• Title/Summary/Keyword: Medication adherence

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Factors Influencing Adherence to Vestibular Rehabilitation Exercise Program in Patients with Dizziness (어지럼 환자의 전정재활 운동요법 이행과 관련요인: 건강신념변수를 중심으로)

  • Lee, Hyun Jung;Choi-Kwon, Smi
    • Korean Journal of Adult Nursing
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    • v.26 no.4
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    • pp.434-443
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    • 2014
  • Purpose: This study investigated the level of adherence to vestibular rehabilitation exercise program(VREP) and evaluated how health belief model (HBM) variables are related with adherence to VREP in patients with dizziness. Methods: The data were collected from 150 individuals, who agreed to participate in the study between December, 2012 and May, 2013. Adherence to VREP, severity of dizziness, health belief variables (health belief scale) and self-efficacy (self-efficacy scale) were measured. Results: The result of this study showed poor adherence to VREP. The mean adherence score to VREP was $2.11{\pm}1.05$ (1-5). In multivariate analysis, severity of dizziness (p<.001), taking sedative medication (p<.001), high self-efficacy (p<.001), high perceived seriousness (p=.019) & benefit (p=.036) were independent predicting factors explaining 57.7% of adherence to VREP. Conclusion: Adherence to VREP was poor among these patients. To improve the patient's adherence to VREP, strategies to increase perceived seriousness, benefit, or self-efficacy and to decrease barriers are urgently needed.

Factors Influencing Adherence to Self Care in Patients with Chronic Heart Failure (만성 심부전 환자의 자가간호 이행 관련요인)

  • Son, Youn-Jung;Kim, Sun-Hee;Kim, Gi-Yon
    • Korean Journal of Adult Nursing
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    • v.23 no.3
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    • pp.244-254
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    • 2011
  • Purpose: The objective of this study was to evaluate adherence to self-care and identify associated factors in outpatients with Heart Failure (HF). Methods: Using a cross-sectional design, a convenience sample of 249 outpatient clinic patients were recruited at S university hospital. Between October 2009 and December 2009, data were collected through questionnaires and medical record review. Results: The total mean score of adherence to self-care was $18.07{\pm}3.56$ out of a possible 45 points. Among self-care dimensions, adherence to medication and low salt diet was high, while lower adherence was reported in contact with health professionals if symptoms such as weight gain, edema and fatigue were presented. Multivariate analysis adjusted for other socio-demographic and clinical factors showed that disease knowledge related to heart failure (p<.001) and left ventricular ejection fraction (p=.027) were independent predictors of adherence to self-care. These factors explained 23% of total variance in the adherence to self-care. Conclusion: Heart failure patients with higher disease knowledge and those who have good systolic function may be more likely to engage in adherence to self-care than those with lack of disease knowledge and low contractility. Further research is needed to confirm these results and identify other predictors of adherence to self-care.

Predictors of Persistence and Adherence with Secondary Preventive Medication in Stroke Patients (지역사회 뇌졸중 환자들의 이차 예방을 위한 치료 지속률과 약물 순응도 관련 요인)

  • Kim, Young Taek;Park, Ki Soo;Bae, Sang-Geun
    • Journal of agricultural medicine and community health
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    • v.40 no.1
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    • pp.9-20
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    • 2015
  • Objectives: This study aimed to explore the persistence and adherence to secondary preventive medication of stroke patients after discharge and to assess the reasons for persistence and nonadherence. Methods: Four hundred twenty-nine patients with stroke were surveyed to determine their behaviors from discharge. Reasons for stopping medications were ascertained. Persistence was defined as continuation of all secondary preventive medications prescribed at hospital discharge, and adherence as continuation of prescribed medications according to health care provider instructions. Results: Of the 429 patients, 86.5% were treatment persistent and 41.2%(non-intentional nonadherence=39.4%, intentional nonadherence=19.4%) were adherent. Independent predictors of persistence included having experience about health education. Independent predictors of non-intentional nonadherence were modified Rankin Scale(mRS) (Exp(B)=2.858, p=0.001) and health education experience (Exp(B)=0.472, p=0.032), and independent predictors of intentional nonadherence were mRS (Exp(B)=2.533, p=0.006), depressive symptoms (Exp(B)=1.113, p=0.016), beliefs about medications questionnaire(necessity, Exp(B)=0.879, p=0.011, concern, Exp(B)=1.098, p=0.019). Conclusions: Although up to one-ninth of stroke patients continued secondary prevention medications, nonadherence is common. Several potentially modifiable patient, provider, and system-level factors associated with persistence and adherence may be targets for future interventions. Specially, interventions to improve adherence should target patients' beliefs about their medication.

