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Electronic adherence monitor

Yves Lafort, Aleny Couto, Ute Sunderbrink, Roxanne Hoek, Estifanos Shargie, Jinkou Zhao, Kirsi Viisainen, Bertha Simwaka
BACKGROUND: Retention in anti-retroviral therapy (ART) presents a challenge in sub-Saharan Africa. In Mozambique, after roll-out to peripheral facilities, the 12-month retention rate was reported mostly from sites with an electronic patient tracking system (EPTS), representing only 65% of patients. We conducted a nationally representative study, compared 12-month retention at EPTS and non-EPTS sites, and its predictors. METHODS: Applying a proportionate to population size sampling strategy, we obtained a nationally representative sample of patients who initiated ART between January 2013 and June 2014...
2018: PloS One
Jeffrey I Campbell, Nir Eyal, Angella Musiimenta, Bridget Burns, Sylvia Natukunda, Nicholas Musinguzi, Jessica E Haberer
Many new technologies monitor patients' and study participants' medical adherence. Some have cautioned that these devices transgress personal autonomy and ethics. But do they? This qualitative study explored how Ugandan study participants perceive the effect of electronic monitoring of their adherence to antiretroviral therapy (ART) on their freedoms to be non-adherent and pursue other activities that monitoring may inadvertently expose. Between August 2014 and June 2015, we interviewed 60 Ugandans living with HIV and enrolled in the Uganda AIDS Rural Treatment Outcomes (UARTO) study, a longitudinal, observational study involving electronic adherence monitors (EAMs) to assess ART adherence...
June 20, 2018: AIDS and Behavior
Abbas Sheikhtaheri, Monireh Sadeqi-Jabali, Zahra Hashemi-Dehaghi
Background: To prevent health care errors, the main causes and preventive strategies should be identified. The purpose of this study was to identify the causes and preventive strategies of health care errors from the perspectives of physicians. Methods: We surveyed 250 randomly selected physicians in five teaching hospitals in Tehran, Iran, in 2015. We used a questionnaire with 29 questions regarding causes and 17 ones regarding the preventive strategies. The participants were asked to answer the questions based on Likert's five-point score (1=very low to 5= very high)...
May 2018: Iranian Journal of Public Health
C Lee Ventola
Adverse drug events (ADEs), including drug interactions, have a tremendous impact on patient health and generate substantial health care costs. A "big data" approach to pharmacovigilance involves the identification of drug-ADE associations by data mining various electronic sources, including: adverse event reports, the medical literature, electronic health records, and social media. This approach has been useful in assisting the Food and Drug Administration and other regulatory agencies in monitoring and decision-making regarding drug safety...
June 2018: P & T: a Peer-reviewed Journal for Formulary Management
Maria Pyra, Peter L Anderson, Craig W Hendrix, Renee Heffron, Kenneth Mugwanya, Jessica E Haberer, Katherine K Thomas, Connie Celum, Deborah Donnell, Mark A Marzinke, Elizabeth A Bukusi, Nelly R Mugo, Stephen Asiimwe, Elly Katabira, Jared M Baeten
OBJECTIVES: Pregnancy is a time of increased HIV acquisition risk and pregnancy reduces concentrations of antiretrovirals used for treatment. We assessed whether pregnancy lowers concentrations of tenofovir (TFV) and tenofovir-diphosphate (TFV-DP) among HIV-uninfected women using oral pre-exposure prophylaxis (PrEP). METHODS: We analyzed data from an open-label PrEP study, comparing concentrations of TFV in plasma and TFV-DP in dried blood spots (DBS) among 37 pregnant women and 97 non-pregnant women...
June 11, 2018: AIDS
Claire L Schwartz, Ashkon Seyed-Safi, Sayeed Haque, Emma P Bray, Shelia Greenfield, F D Richard Hobbs, Paul Little, Jonathan Mant, Bryan Williams, Richard J Mcmanus
OBJECTIVE: Self-management of hypertension can reduce and control blood pressure (BP) compared with clinic monitoring. However, self-management relies on patients following an algorithm, which may be variably adhered to. This study reports fidelity of high-risk patients to the self-management algorithm set by the TASMIN-SR trial. METHODS: Patients with hypertension, above target clinic BP and one or more of stroke, diabetes, coronary heart disease or chronic kidney disease, were invited to self-monitor following an individualized self-titration algorithm...
