scholarly journals Predictors of client retention in a state-based tobacco quitline

2020 ◽  
Vol 15 (2) ◽  
pp. 67-75
Author(s):  
Uma S. Nair ◽  
Brooke Rabe ◽  
Benjamin R. Brady ◽  
Melanie L. Bell
Keyword(s):  
Treatment Adherence ◽  
Tobacco Use ◽  
Standard Care ◽  
Adherence To Treatment ◽  
Client Engagement ◽  
Client Retention ◽  
High Adherence ◽  
Retention In Treatment ◽  
High Treatment

AbstractIntroductionQuitlines are standard care for smoking cessation; however, retaining clients in services is a problem. Little is known about factors that may predict dropout.AimsTo examine predictors of retention while in-program and at follow-up for clients enrolling in a state quitline.MethodsThis was a retrospective analysis of quitline enrolled clients from 2011 to 2017 (N = 49,347). Client retention in-program was categorized as (a) low adherence to treatment (receiving zero coaching calls), moderate (1–2 calls), and high adherence (3+ calls). Dropout at follow-up included participants who were not reached for the 7-month follow-up.ResultsMore than half the sample dropped out during treatment; 61% were not reached for follow-up. Women (odds ratio (OR) = 1.21; 95% confidence interval (CI) = [1.16, 127]) and those with high levels of nicotine dependence (OR = 1.03; 95% CI = [1.02, 1.04]) were more likely to have moderate adherence to treatment (1–2 coaching calls). Dropout at follow-up was more likely among clients who used nicotine replacement therapy (OR = 1.14; 95% CI = [1.09, 1.19]) and less likely among those who had high treatment adherence (OR = 0.41; 95% CI = [0.39, 0.42]).ConclusionGiven the relapsing nature of tobacco use and the harms related to tobacco use, quitlines can improve their impact by offering tailored services to enhance client engagement and retention in-treatment and at follow-up.

scholarly journals TRIUMF-3: antihypertensive therapy in Ukraine – optimization of blood pressure in focus. The use of a triple fixed combination of antihypertensive drugs in the practice of a family doctor

2020 ◽  
Vol 27 (3) ◽  
pp. 9-24
Author(s):  
M. І. Lutay ◽  
G. F. Lysenko ◽  
І. P. Golikova ◽  
O. M. Lomakovsky ◽  
O. І. Moiseyenko
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Therapy ◽  
Fixed Combination ◽  
Antihypertensive Drugs ◽  
Family Doctor ◽  
Adherence To Treatment ◽  
Family Doctors ◽  
High Adherence ◽  
Comparison Of The Results

The aim – to investigate the profile of patients with the uncontrolled arterial hypertension who concomitantly take two or three antihypertensive products and to evaluate the results of BP control achievement in this population after therapy adjustment. Materials and methods. A total of 4113 patients with hypertension were invited to take part in TRIUMF-3 (antihypertensive therapy in Ukraine – optimization of blood pressure in focus) study, they were under the supervision of family doctors. Anamnestically all participants (average age – 64; 36.1 % – are men), at least 1 month before the study, took 2 or 3 antihypertensive drugs without sufficient effect. The average values of office BP were 172/99 mm Hg, in > 40 % of patients they exceeded 180/110 mm Hg. The drug of choice for further therapy for 4103 participants was fixed combination of perindopril arginine, amlodipine and indapamide – «Triplixam» (Servier, France). The follow-up period for each patient was 3 months. Patients visited doctors after 1-2 weeks, 2 and 3 months after the start of the study and the corresponding correction of therapy. Before and after 2 months, the indicator of adherence to treatment was assessed. The last analysis included a comparison of the results of TRIUMF-3 and TRIUMF-2 with patients who were under outpatient supervision by family doctors and cardiologists. Results and discussion. The prescription of the original triple fixed combination for 3 months was allowed by the gradually decrease of BP to ~ 130/80 mm Hg; SBP (systolic BP) on average by ~ 42, DBP (diastolic BP) – by ~ 19 mm Hg. Target levels: < 140/90 mm Hg reached 73.4 % of patients, and ≤ 130/80 mm Hg – 59.1 %. In most patients (70 %) during the study, the rate of high adherence to treatment increased from an average of 9.5 % to 46.4 %. Triple fixed combination of perindopril arginine, indapamide and amlodipine therapy was well tolerated. Conclusions. The use of an original triple fixed combination of perindopril arginine, indapamide and amlodipine by family doctors was accompanied by the achievement of target BP levels in more than 2/3 of patients with hypertension in whom the previous two- or three-component therapy was ineffective. The use of triple fixed combination of perindopril arginine, indapamide and amlodipine was effective in both groups of patients with hypertension observed in family doctors (TRIUMF-3) and cardiologists (TRIUMF-2). However, cardiologists used the largest doses of the drug almost twice as often, which led to more optimal BP control (≤ 130/80 mm Hg) in a larger group of patients: 69.7 % vs. 59.1 % in family doctors. Regular drug monitoring, antihypertensive efficacy, and ease of administration of a triple fixed combination of perindopril arginine, indapamide and amlodipine were likely to be determinants of increased adherence to treatment in most participants in both studies, 75 % to TRIUMF-2, and 70 % to TRIUMF-3. Moreover, the rate of high adherence during the 2-months follow-up period increased in both studies by almost 5 times.