Qualitative Study for Medication Use among Visually Impaired in Korea (국내 시각장애인의 의약품 안전사용 실태에 대한 심층면접조사)

  • Koo, Heejo;Jang, Sunmee;Oh, Jung Mi;Han, Nayoung;Han, Euna
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.1
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    • pp.24-32
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    • 2016
  • Objective: The visually impaired have limited access to health care services and related information, and thus, they can have serious hurdles against properly taking medications. Despite that it is important to improve self-care ability of the visually impaired for correct medication use, there have been few studies investigating their needs for health care services in Korea, particularly focusing on proper medication usage. This study is to explore safety-related issues regarding mediation usage among the visually impaired based on in-depth interview. We particularly focus on any obstacles for safe use of medicines including experience on medication-related adverse effects in order to provide preliminary evidence for policy measures to improve proper medication use among the visually impaired. Methods: Study sample was visually impaired individuals who resided in Seoul area and were registered in the National Association of Visually Impaired. The association helped the process of recruiting the study participants. In-depth interview for each study participants was conducted. Each interview was recorded and later converted into a written script to extract core contents for the analysis. Results: The study participants comprised of three women (42.9%) and four men (57.1%). One was in his 20's, and there were four participants in 30's and two in 40's. Fully impaired participants were majority (5 out of 7). Limitation to physical access to health care providers and health information were the key factors to hamper safe medication utilization among the study participants. Difficulty reading medication information and may take the wrong medication or incorrect doses of medication, resulting in serious consequences, including overdose or inadequate treatment of health problems. Visually impaired patients report increased anxiety related to medication management and must rely on others to obtain necessary drug information. Pharmacists have a unique opportunity to pursue accurate medication adherence in this special population. This article reviews literature illustrating how severe medication mismanagement can occur in the visually impaired elderly and presents resources and solutions for pharmacists to take a larger role in adherence management in this population. Conclusion: The visually impaired had difficulties reading medication information and identifying medicines, and took incorrect doses of medications. Public support for safe medication use and medication management among the visually impaired is necessary.

Adherence to Capecitabine Treatment and Contributing Factors among Cancer Patients in Malaysia

  • Zahrina, Abdul Kadir;Norsa'adah, Bachok;Hassan, Norul Badriah;Norazwany, Yaacob;Norhayati, Md Isa;Roslan, Mohd Haron;Wan Nazuha, Wan Rusik
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9225-9232
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    • 2014
  • Ensuring adherence to chemotherapy is important to prevent disease progression, prolong survival and sustain good quality of life. Capecitabine is a complex chemotherapeutic agent with many side effects that might affect patient adherence to treatment. This cross sectional study aimed to determine adherence to capecitabine and its contributing factors among cancer outpatients in Malaysia. One hundred and thirteen patients on single regime capecitabine were recruited from Hospital Sultan Ismail and Hospital Kuala Lumpur from October 2013 to March 2014. Adherence was determined based on adherence score using validated Medication Compliance Questionnaire. Patient socio-demographics, disease, and treatment characteristics were obtained from medical records. Satisfaction score was measured using the validated Patient Satisfaction with Healthcare questionnaire. The mean adherence score was 96.1% (standard deviation: 3.29%). The significant contributing factors of adherence to capecitabine were Malay ethnicity [${\beta}=1.3$; 95% confidence interval (CI): 0.21, 2.43; p value=0.020], being female [${\beta}=1.8$; 95%CI: 0.61, 2.99; p value=0.003]), satisfaction score [${\beta}=0.08$; 95%CI: 0.06, 1.46; p value=0.035], presence of nausea or vomiting [${\beta}=2.3$; 95%CI: 1.12, 3.48; p value <0.001] and other side effects [${\beta}=1.45$; 95%CI: 0.24, 2.65; p value=0.019]. Adherence to capecitabine was generally high in our local population. Attention should be given to non-Malay males and patients having nausea, vomiting or other side effects. Sufficient information, proactive assessment and appropriate management of side effects would improve patient satisfaction and thus create motivation to adhere to treatment plans.

