scholarly journals Medication Adherence in a Community Population with Uncontrolled Asthma

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 183
Author(s):  
Sarah Serhal ◽  
Bandana Saini ◽  
Sinthia Bosnic-Anticevich ◽  
Ines Krass ◽  
Frances Wilson ◽  
...  
Keyword(s):  
At Risk ◽  
Allergic Rhinitis ◽  
Medication Adherence ◽  
Asthma Control ◽  
Hospital Admissions ◽  
Medication Management ◽  
Uncontrolled Asthma ◽  
Medication History ◽  
Factors Affecting ◽  
Oral Corticosteroids

It is well documented that the use of medications in asthma and allergic rhinitis is often suboptimal, and consequently, patients remain symptomatic. This study aimed to determine the extent and type of medication-related issues contributing to poor asthma control by profiling medication management in those most at risk—a population with clinically uncontrolled asthma. Participants (n = 363) were recruited from Australian community pharmacies, and a dispensed medication history report for the previous 12 months was collected to examine medication adherence and factors affecting adherence. Information was also collected regarding participant asthma control and asthma/allergic rhinitis (if applicable) management. The participants’ mean asthma control score was 2.49 (± 0.89 SD, IQR = 1.20) (score ≥ 1.5 indicative of poorly controlled asthma), and 72% were either non-adherent or yet to initiate preventer therapy. Almost half had been prescribed high doses of inhaled corticosteroid and 24% reported use of oral corticosteroids. Only 22% of participants with concomitant allergic rhinitis were using first line treatment. A logistic regression model highlighted that participant health care concession status and hospital admissions were associated with better adherence. Suboptimal medication management is evident in this at-risk population.

Behavioral Side Effects of Medications Used to Treat Asthma and Allergic Rhinitis

1995 ◽  
Vol 16 (9) ◽  
pp. 333-335
Author(s):  
Henry Milgrom ◽  
Bruce Bender
Keyword(s):  
Allergic Rhinitis ◽  
Verbal Memory ◽  
Time Factors ◽  
Prescribing Patterns ◽  
Hand Tremor ◽  
Factors Affecting ◽  
Inhaled Steroids ◽  
Beta Agonists ◽  
Oral Corticosteroids ◽  
Psychotic Behavior

Parents, teachers, and physicians are concerned that medicines may alter children's mood, behavior, and ability to learn. In clinical practice, adverse reactions to drugs and the perceptions associated with them influence prescribing patterns and undermine compliance. In the treatment of chronic disorders such as asthma, where successful management requires that patients take medications consistently over prolonged periods of time, factors affecting compliance become profoundly important. Asthma medications have been associated with behavioral, affective, and neuropsychological changes in children. Oral corticosteroids exacerbate depression and impair verbal memory, and there are anecdotal reports of severe reactions to inhaled steroids among children, including psychotic behavior. Oral beta agonists have been reported to cause psychotic reactions in adult patients. In children, inhaled albuterol frequently induces a short-term hand tremor, but does not compromise more complex psychomotor functions. Theophylline improves concentration and results in slightly increased hand tremor and feelings of anxiety. Medicines for allergic rhinitis and those used for cough and colds frequently are administered by parents without the supervision of physicians. Many of these preparations, given not only to children who have allergic disease but also to those who have self-limiting respiratory symptoms, are available over the counter (OTC). This confusing array of combination antihistamines, decongestants, expectorants, and anticholinergic agents constitutes the largest group of drugs taken by children.

scholarly journals Level of asthma control and its relationship with medication use in asthma patients in Brazil

2014 ◽  
Vol 40 (5) ◽  
pp. 487-494 ◽  
Author(s):  
Josiane Marchioro ◽  
Mariana Rodrigues Gazzotti ◽  
Oliver Augusto Nascimento ◽  
Federico Montealegre ◽  
James Fish ◽  
...  
Keyword(s):  
Asthma Control ◽  
Latin American ◽  
Rescue Medication ◽  
Uncontrolled Asthma ◽  
The Past ◽  
Global Initiative For Asthma ◽  
Asthma Patients ◽  
Oral Corticosteroids ◽  
Global Initiative ◽  
Asthma Group

