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Nonadherence

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https://www.readbyqxmd.com/read/27910217/disentangling-estimands-and-the-intention-to-treat-principle
#1
Ann-Kristin Leuchs, Andreas Brandt, Jörg Zinserling, Norbert Benda
Randomized controlled trials (RCTs) aim at providing reliable estimates of treatment benefit. Missing data and nonadherence to treatment are distinct problems that can substantially impede this task. In practice, the fact that the handling of missing data due to nonadherence affects the question that is addressed is often ignored. Estimands allow precisely predefining the question of interest. Estimands are definitions of that which is being estimated with regard to population, endpoint, and handling of postrandomization events (eg, nonadherence)...
December 2, 2016: Pharmaceutical Statistics
https://www.readbyqxmd.com/read/27901520/depot-antipsychotics-where-do-we-stand
#2
Ahsan Y Khan, Salman Salaria, Muhammad Ovais, George D Ide
BACKGROUND: Nonadherence to medication is a major problem for patients with schizophrenia. To counter this problem, pharmaceutical companies began developing depot antipsychotics. Although there are currently 5 first-generation and 6 second-generation depot antipsychotics available worldwide, many physicians are still reluctant to use this category of drug initially. This review provides the latest information about the use of depot antipsychotics in schizophrenia treatment as well as several studies in support of depot antipsychotic use as first-line treatment for patients with schizophrenia...
November 2016: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
https://www.readbyqxmd.com/read/27901391/comparison-of-antibacterial-effects-among-three-foams-used-with-negative-pressure-wound-therapy-in-an-ex-vivo-equine-perfused-wound-model
#3
Lore L Van Hecke, Maarten Haspeslagh, Katleen Hermans, Ann M Martens
OBJECTIVE To compare antibacterial effects among 3 types of foam used with negative-pressure wound therapy (NPWT) in an ex vivo equine perfused wound model. SAMPLES Abdominal musculocutaneous flaps from 6 equine cadavers. PROCEDURES Each musculocutaneous flap was continuously perfused with saline (0.9% NaCl) solution. Four 5-cm circular wounds were created in each flap and contaminated with 10(6) CFUs of both Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA). After a 1-hour incubation period, 1 of 4 treatments (NPWT with silver-impregnated polyurethane foam [NPWT-AgPU], polyurethane foam [NPWT-PU], or polyvinyl alcohol foam [NPWT-PVA] or a nonadherent dressing containing polyhexamethylene biguanide without NPWT [control]) was randomly applied to each wound...
December 2016: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/27900734/lithium-side-effects-and-toxicity-prevalence-and-management-strategies
#4
REVIEW
Michael Gitlin
Despite its virtually universal acceptance as the gold standard in treating bipolar disorder, prescription rates for lithium have been decreasing recently. Although this observation is multifactorial, one obvious potential contributor is the side effect and toxicity burden associated with lithium. Additionally, side effect concerns assuredly play some role in lithium nonadherence. This paper summarizes the knowledge base on side effects and toxicity and suggests optimal management of these problems. Thirst and excessive urination, nausea and diarrhea and tremor are rather common side effects that are typically no more than annoying even though they are rather prevalent...
December 2016: International Journal of Bipolar Disorders
https://www.readbyqxmd.com/read/27899520/is-adherence-to-the-american-college-of-chest-physicians-recommended-anticoagulation-treatment-duration-associated-with-different-outcomes-among-patients-with-venous-thromboembolism
#5
Alex C Spyropoulos, Ron Preblick, Winghan J Kwong, Melissa Lingohr-Smith, Jay Lin
Clinical and economic outcomes associated with venous thromboembolism (VTE) patient adherence to the American College of Chest Physicians (ACCP) anticoagulant (AC) treatment guidelines are incompletely understood. Patients with ≥1 inpatient or ≥2 separate outpatient claims for deep vein thrombosis and/or pulmonary embolism, based on International Classification of Diseases, Ninth Revision, Clinical Modification codes, were identified from the IMS PharMetrics Plus database. Patients had continuous insurance coverage for 12 months before (baseline) and after (follow-up) the index event (first VTE claim) but no baseline VTE claims...