Analyzing association between low-density lipoprotein reduction by statin and adherence to medication using national health insurance service-national sample cohort (NHIS-NSC) (표본코호트기반 고지혈증 약제의 저밀도 콜레스테롤 감소량 및 투약순응도 분석)

  • Kim, Kyu-Jin;Jun, Chi-Hyuck;Lee, Hyeseon;Kim, Hun-Sung
    • Journal of the Korean Data and Information Science Society
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    • v.28 no.5
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    • pp.1027-1041
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    • 2017
  • Hyperlipidemia, the status of blood with high level of low-density lipoprotein cholesterol (LDL-C), is known as a main cause of coronary artery diseases such as myocardiac infarction or brain infarct. Statin is the representative prescription to hyperlipidemia and the effects of it depend on the patient's individual conditions such as health-caring habits or adherence to medication. The main effect of statin is reducing LDL-C, which should reach the target range based on National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) guideline. In this research, the reduction of LDL-C and attainment to patient's target range are considered effects of statin. The association between factors - individual conditions and adherence to medication of patients - and the effects of statin is analyzed with National Health Insurance Service-National Sample Cohort (NHIS-NSC).

The Effect of a Clinic Based Incentive Program on Medication Adherence among Patients with Hypertension or Diabetes Mellitus in Incheon (인천광역시 의원기반 건강포인트제도가 고혈압·당뇨병 환자의 지속치료에 미치는 영향)

  • Cheong, Won;Yim, Jun;Oh, Dae-Kyu;Im, Jeong-Soo;Ko, Kwang Pil;Park, Ie Byung
    • Health Policy and Management
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    • v.23 no.4
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    • pp.427-433
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    • 2013
  • Background: This study was conducted to evaluate the factors affecting adherence in patients with hypertension and type 2 diabetes mellitus before and after a clinic based patient incentive program in Incheon. Methods: An observational follow-up study was done for 28,355 patients in one registered group and 245,598 patients in a non-registered group from March 16th 2009 to December 31th 2010 in Incheon. The registration, mandatory laboratory tests and number of clinic visits were collected by merging the Incheon Chronic Disease Management System data and the National Health Insurance Corporation (NHIC) data. As a measure of patient adherence, we used a variable of prescription days from the NHIC and defined above 80% of average prescription days as an appropriate patient adherence. Repeated measures analysis of variance and logistic regression were used to analyze the differences in patient adherence and factors affecting adherence. Results: The changes in prescription days for the registered group are larger than for the non-registered group. In the logistic regression model, including the variables with sex, age, income status and number of clinic visits, the registered group exhibited a higher Odds ratio in the patient adherence. Conclusion: This study revealed the association between registration and appropriate patient adherence in patients with hypertension or type 2 diabetes mellitus.

Relationship Between Belief about Analgesics, Analgesic Adherence and Pain Experience in Taiwanese Cancer Outpatients

  • Liang, Shu-Yuan;Chen, Kang-Pan;Tsay, Shiow-Luan;Wu, Shu-Fang;Chuang, Yeu-Hui;Wang, Tsae-Jyy;Tung, Heng-Hsin;Cheng, Su-Fen
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.713-716
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    • 2013
  • Social and behavioral scientists have proposed that a person's belief system crucially influences his or her behaviour, and therefore may affect outcomes of pain management. The purpose of this study was to explore the relationship between analgesic beliefs, analgesic adherence and pain experience amongst Taiwanese cancer outpatients. The cross-sectional study included 92 oncology outpatients in two teaching hospitals in the Taipei area of Taiwan. The research instruments included the Pain Opioid Analgesic Beliefs Scale-Cancer (POABS-CA), opioid adherence, and the Brief Pain Inventory-Chinese (BPI-Chinese). Beliefs about pain and opioids demonstrated a significant relationship with patients' opioid adherence (r = -0.30, p < 0.01). The more negative beliefs regarding opioids and pain the patient had, the worse their adherence to around the clock (ATC) analgesic regimen. However, there was no significant correlation between opioid belief and pain experience. As well, there were no significant relationships between adherence to opioid regimen and any of the measures of pain experience. The study highlights the potential importance of a patient's pain and opioid beliefs in adherence to pain medication.