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Jonathan D Fuchs, Kristefer Stojanovski, Eric Vittinghoff, Vanessa M McMahan, Sybill G Hosek, K Rivet Amico, Aminta Kouyate, Hailey J Gilmore, Susan P Buchbinder, Richard T Lester, Robert M Grant, Albert Y Liu
Preexposure prophylaxis is a highly protective HIV prevention strategy, yet nonadherence can significantly reduce its effectiveness. We conducted a mixed methods evaluation of a mobile health intervention (iText) that utilized weekly bidirectional text or e-mail support messages to encourage preexposure prophylaxis (PrEP) adherence among participants in the multi-site iPrEx open-label extension study. A convenience sample of PrEP users from the San Francisco and Chicago sites participated in a 12-week pilot study...
March 2018: AIDS Patient Care and STDs
Lucy Barnard-Brak, Brook Roberts, Evelyn Valenzuela
OBJECTIVE: Pharmacological interventions combined with behavioral treatment have been associated with better outcomes for children with ADHD. Yet, as children age into adolescence and gain autonomy, they may choose not to adhere to taking a prescribed medication. The purpose of the current study was to examine school outcomes among adolescents with ADHD who take medication breaks versus resisting medication with respect to grades and school behaviors. METHOD: We statistically controlled for a variety of variables such as the child's age, sex, the presence of side effects, and parent's relationship with child...
March 1, 2018: Journal of Attention Disorders
Cyd K Eaton, Ana M Gutierrez-Colina, Lauren F Quast, Rochelle Liverman, Jennifer L Lee, Laura L Mee, Bonney Reed-Knight, Grace Cushman, Gloria Chiang, Rene Romero, Chad Mao, Rouba Garro, Ronald L Blount
Objective: To (a) examine levels of medication nonadherence in adolescent and young adult (AYA) solid organ transplant recipients based on AYA- and caregiver proxy-reported nonadherence to different medication types and the medication-level variability index (MLVI) for tacrolimus, and (b) examine associations of adherence barriers and AYA and caregiver emotional distress symptoms with reported nonadherence and the MLVI. Method: The sample included 47 AYAs (M age = 16...
March 17, 2018: Journal of Pediatric Psychology
Brendan A Andres, Benjamin R Childs, Heather A Vallier
OBJECTIVES: To determine the incidence of hypovitaminosis D and to evaluate a supplementation intervention. We hypothesized that patients would exhibit high adherence with a free sample, and levels would become sufficient. DESIGN: Prospective observational study. SETTING: Level 1 trauma center. PATIENTS: One hundred forty-four consecutive, skeletally mature patients treated for acute fractures. INTERVENTION: All were provided 600 mg calcium and 800 IU vitamin D3 capsules twice daily...
April 2018: Journal of Orthopaedic Trauma
Farah Khorassani, Shannon Tellier, Demetra Tsapepas
Medication nonadherence rates are high in both the transplant and psychiatric populations. The consequence of medication nonadherence posttransplant is graft rejection and psychiatric decompensation, highlighting the importance of optimizing adherence to medication regimens. Pharmacists may work with transplant patients with psychiatric comorbidity to improve medication adherence through identifying patient-specific barriers and recommending an appropriate intervention. Multiple evidence-based practices for improving nonadherence have been detailed in the transplant and psychiatric population...
January 1, 2018: Journal of Pharmacy Practice
Imran Ahmed, Niall Safir Ahmad, Shahnaz Ali, Shair Ali, Anju George, Hiba Saleem Danish, Encarl Uppal, James Soo, Mohammad H Mobasheri, Dominic King, Benita Cox, Ara Darzi
BACKGROUND: Medication adherence is an expensive and damaging problem for patients and health care providers. Patients adhere to only 50% of drugs prescribed for chronic diseases in developed nations. Digital health has paved the way for innovative smartphone solutions to tackle this challenge. However, despite numerous apps available claiming to improve adherence, a thorough review of adherence apps has not been carried out to date. OBJECTIVE: The aims of this study were to (1) review medication adherence apps available in app repositories in terms of their evidence base, medical professional involvement in development, and strategies used to facilitate behavior change and improve adherence and (2) provide a system of classification for these apps...
March 16, 2018: JMIR MHealth and UHealth
Jaclyn Hirschey, Sunetra Bane, Moussa Mansour, Jodi Sperber, Stephen Agboola, Joseph Kvedar, Kamal Jethwani
BACKGROUND: Atrial fibrillation (AFib) is the most common form of heart arrhythmia and a potent risk factor for stroke. Nonvitamin K antagonist oral anticoagulants (NOACs) are routinely prescribed to manage AFib stroke risk; however, nonadherence to treatment is a concern. Additional tools that support self-care and medication adherence may benefit patients with AFib. OBJECTIVE: The aim of this study was to evaluate the perceived usability and usefulness of a mobile app designed to support self-care and treatment adherence for AFib patients who are prescribed NOACs...
