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Electronic adherence monitor

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https://www.readbyqxmd.com/read/28097009/statin-utilisation-in-a-real-world-setting-a-retrospective-analysis-in-relation-to-arterial-and-cardiovascular-autonomic-function
#1
John D Sluyter, Alun D Hughes, Andrew Lowe, Carlos A Camargo, Robert K R Scragg
Randomized trials suggest that statin treatment may lower blood pressure and influence cardiovascular autonomic function (CVAF), but the impact of duration of usage, discontinuation, and adherence to this therapy is unknown. We examined these issues with regard to blood pressure (BP)-related variables in a large, population-based study. Participants were 4942 adults (58% male; aged 50-84 years): 2179 on statin treatment and 2763 untreated. Days of utilization, adherence (proportion of days covered ≥0.8), and discontinuation (non-use for ≥30 days immediately prior to BP measurement) of three statins (atorvastatin, pravastatin, and simvastatin) over a period of up to 2 years was monitored retrospectively from electronic databases...
December 2016: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28077345/tips-and-traps-lessons-from-codesigning-a-clinician-e-monitoring-tool-for-computerized-cognitive-behavioral-therapy
#2
Frederick Sundram, Susan J Hawken, Karolina Stasiak, Mathijs Fg Lucassen, Theresa Fleming, Matthew Shepherd, Andrea Greenwood, Raechel Osborne, Sally N Merry
BACKGROUND: Computerized cognitive behavioral therapy (cCBT) is an acceptable and promising treatment modality for adolescents with mild-to-moderate depression. Many cCBT programs are standalone packages with no way for clinicians to monitor progress or outcomes. We sought to develop an electronic monitoring (e-monitoring) tool in consultation with clinicians and adolescents to allow clinicians to monitor mood, risk, and treatment adherence of adolescents completing a cCBT program called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts)...
January 11, 2017: JMIR Mental Health
https://www.readbyqxmd.com/read/28076703/a-systematic-review-to-assess-the-adherence-and-persistence-with-statins
#3
Sohan Deshpande, Ruben G W Quek, Carol A Forbes, Shelley de Kock, Jos Kleijnen, Shravanthi R Gandra, Ross J Simpson
OBJECTIVE: To identify and assess studies published over a 10-year period up to February 2016 which measure adherence or persistence with statins, to summarise their methods, strengths and weaknesses and to summarise evidence linking statin adherence/persistence with risk of cardiovascular events. METHODS: Electronic databases and abstracts from four major cardiovascular disease conferences were searched from January 2005 to February 2016. The study selection process was performed by two reviewers working independently...
January 11, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28069618/adherence-to-guidelines-for-creatinine-and-potassium-monitoring-and-discontinuation-following-renin-angiotensin-system-blockade-a-uk-general-practice-based-cohort-study
#4
Morten Schmidt, Kathryn E Mansfield, Krishnan Bhaskaran, Dorothea Nitsch, Henrik Toft Sørensen, Liam Smeeth, Laurie A Tomlinson
OBJECTIVES: To examine adherence to serum creatinine and potassium monitoring and discontinuation guidelines following initiation of treatment with ACE inhibitors (ACEI) or angiotensin receptor blockers (ARBs); and whether high-risk patients are monitored. DESIGN: A general practice-based cohort study using electronic health records from the UK Clinical Practice Research Datalink and Hospital Episode Statistics. SETTING: UK primary care, 2004-2014...
January 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28069068/the-sygma-programme-of-phase-3-trials-to-evaluate-the-efficacy-and-safety-of-budesonide-formoterol-given-as-needed-in-mild-asthma-study-protocols-for-two-randomised-controlled-trials
#5
Paul M O'Byrne, J Mark FitzGerald, Nanshan Zhong, Eric Bateman, Peter J Barnes, Christina Keen, Gun Almqvist, Kristine Pemberton, Carin Jorup, Stefan Ivanov, Helen K Reddel
BACKGROUND: In many patients with mild asthma, the low frequency of symptoms and the episodic nature of exacerbations make adherence to regular maintenance treatment difficult. This often leads to over-reliance on short-acting β2-agonist (SABA) reliever medication and under-treatment of the underlying inflammation, with poor control of asthma symptoms and increased risk of exacerbations. The use of budesonide/formoterol 'as needed' in response to symptoms may represent an alternative treatment option for patients with mild asthma...
