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Aims Medication‐taking behaviours of breast cancer survivors undergoing adjuvant hormone therapy have received considerable attention. This study aimed to determine factors affecting medication‐taking behaviours in people with breast cancer using data mining. Design A longitudinal observational retrospective cohort study with a hospital‐based survey. Methods A total of 385 subjects were surveyed, analysing existing data from January 2010 to December 2017 in Taiwan. Three data mining approaches—multiple logistic regression, decision tree and artificial neural network—were used to build the prediction models and rank the importance of influencing factors. Accuracy, specificity and sensitivity were used as assessment indicators for the prediction models. Results Multiple logistic regression was the most effective approach, achieving an accuracy of 96.37%, specificity of 96.75% and sensitivity of 96.12%. The duration of adjuvant hormone therapy discontinuation, duration of adjuvant hormone therapy use and age at diagnosis by data mining were the three most critical factors influencing the medication‐taking behaviours of people with breast cancer.

•This study explores influences on T2DM medication use among Vietnamese Australians.•Findings suggest environmental, social, and individual barriers/enablers.•Theoretically informed intervention development may be guided by findings. To explore factors influencing diabetes medication-taking among adults of Vietnamese heritage with type 2 diabetes mellitus (T2DM) residing in Australia. Barriers to and enablers of optimal medication use, as perceived by those with diabetes and health professionals working with this community, were explored via the Theoretical Domains Framework (TDF). This qualitative study was conducted between November 2021 – March 2023 with input from an advisory group consisting of 4 individuals of Vietnamese heritage (a person living with T2DM, a credentialed diabetes care and education specialist, a General Practitioner, and Nephrologist). Data were collected using semistructured interviews with people with T2DM (adults, living in Australia, Vietnamese country of birth and/or language spoken at home) and focus group discussions with health professionals involved in the care of people with T2DM from Vietnamese background. Recruitment of participants was from a national diabetes registry and/or a tertiary hospital. The 14 domains of the TDF informed the development of the study aim, guided data collection, and thematic analysis. The TDF is a comprehensive framework that can be used to identify barriers and facilitators that influence health behaviors. Twenty-three interviews were conducted with adults with T2DM (n = 14 women; median [IQR] age = 60 [16] years; n = 15 insulin-treated; all Vietnamese born, with n = 15 reporting Vietnamese as primary language). One focus group was undertaken with each group of health professionals (n = 7 doctors - 5 endocrinologists and 2 advanced endocrinology physician trainees, n = 6 credentialed diabetes care and education specialists, and n=3 pharmacists). A wide range of themes about the barriers and enablers [determinants] of medication taking were generated and mapped on 13 of 14 Theoretical Domains Framework domains, only excluding the domain of ``goals.'' The most important (determined through frequency and richness) domains that influenced medication-taking were: Environmental Context and Resources-access to subsidized medications is facilitated via the Australian Pharmaceutical Benefits Scheme, but high costs remained a significant barrier for many. Emotion-participants reported anxiety about diabetes complications as a motivator for medication-taking, while fears about long-term side effects created barriers. Social Influences-family support was an enabler of medication-taking. However, lack of support and pressure to use alternative treatments posed barriers for some participants. Beliefs About Consequences- belief in the negative outcomes of missed doses motivated medication-taking, while a lack of immediate side effects from missed doses reinforced perceptions that skipping medication was harmless. Memory, attention, and decision making-participants prioritized certain medications, sometimes neglecting others they viewed as less important. Medication-taking among adult Australian Vietnamese individuals with T2DM is influenced by a complex interplay of environmental, social, and individual factors. This study identified potentially relevant domains that can guide future interventions to enhance medication-taking in this population.