November 28, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27898289/adherence-to-medication-regimen-in-patients-with-severe-and-chronic-psychiatric-disorders-a-qualitative-study
#6
Kourosh Zarea, Malek Fereidooni-Moghadam, Ashrafalsadat Hakim
Nonadherence to treatment is common in patients with chronic psychiatric disorders. Few studies have been conducted in Iran on lack of adherence to medication regimen in patients with severe psychiatric disorders. The present study was carried out with the purpose of gaining insight into the experiences of patients, their family members, and nurses on the medication adherence in patients with severe and chronic psychiatric disorders in selected hospitals in Ahvaz, Iran. A qualitative content analysis study was used in the study and the participants included 7 nurses, 5 patients, and 4 family members...
November 2016: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/27895506/patient-reported-financial-barriers-to-adherence-to-treatment-in-neurology
#7
Lidia Mvr Moura, Eli L Schwamm, Valdery Moura Junior, Michael P Seitz, Daniel B Hoch, John Hsu, Lee H Schwamm
OBJECTIVE: Many effective medical therapies are available for treating neurological diseases, but these therapies tend to be expensive and adherence is critical to their effectiveness. We used patient-reported data to examine the frequency and determinants of financial barriers to medication adherence among individuals treated for neurological disorders. PATIENTS AND METHODS: Patients completed cross-sectional surveys on iPads as part of routine outpatient care in a neurology clinic...
2016: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/27895069/association-between-poorer-cognitive-function-and-reduced-objectively-monitored-medication-adherence-in-patients-with-heart-failure
#8
Mary A Dolansky, Misty A W Hawkins, Julie T Schaefer, Abdus Sattar, John Gunstad, Joseph D Redle, Richard Josephson, Shirley M Moore, Joel W Hughes
BACKGROUND: Subclinical cognitive impairment is prevalent in heart failure (HF); however, its role in important clinical outcomes, such as HF treatment adherence, is unclear. Given the complex polypharmacy in HF treatment, cognitive deficits may be important in predicting medication management. Thus, the objective of the current study was to examine the impact of cognitive function on medication adherence among community-dwelling patients with HF using objective assessments. METHODS AND RESULTS: A prospective observational cohort design of 309 community-dwelling patients with HF (59...
December 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27894670/does-cost-related-medication-nonadherence-among-cardiovascular-disease-patients-vary-by-gender-evidence-from%C3%A2-a%C3%A2-nationally-representative-sample
#9
Soumitra S Bhuyan, Olayinka Shiyanbola, Satish Kedia, Aastha Chandak, Yang Wang, Oluwaseyi O Isehunwa, Nnamdi Anunobi, Ikenna Ebuenyi, Pallav Deka, SangNam Ahn, Cyril F Chang
INTRODUCTION: Cardiovascular disease (CVD) is a leading cause of death and disability as well as a major burden on the U.S. healthcare system. Cost-related medication nonadherence (CRN) to prescribed medications is common among patients with CVD. This study examines the gender differences in CRN among CVD patients. METHODS: We used 2011 to 2014 data from the National Health Interview Survey, an annual, cross-sectional, nationally representative household survey of the noninstitutionalized U...
November 25, 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/27893929/a-review-of-cost-communication-in-oncology-patient-attitude-provider-acceptance-and-outcome-assessment
#10
REVIEW
Ya-Chen Tina Shih, Chun-Ru Chien
The American Society of Clinical Oncology released its first guidance statement on the cost of cancer care in August 2009, affirming that patient-physician cost communication is a critical component of high-quality care. This forward-thinking recommendation has grown increasingly important in oncology practice today as the high costs of cancer care impose tremendous financial burden to patients, their families, and the health care system. For the current review, a literature search was conducted using the PubMed and Web of Science databases to identify articles that covered 3 topics related to patient-physician cost communication: patient attitude, physician acceptance, and the associated outcomes; and 15 articles from 12 distinct studies were identified...
