• Title/Summary/Keyword: Adherence

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Pseudo-Resistant Schizophrenia: Non-Adherence to Treatment (치료 위저항성 조현병: 치료 비순응을 중심으로)

  • Kim, Hyerim;Lee, Seung Jae
    • Korean Journal of Schizophrenia Research
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    • v.23 no.2
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    • pp.51-57
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    • 2020
  • Treatment-resistant schizophrenia (TRS) has been defined as the persistence of positive symptoms despite two or more trials of antipsychotic medication of adequate dose and duration. TRS is a serious clinical problem and occurs in approximately 30% of patients with schizophrenia. It is important that patients who do not adequately respond to antipsychotics be reevaluated to exclude or address causes other than non-responsiveness to medication, that is, the possibility of pseudo-resistance. In particular, non-adherence to oral antipsychotic treatment should be monitored to rule out pseudo-resistant cases of TRS. Moreover, patients with TRS who take their medication as required may have subtherapeutic antipsychotic plasma levels, secondary to pharmacokinetic factors. In this paper, we review the concept and exclusion of pseudo-resistance, especially owing to non-adherence or pharmacokinetic factors, and present methods to enhance drug adherence.

Factors Influencing Aquatic Exercise Adherence of Patients with Arthritis (만성관절염 환자의 수중운동 지속에 영향을 미치는 요인)

  • Kang, Hyun-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.15 no.3
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    • pp.350-359
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    • 2008
  • Purpose: The purpose of this study was to identify change in the exercise behavior and to identify factors influencing long-term adherence to aquatic exercise in patients with arthritis as a follow-up study after five years. Method: Baseline data had been collected using a structured interview 6 months after participants completed the aquatic exercise educational program. This second follow-up data collection included 133 participants from the original baseline study and was done 5 years after the original baseline study. Data was analyzed using SPSS 16 Win program. Results: The stage of change for the participants was as follows: Precontemplation (44.3%), Contemplation (24.1%), Preparation (3.0%), Action (0%) and Maintenance (adherence, 28.6%). The adherers (N=38) had significantly higher scores than non-adherers (N=91) in self-efficacy, outcome expectancy, group coherence and self-evaluation, and significantly lower scores in barriers to exercise. In logistic regression analysis, self-efficacy, group cohesion, barriers to exercise and self-evaluation were associated with exercise adherence (Chi Square=17.14, p=.002). Group cohesion (OR=2.5871, 95% CI=1.094-6.113, p= .030) was the most important factor. Conclusion: Self-efficacy, group cohesion, barriers to exercise and self-evaluation need to be considered in planning exercise programs to improve exercise adherence.

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Effects of an Integrated Case Management Program on Medication Adherence, Pain, Physical Function and Depression among Korean Medical Aid Beneficiaries with Osteoarthritis (의료급여 관절염환자의 복약순응향상을 위한 통합중재프로그램의 효과)

  • Ahn, Yang Heui
    • Journal of Korean Public Health Nursing
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    • v.28 no.1
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    • pp.32-45
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    • 2014
  • Purpose: The purpose of this study was to test the effectiveness of an eight session integrated case management program for improvement of medication adherence, physical function, pain, and depression among medical aid beneficiaries with osteoarthritis. Method: A nonequivalent control group pre-posttest design was employed. Participants were 55 medical aid beneficiaries who agreed to participate in this study, and were assigned to an experimental group (n=28) or control group (n=27). The framework of this research derived from Cox's Interaction Model of Client Health Behavior guided the overall intervention and the components. The program led by a case manager with a medication calendar, motivating interviewing and coaching strategies and collaboration with a pharmacist. Analysis included change in scores, ${\chi}^2$-test, and t-test. Result: The results showed significant increase in medication adherence, physical function and decrease joint pain, joint stiffness and depression in the experimental group compared to the control group. Conclusion: The eight session integrated case management program indicated an effect on medication adherence, pain, physical function, and depression. Partnership with a pharmacist is recommended for medication adherence and conduct of further studies will be needed in order to determine the long-term effect of an extended integrated program on health outcomes.