scholarly journals ANALYTICAL STUDY OF TREATMENT ADHERENCE AMONG PATIENTS WITH ALLERGIC AND NON-ALLERGIC DISEASES OF THE UPPER RESPIRATORY TRACT

2020 ◽  
Vol 66 (6) ◽  
pp. 4-4
Author(s):  
N.N. Zhukova ◽  
◽  
M.V. Manzhos ◽  
A.V. Seleznev ◽  
◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Treatment Adherence ◽  
Specific Treatment ◽  
Allergic Diseases ◽  
Lifestyle Changes ◽  
Upper Respiratory Tract ◽  
Allergen Specific Immunotherapy ◽  
High Adherence ◽  
Upper Respiratory

Adherence is key to improving quality of life of patients with allergopathology on allergen-specific immunotherapy (ASI). Treatment adherence is influenced by a variety of parameters: socio-economic, medical, patient-related factors, health condition and therapy specifics. The purpose of the study was to evaluate adherence of patients with allergic and non-allergic diseases to specific and non-specific treatment. A study of adherence of patients (n=270) residing in the Samara region was conducted using a standardized questionnaire. The result was calculated according to the formulas and was rated as unsatisfactory, satisfactory and high. The adherence rate of patients with allergic and non-allergic diseases of the upper respiratory tract added up to 61.84 and 52.07, respectively, both corresponding to the average indicators. High adherence rates were more common in the group of patients with allergic diseases rather than in the comparison group: 73.6% versus 51% (ꭓ2 =13.9, p=0.001). Male and female adherence indicators hardly differed. In patients under 18, high adherence rates were significantly more frequent – 85.2% in children versus 56% in adults (ꭓ2=22.37, p=0.0001). In general, among all patients, readiness for follow-up was higher compared to the adherence to lifestyle changes (U=54164.5, p=0) and to drug treatment (U=40701, p=0.019) among all patients. Regular medical follow-up does not eliminate the need for lifestyle changes and drug therapy. There is a need to improve measures aimed at improving adherence.

Compliance therapy in patients with chronic heart failure: a review

2011 ◽  
Vol 6 (1) ◽  
pp. 240
Author(s):  
Maria Fernanda de Oliveira Carvalho ◽  
João Carlos Alchieri
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Treatment Adherence ◽  
Psychological Assessment ◽  
Patient Adherence ◽  
Adherence To Treatment ◽  
Disease Characteristics ◽  
Compliance Behavior ◽  
Insuficiencia Cardiaca

