scholarly journals Patient Adherence to Scheduled Vital Sign Measurements During Home Telemonitoring: Analysis of the Intervention Arm in a Before and After Trial

2017 ◽  
Author(s):  
Branko Celler ◽  
Ahmadreza Argha ◽  
Marlien Varnfield ◽  
Rajiv Jayasena
Keyword(s):  
Vital Sign ◽  
Patient Adherence ◽  
Home Telemonitoring ◽  
Before And After

scholarly journals Patient Adherence to Scheduled Vital Sign Measurements During Home Telemonitoring: Analysis of the Intervention Arm in a Before and After Trial (Preprint)

2017 ◽  
Author(s):  
Branko Celler ◽  
Ahmadreza Argha ◽  
Marlien Varnfield ◽  
Rajiv Jayasena
Keyword(s):  
Blood Pressure ◽  
Chronic Conditions ◽  
Patient Adherence ◽  
Vital Signs ◽  
Adherence Rate ◽  
Community Settings ◽  
Home Telemonitoring ◽  
Before And After ◽  
Different Levels ◽  
Over Time

BACKGROUND In a home telemonitoring trial, patient adherence with scheduled vital signs measurements is an important aspect that has not been thoroughly studied and for which data in the literature are limited. Levels of adherence have been reported as varying from approximately 40% to 90%, and in most cases, the adherence rate usually dropped off steadily over time. This drop is more evident in the first few weeks or months after the start. Higher adherence rates have been reported for simple types of monitoring and for shorter periods of intervention. If patients do not follow the intended procedure, poorer results than expected may be achieved. Hence, analyzing factors that can influence patient adherence is of great importance. OBJECTIVE The goal of the research was to present findings on patient adherence with scheduled vital signs measurements in the recently completed Commonwealth Scientific and Industrial Research Organisation (CSIRO) national trial of home telemonitoring of patients (mean age 70.5 years, SD 9.3 years) with chronic conditions (chronic obstructive pulmonary disease, coronary artery disease, hypertensive diseases, congestive heart failure, diabetes, or asthma) carried out at 5 locations along the east coast of Australia. We investigated the ability of chronically ill patients to carry out a daily schedule of vital signs measurements as part of a chronic disease management care plan over periods exceeding 6 months (302 days, SD 135 days) and explored different levels of adherence for different measurements as a function of age, gender, and supervisory models. METHODS In this study, 113 patients forming the test arm of a Before and After Control Intervention (BACI) home telemonitoring trial were analyzed. Patients were required to monitor on a daily basis a range of vital signs determined by their chronic condition and comorbidities. Vital signs included noninvasive blood pressure, pulse oximetry, spirometry, electrocardiogram (ECG), blood glucose level, body temperature, and body weight. Adherence was calculated as the number of days during which at least 1 measurement was taken over all days where measurements were scheduled. Different levels of adherence for different measurements, as a function of age, gender, and supervisory models, were analyzed using linear regression and analysis of covariance for a period of 1 year after the intervention. RESULTS Patients were monitored on average for 302 (SD 135) days, although some continued beyond 12 months. The overall adherence rate for all measurements was 64.1% (range 59.4% to 68.8%). The adherence rates of patients monitored in hospital settings relative to those monitored in community settings were significantly higher for spirometry (69.3%, range 60.4% to 78.2%, versus 41.0%, range 33.1% to 49.0%, P<.001), body weight (64.5%, range 55.7% to 73.2%, versus 40.5%, range 32.3% to 48.7%, P<.001), and body temperature (66.8%, range 59.7% to 73.9%, versus 55.2%, range 48.4% to 61.9%, P=.03). Adherence with blood glucose measurements (58.1%, range 46.7% to 69.5%, versus 50.2%, range 42.8% to 57.6%, P=.24) was not significantly different overall. Adherence rates for blood pressure (68.5%, range 62.7% to 74.2%, versus 59.7%, range 52.1% to 67.3%, P=.04), ECG (65.6%, range 59.7% to 71.5%, versus 56.5%, range 48.7% to 64.4%, P=.047), and pulse oximetry (67.0%, range 61.4% to 72.7%, versus 56.4%, range 48.6% to 64.1%, P=.02) were significantly higher in males relative to female subjects. No statistical differences were observed between rates of adherence for the younger patient group (70 years and younger) and older patient group (older than 70 years). CONCLUSIONS Patients with chronic conditions enrolled in the home telemonitoring trial were able to record their vital signs at home at least once every 2 days over prolonged periods of time. Male patients maintained a higher adherence than female patients over time, and patients supervised by hospital-based care coordinators reported higher levels of adherence with their measurement schedule relative to patients supervised in community settings. This was most noticeable for spirometry. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12613000635763; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364030&isReview=true (Archived by WebCite at http://www.webcitation.org/6xPOU3DpR).

