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Tamsin Phillips, Annibale Cois, Robert H Remien, Claude A Mellins, James A McIntyre, Greg Petro, Elaine J Abrams, Landon Myer
BACKGROUND: Antiretroviral therapy (ART) regimens containing efavirenz (EFV) are recommended as part of universal ART for pregnant and breastfeeding women. EFV may have appreciable side effects (SE), and ART adherence in pregnancy is a major concern, but little is known about ART SE and associations with adherence in pregnancy. METHODS: We investigated the distribution of patient-reported SE (based on Division of AIDS categories) and the association of SE with missed ART doses in a cohort of 517 women starting EFV+3TC/FTC+TDF during pregnancy...
2016: PloS One
Svetlana Villevalde, Zhanna Kobalava
OBJECTIVE: Antihypertensive medication nonadherence is significant contributor to poor BP control. Patient-related factors (lack of motivation or risk understanding) are important. The aim of PRISMA study was to determine the impact of integrated approach with therapy based on perindopril arginine in the improvement of motivation, adherence to antihypertensive treatment and BP control. DESIGN AND METHOD: 906 (315 male, 56.0 ± 10.6 years) non-adherent (score < 4 in Morisky and Green Test for Measure of Adherence to Therapy) hypertensive patients with planning or action stages of behavior changes (Prochaska and DiClemente model) with uncontrolled hypertension (BP > 140/90 mmHg) were randomly assigned to 2 strategies: integrated approach with therapy based on perindopril arginine with added-on therapy if necessary (G1, n = 755) or routine practice (G2, n = 151)...
September 2016: Journal of Hypertension
Yutaka Imai
It has been confirmed that clinical significance of home blood pressure measurements (HBPM) is higher than clinic BP measurements and ambulatory BP monitoring. However, several drawbacks of HBPM have also been mentioned, e.g. selection and reporting biases, difficulties of calculation of multiple measurements, difficulties of onsite judgement of numerous recordings, etc. Recent devices for HBPM incorporate memory function. This function can overcome such drawbacks of HBPM. These memorized data can transmit, storage, retrieve, be arithmetic and control, be judged based on algorithm and be got feedback...
September 2016: Journal of Hypertension
Maciej Tomaszewski
Non-adherence to antihypertensive treatment is a common cause of poor blood pressure control and pseudo-resistant hypertension. The lecture will provide an overview of the current diagnostic and therapeutic applications of HPLC-MS/MS-based urine analysis in management of hypertensive patients.
September 2016: Journal of Hypertension
Dorairaj Prabhakaran
Among individuals with established CVD, multiple medications (aspirin, blood pressure lowering drugs and statins) are required to manage CVD and it is well established that non adherence to prescribed treatments is substantial in the long term. Such discontinuation of CV-preventive medications and low adherence rates has been shown to affect the success of CVD prevention efforts. In low- and middle income countries only less than 20% patients receive recommended therapy for CVD prevention, but even in high-income countries treatment coverage in the community is only about 50% in those with heart disease and 35% in those with stroke...
September 2016: Journal of Hypertension
Jeong Bae Park
Blood pressure fluctuates beat to beat, minute to minute, day and night, day by day and even over longer period. However, changes in blood pressure (BP) itself reflect body's ability to adapt. These fluctuation or variability makes it difficult to diagnose and treat hypertension. And therefore, even though the clinic BP was the standard of BP for more than 100 years, there were many attempts to find other BP effects which influence on prognosis independent from clinical BP since there was the breakout of white coat effect and masked effect in clinic BP...
September 2016: Journal of Hypertension
Courtney M Peterson, John W Apolzan, Courtney Wright, Corby K Martin
We conducted two studies to test the validity, reliability, feasibility and acceptability of using video chat technology to quantify dietary and pill-taking (i.e. supplement and medication) adherence. In study 1, we investigated whether video chat technology can accurately quantify adherence to dietary and pill-taking interventions. Mock study participants ate food items and swallowed pills, while performing randomised scripted 'cheating' behaviours to mimic non-adherence. Monitoring was conducted in a cross-over design, with two monitors watching in-person and two watching remotely by Skype on a smartphone...