OBJECTIVE: To assess asthma patients in Brazil in terms of the level of asthma control, compliance with maintenance treatment, and the use of rescue medication. METHODS: We used data from a Latin American survey of a total of 400 asthma patients in four Brazilian state capitals, all of whom completed a questionnaire regarding asthma control and treatment. RESULTS: In that sample, the prevalence of asthma was 8.8%. Among the 400 patients studied, asthma was classified, in accordance with the Global Initiative for Asthma criteria, as controlled, partially controlled, and uncontrolled in 37 (9.3%), 226 (56.5%), and 137 (34.3%), respectively. In those three groups, the proportion of patients on maintenance therapy in the past four weeks was 5.4%, 19.9%, and 41.6%, respectively. The use of rescue medication was significantly more common in the uncontrolled asthma group (86.9%; p < 0.001). CONCLUSIONS: Our findings suggest that, in accordance with the established international criteria, asthma is uncontrolled in the vast majority of asthma patients in Brazil. Maintenance medications are still underutilized in Brazil, and patients with partially controlled or uncontrolled asthma are more likely to use rescue medications and oral corticosteroids.

scholarly journals Medication Management at Home and Medication Adherence in Older Patients with Polypharmacy: In-Depth Interviews with Home Visits

2021 ◽  
Author(s):  
Pasitpon Vatcharavongvan ◽  
Viwat Puttawanchai
Keyword(s):  
Medication Adherence ◽  
Elderly Patients ◽  
Medication Management ◽  
Home Visits ◽  
Medication Administration ◽  
Medication Nonadherence ◽  
Factors Affecting ◽  
Medication Storage ◽  
Depth Interviews ◽  
At Home

Objectives: This study qualitatively explores the patients with polypharmacy medication management at home. Design: Qualitative study with in-depth interviews and home visits Setting: A semiurban area in the Pathum-Thani province, Thailand. Participants: We interviews 19 elderly patients aged ≥60 years with polypharmacy at their houses and took photos of medication storage locations. Results: Of the 19 patients (mean age=69 years), nine reported good medication adherence. Two themes emerged: medication management at home and factors affecting medication adherence. Medication management at home comprised three subthemes: a medication storage system, a medication sorting system, and remaining medications. Some patients with medication nonadherence removed medications from blister packages. Other factors affecting medication adherence included knowledge, attitude, and lifestyles. All the patients had a positive attitude towards medication adherence; however, misunderstanding about medication administration prevented them from adhering to medications. Conclusion: The elderly patients managed medications at home differently. Medication nonadherence was common in those who removed medications from blister packages. Doctors and pharmacists should encourage the patients to use pillboxes or discourage patients from removing medications from blister packages.

scholarly journals Effects of a pilot multidisciplinary clinic for frequent attending elderly patients on deprescribing

2016 ◽  
Vol 40 (1) ◽  
pp. 86 ◽  
Author(s):  
Alison Mudge ◽  
Katherine Radnedge ◽  
Karen Kasper ◽  
Robert Mullins ◽  
Julie Adsett ◽  
...  
Keyword(s):  
Pilot Study ◽  
Elderly Patients ◽  
Adverse Drug Events ◽  
Hospital Admissions ◽  
Medication Management ◽  
Management Plan ◽  
Transitions Of Care ◽  
Potentially Inappropriate Medications ◽  
Medical Patients ◽  
Medication History

Objective Multimorbidity and associated polypharmacy are risk factors for hospital re-admission. The Targeting Hospitalization Risks in Vulnerable Elders (THRIVE) clinic is a novel multidisciplinary out-patient clinic to improve transitions of care and decrease re-admission risk for older medical patients with frequent hospital admissions. This pilot study examined the effect of the THRIVE model on medication count, tablet load and potentially inappropriate medicines (PIMs). Methods Participants with frequent medical admissions were referred within 2 weeks of discharge from hospital and assessed at baseline and then at 4 and 12 weeks by the THRIVE team. A thorough reconciliation of all medications was performed collaboratively by a clinical pharmacist and a physician. Optimising medications, including deprescribing, was in collaboration with the participants’ general practitioner. The complete medication history of each patient was compared retrospectively by an independent assessor at baseline and after the 12-week clinic, comparing total number of regular medications, tablet load and PIMs (measured using the Screening Tool of Older Persons Prescriptions (STOPP) tool). Results All 17 participants attending the pilot THRIVE clinic were included in the study. At 12 weeks, there was a significant reduction in mean medication count (from 14.3 to 11.2 medications; P < 0.001) and mean tablet load (from 20.5 to 16.9 tablets; P < 0.01). There was an absolute reduction in the total number of PIMs from 38 to 14. Common medications deprescribed included opioids, tricyclic antidepressants, benzodiazepines and diuretics. Conclusions Patients who attended the THRIVE clinic had a significant reduction in medication count and tablet load. The pilot study demonstrates the potential benefits of a multidisciplinary out-patient clinic to improve prescribing and reduce unwarranted medications in an elderly population. An adequately powered comparative study would allow assessment of clinical outcomes and costs. What is known about the topic? Elderly patients are prone to polypharmacy. The identification and deprescribing of potentially inappropriate medications is effective in reducing adverse drug events in this population. However, acute hospitalisation is not always the ideal setting to initiate deprescribing. What does the paper add? Intensive multidisciplinary out-patient care for frequently re-admitted patients optimises their medication management plan and helps reduce the use of unwarranted medications. What are the implications for practitioners? Effective deprescribing in elderly patients can be achieved after hospital discharge using a multidisciplinary collaborative model, but costs and clinical benefits require further investigation.