Background The purpose of this study is to address the serious challenges China faces in diabetes prevention and treatment. Amidst the rapid global increase in diabetes prevalence, China now has the largest number of diabetes patients worldwide. To address this problem, the present study aimed to evaluate a family doctor-led community intervention model to provide an effective and sustainable solution for diabetes management. Methods Using a randomized controlled trial design in this 3-month intervention study (conducted from March to June 2023), 180 participants were divided into an intervention and control group. The control group received only routine diabetes management; the intervention group received additional services provided by a family doctor, including a professional treatment plan, diabetes education, medication reminders, personalized follow-up, and guidance assessment. Differential analysis and multiple factor linear regression analysis were used to evaluate the effects of intervention measures in patients with type 2 diabetes mellitus. Results After intervention, the intervention group demonstrated a significant decrease in glycated hemoglobin levels (t = 8.184, P  < 0.001), as well as significant improvements in knowledge, attitude, behavior, and medication taking scores ( P  < 0.001). Further studies showed that improvements in knowledge (β = 0.720, P  < 0.001), attitude (β = 0.135, P  < 0.001), behavior (β = 0.526, P  < 0.001), and medication taking (β = 0.205, P  < 0.001) all contributed to the enhancement of self-management capabilities in patients with type 2 diabetes mellitus, jointly accounting for 99.9% of the improvement in overall self-management (adjusted R² = 0.999). Conclusions Implementing a comprehensive intervention led by family doctors for patients with type 2 diabetes mellitus in the community significantly improved patients’ key physiological indicators and enhanced various aspects of patients’ knowledge, attitude, behavior and medication taking. Trial registration Chinese Clinical Trial Registry, ChiCTR2400079653, retrospectively registered on 09 January 2024.

Background: Australia has a high proportion of migrants with an increasing migration rate from India. Type II diabetes is a long-term condition common amongst the Indian population. Aims: To investigate patients’ medication-taking behaviour and factors that influence adherence at the three phases of adherence. Methods: Semi-structured interviews were conducted with a convenience sample of 23 Indian migrants living in Sydney. All interviews were audio-recorded, transcribed verbatim and thematically analysed. Results: 1) Initiation: The majority of participants were initially prescribed oral antidiabetic medicine and only two were started on insulin. Most started taking their medicine immediately while some delayed initiating therapy due to fear of side-effects. 2) Implementation : Most participants reported taking their medicine as prescribed. However, some reported forgetting their medicine especially when they were in a hurry for work or were out for social events. 3) Discontinuation: A few participants discontinued taking their medicine. Those who discontinued did so to try Ayurvedic medicine. Their trial continued for a few weeks to a few years. Those who did not receive expected results from the Ayurvedic medicine restarted their prescribed conventional medicine. Conclusion: A range of medication-taking behaviours were observed, ranging from delays in initiation to long-term discontinuation, and swapping of prescribed medicine with Ayurvedic medicine. This study highlights the need for tailored interventions, including education, that focus on factors that impact medication adherence from initiation to discontinuation of therapy.

Background This study was designed to determine risk factors and potential harm associated with medication errors at hospital admission. Methods Study pharmacist and hospital-physician medication histories were compared with medication orders to identify unexplained history and order discrepancies in 651 adult medicine service inpatients with 5,701 prescription medications. Discrepancies resulting in order changes were considered errors. Logistic regression was used to analyze the association of patient demographic and clinical characteristics including patients’ number of pre-admission prescription medications, pharmacies, prescribing physicians and medication changes; and presentation of medication bottles or lists. These factors were tested after controlling for patient demographics, admitting service and severity of illness. Results Over one-third of study patients (35.9%) experienced 309 order errors; 85% of patients had errors originate in medication histories, and almost half were omissions. Cardiovascular agents were commonly in error (29.1%). If undetected, 52.4% of order errors were rated as potentially requiring increased monitoring or intervention to preclude harm; 11.7% were rated as potentially harmful. In logistic regression analysis, patient’s age ≥65 [odds ratio (OR), 2.17; 95% confidence interval (CI), 1.09–4.30] and number of prescription medications (OR, 1.21; 95% CI, 1.14–1.29) were significantly associated with errors potentially requiring monitoring or causing harm. Presenting a medication list (OR, 0.35; 95% CI, 0.19–0.63) or bottles (OR, 0.55; 95% CI, 0.27–1.10) at admission was beneficial. Conclusion Over one-third of the patients in our study had a medication error at admission, and of these patients, 85% had errors originate in their medication histories. Attempts to improve the accuracy of medication histories should focus on older patients with a large number of medications. Primary care physicians and other clinicians should help patients utilize and maintain complete, accurate and understandable medication lists.