November 28, 2016: Cancer
https://www.readbyqxmd.com/read/27893470/the-association-between-out-of-pocket-costs-and-adherence-to-adjuvant-endocrine-therapy-among-newly-diagnosed-breast-cancer-patients
#11
Albert J Farias, Ryan N Hansen, Steven B Zeliadt, India J Ornelas, Christopher I Li, Beti Thompson
OBJECTIVE: To determine how out-of-pocket costs for adjuvant endocrine therapy (AET) medication affects adherence among newly diagnosed breast cancer survivors with private health insurance who initiate therapy. MATERIALS AND METHODS: We examined medical and pharmacy claims for the 1-year period after initiating AET using the Truven Health Analytics MarketScan database. Adherence was defined as ≥80% proportion of days covered. Mean out-of-pocket costs for AET fill were measured as the sum of copayments, coinsurance, and deductibles and adjusted to 30-day amounts...
November 23, 2016: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27892443/medication-adherence-pattern-and-factors-affecting-adherence-in-helicobacter-pylori-eradication-therapy
#12
S Shakya Shrestha, M Bhandari, S R Thapa, R Shrestha, R Poudyal, B Purbey, R B Gurung
Background Helicobacter pylori (H. pylori) infection is the most common chronic bacterial infection worldwide affecting approximately half of the world's population. A number of screening tests as well as complex multi-drug therapies are available for the detection and treatment of H. pylori infection. However, the optimum eradication rates of H. pylori infection can only be achieved if adherence to drug therapy is higher. Therefore, it is of utmost importance to determine the factors leading to poor adherence to obtain successful treatment outcomes...
January 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/27884129/in-vivo-optical-coherence-tomography-visualization-of-intraplaque-neovascularization-at-the-site-of-coronary-vasospasm-a-case-report
#13
Kenichi Tsujita, Koichi Kaikita, Satoshi Araki, Toshihiro Yamada, Suguru Nagamatsu, Kenshi Yamanaga, Kenji Sakamoto, Sunao Kojima, Seiji Hokimoto, Hisao Ogawa
BACKGROUND: Coronary plaques in patients with coronary vasospastic angina have been characterized by diffuse intima-media thickening with homogeneous fibrous tissue, without confluent necrotic tissue. However, coronary vasospasm can trigger coronary thrombosis, and may play an important role in the pathogenesis of acute coronary syndromes, though the precise morphological mechanisms underlying this process remain unclear. CASE PRESENTATION: A 43-year-old man with a history of multivessel coronary vasospastic angina had been treated with long-acting diltiazem and fluvastatin since 2004...
November 25, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27875376/rhinitis-adherence-to-treatment-and-new-technologies
#14
Fulvio Braido, Ilaria Baiardini, Francesca Puggioni, Silvia Garuti, Ruby Pawankar, G Walter Canonica
PURPOSE OF REVIEW: Nonadherence to treatment is a major issue in approximately 50% of patients suffering from chronic diseases. The availability of new technologies could represent a possible way to improve patients' engagement and adherence in a real-life setting. Research and technology tools made available or in process of being made available to patients with allergic diseases and their physicians could potentially improve the management of these disease in daily life by improving adherence...
