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Introduction Treatment retention and adherence are used as outcomes in numerous randomized clinical trials and observational studies conducted in the addiction field. Although usual criteria are 3/6 months of treatment retention or number of sessions attended, there is not a methodological support for conclusions using these criteria. This study analyzed the usefulness of retention and adherence to predict therapeutic success. Methods Retrospective observational study using real‐world data from electronic health records of 11,907 patients in treatment diagnosed with cocaine, alcohol, cannabis and opiate use disorders or harmful use. Results Moderate effect size relations were found between the different type of clinical discharge and months in retention (η2 = 0.12) and proportion of attendance (η2 = 0.10). No relationship was found with the number of sessions attended. Using cut‐off points (i.e., 3 or 6 months in treatment or attending 6 therapy sessions) worsens the ability to predict the type of discharge. Discussions/Conclusion Treatment retention and adherence are indicators moderately related to therapeutic success. Research using these indicators to assess the effectiveness of therapies should complement their results with other clinical indicators and quality of life measures.

To guide the interventions of health professionals, it is necessary to identify the reasons for non-adherence to treatment. This scoping review aims to identify and discuss barriers and facilitators for adherence to pharmacotherapy in chronic diseases. Of the 3,482 eligible studies, it was observed that in the 114 studies that met the selection criteria, facilitators such as income, social support, older age, education, motivation to use pharmacotherapy, formation of a bond with the health professional, health education, believe in pharmacotherapy, realize the benefits of pharmacotherapy, motivation for self-care, and disease severity, were common to the various chronic health conditions. Regarding the common barriers, were: cost of the medication, complexity of pharmacotherapy; adverse drug reaction, greater number of prescribers and pharmacies used, greater number of visits to urgent and emergency services, believing that the medication is not necessary, and having depression. The analysis of these factors provides support for the health professional to identify the reasons that led to non-adherence and guide the interventions to be carried out, promoting adherence to treatment.

Background: Available evidence shows that India's ongoing COVID-19 pandemic response has adversely affected the national tuberculosis elimination program. Objectives: The study attempted to understand the barriers to successful treatment adherence for female tuberculosis (TB) patients due to disruptions caused by the pandemic. Methods: The study draws on qualitative in-depth interviews conducted with patients and TB health visitors from Bengaluru city before and during the pandemic period using a grounded theory approach. Results: While TB has the potential to push female patients who worked in informal arrangements to joblessness and poverty, the pandemic situation has exacerbated these vulnerabilities. The pandemic situation slowed down or suspended vital frontline interventions such as active case finding, distribution of medicine, follow-up of sputum examination, monitoring of medicine intake, and patient support measures. Conclusion: The pandemic-induced barriers to treatment adherence for the vulnerable TB patients can lead to adverse treatment outcomes including disease relapse and drug resistance. It is hence suggested that there is an urgent need for recasting the frontline TB interventions in India in the context of the pandemic in order to achieve the goal of TB elimination.

Background Increased knowledge of the concept of adherence is needed for development patient‐centered care, nursing interventions, and guidelines for patients with coronary heart disease (CHD). The aim of this study was to test and extend the Theory of Adherence to Treatment regarding informational support in patients with CHD. Methods The study utilized an explanatory and descriptive survey. The study was conducted in 2013 and involved 416 patients in five hospitals in Finland. The Adherence of Patients with Chronic Disease instrument and the Social Support for People with CHD instrument were used. The model was tested using structural equation modeling (SEM). Results SEM confirmed direct associations between motivation (β = 0.49, p < 0.001) and results of care (β = 0.29, p < 0.01), and indirect associations between sense of normality, fear of complications, support from nurses and next of kin, and informational support to adherence to a healthy lifestyle and medication. Informational support included information and advice on CHD risk factors, physical exercise, chest pain, medication, continuum of care, and rehabilitation. Indirect standardized path coefficients varied between 0.14 and 0.45. The model explained 45% of adherence to a healthy lifestyle and medication. Conclusion The results of this study showed that informational support is a justified extension to the original Theory of Adherence to Treatment in Patients with CHD. Informational support seems to offer a new perspective that can be used to develop patient‐centered nursing interventions and thus support adherence to treatment by patients with a lifelong disease such as CHD. Testing the associations between adherence to a healthy lifestyle and medication, and the various dimensions of ACDI, informational support, and direct connections. Standardized Regression Weights were used,*p < 0.05, **p < 0.01, ***p < 0.001. Key points The Theory of Adherence to Treatment in Patients with Chronic Disease has already been found to be suitable for evaluating adherence to treatment in different patient groups, but must nonetheless be critically examined, because patients' role in care has changed significantly over time. Informational support is a justified extension to the original Theory of Adherence to Treatment in Patients with Chronic Disease Informational support as part of patient‐centered nursing interventions supports adherence to treatment among post‐PCI patients.

