions. Ten participants (71.42%) in the control group completed follow-up. The intervention was found to be acceptable by participants and the intervention nurse. Comparing with the control group, participants in the intervention group showed significant improvements in medication adherence (β = 0.26, 95%CI 0.12, 0.40, P < 0.001), medication knowledge (β = 4.43, 95%CI 1.11, 7.75, P = 0.009), and perceived necessity of medications (β = −2.84, 95%CI -5.67, −0.01, P = 0.049) at follow-up. Conclusions The nurse-led medication self-management intervention is feasible and acceptable among older people with multimorbidity. Preliminary results showed that the intervention may improve patients’ medication knowledge and beliefs and thus lead to improved adherence.

scholarly journals Disclosure and health-related outcomes among children living with HIV and their caregivers

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Margaret Amankwah-Poku ◽  
Delight Abla Klutsey ◽  
Kwaku Oppong Asante
Keyword(s):  
Medication Adherence ◽  
Psychological Health ◽  
Positive Impact ◽  
Well Being ◽  
Demographic Variables ◽  
Hiv Status ◽  
African Countries ◽  
Psychological Well Being ◽  
Adherence To Medication ◽  
Living With Hiv

Abstract Background The prevalence of disclosure of status to children living with the Human Immunodeficiency Virus (HIV) is low in most sub-Saharan African countries, leading to poor compliance and adverse psychological outcomes in these children. This study examined the influence of disclosure on health outcomes in children living with HIV and their caregivers. Methods Using a cross-sectional design, 155 HIV-positive children between age 6–15 years and their caregivers were administered standardized questionnaires measuring adherence to medication, children's psychological well-being, caregiver burden, and caregivers’ psychological health. Results Results indicated that only 33.5% of the children sampled knew their status. Disclosure of HIV status was significantly related to medication adherence, psychological wellbeing, the burden of caregiving, and the length of the disclosure. A child’s age and level of education were the only demographic variables that significantly predicted disclosure of HIV status. In a hierarchical analysis, after controlling for all demographic variables medication adherence, psychological well-being and burden of caregiving were found to be significant predictors of disclosure of status in children living with HIV. Conclusions Findings suggest the need for disclosure of status among children living with HIV for a positive impact on their medication adherence and psychological health. These findings underscore the need for the development of context-specific interventions that will guide and encourage disclosure of status by caregivers to children living with HIV.

scholarly journals The 8-item Morisky medication adherence scale: validation of a Portuguese version in HIV patients

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Aguiar ◽  
C Piñeiro ◽  
R Serrão ◽  
R Duarte
Keyword(s):  
Medication Adherence ◽  
Psychometric Properties ◽  
Reliability Analysis ◽  
Cronbach’S Alpha ◽  
Portuguese Version ◽  
Cronbach's Alpha ◽  
Adherence To Medication ◽  
Morisky Medication Adherence Scale ◽  
Adherence Scale ◽  
The Mean

Abstract Background Antiretroviral therapy (ART) has the most effective treatment for people with HIV, but its effectiveness depends on the individual medication adherence. Morisky Medication Adherence Scale (MMAS-8) is one of the most widely used scales to assess patient adherence. Thus, we aimed to validate a Portuguese version of MMAS-8 and determine its psychometric properties in HIV positive patients. Methods A cross-sectional survey was conducted in Centro Hospitalar Universitário São João (Porto, northern Portugal) at the infectious diseases department. After authorization to use the scale - granted by the author - and, a standard forward-backwards procedure to translate MMAS-8 to Portuguese, the questionnaire was applied to 233 patients with HIV doing ART. Reliability was assessed using Cronbach's alpha and test-retest reliability. Three levels of adherence were considered: 0 to < 6 (low), 6 to < 8 (medium), 8 (high). Results In the studied sample, the mean age was 45.03 years (SD = 11.63), 80.3% men, 19.3% women and 1 transgender, and 53.8% had ≤9 years of education. The mean number of prescribed ART per patient was 1.76. The mean score for the medication adherence scale was 7.29 (SD = 6.74). For the reliability analysis, 12 patients were excluded due to missing data (n = 221). Regarding the level of adherence, 22.5% were low adhering, 71.6% medium and 5.9% high. Corrected item-total correlations showed that 1 item does not correlate very well with the overall scale and was dropped. Scale reliability analysis for the remaining 7 items revealed an overall Cronbach's alpha of 0.661. Women had a protective effect on adherence (OR = 0.31;95%CI:0.15-0.66). Number of years doing ART, age of participants, and type of residence didn't show to be correlated with adherence. Conclusions MMAS-8 is a reliable and valid measure to detect patients at risk of non-adherence. A satisfactory Cronbach's alfa (0.661) was obtained. In general, adherence to medication was medium or high. Key messages This scale can be applied nationwide in other different hospitals, as it could serve as a tool for measuring adherence to ART that can allow for better health care to the ones that are low adhering. A Portuguese version of the MMAS-8 was created for measuring adherence to ART that maintained a similar structure to the original MMAS-8 and good psychometric properties.

scholarly journals Chronic polytherapy after myocardial infarction: the trade-off between hospital and community-based providers in determining adherence to medication

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mirko Di Martino ◽  
Michela Alagna ◽  
Adele Lallo ◽  
Kendall Jamieson Gilmore ◽  
Paolo Francesconi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Medication Adherence ◽  
Geographic Variation ◽  
Best Practice ◽  
Multilevel Models ◽  
Medication Possession Ratio ◽  
Coronary Intervention ◽  
Community Based ◽  
Optimal Care ◽  
Adherence To Medication

Abstract Background The benefits of chronic polytherapy in reducing readmissions and death after myocardial infarction (MI) have been clearly shown. However, real-world evidence shows poor medication adherence and large geographic variation, suggesting critical issues in access to optimal care. Our objectives were to measure adherence to polytherapy, to compare the amount of variation attributable to hospitals of discharge and to community-based providers, and to identify determinants of adherence to medications. Methods This is a population-based study. Data were obtained from the information systems of the Lazio and Tuscany Regions, Italy (9.5 million inhabitants). Patients hospitalized with incident MI in 2010–2014 were analyzed. The outcome measure was medication adherence, defined as a Medication Possession Ratio (MPR) ≥ 0.75 for at least 3 of the following drugs: antiplatelets, β-blockers, ACEI/ARBs, statins. A 2-year cohort-study was performed. Cross-classified multilevel models were applied to analyze geographic variation. The variance components attributable to hospitals of discharge and community-based providers were expressed as Median Odds Ratio (MOR). Results A total of 32,962 patients were enrolled. About 63% of patients in the Lazio cohort and 59% of the Tuscan cohort were adherent to chronic polytherapy. Women and patients aged 85 years and over were most at risk of non-adherence. In both regions, adherence was higher for patients discharged from cardiology wards (Lazio: OR = 1.58, p < 0.001, Tuscany: OR = 1.59, p < 0.001) and for patients with a percutaneous coronary intervention during the index admission. Relevant variation between community-based providers was observed, though when the hospital of discharge was included as a cross-classified level, in both Lazio and Tuscany regions the variation attributable to hospitals of discharge was the only significant component (Lazio: MOR = 1.30, p = 0.001; Tuscany: MOR = 1.31, p = 0.001). Conclusion Adherence to best practice treatments after MI is not consistent with clinical guidelines, and varies between patient groups as well as within and between regions. The variation attributable to providers is affected by the hospital of discharge, up to two years from the acute episode. This variation is likely to be attributable to hospital discharge processes, and could be reduced through appropriate policy levers.

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