October 18, 2016: British Journal of Nutrition
Nikita Barai, Anne Monroe, Catherine Lesko, Bryan Lau, Heidi Hutton, Cui Yang, Anika Alvanzo, Mary Elizabeth McCaul, Geetanjali Chander
Heavy alcohol use has adverse effects in women with HIV. We examined the association between changes in alcohol use (measured with Timeline Followback) and changes in antiretroviral therapy adherence (medication possession ratio) and viral suppression (HIV RNA), measured over 6-month intervals. Among women who were (1) non-adherent or not virologically suppressed and (2) infrequent binge drinkers or non-heavy drinkers at baseline, increasing drinking was significantly associated with lower odds of subsequently improving adherence or viral suppression (OR of becoming adherent of 0...
October 17, 2016: AIDS and Behavior
Alain Menanga, Sandrine Edie, Clovis Nkoke, Jérôme Boombhi, Ahmadou Jingi Musa, Liliane Kuate Mfeukeu, Samuel Kingue
BACKGROUND: Hypertension is associated with considerable morbidity and mortality. Improvement of its management to reduce adverse cardiovascular outcomes will require an understanding of the patient characteristics and treatment factors associated with uncontrolled blood pressure. Factors that affect blood pressure control have not been sufficiently described in Cameroon. The main goal of our study was to determine the predictors of blood pressure control in patients with hypertension in an urban city in Cameroon...
October 2016: Cardiovascular Diagnosis and Therapy
Tereza Touskova, Magda Vytrisalova, Vladimir Palicka, Tereza Hendrychova, Yang-Ti Chen, Leos Fuksa
Background: Osteoporosis is a chronic disease and adherence can fluctuate over time. Therefore, longer observation is necessary to investigate the stability of patients' adherence. The study aim was to compare the overall adherence (OA) to supplementation with the fixed combination of calcium and vitamin D (Ca/D) in postmenopausal women at baseline and after 1 year, and to evaluate the fluctuation of the OA in individual months. Furthermore, we studied whether adherence is influenced by signing of informed consent and routine medical check-up...
2016: Frontiers in Pharmacology
Michał Mazurek, Menno V Huisman, Gregory Y H Lip
BACKGROUND: Recent improvements in atrial fibrillation diagnosis and management have prompted the initiation of various registries, predominantly to assess adherence to new guidelines, but also to address the pending questions of safety and effectiveness of newly introduced management options in 'real world' clinical practice settings. In this review we appraise antithrombotic treatment patterns for stroke prevention in atrial fibrillation registries. METHODS AND RESULTS: We searched PubMed, Science Direct and the Cochrane databases for registries focusing on stroke thromboprophylaxis in atrial fibrillation...
October 13, 2016: American Journal of Medicine
O M Gbotolorun, I M Dipo-Fagbemi, A O Olojede, S Ebigwei, J O Adetoye
This double-blind, randomized controlled study was done to assess the necessity of systemic antibiotics in the prevention of wound healing complications after intra-alveolar dental extraction. A consecutive recruitment method was used to allocate participants to two treatment groups. Subjects in group A (antibiotics group, n=75) received amoxicillin and metronidazole for 5 days postoperatively, while those in group B (placebo group, n=75) were given identical-looking placebo drugs in place of the antibiotics...
October 13, 2016: International Journal of Oral and Maxillofacial Surgery
Na Yi, Bock-Gie Jung, Xisheng Wang, RamaKrishna Vankayalapati, Buka Samten
Abnormalities in hematopoiesis are common in tuberculosis patients and highly prevalent in AIDS patients with tuberculosis coinfection. To explore the potential role of the early secreted antigenic target of 6-kD (ESAT-6) of Mycobacterium tuberculosis (Mtb) in abnormal hematopoiesis in tuberculosis, we studied the effect of ESAT-6 on proliferation and differentiation of in vitro-expanded CD34(+) cells isolated from the peripheral blood of the healthy donors. ESAT-6 but not control protein antigen 85A (Ag85A) of Mtb inhibited the proliferation of CD34(+) cell derived peripheral blood stem/progenitor cells (PBSPC) in a dose dependent manner when determined by MTT-assay...
September 28, 2016: Tuberculosis
Kendall R Beck, Nicole Kim, Mandana Khalili
BACKGROUND: Vulnerable populations are disproportionately affected by hepatitis C virus (HCV) infection and experience high rates of health disparity. There are no data on real-world experience with highly efficacious direct-acting anti-HCV treatment in this population. AIMS: We aimed to evaluate the real-world experience with sofosbuvir-based regimens among a vulnerable HCV-infected population. METHODS: HCV treatment response was assessed among 204 patients who completed 12-24 weeks of sofosbuvir-based regimens (in combination with pegylated interferon and ribavirin, simeprevir, ledipasvir, or daclatasvir) at the San Francisco safety-net healthcare system liver specialty clinic between January 2014 and December 2015...