IntroductionNon adherence to psychotropic drugs is associated with negative outcomes, including hospitalizations, aggressive behaviors, suicide attempts and increased premature mortality. It represents a psychiatric challenge, especially in young adults who show higher risk of non-adherence to treatmentObjectivesFirstly this study evaluates the incidence of non-adherence to therapy in 18-24 years patients from a Psycho-Social Center in Milan; and then to analyze the predictive factors of non-adherence.MethodsIn this retrospective “Real Life” observational study, 120 outpatients aged 18 to 24 years, from Psycho-social Center of L. Sacco University Hospital in Milan, were recruited in 2019. Non-adherence to treatment, according to the World Health Organization, was considered “a modality of assuming medications that does not correspond to healthcare professionals’ recommendations”. Statistical analysis were performed with chi-square, ANOVA and linear regression tests, setting significance to p<0.05.Results88 of 120 outpatients (73.3%) received an indication to psychopharmacological treatment. Of these, 23 (26.1%) did not show adherence to therapy. Results showed a positive association between non-adherence and increased hospitalizations (p <.01), oral antipsychotics (p<.05) and drop-out rates (p<.001). A significant correlation was also observed between non-adherence and Intellectual Disability (p<.05), Bipolar Disorder (p<.05), psychotic symptoms (p<.05), alterations in affectivity and mood (p<.005), alterations in sleep pattern (p<.05), school dropout (p<.05) and poor family support (p<.01).ConclusionsThis study confirms that non-adherence has a relevant incidence in young-adults psychiatric population, highlighting the importance of effective and structured assessment in clinical practice to identify predictive factors and risk profiles associated with this phenomenon.DisclosureNo significant relationships.

The use of technology to support health and health care has grown rapidly in the last decade across all ages and medical specialties. Newly developed eHealth tools are being implemented in long-term management of growth failure in children, a low prevalence pediatric endocrine disorder. Our objective was to create a framework that can guide future implementation and research on the use of eHealth tools to support patients with growth disorders who require growth hormone therapy. A total of 12 pediatric endocrinologists with experience in eHealth, from a wide geographical distribution, participated in a series of online discussions. We summarized the discussions of 3 workshops, conducted during 2020, on the use of eHealth in the management of growth disorders, which were structured to provide insights on existing challenges, opportunities, and solutions for the implementation of eHealth tools across the patient journey, from referral to the end of pediatric therapy. A total of 815 responses were collected from 2 questionnaire-based activities covering referral and diagnosis of growth disorders, and subsequent growth hormone therapy stages of the patient pathway, relating to physicians, nurses, and patients, parents, or caregivers. We mapped the feedback from those discussions into a framework that we developed as a guide to integration of eHealth tools across the patient journey. Responses focused on improved clinical management, such as growth monitoring and automation of referral for early detection of growth disorders, which could trigger rapid evaluation and diagnosis. Patient support included the use of eHealth for enhanced patient and caregiver communication, better access to educational opportunities, and enhanced medical and psychological support during growth hormone therapy management. Given the potential availability of patient data from connected devices, artificial intelligence can be used to predict adherence and personalize patient support. Providing evidence to demonstrate the value and utility of eHealth tools will ensure that these tools are widely accepted, trusted, and used in clinical practice, but implementation issues (eg, adaptation to specific clinical settings) must be addressed. The use of eHealth in growth hormone therapy has major potential to improve the management of growth disorders along the patient journey. Combining objective clinical information and patient adherence data is vital in supporting decision-making and the development of new eHealth tools. Involvement of clinicians and patients in the process of integrating such technologies into clinical practice is essential for implementation and developing evidence that eHealth tools can provide value across the patient pathway.

