Pill Count, Self-Report, and Pharmacy Claims Data to Measure Medication Adherence in the Elderly

1998 ◽  
Vol 32 (7-8) ◽  
pp. 749-754 ◽  
Author(s):  
Ruby E Grymonpre ◽  
Cathy D Didur ◽  
Patrick R Montgomery ◽  
Daniel S Sitar
Keyword(s):  
Medication Adherence ◽  
Repeated Measures ◽  
Claims Data ◽  
Pill Count ◽  
Self Report ◽  
Data Sources ◽  
Controlled Study ◽  
Unexpected Finding ◽  
Claims Database ◽  
Wellness Center

OBJECTIVE: To compare medication adherence calculated from four different data sources including a pill count and self-report obtained during a home medication history, as well as calculations based on refill frequency derived from a provincial prescription claims database (manual and electronic). DESIGN: Baseline medication adherence was collected as part of a prospective, randomized, controlled study. Mean medication adherence results obtained from the four data sources were compared using repeated-measures ANOVA followed by a Tukey's multiple range test. SETTING: A pharmacy consultation service located at an interdisciplinary wellness center for noninstitutionalized elderly. PATIENTS: 65 years or older, noninstitutionalized, taking one or more prescribed or nonprescribed medications. Clients would either present to the wellness center or be referred by the Provincial Home Care program. RESULTS: When calculated from self-report or manual or electronic prescription claims data, mean percent adherence by drug was high and not statistically different (95.8% ± 17.1%, 107.6% ± 40.3%, and 94.6% ± 24.0%, respectively), whereas the pill count adherence was significantly lower at 74.0% ± 41.5% (p < 0.0001). CONCLUSIONS: An unexpected finding was that the pill count technique used in this study of elderly clients using chronic, repeat medications appeared to underestimate medication adherence. Numerous other limitations of pill count, self-report, and a province-wide prescription claims database in estimating medication adherence are presented. When using medication adherence as a process measure, the researcher and practitioner should be aware of the limitations unique to the data source they choose, and interpret data cautiously.

scholarly journals Self-reported Morisky 8 item medication adherence scale to statins concords with pill count method and correlates with serum lipid profile parameters and Serum HMGCoA Reductase levels

2019 ◽  
Author(s):  
Abhinav Grover ◽  
Mansi Oberoi ◽  
Harmeet Rehan ◽  
Lalit Gupta ◽  
Madhur Yadav
Keyword(s):  
Medication Adherence ◽  
Lipid Profile ◽  
Density Lipoprotein ◽  
Correlation Coefficients ◽  
Pill Count ◽  
Self Report ◽  
Adherence Score ◽  
Count Method ◽  
High Adherence ◽  
Adherence Scale

ABSTRACTBackgroundIt is imperative that non-compliance to statins be identified and addressed to optimize the clinical benefit of statins. Patient self-reporting methods are convenient to apply in clinical practice but need to be validated.ObjectiveWe studied the concordance of a patient self-report method, MMAS (Morisky eight item medication adherence scale) with pill count method in measuring adherence to statins and their correlation with extended lipid profile parameters and serum HMGCoA-R (hydroxymethylglutaryl coenzyme A reductase) enzyme levels.MethodsMMAS and pill count method were used to measure the adherence to statins in patients on statins for any duration. Patients were subjected to estimation of extended lipid profile and serum HMGCoA-R levels at the end of 3 months follow-up.ResultsOut of a total of 200 patients included in the study, 117 patients had low adherence (score less than 6 on MMAS) whereas 65 and 18 patients had medium (score 6 to less than 8) and high adherence (score of 8) respectively. Majority of patients who had low adherence to statins by MMAS were nonadherent by pill count method yielding concordance of 96.5%. Medium or high adherence to statins by MMAS method had concordance of 89.1% with pill count method. The levels of total cholesterol, low density lipoprotein-cholesterol, apolipoprotein B and HMGCoA-R were significantly negatively correlated with compliance measured by pill count and MMAS with similar correlation coefficients. HMGCoA-R levels demonstrated a plateau phenomenon with levels being 9-10 ng/ml when compliance to statin therapy was greater than 60% by pill count and greater than 6 on Morisky scale.ConclusionIn conclusion, MMAS and pill count methods showed concordance in measuring adherence to statins. These methods need to be explored further for their interchangeability as surrogates for biomarker levels.