ABSTRACTObjective: to check which instruments have been used in psychological assessment of treatment adherence, the indicators have shown the results from these instruments for research and evaluation of this aspect, as well as reflect on the applicability of the practice of the psychologist. Method: this integrative review is performed in the Portal Periodicos Capes, using the keywords adherence, instruments and chronic heart failure and correlates in English. Results: poor adherence to treatment may be associated with several factors, from socioeconomic, psychological disorders and cognitive impairment until the disease characteristics and complexity of treatment, the relationship between health professional and patient, however, is one of the factors contributing to treatment adherence. Conclusion: some authors have sought to present methods to assess adherence to treatment, including psychological tests and inventories, but there are a limited number of investigations in this direction. It is known that the compliance behavior involves many different factors, which requires thorough investigation by means of psychological assessment, to identify those which favor or hinder the appropriate follow-up treatment, and promote greater understanding of both the healthcare staff as to patient, allowing for intervention strategies. Descriptors: heart failure; patient adherence; treatment.RESUMOObjetivo: verificar quais instrumentos psicológicos vêm sendo utilizados na avaliação da aderência terapêutica, apresentar os indicadores evidenciados nos resultados provenientes de tais instrumentos para investigação e avaliação deste aspecto, bem como refletir acerca da aplicabilidade destes na prática de atuação do psicólogo. Método: trata-se de revisão integrativa realizada no portal Periódicos Capes, utilizando-se os descritores aderência, instrumentos e insuficiência cardíaca crônica, bem como os correlatos em língua inglesa. Resultados: a baixa adesão ao tratamento pode estar associada a diversos fatores, desde problemas socioeconômicos, distúrbios psicológicos, e prejuizos cognitivos, até as características da doença e a complexidade do tratamento; o relacionamento entre o profissional de saude e o paciente, em contrapartida, é um dos fatores que contribui à adesão ao tratamento. Conclusão: alguns autores vêm buscando apresentar métodos que avaliem a adesão ao tratamento incluindo testes e inventários psicológicos, porém há um número limitado de investigação nesse sentido. Sabe-se que o comportamento aderente envolve muitos e diferentes fatores, o que requer investigação aprofundada por meio da avaliação psicológica, no sentido de identificar quais destes favorecem ou dificultam o seguimento adequado do tratamento, e promover maior conhecimento tanto à equipe de saude quanto ao paciente, possibilitando estratégias de intervenção. Descritores: insuficiência cardíaca; adesão do paciente; tratamento.RESUMENObjetivo: comprobar que instrumentos psicológicos han sido utilizados en la evaluación de la adherencia al tratamiento, presente los indicadores que se evidencia en los resultados de estos instrumentos para la investigación y la evaluación de este aspecto, así como reflexionar sobre la aplicabilidad destas en la práctica del psicólogo. Método: se trata de un revisión integradora celebrada en el Portal Periodicos Capes, utilizando los descriptores la adhesión, los instrumentos y la insuficiencia cardiaca crónica y se correlaciona en inglés. Resultados: la mala adherencia al tratamiento puede estar asociado con varios factores, desde socioeconómica, trastornos psicológicos y deterioro cognitivo hasta la características de la enfermedad y la complejidad del tratamento; la relación entre el profesional de la salud y el paciente, sin embargo, es uno de los factores que contribuyen a la adherencia al tratamiento. Conclusión: algunos autores han tratado de presentar los métodos para evaluar la adherencia al tratamiento, incluyendo las pruebas psicológicas y los inventarios, pero hay un número limitado de investigaciones en esta dirección. Se sabe que el comportamiento de cumplimiento implica muchos factores diferentes, lo que requiere una investigación a fondo por medio de la evaluación psicológica, para identificar los que favorecen o dificultan la comprensión de un seguimiento adecuado del tratamiento, y promover una mayor conocimiento tanto del personal médico en cuanto a paciente, teniendo en cuenta las estrategias de intervención. Descriptores: insuficiencia cardíaca; adhesión del paciente; el tratamiento.

The Predictive Value of Degree of Preference for Extended-Release Naltrexone for Treatment Adherence, Opioid Use, and Relapse

2021 ◽  
pp. 1-12
Author(s):  
Zhanna Gaulen ◽  
Ida Halvorsen Brenna ◽  
Lars Thore Fadnes ◽  
Jūratė Šaltytė Benth ◽  
Kristin K. Solli ◽  
...  
Keyword(s):  
Treatment Adherence ◽  
Extended Release ◽  
Adherence Rate ◽  
Adherence To Treatment ◽  
Opioid Use ◽  
Open Label ◽  
Short Term Treatment ◽  
Baseline Preference ◽  
Risk Of Relapse