March 15, 2018: JMIR Human Factors
Babita Saigal, Laura Guerra
BACKGROUND: A common class-specific toxicity of mammalian target of rapamycin (mTOR) inhibitors is stomatitis. Some patients experience a severe form of mTOR inhibitor-associated stomatitis (mIAS) that can have a negative effect on nutritional status, compromise quality of life, and potentially lead to nonadherence, reducing the efficacy of cancer therapy. OBJECTIVES: This article aims to address an unmet need for education about mIAS among oncology nurses and patients and to share findings about everolimus-related stomatitis from the SWISH trial...
April 1, 2018: Clinical Journal of Oncology Nursing
Rossana Malatesta-Muncher, Karen W Eldin, Laurence H Beck, Mini Michael
BACKGROUND: Idiopathic membranous nephropathy is an uncommon cause of nephrotic syndrome in children and can present treatment challenges. The current treatment options of steroids and cyclophosphamide, cyclosporine, or mycophenolate require prolonged treatment durations and the associated side effects may result in nonadherence in children, especially in adolescents. CASE-DIAGNOSIS: We report two adolescent patients with idiopathic membranous nephropathy with nephrotic range proteinuria and elevated anti-phospholipase A2 receptor levels who did not achieve remission with steroids and were later treated with rituximab...
March 15, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Roseanne O Yeung, Jing-Heng Cai, Yuying Zhang, Andrea O Luk, Jun-Hao Pan, Junmei Yin, Risa Ozaki, Alice P S Kong, Ronald Ma, Wing-Yee So, Chiu Chi Tsang, K P Lau, Edwin Fisher, Williams Goggins, Brian Oldenburg, Julianna Chan
Background: In a randomized controlled trial of 628 Chinese patients with type 2 diabetes receiving multidisciplinary care in the Joint Asia Diabetes Evaluation (JADE) Progam, 372 were randomized to receive additional telephone-based peer support (Peer Empowerment And Remote communication Linked by information technology, PEARL) intervention. After 12 months, all-cause hospitalization was reduced by half in the PEARL group especially in those with high Depression Anxiety and Stress Scale (DASS) scores...
2018: Clinical Diabetes and Endocrinology
Redhouane Abdellaoui, Pierre Foulquié, Nathalie Texier, Carole Faviez, Anita Burgun, Stéphane Schück
BACKGROUND: Medication nonadherence is a major impediment to the management of many health conditions. A better understanding of the factors underlying noncompliance to treatment may help health professionals to address it. Patients use peer-to-peer virtual communities and social media to share their experiences regarding their treatments and diseases. Using topic models makes it possible to model themes present in a collection of posts, thus to identify cases of noncompliance. OBJECTIVE: The aim of this study was to detect messages describing patients' noncompliant behaviors associated with a drug of interest...
March 14, 2018: Journal of Medical Internet Research
Emmet A Francis, Volkmar Heinrich
Global bursts in free intracellular calcium (Ca2+ ) are among the most conspicuous signaling events in immune cells. To test the common view that Ca2+ bursts mediate rearrangement of the actin cytoskeleton in response to the activation of G protein-coupled receptors, we combined single-cell manipulation with fluorescence imaging and monitored the Ca2+ concentration in individual human neutrophils during complement-mediated chemotaxis. By decoupling purely chemotactic pseudopod formation from cell-substrate adhesion, we showed that physiological concentrations of anaphylatoxins, such as C5a, induced nonadherent human neutrophils to form chemotactic pseudopods but did not elicit Ca2+ bursts...
March 13, 2018: Science Signaling
Barbara Guerard, Vincent Omachonu, Blake Perez, Bisakha Sen
The issue of medication nonadherence has generated significant interest because of its complexity from both cost and outcomes perspectives. Of the 3.2 billion prescriptions written annually in the United States, estimates indicate that half are not taken as prescribed, especially among patients with asymptomatic chronic conditions. The objective of this study was to assess whether a comprehensive wellness assessment (CWA) program helps improve medication adherence for oral diabetic medications, statins, and angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (ACE/ARBs) in a Medicare Advantage (MA) plan diabetic population...