Impact of a mobile hypertension program in four rural Dominican bateyes

2018 ◽  
Author(s):  
◽  
Tammie M. Conley
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Blood Pressure Control ◽  
Migrant Workers ◽  
Repeated Measures ◽  
Large Population ◽  
Pressure Control ◽  
Academic Community ◽  
Self Report ◽  
The Impact

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] Hypertension contributes significantly to cardiovascular risk and overall mortality worldwide. Among Haitians, uncontrolled hypertension is a leading contributing cause of death. The Dominican Republic is home to a large population of Haitian migrant workers who are living in poverty in sugar cane villages called bateyes. Like other rural impoverished communities, batey residents often lack access to basic health and education services which can result in poor cardiovascular health outcomes. This dissertation examined the impact of the first 12 months of an ongoing mobile hypertension program. The program, developed via an academic-community partnership, was delivered by a local Dominican non-governmental organization (NGO) in four rural bateyes. A ‘promotora’ (lay health promoter) who is a resident of each batey works closely with the team to enhance community participation in the program. Descriptive statistics were used to describe the study sample (n=70). A within-group, repeated-measures, pre-/post design examined the impact of the program on the main outcome measure of blood pressure control. Other outcome measures of interest were body mass index (BMI) and self-reported salt, alcohol, and smoking behaviors, and medication adherence (measured by self-report and pill counts). Results from analyses of 5 visits over a 12-month period showed a decrease in mean systolic and diastolic blood pressure over time (p less than .005). Of note, 68% of the participants were >80% adherent to their antihypertensive medications. A Pearson’s correlation showed that individuals with increased medication adherence also had clinically and statistically significant reductions in SBP and DBP. Findings from this analysis of the first 12 months of the program indicate that the mobile hypertension screening and treatment program has a positive impact on blood pressure control. Evaluation of the program is ongoing and could serve as a model that has widespread implication in other isolated communities worldwide.

815-P: Medication Adherence by Pill Count Using Medical Reconciliation in Patients with Type 2 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 815-P
Author(s):  
MEGUMI SHIOMI ◽  
YOICHI TANAKA ◽  
MOMOKA KUROBUCHI ◽  
TESSHU TAKADA ◽  
KATSUYA OTORI
Keyword(s):  
Type 2 Diabetes ◽  
Medication Adherence ◽  
Pill Count

scholarly journals Effectiveness of Abdominal and Gluteus Medius Training in Lumbo-Pelvic Stability and Adductor Strength in Female Soccer Players. A Randomized Controlled Study

2021 ◽  
Vol 18 (4) ◽  
pp. 1528
Author(s):  
Héctor Guerrero-Tapia ◽  
Rodrigo Martín-Baeza ◽  
Rubén Cuesta-Barriuso
Keyword(s):  
Repeated Measures ◽  
Gluteus Medius ◽  
Soccer Players ◽  
Controlled Study ◽  
Control Group ◽  
Extrinsic Factors ◽  
Randomized Controlled ◽  
Limb Injuries ◽  
Experimental Group

Background. Abdominal and lumbo-pelvic stability alterations may be the origin of lower limb injuries, such as adductor pathology in soccer players. Imbalance can be caused by both intrinsic and extrinsic factors. Methods: In this randomized controlled trial over 8 weeks, 25 female footballers were randomly allocated to an experimental group (isometric abdominal training and gluteus medius-specific training) or a control group (isometric abdominal training). Evaluations were performed at baseline, at the end of the intervention and after a 4-week follow-up period. The exercise protocol in common for both groups included three exercises: Plank, Lateral plank and Bird dog. Specific exercises for the gluteus medius were: Pelvic drop and Stabilization of the gluteus medius in knee valgus. Outcome measures were lumbar-pelvic stability and adductor strength. Results: After the intervention, there was an increase in lumbo-pelvic stability in both groups, being greater in the control group than in the experimental group (mean differences [MD]: 4.84 vs. MD: 9.58; p < 0.01) with differences in the analysis of repeated measures (p < 0.001), but not in group interaction (p = 0.26). Changes were found in adductor strength in the experimental group (MD: −2.48; p < 0.001 in the left adductor; MD: −1.48; p < 0.01 in right adductor) and control group (MD: −1.68; p < 0.001 in the left adductor; MD: −2.05; p < 0.001 in the right adductor) after the intervention, with differences in the analysis of repeated measures in left (p < 0.001) and right (p < 0.001) adductor strength. Conclusions: An abdominal and gluteal training protocol shows no advantage over a protocol of abdominal training alone for lumbo-pelvic stability and adductor strength, while improvements in both variables are maintained at four weeks follow-up.