Purpose Five to 10 years of adjuvant hormonal therapy is recommended to prevent breast cancer recurrence. This study investigated modifiable influences on adjuvant hormonal therapy medication-taking behaviour (MTB) in women with stage I–III breast cancer. Methods Semi-structured face-to-face interviews among women with stage I–III breast cancer prescribed adjuvant hormonal therapy purposively sampled by their MTB at two cancer centres. Thematic analysis was conducted based on the Framework approach, with the Theoretical Domains Framework (TDF) informing the analysis framework; the TDF is an integrative framework consisting of 14 domains of behavioural change to inform intervention design. Results Thirty-one women participated in interviews (14 adherent/persistent; 7 non-adherent/persistent; 10 non-persistent). Three domains identified both barriers and enablers to hormonal therapy MTB across the three MTB strata: beliefs about consequences, intentions and goals and behaviour regulation, but their influence was different across the strata. Other domains influenced individual MTB strata. Key enablers for adherent/persistent women were identified within the domain beliefs about consequences (breast cancer recurrence), intentions and goals (high-priority), beliefs about capabilities (side effects) and behaviour regulation (managing medication). Barriers were identified within the domain behaviour regulation (no routine), memory, attention and decision processes (forgetting) and environmental context and resources (stressors) for non-adherent/persistent women and intentions and goals (quality of life), behaviour regulation (temporal self-regulation), reinforcement, beliefs about consequences (non-necessity) and social influences (clinical support) for non-persistent women. Conclusion This study identified modifiable influences on hormonal therapy MTB. Targeting these influences in clinical practice may improve MTB and hence survival in this population.

Background: Stroke is one of the top 10 leading diseases worldwide, with high mortality and morbidity rates. There is an incomplete understanding of the various types of self-efficacy involved in the prevention of recurrent stroke, and one of them is medication-taking self-efficacy. Objective: This study aimed to explore the fundamental needs and barriers of medication-taking self-efficacy in poststroke patients in Malaysia. Methods: We performed in-depth individual interviews with poststroke patients (N=10) from the Outpatient Neurology Clinic, Hospital Kuala Lumpur. All interviews were transcribed verbatim, and an inductive thematic analysis was performed on the data collected from the interviews. Results: Two key themes were identified: (1) self-efficacy in taking the effort to understand stroke and its preventative treatment for recurrent stroke and (2) self-efficacy in taking prescribed medication to prevent stroke. Patients needed to be proactive in seeking reliable information about stroke and the perceived benefits of preventative treatment for stroke. The discussion was focused on eliciting the needs and barriers related to medication-taking self-efficacy. Patients needed to develop independence and self-reliance to overcome barriers such as dependency and low motivation. External factors such as limited information resources, low perceived severity, poor social environment, and poor communication add to the challenges of poststroke patients to improve their self-efficacy of managing their medications. Conclusions: The study identified potential key findings related to the needs of patients in a localized setting, which are also related to several health behavioral concepts and constructs, indicating the importance of overcoming barriers to improve the quality of life in poststroke patients. We anticipate that the results will be taken into consideration for future personalized patient education interventions.