scholarly journals A descriptive study of factors associated with anti-fungal medication adherence among patients with dermatophytosis

2020 ◽  
Vol 11 (4) ◽  
pp. 7027-7033
Author(s):  
Mohammad Javad Hashemi ◽  
Mohammad Manaf ◽  
Bhanu Priya HR ◽  
Laween Merris Lenos ◽  
Prabhu M ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Fungal Infection ◽  
Hospital Admissions ◽  
Fungal Infections ◽  
Descriptive Analysis ◽  
Dermatology Department ◽  
Factors Affecting ◽  
Factors Associated ◽  
Strongly Agree ◽  
Anti Fungal

The prevalence of superficial Mycotic infection worldwide is 20–25%. Medication non-adherence in patients leads to worsening of the disease, death and increased health care costs. More than 30% of medicine-related hospital admissions occur due to medication non-adherence. The aim of the study is assessing the factors associated with medication adherence in patients with dermatophytosis. Data were analyzed by using descriptive analysis of 305 patients attending the dermatology department. The period of study was three months. Medication adherence was determined using Morisky Green Levine Scale for dermatophytosis patients who are undergoing treatment. KAP (knowledge, attitude, practice) was used to determine the knowledge gaps, general health practice, and beliefs of the patient towards fungal infection. It was found that 47.86% of the subjects in the study are non- adherent and 49.50% are moderate adherents, and only 2.62% are highly adherent to medications prescribed. In KAP study, it was found that (14.4%) strongly agree that fungal infection does not create hindrance in normal life, while (28.85%) strongly disagree. Practice where analyzed in 305 subjects, (52.13%) share clothing with family members or friends, (50.16%) do not take medication as prescribed. The patient affected with fungal infections had poor adherence to the medicines prescribed. The risk factors affecting medication adherence are poor hygiene, sharing of cloths of friends or family, dosing schedule, complex regimens, access barriers, and cost of the drug. Patient education, in the early stages of fungal infection, can avoid non- adherence.

scholarly journals Montelukast as Add-On Therapy with Inhaled Corticosteroids or Inhaled Corticosteroids and Long-Acting Beta-2-Agonists in the Management of Patients Diagnosed with Asthma and Concurrent Allergic Rhinitis (The RADAR Trial)

2009 ◽  
Vol 16 (suppl a) ◽  
pp. 17A-24A ◽  
Author(s):  
Paul K Keith ◽  
Caroline Koch ◽  
Michel Djandji ◽  
Jacques Bouchard ◽  
Eliofotisti Psaradellis ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Consensus Guidelines ◽  
Uncontrolled Asthma ◽  
Asthma Control Questionnaire ◽  
Asthma Symptoms ◽  
Beta 2 ◽  
Clinically Significant ◽  
Long Acting

OBJECTIVE: To evaluate the effectiveness of montelukast as add-on therapy for patients diagnosed with asthma and concurrent allergic rhinitis who remain uncontrolled while receiving inhaled corticosteroid (ICS) monotherapy or ICS/long-acting beta-2-agonist (LABA) therapy in a community practice setting.DESIGN: An eight-week, multicentre, open-label, observational study. Patients were 15 years of age or older and, while treated with an ICS or ICS/LABA, had allergic rhinitis and uncontrolled asthma symptoms by at least two criteria as per the Canadian Asthma Consensus Guidelines. The primary outcome measure was the percentage of patients with controlled asthma symptoms after eight weeks of treatment with montelukast 10 mg once daily added to ICS or ICS/LABA therapy.RESULTS: In total, 1004 patients participated in the survey phase of the study. Of these patients, 319 continued in the treatment phase and 301 (94.4%) completed the eight-week assessment. At baseline, all patients had uncontrolled asthma symptoms based on the Canadian Asthma Consensus Guidelines; at the eight-week assessment, 229 patients (76.1%) achieved asthma control. According to the Asthma Control Questionnaire (as determined by scores of 0.75 or less), 164 patients (54.7%) achieved well-controlled asthma at week 8. The mean (± SD) Asthma Control Questionnaire score decreased from 2.03±0.80 to 0.92±0.80 (P<0.001) for all patients, representing a clinically significant improvement. A statistically and clinically significant reduction in the overall Mini Rhinitis Quality of Life Questionnaire score was achieved with a decrease from 2.57±1.20 to 1.12±1.00 (–1.45±1.35; P<0.001). Patient and physician satisfaction rates with montelukast add-on therapy were also significantly increased when compared with baseline treatment.CONCLUSION: Montelukast add-on therapy is effective for managing asthma and allergic rhinitis symptoms in patients who were previously uncontrolled with ICS or ICS/LABA treatment.