October 14, 2016: Digestive Diseases and Sciences
Nisha A Gilotra, Adam Shpigel, Ike S Okwuosa, Ruth Tamrat, Deirdre Flowers, Stuart D Russell
BACKGROUND: There is a paucity of data describing patient-identified precipitants of heart failure (HF) hospitalization. We hypothesized a patient's perception of reason for or preventability of an admission may be related to 30-day readmission rates. METHODS AND RESULTS: Ninety-four patients admitted with decompensated HF from July 2014 to March 2015 completed a brief questionnaire regarding circumstances leading to admission. Thirty-day outcomes were assessed via telephone call and chart review...
October 11, 2016: Journal of Cardiac Failure
Amedeo F Capetti, Gaetana Sterrantino, Maria Vittoria Cossu, GianCarlo Orofino, Giorgio Barbarini, Giuseppe V De Socio, Simona Di Giambenedetto, Antonio Di Biagio, Benedetto M Celesia, Barbara Argenteri, Giuliano Rizzardini
INTRODUCTION: Little information is available on the efficacy and safety of the dual combination of ripivirine plus dolutegravir. This work aims at beginning to fill this gap. METHODS: All HIV-1 infected subjects treated with ripivirine plus dolutegravir between October 2014 and September 2015 in eight Italian centres were included in an observational cohort. Data were collected at baseline and at weeks 4, 12, 24 and 48. RESULTS: One hundred and thirty-two subjects were followed for a median of 24 months, mean 33 months...
2016: PloS One
Georgia Spiridon Karanasiou, Evanthia Eleftherios Tripoliti, Theofilos Grigorios Papadopoulos, Fanis Georgios Kalatzis, Yorgos Goletsis, Katerina Kyriakos Naka, Aris Bechlioulis, Abdelhamid Errachid, Dimitrios Ioannis Fotiadis
Heart failure (HF) is a chronic disease characterised by poor quality of life, recurrent hospitalisation and high mortality. Adherence of patient to treatment suggested by the experts has been proven a significant deterrent of the above-mentioned serious consequences. However, the non-adherence rates are significantly high; a fact that highlights the importance of predicting the adherence of the patient and enabling experts to adjust accordingly patient monitoring and management. The aim of this work is to predict the adherence of patients with HF, through the application of machine learning techniques...
September 2016: Healthcare Technology Letters
Brandon Battis, Linda Clifford, Mostaqul Huq, Edrick Pejoro, Scott Mambourg
OBJECTIVES: Patients treated with oral chemotherapy appear to have less contact with the treating providers. As a result, safety, adherence, medication therapy monitoring, and timely follow-up may be compromised. The trend of treating cancer with oral chemotherapy agents is on the rise. However, standard clinical guidance is still lacking for prescribing, monitoring, patient education, and follow-up of patients on oral chemotherapy across the healthcare settings. The purpose of this project is to establish an oral chemotherapy monitoring clinic, to create drug and lab specific provider order sets for prescribing and lab monitoring, and ultimately to ensure safe and effective treatment of the veterans we serve...
October 12, 2016: Journal of Oncology Pharmacy Practice
L Schiavo, G Scalera, V Pilone, G De Sena, F R Ciorra, A Barbarisi
BACKGROUND: One of the most effective surgeries for sustainable weight loss in morbidly obese patients is laparoscopic sleeve gastrectomy (LSG). The present study aimed to assess the adherence of LSG patients with respect to following post-operative dietary requirements and micronutrient supplementation, as well as to investigate their perceived barriers in achieving optimal adherence. METHODS: Retrospective data analysis was performed (3, 6, 9 and 12 months after LSG) using the medical records of 96 morbidly obese patients who had undergone LSG at our institution during 2011-2013...
October 11, 2016: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
Sarah Bigi
The paper discusses the role of argumentative competencies for the achievement of patient engagement through communication in doctor-patient consultations. The achievement of patient engagement is being proposed by recent studies as a condition that can facilitate in particular patient adherence, which involves behavior change. One obstacle to behavior change that has been observed is reactance, i.e., resistance to persuasive messages when a threat to freedom is perceived. In the medical field, reactance theory has been mostly applied in the field of mental health, less frequently to understand non-adherence in general...
2016: Frontiers in Psychology
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