HUBUNGAN PELAYANAN INFORMASI OBAT TERHADAP KEPATUHAN MINUM OBAT PASIEN HIPERTENSI DI RSUD PENAJAM PASER UTARA

2017 ◽  
Vol 3 (1) ◽  
pp. 7
Author(s):  
Triswanto Sentat
Keyword(s):  
Patient Adherence ◽  
Information Service ◽  
Rank Correlation ◽  
Pill Count ◽  
Adherence Rate ◽  
Validity And Reliability ◽  
Adherence To Medication ◽  
Count Method ◽  
Before And After ◽  
Questionnaire Method

The Drug Information Service or Pelayanan Informasi Obat (PIO) is indispensable for improving patient compliance with their treatment. With the PIO can change the knowledge and compliance of patients, especially hypertensive patients. This study was conducted to determine whether PIO can influence adherence to medication hypertension patients in RSUD Penajam Paser Utara. Sampling was done by purposive sampling and analyzed using Spearman Rank Correlation Test where the compliance aspect was assessed using validity and reliability tested questionnaire method, given before PIO and after PIO, and Pill Count method (calculating the remaining pills for 4 weeks) . Samples were obtained by 50 people, the results showed no improvement in adherence before and after PIO administration, and there was a relationship of compliance measurement results with questionnaire method after counseling and Pill Count method. The percentage of patient adherence after PIO administration was based on a high-compliance 70% (35 person) questionnaire method and based on the Pill Count method with a high adherence rate of 60% (30 persons), the compliance data obtained from both methods indicated that the provision of PIO can not improve compliance to take medication of hypertension patient of RSUD Penajam Paser Utara

scholarly journals The Incidence and Severity of Drug Interactions Before and After Antiretroviral Therapy Simplification in Treatment-Experienced Patients With HIV Infection

2019 ◽  
Vol 54 (1) ◽  
pp. 36-42
Author(s):  
Nicholas V. Hastain ◽  
Aleena Santana ◽  
Jason J. Schafer
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Drug Interactions ◽  
Patient Adherence ◽  
Potential Interaction ◽  
Rank Test ◽  
Signed Rank ◽  
Before And After ◽  
Signed Rank Test

Background: Current guidelines advocate for antiretroviral therapy (ART) simplification in patients on complicated regimens. Simplifying ART improves patient adherence and quality of life, but changes in drug interactions (DIs) are uncertain. Objective: This study assessed changes in DIs following ART simplification in patients with HIV. Methods: This was an observational, retrospective cohort study of patients attending an urban HIV clinic. Patients were included if they had ART simplification (a decreased number of daily tablets) and ≥1 concomitant medication (CM). Total DI scores were generated for each patient pre–ART simplification and post–ART simplification using an online DI database. Each ART-CM pair labeled as “do not co-administer” was given a score of 2, “potential interaction” a score of 1, or “no interaction” a score of 0. Differences in total DI scores following simplification were analyzed with a Wilcoxon Signed-Rank test. Predictors of DI score reductions were examined with linear regression. Results: A total of 99 patients were included. Their median age was 54 years, and 79% were male. The median durations of HIV infection and ART were 16 and 10 years, respectively. Patients were receiving an average of 4.5 CMs. Median interaction scores presimplification and postsimplification were 3 (interquartile range [IQR], 1-6) and 1 (IQR, 0-2) respectively ( P < 0.001). Predictors of score reductions were the patient’s number of CMs, discontinuing a protease inhibitor, and switching to a dolutegravir-based regimen. Conclusion and Relevance: ART simplification decreased the incidence of DIs in this analysis of patients with advanced age who had ART experience and polypharmacy.