January 10, 2017: Trials
https://www.readbyqxmd.com/read/28068789/pragmatic-trial-of-video-education-in-nursing-homes-the-design-and-rationale-for-a-pragmatic-cluster-randomized-trial-in-the-nursing-home-setting
#6
Vincent Mor, Angelo E Volandes, Roee Gutman, Constantine Gatsonis, Susan L Mitchell
Background/Aims Nursing homes are complex healthcare systems serving an increasingly sick population. Nursing homes must engage patients in advance care planning, but do so inconsistently. Video decision support tools improved advance care planning in small randomized controlled trials. Pragmatic trials are increasingly employed in health services research, although not commonly in the nursing home setting to which they are well-suited. This report presents the design and rationale for a pragmatic cluster randomized controlled trial that evaluated the "real world" application of an Advance Care Planning Video Program in two large US nursing home healthcare systems...
January 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28066820/hiv-care-providers-attitudes-regarding-mobile-phone-applications-and-web-based-dashboards-to-support-patient-self-management-and-care-coordination-results-from-a-qualitative-feasibility-study
#7
Dallas Swendeman, Shu Farmer, Deborah Mindry, Sung-Jae Lee, Melissa Medich
In-depth qualitative interviews were conducted with healthcare providers (HCPs) from five HIV medical care coordination teams in a large Los Angeles County HIV clinic, including physicians, nurses, and psychosocial services providers. HCPs reported on the potential utility, acceptability, and barriers for patient self-monitoring and notifications via mobile phones, and web-based dashboards for HCPs. Potential benefits included: 1) enhancing patient engagement, motivation, adherence, and self-management; and 2) improving provider-patient relationships and HCP care coordination...
October 2016: Journal of HIV and AIDS
https://www.readbyqxmd.com/read/28063462/going-digital-a-narrative-overview-of-the-clinical-and-organisational-impacts-of-ehealth-technologies-in-hospital-practice
#8
Justin Keasberry, Ian A Scott, Clair Sullivan, Andrew Staib, Richard Ashby
Objective The aim of the present study was to determine the effects of hospital-based eHealth technologies on quality, safety and efficiency of care and clinical outcomes.Methods Systematic reviews and reviews of systematic reviews of eHealth technologies published in PubMed/Medline/Cochrane Library between January 2010 and October 2015 were evaluated. Reviews of implementation issues, non-hospital settings or remote care or patient-focused technologies were excluded from analysis. Methodological quality was assessed using a validated appraisal tool...
January 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28055097/assessment-of-patient-adherence-to-direct-oral-anticoagulant-vs-warfarin-therapy
#9
Salma I Patel, Chad Cherington, Robyn Scherber, Kathryn Barr, Ryan McLemore, Donald E Morisky, Stephen Cha, Farouk Mookadam, Fadi Shamoun
CONTEXT: Direct oral anticoagulants (DOACs) may be as effective as, and at times safer than, warfarin. Because DOACs do not require regular serum level monitoring, patients' interaction with the health care system may be reduced. To the authors' knowledge, although studies have evaluated warfarin adherence, few studies have evaluated the real-world adherence to DOACs. OBJECTIVE: To evaluate whether a difference exists between medication adherence of patients taking DOACs vs patients taking warfarin...
January 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/28043163/assessing-adherence-to-multiple-medications-and-in-daily-life%C3%A2-among-patients-with-multimorbidity
#10
Jennifer Inauen, Walter Bierbauer, Janina Lüscher, Claudia König, Robert Tobias, Andreas Ihle, Lukas Zimmerli, Barbara M Holzer, Edouard Battegay, Klarissa Siebenhüner, Matthias Kliegel, Urte Scholz
OBJECTIVE: Chronic conditions often require multiple medication intake. However, past research has focused on assessing overall adherence or adherence to a single index medication only. This study explored adherence measures for multiple medication intake, and in daily life, among patients with multiple chronic conditions (i.e. multimorbidity). DESIGN: Eighty-four patients with multimorbidity and multiple-medication regimens completed three monthly panel questionnaires...