<b><i>Background:</i></b> Extended-release naltrexone (XR-NTX) is effective for illicit opioid abstinence as an opioid maintenance treatment. To improve treatment outcomes, patient’s preference for the modality of treatment is an important factor. <b><i>Objectives:</i></b> We aimed to test the relationship between baseline preference for XR-NTX and adherence to treatment, use of illicit opioids, and risk of relapse. <b><i>Methods:</i></b> In an open-label, Norwegian clinical trial participants with opioid use disorder were randomized to either monthly injections with XR-NTX or daily sublingual buprenorphine-naloxone (BP-NLX) for 12 weeks. Subsequently, participants could continue with their preferred medication in a 36-week follow-up and in a prolonged period of 104 weeks. <b><i>Results:</i></b> Of 153 participants who completed detoxification, 72% were men, with a mean age of 36 years. Preference levels were similar across the randomized groups, with no significant associations between preference and adherence to treatment, opioid use, or relapse. The BP-NLX group had a significantly higher risk of first relapse to opioids than the XR-NTX group for all levels of preference (<i>p</i> &#x3c; 0.001) and a significantly higher number of days of illicit opioid use. In the follow-up period, the adherence rate was twice as high among participants with the highest preference compared to participants with the lowest preference, both among those who switched to XR-NTX and those who continued (hazard ratio 2.2; 1.2–4.0, <i>p</i> = 0.013). Opioid use was significantly higher among participants who switched to XR-NTX with the lowest preference than the medium (<i>p</i> = 0.003) or the highest (<i>p</i> = 0.001) preference. The risk of relapse to opioids, however, was significantly higher among XR-NTX continuing participants with the lowest (<i>p</i> = 0.002) or the medium (<i>p</i> = 0.043) preference than those with the highest preference. <b><i>Conclusions:</i></b> Individuals who matched with their preferred treatment used less illicit opioids than those who did not during short-term treatment. However, baseline preference for XR-NTX treatment primarily influenced longer term opioid use and treatment adherence.

scholarly journals The Importance of Family Support in Successful Treatment Adherence of Schizophrenic Patient

2021 ◽  
Vol 10 (2) ◽  
pp. 83
Author(s):  
Lia Jessica ◽  
Izzatul Fithriyah ◽  
I Gusti Ayu Indah Ardani
Keyword(s):  
Family Support ◽  
Schizophrenic Patient ◽  
Treatment Adherence ◽  
Schizophrenia Patient ◽  
Paranoid Schizophrenia ◽  
Chief Complaint ◽  
Adherence To Treatment ◽  
Good Mental Health ◽  
High Adherence ◽  
Long Life

Background: Schizophrenia is a treatable disease  but requires patient’s high adherence to treatment. Family support of a schizophrenic patient plays an important role in encouraging the patient to continue his treatment. This report aims to enhance the importance of family support of schizophrenic patient in patient’s adherence to achieve a good mental health for all family member.Case: A hospitalized male paranoid schizophrenic patient who was admitted and observed in Dr. Soetomo General Hospital from September 15th-25th, 2020. Patient came to the hospital with chief complaint could not stop talking (rambling) since 1 day before admission. Patient could neither eat nor sleep for that day. Patient relapsed after stopping taking medication from the psychiatrist.Discussions: The patient in this case suffered a relapse of his paranoid schizophrenia because he stopped taking medication. Lack of support from family is the most important factor in a schizophrenia patient. Psychoeducation to patient’s family about schizophrenia and the importance of medication would be a great help for patient’s adherence to treatment.Conclusions: Schizophrenia needs a long-life treatment. High adherence to treatment could improve schizophrenia’s symptoms and prevent relapse. Family support is important to make sure the patient keeps taking his medicine regularly.

scholarly journals Oral Tranexamic Acid for the Treatment of Melasma

2014 ◽  
Vol 10 (4) ◽  
pp. 40-43 ◽  
Author(s):  
D Karn ◽  
S KC ◽  
A Amatya ◽  
EA Razouria ◽  
M Timalsina
Keyword(s):  
Tranexamic Acid ◽  
Controlled Trial ◽  
Severity Index ◽  
Sustained Improvement ◽  
Treatment Measures ◽  
Group A ◽  
Group B ◽  
Novel Concept ◽  
High Treatment

Background Melasma poses a great challenge as its treatment is unsatisfactory and recurrence is high. Treatment of melasma using tranexamic acid (oral, topical or intralesional) is a novel concept. Objective To compare the efficacy of oral tranexamic acid with routine topical therapies for the treatment of melasma. Methods It is a prospective, interventional, randomized controlled trial conducted among 260 melasma patients. Patients were divided into two groups consisting of 130 patients each. First group (Group A) was given routine treatment measures and oral Tranexamic Acid while second group (Group B) was treated only with routine topical measures. Capsule Tranexamic Acid was prescribed at a dose of 250 mg twice a day for three months and cases were followed for three months. Response was evaluated on the basis of Melasma Assessment Severity Index (MASI). Mean scores between the two groups were then compared. Results Statistically significant decrease in the mean Melasma Assessment Severity Index from baseline to 8 and 12 weeks was observed among group A patients (11.08±2.91 vs 8.95±2.08 at week 8 and vs. 7.84±2.44 at week 12; p<0.05 for both). While among group B patients the decrease in mean score was significant at 8 weeks and insignificant at 12 weeks follow up (11.60±3.40 vs 9.9±2.61 at 8 weeks and vs. 9.26±3 at 12 weeks; p<0.05 for former but p>0.05 for later). Conclusion Addition of oral tranexamic acid provides rapid and sustained improvement in the treatment of melasma. DOI: http://dx.doi.org/10.3126/kumj.v10i4.10993 Kathmandu Univ Med J 2012;10(4):40-43

scholarly journals Exploring the gateway hypothesis of e-cigarettes and tobacco: a prospective replication study among adolescents in the Netherlands and Flanders