scholarly journals Montelukast as Add-On Therapy with Inhaled Corticosteroids Alone or Inhaled Corticosteroids and Long-Acting Beta-2-Agonists in the Management of Patients Diagnosed with Asthma and Concurrent Allergic Rhinitis (the RADAR Trial)

2009 ◽  
Vol 16 (suppl a) ◽  
pp. 17A-24A ◽  
Author(s):  
Paul K Keith ◽  
Caroline Koch ◽  
Michel Djandji ◽  
Jacques Bouchard ◽  
Eliofotisti Psaradellis ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Consensus Guidelines ◽  
Uncontrolled Asthma ◽  
Asthma Control Questionnaire ◽  
Asthma Symptoms ◽  
Beta 2 ◽  
Clinically Significant ◽  
Long Acting

OBJECTIVE: To evaluate the effectiveness of montelukast as add-on therapy for patients diagnosed with asthma and concurrent allergic rhinitis who remain uncontrolled while receiving inhaled corticosteroid (ICS) monotherapy or ICS/long-acting beta-2-agonist (LABA) therapy in a community practice setting.DESIGN: An eight-week, multicentre, open-label, observational study. Patients were 15 years of age or older and, while treated with an ICS or ICS/LABA, had allergic rhinitis and uncontrolled asthma symptoms by at least two criteria as per the Canadian Asthma Consensus Guidelines. The primary outcome measure was the percentage of patients with controlled asthma symptoms after eight weeks of treatment with montelukast 10 mg once daily added to ICS or ICS/LABA therapy.RESULTS: In total, 1004 patients participated in the survey phase of the study. Of these patients, 319 continued in the treatment phase and 301 (94.4%) completed the eight-week assessment. At baseline, all patients had uncontrolled asthma symptoms based on the Canadian Asthma Consensus Guidelines; at the eight-week assessment, 229 patients (76.1%) achieved asthma control. According to the Asthma Control Questionnaire (as determined by scores of 0.75 or less), 164 patients (54.7%) achieved well-controlled asthma at week 8. The mean (± SD) Asthma Control Questionnaire score decreased from 2.03±0.80 to 0.92±0.80 (P<0.001) for all patients, representing a clinically significant improvement. A statistically and clinically significant reduction in the overall Mini Rhinitis Quality of Life Questionnaire score was achieved with a decrease from 2.57±1.20 to 1.12±1.00 (–1.45±1.35; P<0.001). Patient and physician satisfaction rates with montelukast add-on therapy were also significantly increased when compared with baseline treatment.CONCLUSION: Montelukast add-on therapy is effective for managing asthma and allergic rhinitis symptoms in patients who were previously uncontrolled with ICS or ICS/LABA treatment.

ADOLESCENTS IN CRIMINAL STREET GROUPINGS: REASONS AND MOTIVATIONS

2019 ◽  
Vol 29 (2) ◽  
pp. 195-199
Author(s):  
E.O. Chernova
Keyword(s):  
At Risk ◽  
Preventive Measures ◽  
Experimental Studies ◽  
Motivational Factors ◽  
Social Motives ◽  
Factors Affecting ◽  
Social Communities ◽  
Criminal Groups

The article gives an analysis of the results of authorial experimental studies. Motivational factors affecting adolescents' participation in criminal groups are considered, they are: dominant groups of motives, the predominance of aspiration to success or avoidance of failures. Thus, the author explores the subjective potential of the personality of adolescent groupers. According to the results of the research, the author concludes that the specificity of the motivation of such adolescents consists in the predominance of material motives, social motives (involvement in social communities, groupings) and motives of recognition and respect. The author notes that the motivation for avoiding failures is more characteristic of such adolescents than the motivation for the pursuit of success. It is concluded that the data obtained can serve as a basis for developing preventive measures when working with adolescents at risk.

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