Fasting Blood Sugar and Adherence to Diabetes Control Recommendation : Impact of Education Using Short Messaging Service of Cellular Phone (휴대폰 문자메시지 교육이 제2형 당뇨병환자의 공복혈당과 자가관리에 미치는 효과)

  • Kim, Hee-Seung
    • Journal of Korean Biological Nursing Science
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    • v.5 no.2
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    • pp.13-19
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    • 2003
  • Purpose : The purpose of this study was to investigate the effects of the education using short messaging service(SMS) on fasting blood sugar(FBS) and diabetes adherence. Method : Forty-five diabetic patients being assessed pre and post intervention was used to assess the effectiveness of the education. Participants were requested to input the FBS and 2 hours post-prandial blood sugar everyday in http://www.biodang.com by cellular phone or wire Internet. The goal of the education was to lower FBS and keep diabetes adherence. The education was applied to the for 12 weeks. The education consisted of continuous education and reinforcement of diet, exercise, medication adjustment, as well as frequent self-monitoring of blood glucose levels. The education performed weekly. All medication adjustments were communicated to the participants' doctor. FBS and diabetes adherence were measured before and after the education. Results : The education using SMS of cellular phone had decrease FBS and increase oral medication taking, exercise, foot care, and hypoglycemia preparation adherence.

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The Relationship between Self-efficacy and Aquatic Exercise Adherence in Patients with Chronic Arthritis (만성 관절염 환자의 자기효능과 수중 운동지속과의 관계)

  • Kang, Hyun-Sook;Kim, Jong-Im;Lee, Eun-Ok
    • Journal of muscle and joint health
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    • v.6 no.2
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    • pp.317-324
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    • 1999
  • The purpose of this study was to identify the relationship between self-efficacy and adherence of aquatic exercise in patients with chronic arthritis. Subjects were 54 patients with rheumatoid arthritis and osteoarthritis who had participated in the 6-week aquatic exercise program. The results indicated that the relationship between self-efficacy and aquatic exercise adherence in patients with chronic arthritis was statistically significant. A significant difference of self-efficacy was found between adherers and non-adherers and self-efficacy of adherer was higher than that of non-adherer(t=5.21, p=.000). Self-efficacy was significantly associated with the total duration of an aquatic exercise adherence(r=.44, p=.001). Based on these results, self-efficacy was the important factor which affect adherence of aquatic exercise in patients with chronic arthritis. Further study was suggested to identify the relationships among self-efficacy, exercise barrier and other possible factors.

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Effect of Shotcrete Lining Adherence on Load Carrying Capacity of Lining (숏크라트 라이닝 층간 부착성이 라이닝의 하중지지력에 미치는 영향)

  • Yoo, Chung-Sik;Kim, Sun-Bin;Bae, Gyu-Jin;Shin, Hyu-Soung
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.8 no.1
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    • pp.41-51
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    • 2006
  • This paper concerns the effect of lining interface adherence on the lining's load carrying capacity. A series of reduced scale laboratory tests and finite element anlayses were carried out with the aim of gaining insight into the effect of shotcrete lining adherence on the load carrying capacity of double shell lining. The results indicated among other things that the load carrying capacity of a double shell tunnel is significantly affected by the adherence between layers. Also revealed was that for cases with low lining layer adherence stress concentration may occur due to relative movement between the lining layers with this trend being more pronounced with increasing tunnel cover depth. Practical implications from the results of this study are discussed in great detail.

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Development and Clinical Use of Assessment Indicators for Improving Medication Adherence of Elderly Residents in Nursing Home (노인요양원 입소자의 복약순응도 향상을 위한 평가지표의 개발 및 임상활용)

  • Park, Duck-Soon;Kang, Minku;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.1
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    • pp.13-23
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    • 2016
  • Background: South Korea is rapidly being an aging-society and the demand of long-term care insurance services for elderly patients is rising. In addition, because the elderly taking multiple medicines, the adherence is lowered and the adverse events are easily occurred. Therefore, many are interested in introducing the geriatric pharmacy specialist to manage this situation. Purpose: By applying a similar program such as the geriatric pharmacy specialist working in nursing home, we conducted this study to evaluate the potential contribution to both the health insurance services and financial savings for the elderly patients. Methods: We conducted a trial in an elderly nursing home to collaborate between doctor and pharmacist making a checklist for improving medication adherence and establish a consultation system. Also we applied a smart phone application in the pharmaceutical care processes. Results: Thereby completing the drug therapy related checklist apply to nursing facilities in South Korea. And we got a performance that improves medication adherence when used in the clinical practice settings. Conclusion: By introducing a training program of pharmacy care managers and geriatric professionals such as the United States and Japan, we revealed the elderly nursing home residents and vulnerable elderly people living alone were improved the medication adherence and it will contributed to the health and quality of life of the patients.