2021 ◽  
pp. tobaccocontrol-2021-056528
Author(s):  
Thomas Martinelli ◽  
Math J J M Candel ◽  
Hein de Vries ◽  
Reinskje Talhout ◽  
Vera Knapen ◽  
...  
Keyword(s):  
The Netherlands ◽  
Tobacco Use ◽  
Tobacco Smoking ◽  
Longitudinal Design ◽  
Positive Association ◽  
Cigarette Use ◽  
Convenience Sample ◽  
Frequent Use ◽  
Never Smokers

BackgroundStudies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the gateway effect. However, most studies only investigated gateways from e-cigarettes to tobacco smoking. This study replicates a cornerstone study revealing a positive association between both adolescent e-cigarette use and subsequent tobacco use; and tobacco and subsequent e-cigarette use in the Netherlands and Flanders.DesignThe longitudinal design included baseline (n=2839) and 6-month (n=1276) and 12-month (n=1025) follow-up surveys among a school-based cohort (mean age: 13.62). Ten high schools were recruited as a convenience sample. The analyses involved (1) associations of baseline e-cigarette use and subsequent tobacco smoking among never smokers; (2) associations of e-cigarette use frequency at baseline and tobacco smoking frequency at follow-up; and (3) the association of baseline tobacco smoking and subsequent e-cigarette use among non-users of e-cigarettes.FindingsConsistent with prior findings, baseline e-cigarette use was associated with higher odds of tobacco smoking at 6-month (OR=1.89; 95% CI 1.05 to 3.37) and 12-month (OR=5.63; 95% CI 3.04 to 10.42) follow-ups. More frequent use of e-cigarettes at baseline was associated with more frequent smoking at follow-ups. Baseline tobacco smoking was associated with subsequent e-cigarette use (OR=3.10; 95% CI 1.58 to 6.06 at both follow-ups).ConclusionOur study replicated the positive relation between e-cigarette use and tobacco smoking in both directions for adolescents. This may mean that the gateway works in two directions, that e-cigarette and tobacco use share common risk factors, or that both mechanisms apply.

scholarly journals Health workers’ perceptions on where and how to integrate tobacco use cessation services into tuberculosis treatment; a qualitative exploratory study in Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elizeus Rutebemberwa ◽  
Kellen Nyamurungi ◽  
Surabhi Joshi ◽  
Yvonne Olando ◽  
Hadii M. Mamudu ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Tobacco Cessation ◽  
Health Workers ◽  
High Volume ◽  
Health Facilities ◽  
Hospital Treatment ◽  
Management Support ◽  
Tobacco Use Cessation ◽  
Tb Treatment

Abstract Background Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda. Methods Between March and April 2019, nine focus group discussions (FGDs) and eight key informant interviews were conducted among health workers attending to patients with tuberculosis on a routine basis in nine facilities from the central, eastern, northern and western parts of Uganda. These facilities were high volume health centres, general hospitals and referral hospitals. The FGD sessions and interviews were tape recorded, transcribed verbatim and analysed using content analysis and the Chronic Care Model as a framework. Results Respondents highlighted that just like TB prevention starts in the community and TB treatment goes beyond health facility stay, integration of tobacco cessation should be started when people are still healthy and extended to those who have been healed as they go back to communities. There was need to coordinate with different organizations like peers, the media and TB treatment supporters. TB patients needed regular follow up and self-management support for both TB and tobacco cessation. Patients needed to be empowered to know their condition and their caretakers needed to be involved. Effective referral between primary health facilities and specialist facilities was needed. Clinical information systems should identify relevant people for proactive care and follow up. In order to achieve effective integration, the health system needed to be strengthened especially health worker training and provision of more space in some of the facilities. Conclusions Tobacco cessation activities should be provided in a continuum starting in the community before the TB patients get to hospital, during the patients’ interface with hospital treatment and be given in the community after TB patients have been discharged. This requires collaboration between those who carry out health education in communities, the TB treatment supporters and the health workers who treat patients in health facilities.

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