November 21, 2016: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27871509/a-cross-sectional-study-of-preoperative-medication-adherence-and-early-postoperative-recovery
#15
Anthony P Notaras, Elisabeth Demetriou, Jessica Galvin, Erez Ben-Menachem
STUDY OBJECTIVE: To quantify the impact of preoperative medication adherence on recovery length of stays and complication rates. DESIGN: Cross-sectional analytical study. SETTING: Postanesthetic care unit (PACU) of a single-center tertiary hospital. PATIENTS: Surgical patients admitted for surgery at our institution over a 4-month period. INTERVENTION: A data collection tool was used to collect demographic data, length of stay in recovery, prespecified conditions likely to impact on PACU recovery (chronic pain, insulin-dependent diabetes, epilepsy, hypertension, on a methadone program, and Parkinson disease), medication compliance, and complications in PACU...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27866336/the-role-of-clinical-pharmacists-in-treatment-adherence-fast-impact-in-suppression-of-chronic-myeloid-leukemia-development-and-symptoms
#16
Silmara Mendes Martins Moulin, Frederico Jacob Eutrópio, Jessica de Oliveira Souza, Fernanda de Oliveira Busato, David N Olivieri, Carlos Eduardo Tadokoro
PURPOSE: Chronic myeloid leukemia (CML) is a clonal myeloproliferative disease, accounting for 15 to 20% of leukemias, with an incidence of one to two cases/100,000 inhabitants. In Brazil, the estimated incidence of leukemia is six cases/100,000 men and 4.28 cases/100,000 women. CML is characterized by the presence of the Philadelphia chromosome. At present, three types of tyrosine kinase inhibitors (TKI) are administered to treat CML patients in the Brazilian public national health system (NHS), called the Unified Health System (in Portuguese, "Sistema Único de Saúde", SUS)...
November 19, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27864493/challenges-in-the-screening-and-management-of-osteoporosis
#17
Lisa A LaVallee, Mollie Ashe Scott, Stephen D Hulkower
Osteoporosis imposes a significant burden of morbidity, mortality, and cost on patients and the health care system. Compliance with existing screening and treatment recommendations is low. There are multiple barriers to treatment including complexity of medical management, cost of medications, real and perceived side effects of medications, and nonadherence.
November 2016: North Carolina Medical Journal
https://www.readbyqxmd.com/read/27863801/long-acting-injectable-antipsychotics-for-the-prevention-of-relapse-in-patients-with-recent-onset-psychotic-disorders-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#18
Taro Kishi, Kazuto Oya, Nakao Iwata
This meta-analysis of randomized controlled trials (RCTs) investigated the advantages of long-acting injectable antipsychotics (LAI-APs) over oral antipsychotics (OAPs) with regard to efficacy and safety for patients with recent-onset psychotic disorders. Effect sizes and 95% confidence intervals (95%CIs) were calculated. We identified five RCTs (1022 patients, mean study duration=18±7.59 months) that compared LAI-APs (paliperidone or risperidone) with OAPs. Pooled LAI-APs did not outperform OAPs in terms of the preventing of relapse (N=3, n=875)...
November 3, 2016: Psychiatry Research
https://www.readbyqxmd.com/read/27859970/barriers-for-guideline-adherence-in-knee-osteoarthritis-care-a-qualitative-study-from-the-patients-perspective
#19
David Spitaels, Patrik Vankrunkelsven, Jurgen Desfosses, Frank Luyten, Sabine Verschueren, Dieter Van Assche, Bert Aertgeerts, Rosella Hermens
RATIONALE, AIMS AND OBJECTIVES: Guidelines for patients with knee osteoarthritis (OA) are suboptimally implemented in clinical care. To improve guideline adherence, patients' perceived barriers and facilitators in current care were investigated. METHODS: Eleven patients with knee OA were extensively interviewed using a semistructured script based on quality indicators. Directed content analysis, within the framework of Grol and Wensing, was performed to describe barriers and facilitators in 6 domains: guideline, health care professional, patient, social environment, organization, and financial context...
November 14, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27855435/pharmacist-competences-and-impact-of-pharmacist-intervention-on-medication-adherence-an-observational-study
#20
Jelena Boskovic, Arijana Mestrovic, Marcel Leppée, Martina Bago, Zvonimir Sostar, Dario Naletilic
BACKGROUND: The aim of this study is to determine the results of pharmacist interventions on patient's adherence to drugs in community settings. SUBJECTS AND METHODS: The study was designed using a standard EQ-SDQ questionnaire and a Culig questionnaire about the adherence to drug. General Level Framework (GLF) was used as a tool for competence assessment among community pharmacists. Participants were pharmacists that issued the medication on repeat prescription in the pharmacy...
December 2016: Psychiatria Danubina
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