Background Myasthenia gravis is a chronic, autoimmune, neuromuscular junction disorder characterized by skeletal muscle weakness. Current therapies for myasthenia gravis are associated with significant side effects. The objective of this study was to characterize the side effects, and associated health-related quality of life and treatment impacts, of traditional myasthenia gravis treatments. Methods This study had two phases; a Phase 1 interview and a 2-part web-based survey in Phase 2 that included brainstorming (Step 1) and rating (Step 2) exercises using group concept mapping. In Phase 1, all 14 participants reported experiencing side effects from myasthenia gravis treatments which had significant impacts on daily life. In Phase 2, 246 participants contributed to Step 1; 158 returned for Step 2. Results The brainstorming exercise produced 874 statements about side effects and their impact, which were reduced to 35 side effects and 23 impact-on-daily life statements. When rating these statements on severity, frequency, and tolerability, blood clots, infections/decreased immunity, weight gain, and diarrhea were the least tolerable and most severely rated. The most frequent and severe impacts were sleep interference and reduced physical and social activities. Conclusions Based on these findings, there appears to be a need for better and more tolerable treatments for myasthenia gravis patients.

Purpose: To evaluate the impact of pharmaceutical education on medication adherence in patients with Type 2 Diabetes and Systemic Arterial Hypertension. Patients and Methods: This randomized clinical trial enrolled patients with a diagnosis of Type 2 Diabetes Mellitus and Systemic Arterial Hypertension treated in an internal medicine outpatient clinic of a teaching hospital. One hundred and three patients were randomly assigned to the study groups; 51 to the control group and 52 to the intervention group with a 6 months follow-up. Medication adherence was assessed using the Morisky 8-item medication adherence scale. To improve patient adherence to treatment, a wallet card was provided with an up-to-date list of prescribed medications along with recommendations for follow-up care. Results: One hundred and seventy-nine patients were screened for eligibility, of which 103 (57.5%) participated in the study. The intervention group showed a statistically significant decrease in capillary glucose levels, glycated hemoglobin, systolic and diastolic blood pressure, total cholesterol and triglycerides compared to the control group. The frequencies on medication adherence levels at 3 and 6 months in the control group remained similar to baseline, while in the intervention group the frequency of high adherence increased significantly at 6 months (8.7% to 43.5%). Conclusion: A high percentage of patients are not achieving optimal control of their diabetes. Medication adherence rates were between 45-50% in patients at the baseline of the study, but after receiving education and support from a pharmacist, the intervened group showed a significant increase in their adherence. Keywords: adherence to treatment, chronic disease, health education, morisky medication adherence scale

Objective: To evaluate the status of medication adherence in diabetic patients and its effective factors. Methods: A cross-sectional descriptive study was conducted with 170 diabetic patients in Iran. Participants were assessed for medication adherence, self-efficacy, and social support. Descriptive statistics, bivariate analyses, and multiple stepwise regression were conducted to explore predictors for medication adherence. Results: Regression analysis showed that 48% of medication adherence changes stemmed from the four variables including social support, self-efficacy, income, and education levels, (R2adj = 0.480, F = 39.943, p < 0.001). According to the model, the highest effects were related to income level (β = 0.332, t = 5.493, p ⩽ 0.001) and self-efficacy (β = 0.330, t = 4.789, p ⩽ 0.001), respectively. Based on the final model, only the social support variable showed no significant relationship with adherence (β = 0.002, t = 0.032, p = 0.947). Conclusion: Social support and self-efficacy were related to medication adherence in diabetic patients, and social support can improve medication adherence in patients with diabetes by affecting self-efficacy. Healthcare workers who interact with individuals with diabetes should take into account the factors mentioned above when designing health promotion interventions to address the needs of these individuals.