January 2, 2017: Psychology & Health
https://www.readbyqxmd.com/read/28042353/immunosuppressive-therapy-after-solid-organ-transplantation-does-the-intermed-identify-patients-at-risk-of-poor-adherence
#11
Laurent Michaud, Gundula Ludwig, Sylvie Berney, Stéphanie Rodrigues, Anne Niquille, Valérie Santschi, Anne-Sophie Favre, Anne-Catherine Lange, Annemieke A Michels, Bernard Vrijens, Olivier Bugnon, Nathalie Pilon, Manuel Pascual, Jean-Pierre Venetz, Friedrich Stiefel, Marie-Paule Schneider
BACKGROUND: Lack of adherence to medication is a trigger of graft rejection in solid-organ transplant (SOT) recipients. OBJECTIVE: This exploratory study aimed to assess whether a biopsychosocial evaluation using the INTERMED instrument before transplantation could identify SOT recipients at risk of suboptimal post-transplantation adherence to immunosuppressant drugs. We hypothesized that complex patients (INTERMED>20) might have lower medication adherence than noncomplex patients (INTERMED≤20)...
October 2016: Pharmacy Practice
https://www.readbyqxmd.com/read/27933151/improving-asthma-care-in-a-pediatric-resident-clinic
#12
Julia Lee, Albina Gogo, Daniel Tancredi, Erik Fernandez Y Garcia, Ulfat Shaikh
There is variation in pediatric asthma management in the outpatient setting. Adherence to national asthma guidelines provides a systematic standardized approach to asthma management. There is a gap between usual and guideline-consistent asthma care in resident clinics. Practice improvement modules aimed at improving resident physician adherence to asthma care guidelines have not been consistently utilized and have not yet been studied. Our aim was to increase guideline consistent care in our pediatric resident clinic in a twelve-month period via increasing performance on the following measures to 75%: spirometry testing; influenza immunization recommendation; level of control assessed through the use of a standardized questionnaire; appropriate medications per national guideline; and use of written asthma action plans...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27932381/improving-the-efficiency-of-care-for-pediatric-patients-hospitalized-with-asthma
#13
Kathleen W Bartlett, Victoria M Parente, Vanessa Morales, Jillian Hauser, Heather S McLean
BACKGROUND: Asthma exacerbations are a leading cause of hospitalization among children. Despite the existence of national pediatric asthma guidelines, significant variation in care persists. At Duke Children's Hospital, we determined that our average length of stay (ALOS) and cost for pediatric asthma admissions exceeded that of our peers. Our aim was to reduce the ALOS of pediatric patients hospitalized with asthma from 2.9 days to 2.6 days within 12 months by implementing an asthma pathway within our new electronic health record...
January 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/27925424/evaluation-of-an-institutional-project-to-improve-venous-thromboembolism-prevention
#14
REVIEW
Christina A Minami, Anthony D Yang, Mila Ju, Eckford Culver, Kathryn Seifert, Lindsey Kreutzer, Terri Halverson, Kevin J O'Leary, Karl Y Bilimoria
BACKGROUND: Northwestern Memorial Hospital (NMH) was historically a poor performer on the venous thromboembolism (VTE) outcome measure. As this measure has been shown to be flawed by surveillance bias, NMH embraced process-of-care measures to ensure appropriate VTE prophylaxis to assess healthcare-associated VTE prevention efforts. OBJECTIVE: To evaluate the impact of an institution-wide project aimed at improving hospital performance on VTE prophylaxis measures...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27922719/markov-mixed-effects-modeling-using-electronic-adherence-monitoring-records-identifies-influential-covariates-to-hiv-preexposure-prophylaxis
#15
Kumpal Madrasi, Ayyappa Chaturvedula, Jessica E Haberer, Mark Sale, Michael J Fossler, David Bangsberg, Jared M Baeten, Connie Celum, Craig W Hendrix
Adherence is a major factor in the effectiveness of preexposure prophylaxis (PrEP) for HIV prevention. Modeling patterns of adherence helps to identify influential covariates of different types of adherence as well as to enable clinical trial simulation so that appropriate interventions can be developed. We developed a Markov mixed-effects model to understand the covariates influencing adherence patterns to daily oral PrEP. Electronic adherence records (date and time of medication bottle cap opening) from the Partners PrEP ancillary adherence study with a total of 1147 subjects were used...