March 2018: Journal of Healthcare Management / American College of Healthcare Executives
Maxwell Eyram Afari, Wajih Syed, Lana Tsao
Heart failure (HF), the cardiovascular epidemic of the twenty-first century, is associated with significant comorbidities and high mortality. The prevalence of HF is estimated around 6.5 million people and is expected to increase to 8 million by the year 2030. The associated costs to care for these patients continue to increase. Despite the advancement of pharmacologic therapy with significant improvement in morbidity and mortality, the 5-year survival for heart failure still stands at 61%. The challenges faced by HF patients include difficulty with lifestyle modifications, nonadherence to complex medical regimens, financial limitations, lack of access to medical care, and unfavorable side effects...
March 10, 2018: Heart Failure Reviews
Maria Giner-Soriano, Gerard Sotorra Figuerola, Jordi Cortés, Helena Pera Pujadas, Ana Garcia-Sangenis, Rosa Morros
BACKGROUND: Cardiovascular disease (CVD) is a group of disorders of the heart and blood vessels, such as coronary heart disease (CHD), cerebrovascular disease, and peripheral artery disease. CVD is the leading threat to global health, whether measured by mortality, morbidity, or economic cost. Long-term administration of aspirin, statins, beta-blockers, and angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers improves survival in patients with stablished coronary heart disease...
March 9, 2018: JMIR Research Protocols
Jane Vosper, Michael Evangeli, John B Porter, Farrukh Shah
β-Thalassemia major (β-TM) is a life-long genetic hemoglobin (Hb) disorder requiring intensive treatment regimens, including frequent blood transfusions and daily chelation therapy. Understanding psychosocial correlates of chelation adherence is important for developing interventions to improve adherence. This study investigated within-participant correlates of oral chelation adherence on a daily (episodic) basis. Thirty-seven adult participants with β-TM were recruited from clinics at two hospitals (22 males, 9 females, mean age 34...
March 9, 2018: Hemoglobin
David Price, Dorothy L Keininger, Boomi Viswanad, Matthias Gasser, Susann Walda, Florian S Gutzwiller
Background: Nonadherence to medication and incorrect use of inhalers represent significant barriers to optimal disease management of patients with chronic obstructive pulmonary disease (COPD). Thus, health care professionals (HCPs) play a critical role in educating their patients on appropriate inhaler use and in ensuring medication adherence. However, many patients do not receive appropriate inhaler training or have not had their inhaler technique checked. Methods: The Real-life Experience and Accuracy of inhaLer use (REAL) survey was a computer-assisted, telephonic survey consisting of 23 questions gathering real-world information on correct inhaler use, inhalation technique, device attributes, adherence, dosing accuracy, training, correct device use, ease of use, and factors that influence patient adherence in commercially available inhalers delivering COPD maintenance therapy...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Praveena Chiowchanwisawakit, Wanruchada Katchamart, Manathip Osiri, Pongthorn Narongroeknawin, Parawee Chevaisrakul, Tasanee Kitumnuaypong, Boonjing Siripaitoon, Worawit Louthrenoo
OBJECTIVE: This study aimed to evaluate the long-term effectiveness and safety of the first anti-tumor necrosis factor α therapy (TNFi) and to identify the associated factors of drug discontinuation in patients with spondyloarthritis. METHODS: This was a retrospective cohort study. Patients with spondyloarthritis who were prescribed the first TNFi between December 2009 and October 2014 in the Rheumatic Disease Prior Authorization registry were enrolled. Baseline clinical data were retrieved...
March 7, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Smita Bakhai, Bright Thilagar, Jessica L Reynolds, Kenneth E Leonard
OBJECTIVE: Determine correlates of opiate misuse based on urine drug test (UDT) among patients on chronic opiate therapy (COT) for chronic noncancer pain. DESIGN: A cross-sectional study. SETTING: Urban, academic clinic. PARTICIPANTS: UDT performed in 206 patients on COT for at least 3 months duration within a one-year period. Patients were classified based on UDT results: (1) Appearance of Opiate Adherence: Positive UDT for prescribed opiate and negative for illicit drugs and nonprescribed control substances; (2) Opiate Misuse; Overt nonadherence: (a) Positive UDT for illicit drugs and/or nonprescribed controlled substances AND positive or negative for prescribed opiates (b) Overdose; (3) Possible opiate nonadherence: Negative for prescribed opiates and negative for illicit and nonprescribed controlled substances...
January 2018: Journal of Opioid Management
Ruey Leng Loo, Xin Zou, Lawrence J Appel, Jeremy K Nicholson, Elaine Holmes
Background: Interindividual variation in the response to diet is common, but the underlying mechanism for such variation is unclear. Objective: The objective of this study was to use a metabolic profiling approach to identify a panel of urinary metabolites representing individuals demonstrating typical (homogeneous) metabolic responses to healthy diets, and subsequently to define the association of these metabolites with improvement of risk factors for cardiovascular diseases (CVDs)...
March 1, 2018: American Journal of Clinical Nutrition
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