Severe Maternal Morbidity: A Comparison of Definitions and Data Sources

2021 ◽  
Author(s):  
Jonathan M Snowden ◽  
Audrey Lyndon ◽  
Peiyi Kan ◽  
Alison El Ayadi ◽  
Elliott Main ◽  
...  
Keyword(s):  
Administrative Data ◽  
Maternal Morbidity ◽  
Claims Data ◽  
Birth Certificate ◽  
Population Level ◽  
Kappa Statistic ◽  
Data Sources ◽  
Severe Maternal Morbidity ◽  
Fine Grained ◽  
Control And Prevention

Abstract Severe maternal morbidity (SMM) is a composite outcome measure that indicates serious, potentially life-threatening maternal health problems. There is great interest in defining SMM using administrative data for surveillance and research. In the US, one common way of defining SMM at the population level is an index developed by the Centers for Disease Control and Prevention. Modifications have been proposed to this index (e.g., excluding maternal transfusion); some research defines SMM using an index introduced by Bateman et al. Birth certificate data are also increasingly being used to define SMM. We compared commonly used US definitions of SMM to each other among all California births, 2007-2012, using the Kappa statistic and other measures. We also evaluated agreement between maternal morbidity fields on the birth certificate compared to claims data. Concordance was generally low between the 7 definitions of SMM analyzed (i.e., κ &lt; 0.4 for 13 of 21 two-way comparisons), Low concordance was particularly driven by presence/absence of transfusion and claims data versus birth certificate definitions. Low agreement between administrative data-based definitions of SMM highlights that results can be expected to differ between them. Further research is needed on validity of SMM definitions, using more fine-grained data sources.

Neutral douche: a hydrotherapeutic tool to manage pain and systemic symptoms in primary dysmenorrhea - a randomised controlled study

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Sataz Rahmania ◽  
Vanitha Shetty ◽  
Balakrishnan Ragavendrasamy
Keyword(s):  
Repeated Measures ◽  
Whole Body ◽  
Pharmacological Intervention ◽  
Controlled Study ◽  
Control Group ◽  
Mcgill Pain Questionnaire ◽  
Primary Dysmenorrhea ◽  
Primary Dysmenorrhoea ◽  
Systemic Symptoms ◽  
Experimental Group

AbstractBackground & ObjectivesThe douche, one of the hydrotherapeutic treatment modality is commonly used by Naturopathy physicians as a treatment of choice in the management of several ailments. This study was done to assess the effect of full body neutral douche in the management of pain and systemic symptoms in adult females with primary dysmenorrhoea.Methods68 subjects of age 18-22 years with primary dysmenorrhoea were recruited for the study and were randomly divided into two groups: the experimental group (n = 34) and the control group (n = 34). The experimental group received whole body neutral douche, whereas the control group followed the routine as usual. Assessments for the pain, systemic symptoms and menstrual cramps were done by using McGill Pain Questionnaire, Verbal multidimensional scoring system and analog scale for severity of pain and menstrual cramps respectively at baseline, day 30 and day 60 of intervention. Two- way repeated measures of ANOVA was performed to understand the between group changes, adjusted for the respective baseline values and age.ResultData was analyzed with SPSS (Version 21.0) package. Neutral douche resulted in significant improvement in pain [F(2,66) = 114.564, p < 0.0005, partial ?2 = 0.771], severity of pain [F(2,66) = 70.418, p < 0.0005, partial ?2 = 0.681], cramps [F(2,66) = 75.986, p < 0.0005, partial ?2 = 0.697] and systemic symptoms [F(2,66) = 14.64, p < 0.0005, partial ?2 = 0.307] as compared to the control group.ConclusionFindings suggest that neutral douche can be used as a non-pharmacological intervention in the management of pain and systemic symptoms in primary dysmenorrhea.