Effect of Shadbindu Taila and Haridra Khanda in Pratishyaya (Allergic Rhinitis)

The Healer ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 58-60
Author(s):  
Sadhana Parajuli ◽  
Pramod Bhatta ◽  
D.L Bharkher
Keyword(s):  
Immune Response ◽  
Allergic Rhinitis ◽  
Nasal Mucosa ◽  
Significant Role ◽  
Vital Sign ◽  
Nasal Congestion ◽  
Combined Therapy ◽  
Nasal Discharge ◽  
Before And After ◽  
Airborne Allergens

Allergic rhinitis (AR) is an immune response of the nasal mucosa to airborne allergens and involves nasal congestion, watery nasal discharge, itching of the nose, and sneezing. Ayurveda describes Pratishyaya as one of the most important diseases among the 31 Nasarogas. Acharya Sushruta clearly mentioned that Pratishyaya is the condition in which vata kapha dusti was observed. Haridra Khanda is one of the prominent anti allergic drugs mentioned in ayurveda. Pratimarsha nasya has significant role in the prevention of urdhvajatrugata rogas. Ancient acharya has told to try shadbindu taila and Haridra khanda both locally and systematically in the management of pratishyaya. Here 30 patients were selected open randomly in shalakya opd of ayurveda campus kirtipur. They were given pratimarsha nasya with sadhbindu taila and internally haridra khanda for 30 days. The vital sign and symptom of pratishyaya like nasa srava, nasa kandu, kshavatu, nasa kandu and shira shula were studied before and after the treatment. The result of the study indicated that the combined therapy of internally Haridra Khanda and external pratimarsha narsha with sadbindu tail has given significant result in the treatment of Allergic Rhinitis (Pratishyaya).

ROLE OF PHARMACIST IN COUNSELING ASTHMA TO IMPROVE PATIENT ADHERENCE IN YOGYAKARTA

2017 ◽  
Vol 10 (14) ◽  
pp. 16
Author(s):  
Chynthia Pradiftha Sari ◽  
Lukman Hakim ◽  
I. Dewa Putu P.
Keyword(s):  
Patient Adherence ◽  
Intervention Group ◽  
Persistent Asthma ◽  
Therapy Outcome ◽  
Control Group ◽  
Control Group Design ◽  
Significant Difference ◽  
Before And After ◽  
Asthma Patients ◽  
Pharmacist Counseling

Objective: To identify the effect of pharmacist-provided counseling on patient adherence and to examine the correlation between adherence level and asthma therapy outcomeMethods: Quasi-experimental through control-group design with pretest-posttest. Study was conducted during February–June 2013 (N=120). Only the intervention group received pharmacist counseling. All participants completed MMAS and ACT questionnaires before and after counseling. They were 18–60 y old and having<8 MMAS pretest score with moderate-severe persistent asthma.Results: The intervention was pharmacist counseling for 56 patients, and control group had 50 patients. After counseling, 3.92% severe persistent asthma patients showed low-medium adherence, and 62.64% moderate persistent asthma patients had medium-high adherence. The change of MMAS score in the intervention group was 3.71 and 2, and 1.23 and 1.64 in the control group. Wilcoxon and Mann Whitney test indicated a significant difference in patient adherence before and after counseling (p<0.001). Adherence was positively and significantly correlated with therapy outcome (p<0.001; r=0.583).Conclusion: Pharmacist counseling affects asthma patient adherence. There is a significant correlation between adherence and therapy outcome.