Purpose To investigate whether demographic, clinical and treatment-related risk factors known at treatment initiation can be used to reliably predict future hormonal therapy non-persistence in women with breast cancer, and to inform intervention development. Methods Women with stage I–III breast cancer diagnosed 2000–2012 and prescribed hormonal therapy were identified from the National Cancer Registry Ireland (NCRI) and linked to pharmacy claims data from Ireland’s Primary Care Reimbursement Services (PCRS). Non-persistence was defined as a treatment gap of ≥180 days within 5 years of initiation. Seventeen demographic, clinical and treatment-related risk factors, identified from a systematic review, were abstracted from the NCRI-PCRS dataset. Multivariate binomial models were used to estimate relative risks (RR) and risk differences (RD) for associations between risk factors and non-persistence. Calibration and discriminative performance of the models were assessed. The analysis was repeated for early non-persistence (<1 year of initiation). Results Within 5 years of treatment initiation 680 women (19.9%) were non-persistent. Women aged <50 years (adjusted RR 1.41, 95% CI 1.16–1.70) and those prescribed antidepressants (RR 1.22, 95% CI 1.04–1.45) had increased risk of non-persistence. Married women (RR 0.82 95% CI 0.71–0.94) and those with prior medication use (RR 0.62 95% CI 0.51–0.75) had reduced risk of non-persistence. The area under the receiver-operating characteristic (ROC) curve for non-persistence was 0.61. Findings were similar for early non-persistence. Conclusion The risk prediction model did not discriminate well between women at higher and lower risk of non-persistence at treatment initiation. Future studies should consider other factors, such as psychological characteristics and experience of side-effects.

Past research has demonstrated that older adults tend to use daily activities as cues to remember to take medications. However, they may still experience medication non-adherence because they did not select adequate contextual cues or face situations that interfere with their medication routines. This work addresses two research questions: (1) How does the association that older adults establish between their daily routines and their medication taking enable them to perform it consistently? (2) What problems do they face in associating daily routines with medication taking? For 30 days, using a mixed-methods approach, we collected quantitative and qualitative data from four participants aged 70–73 years old about their medication taking. We confirm that older adults who matched their medication regimens to their habitual routines obtained better results on time-based consistency measures. The main constraints for using daily routines as contextual cues were the insertion of medication taking into broad daily routines, the association of multiple daily routines with medication taking, the lack of strict daily routines, and the disruption of daily routines. We argue that the strategies proposed by the literature for forming medication-taking habits should support their formulation by measuring patients’ dosage patterns and generating logs of their daily activities.

Medication disposal knowledge is a key component of safe pharmaceutical management, while medication adherence remains essential for achieving optimal treatment outcomes among patients with chronic conditions. However, poor adherence may contribute to medication accumulation and waste, which, if not disposed of properly, can pose risks to environmental and public health. Therefore, this study aimed to assess medication disposal knowledge, policy awareness and satisfaction, as well as medication adherence among chronic disease patients, and to examine how these outcomes differed across demographic and clinical subgroups. A cross-sectional design was employed, collecting data from 273 chronic disease patients with long term medication usages at a hospital in Taipei, Taiwan. The questionnaire covered knowledge of medication disposal, medication adherence, clarity of the disposal policy and satisfaction with the disposal policy promotional strategies, and socio-demographics. Independent samples -tests were used to assess the influence of demographic characteristics on knowledge and adherence. Pearson correlation coefficients were applied to evaluate the relationship between knowledge of medication disposal and medication adherence. Younger age and higher education were associated with better medication disposal knowledge. Medication adherence was significantly higher among patients over 65, lower education, who lived alone and those taking five or more medications. The medication disposal knowledge was not significantly different between good or poor adherence. Although most respondents were unaware of the recycling label on medication bags, those who knew the location of disposal stations scored higher knowledge of medication disposal, clarity in the disposal policy and satisfaction with the disposal policy promotional strategies. Medication disposal competency plays an important role in reducing environmental harm, especially in people with poor adherence. Improving knowledge of medication disposal and adherence remains a key objective for medication safety and health issues.