Effects of a Short Message Service Intervention on Adherence to Maximal Sterile Barrier Precautions and Catheter-Related Blood Stream Infections (최대한의 멸균 차단법의 이행도와 중심정맥관 관련 혈류감염 발생에 대한 단문문자메시지 중재 효과)

  • Kang, Moon-Hee;Kim, Dong-Oak
    • Journal of Korean Academy of Nursing Administration
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    • v.18 no.2
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    • pp.244-250
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    • 2012
  • Purpose: The purpose of this study was to investigate the effect of a short message service intervention on adherence to maximal barrier precautions (MBP) and catheter-related blood stream infections. Method: The data were collected from March to September, 2008, at an 826-bed university-affiliated hospital in Daejeon. The study participants were 24 physicians who were inserting central catheters and 133 patients (control group 78 and intervention group 55) with central catheter insertions. The researcher sent the message (adherence to MBP and optimal recommendations) to each internal medicine doctor using the short message service (SMS) for cellular phones. Messages were sent monthly for 3 months. Data were analyzed by chi-square test and t-test using SPSS 12.0 windows program. Result: Adherence to maximal barrier precautions was significantly increased from 44.9% to 69.1% (p=.006) after the SMS intervention. But changes in the rate of CRBSI (catheter related blood stream infection) between the intervention group (1.89) and the control group (4.45) were not significant (p=.323). Conclusions: The results indicate that the SMS intervention is effective in increasing the adherence to maximal barrier precautions and the SMS intervention can be recommended for utilization in infection control nursing practice.

A Structural Equation Model on Health Behavior Adherence for Elders with Prehypertension: Based on Self-Determination Theory (자기결정성 이론에 근거한 고혈압 전단계 노인의 건강행위이행 구조 모형)

  • Lee, Eun-Ha;Park, Jee-Won
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.19 no.3
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    • pp.343-352
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    • 2012
  • Purpose: The purpose of this study was to develop and test a hypothetical model which explains health behavior adherence in elderly people with prehypertension. The model was based on self-determination theory (SDT). Methods: Data were collected from June 21 to July 15, 2010, using self-report questionnaires. The participants were 140 elders with prehypertension who lived in D Metropolitan City. Collected data were analyzed using PASW 18.0 for descriptive statistics and correlation analysis and AMOS 5.0 for covariance structure analysis. Results: It appeared that the overall fit index was good with a ${\chi}^2$ score of 13.23 (p<0.05), GFI of 0.97, AGFI of 0.79 and RMR of 0.28 in the modified model. The results revealed that significant main effects of both health provider's autonomy support and autonomous motivations were found on the measure of health behavior adherence. These factors explained 72% of variance in the participants, health behavior adherence. Conclusion: The overall findings may provide useful assistance in developing effective motivation-enhanced programs for health behavior adherence.

The Influence of Professionalism of Pilates Instructors on Attractiveness of Instructors and Adherence of Pilates Participants (필라테스 지도자의 전문성과 매력성 및 참가자의 운동지속에 대한 융합적 연구)

  • Roh, Su-Yeon
    • Journal of Digital Convergence
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    • v.14 no.7
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    • pp.507-516
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    • 2016
  • This study examined the influence of professionalism of Pilates instructors on attractiveness of instructors and adherence of participants. The subjects of this study were 229 Pilates participants in Seoul and Gyeonggido. The collected data was analyzed by using SPSS & AMOS 18.0 version. The results are as follows. First, the professionalism of Pilates instructors partially affects the attraction. Second, the professionalism of Pilates instructors has partially influence on the adherence of Pilates participants. Third, the attraction of Pilates instructors has partially an effect on the adherence of Pilates participants. Lastly there is a causal relationship between professionalism, attraction of Pilates instructors and adherence of Pilates participants.