December 6, 2016: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27895069/association-between-poorer-cognitive-function-and-reduced-objectively-monitored-medication-adherence-in-patients-with-heart-failure
#16
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/27889904/how-to-screen-for-non-adherence-to-antihypertensive-therapy
#17
REVIEW
Pankaj Gupta, Prashanth Patel, Robert Horne, Heather Buchanan, Bryan Williams, Maciej Tomaszewski
The quality of assessment of non-adherence to treatment in hypertensive is poor. Within this review, we discuss the different methods used to assess adherence to blood-pressure-lowering medications in hypertension patients. Subjective reports such as physicians' perceptions are inaccurate, and questionnaires completed by patients tend to overreport adherence and show a low diagnostic specificity. Indirect objective methods such as pharmacy database records can be useful, but they are limited by the robustness of the recorded data...
December 2016: Current Hypertension Reports
https://www.readbyqxmd.com/read/27859979/diabetes-conflict-outstrips-the-positive-impact-of-self-efficacy-on-youth-adherence-and-glycemic-control-in-type-1-diabetes
#18
Amy E Noser, Lindsay Huffhines, Mark A Clements, Susana R Patton
OBJECTIVE: To examine whether self-efficacy buffers the deleterious consequences of diabetes-specific family conflict on self-monitoring blood glucose (SMBG) and glycated hemoglobin (HbA1c) in youth with type 1 diabetes mellitus (T1DM). METHODS: A total of 129 youth with T1DM (aged 10-16 years) completed measures of diabetes-specific family conflict and self-efficacy for diabetes management, and their blood glucose meter data and HbA1c were extracted from the electronic medical record...
November 17, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27858570/multidisciplinary-optimization-of-oral-chemotherapy-delivery-at-the-university-of-wisconsin-carbone-cancer-center
#19
Daniel L Mulkerin, Jason J Bergsbaken, Jessica A Fischer, Mary J Mulkerin, Aaron M Bohler, Mary S Mably
PURPOSE: Use of oral chemotherapy is expanding and offers advantages while posing unique safety challenges. ASCO and the Oncology Nursing Society jointly published safety standards for administering chemotherapy that offer a framework for improving oral chemotherapy practice at the University of Wisconsin Carbone Cancer Center. METHODS: With the goal of improving safety, quality, and uniformity within our oral chemotherapy practice, we conducted a gap analysis comparing our practice against ASCO/Oncology Nursing Society guidelines...
October 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27835622/real-time-electronic-adherence-monitoring-plus-follow-up-improves-adherence-compared-with-standard-electronic-adherence-monitoring
#20
Jessica E Haberer, Nicholas Musinguzi, Alexander C Tsai, Yap Boum, Bosco M Bwana, Conrad Muzoora, Peter W Hunt, Jeffrey N Martin, David R Bangsberg
The impact of real-time electronic monitoring on antiretroviral therapy adherence warrants further study. We conducted an analysis of cohort participants that initially involved standard electronic adherence monitoring (EAM), followed by real-time EAM and home visits for sustained at least 48-h adherence interruptions. Immediately after switching between the two types of EAM, mean adherence among 112 participants increased from 84% to 93% and remained elevated for 6 months (P < 0.001). Real-time EAM is a promising approach for improving adherence...
January 2, 2017: AIDS
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