scholarly journals Clinical description of affective disorders and efficiency of antidepressant therapy

2018 ◽  
Vol 17 (4) ◽  
pp. 85-93 ◽  
Author(s):  
E. V. Lebedeva ◽  
E. D. Schastnyy ◽  
G. G. Simutkin ◽  
A. N. Repin ◽  
T. G. Nonka
Keyword(s):  
Affective Disorders ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Patient Adherence ◽  
Antidepressant Therapy ◽  
Term Therapy ◽  
Chronic Coronary Artery Disease ◽  
Before And After ◽  
Clinically Significant ◽  
Bipolar Affective Disorders ◽  
Depressive Episodes

Objective:to identify the structure and clinical features of affective disorders (AD) and efficiency of antidepressants in in-patients with chronic coronary artery disease (ChCAD), living in Tomsk and the Tomsk Region.Materials andмethods.At a heart center, 1,131 patients with ChCAD were examined: in 290 persons (25.6%) AD were revealed, among them 72.1% were men (n= 209) and 27.9% were women (n= 81). Mean age of women was (63.5 ± 9.4) years and in men (57.9 ± 7.2) years (р= 0.004). AD structure, main syndromes, severity of depression and anxiety according to data of self-questionnaires and clinical scales before and after antidepressant therapy (predominantly with selective serotonin reuptake inhibitors (SSRI)) were studied. Comparative analysis of clinical indices of CAD respective from AD, presence of antidepressant therapy and its efficiency was performed.Results.Chronic AD were found in 45% of patients. Newly diagnosed depressive episodes made up 24.5% and recurrent depressive disorder (RDD) was 24%. 6.5% were bipolar affective disorders (BAD), predominantly bipolar II disorders. Depressive syndrome in 91.7% of patients had the second significant component (more frequently 54.8%). Characteristic of the clinical picture was dominance of complaints of bodily discomfort and pain, anergy and anhedonia. Moderate mental disturbances made up 49.0% (CGI). AD manifested at the age of 48 (40–55) years and preceded development of ChCAD. Natural course of AD was observed in 52.4% of cases. 47.6% (138/290) of patients received antidepressants, and only in 42% (58/138) clinically significant improvement was noted (more than 50% according to CGI). It was difficult to encourage patient adherence to long-term therapy (30–50% according to CGI). Physical activity tolerance (PAT) according to data of veloergometry increased in responders. Psychopharmaco- and psychotherapy should be included into rehabilitative programs for patients with ChCAD and AD.

Impact of an integrated oral chemotherapy program on patient adherence

2017 ◽  
Vol 24 (5) ◽  
pp. 332-336 ◽  
Author(s):  
Katherine P Morgan ◽  
Benyam Muluneh ◽  
Allison M Deal ◽  
Lindsey B Amerine
Keyword(s):  
Retrospective Study ◽  
Patient Adherence ◽  
Medication Possession Ratio ◽  
Oral Chemotherapy ◽  
Pharmacy Services ◽  
Patient Reported ◽  
Before And After ◽  
Secondary Endpoints ◽  
Specialty Pharmacy ◽  
The Impact

As the use of oral chemotherapy continues to rise, the issue of patient adherence is a concerning aspect of cancer treatment. In this concurrent prospective and retrospective study, we assessed oral chemotherapy adherence in patients receiving their prescriptions at an institutional specialty pharmacy, with an integrated oral chemotherapy program. The primary endpoint is medication possession ratio. Secondary endpoints include self-reported adherence comparing survey data before and after the introduction of the oral chemotherapy program to assess the impact of the comprehensive pharmacy services provided. Patients receiving their oral chemotherapy from the institutional specialty pharmacy have a mean medication possession ratio of 0.92, indicating excellent adherence rates. The oncology clinical pharmacist, in collaboration with the specialty pharmacy, has also decreased the rates of patient-reported non-adherence.

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