scholarly journals Effectiveness of a hydrogel dressing as an analgesic adjunct to first aid for the treatment of acute paediatric burn injuries: a prospective randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e039981
Author(s):  
Maleea Denise Holbert ◽  
Roy M Kimble ◽  
Mark Chatfield ◽  
Bronwyn R Griffin
Keyword(s):  
Randomised Controlled Trial ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Geometric Mean ◽  
First Aid ◽  
Self Report ◽  
Thermal Burn ◽  
Pain Scores ◽  
Registration Number ◽  
Randomised Controlled

ObjectiveTo compare the effectiveness of two acute burn dressings, Burnaid hydrogel dressing and plasticised polyvinylchloride film, on reducing acute pain scores in paediatric burn patients following appropriate first aid.DesignSingle-centre, superiority, two-arm, parallel-group, prospective randomised controlled trial.Participants and settingPaediatric patients (aged ≤16) presenting to the Emergency Department at the Queensland Children’s Hospital, Brisbane, Australia, with an acute thermal burn were approached for participation in the trial from September 2017–September 2018.InterventionsPatients were randomised to receive either (1) Burnaid hydrogel dressing (intervention) or (2) plasticised polyvinylchloride film (Control) as an acute burn dressing.Primary and secondary outcomesObservational pain scores from nursing staff assessed 5 min post application of the randomised dressing, measured using the Face Legs Activity Cry and Consolability Scale was the primary outcome. Repeated measures of pain, stress and re-epithelialisation were also collected at follow-up dressing changes until 95% wound re-epithelialisation occurred.ResultsSeventy-two children were recruited and randomised (n=37 intervention; n=35 control). No significant between-group differences in nursing (mean difference: −0.1, 95% CI −0.7 to 0.5, p=0.72) or caregiver (MD: 1, 95% CI −8 to 11, p=0.78) observational pain scores were identified. Moreover, no significant differences in child self-report pain (MD: 0.3, 95% CI −1.7 to 2.2, p=0.78), heart rate (MD: −3, 95% CI −11 to 5, p=0.41), temperature (MD: 0.6, 95% CI −0.13 to 0.24, p=0.53), stress (geometric mean ratio: 1.53, 95% CI 0.93 to 2.53, p=0.10), or re-epithelialisation rates (MD: −1, 95% CI −3 to 1, p=0.26) were identified between the two groups.ConclusionsA clear benefit of Burnaid hydrogel dressing as an analgesic adjunct to first aid for the treatment of acute paediatric burns was not identified in this investigation.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12617001274369).

Work-Related Subjective Experiences Among Community Residents with Schizophrenia or Schizoaffective Disorder

2005 ◽  
Vol 39 (4) ◽  
pp. 288-299 ◽  
Author(s):  
Geoff Waghorn ◽  
David Chant ◽  
Robert King
Keyword(s):  
Psychometric Properties ◽  
Schizoaffective Disorder ◽  
Repeated Measures ◽  
Supported Employment ◽  
Self Report ◽  
Urban Residents ◽  
Subjective Experiences ◽  
Work Related ◽  
Community Residents ◽  
Test Retest Reliability

Objective: To develop a self-report scale of subjective experiences of illness perceived to impact on employment functioning, as an alternative to a diagnostic perspective, for anticipating the vocational assistance needs of people with schizophrenia or schizoaffective disorders. Method: A repeated measures pilot study (n1 = 26, n2 = 21) of community residents with schizophrenia identified a set of work-related subjective experiences perceived to impact on employment functioning. Items with the best psychometric properties were applied in a 12 month longitudinal survey of urban residents with schizophrenia or schizoaffective disorder (n1 = 104; n2 = 94; n3 = 94). Results: Construct validity, factor structure, responsiveness, internal consistency, stability, and criterion validity investigations produced favourable results. Work-related subjective experiences provide information about the intersection of the person, the disorder, and expectations of employment functioning, which suggest new opportunities for vocational professionals to explore and discuss individual assistance needs. Conclusion: Further psychometric investigations of test-retest reliability, discriminant and predictive validity, and research applications in supported employment and vocational rehabilitation, are recommended. Subject to adequate psychometric properties, the new measure promises to facilitate exploring: individuals' specific subjective experiences; how each is perceived to contribute to employment restrictions; and the corresponding implications for specialized treatment, vocational interventions and workplace accommodations.

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