June 7, 2018: Journal of Hypertension
Marcelo Low, Ronit Almog, Ran D Balicer, Nicky Liberman, Raul Raz, Avi Peretz, Orna Nitzan
BACKGROUND: Antibiotics are frequently prescribed at many of the visits to primary care clinics, often for conditions for which they provide no benefit, including viral respiratory tract infections. OBJECTIVES: The aim was to evaluate primary care visits due to infectious diseases, and to estimate antibiotic prescribing and antibiotic dispensing by pharmacies. METHODS: Diagnosis of infectious disease, antibiotic prescribing and dispensing data at the individual patient level were extracted for 2015 from Clalit Health Services' electronic medical records and linked to determine the condition for which the antimicrobial was prescribed...
June 9, 2018: Annals of Clinical Microbiology and Antimicrobials
Hélène Verdoux, Clélia Quiles, Christian J Bachmann, Dan Siskind
BACKGROUND: As clozapine is under-prescribed in persons with treatment-resistant schizophrenia (TRS), it is necessary to better identify the determinants of health inequalities in access to clozapine use. OBJECTIVE: To identify mental health professionals' characteristics or attitudes and institutional characteristics facilitating or limiting clozapine prescribing. METHOD: We systematically searched multiple electronic databases for articles reporting: (i) mental health professionals' attitudes and characteristics favoring or limiting clozapine prescribing; (ii) institutional characteristics associated with variations in clozapine prescribing; (iii) interventions aimed at enhancing clozapine prescribing...
June 4, 2018: Schizophrenia Research
Alexa Riggs, Vaishali Patel, Bhaskar Paneri, Russell K Portenoy, Marom Bikson, Helena Knotkova
Transcranial direct current stimulation (tDCS) delivered in multiple sessions can reduce symptom burden, but access of chronically ill patients to tDCS studies is constrained by the burden of office-based tDCS administration. Expanded access to this therapy can be accomplished through the development of interventions that allow at-home tDCS applications. Objective: We describe the development and initial feasibility assessment of a novel intervention for the chronically ill that combines at-home tDCS with telehealth support...
2018: Frontiers in Behavioral Neuroscience
Felipe Campos Vale, Ernani Tiaraju de Santa-Helena, Maria Altenfelder Santos, Wania Maria do Espirito Santo Carvalho, Paulo Rossi Menezes, Caritas Relva Basso, Mariliza Henrique Silva, Ana Maroso Alves, Maria Ines Battistella Nemes
OBJECTIVE To present the development and validation of the WebAd-Q Questionnaire, a self-report instrument to monitor adherence to antiretroviral therapy in HIV/AIDS centers in Brazil. METHODS The WebAd-Q is an electronic questionnaire that has three questions about the use of antiretrovirals in the last week. It was constructed from interviews and focus groups with 38 patients. Its validity was tested in a study with a sample of 90 adult patients on antiretroviral therapy for at least three months. We used electronic monitoring bottles, pill counting, and self-report interview to compare adherence...
2018: Revista de Saúde Pública
Fernanda S Tonin, Elyssa Wiecek, Andrea Torres-Robles, Roberto Pontarolo, Shalom Charlie I Benrimoj, Fernando Fernandez-Llimos, Victoria Garcia-Cardenas
BACKGROUND: Poor medication adherence is associated with adverse health outcomes and higher costs of care. However, inconsistencies in the assessment of adherence are found in the literature. OBJECTIVE: To evaluate the effect of different measures of adherence in the comparative effectiveness of complex interventions to enhance patients' adherence to prescribed medications. METHODS: A systematic review with network meta-analysis was performed...
May 19, 2018: Research in Social & Administrative Pharmacy: RSAP
Meghan E McGrady, Christina E Holbein, Aimee W Smith, Caroline F Morrison, Kevin A Hommel, Avani C Modi, Ahna L H Pai, Rachelle R Ramsey
No abstract text is available yet for this article.
May 22, 2018: Annals of Internal Medicine
Thomas Schlöglhofer, Johann Horvat, Francesco Moscato, Zeno Hartner, Georg Necid, Harald Schwingenschlögl, Julia Riebandt, Kamen Dimitrov, Philipp Angleitner, Dominik Wiedemann, Günther Laufer, Daniel Zimpfer, Heinrich Schima
Ventricular assist devices (VADs) are an established therapeutic option for patients with chronic heart failure. Continuous monitoring of VAD parameters and their adherence to guidelines are crucial to detect problems in an early stage to optimize outcomes. A telephone intervention algorithm for VAD outpatients was developed, clinically implemented and evaluated. During the phone calls, a structured inquiry of pump parameters, alarms, blood pressure, INR, body weight and temperature, exit-site status and heart failure symptoms was performed and electronically categorized by an algorithm into 5 levels of severity...
May 25, 2018: Artificial Organs
Angella Musiimenta, Esther C Atukunda, Wilson Tumuhimbise, Emily E Pisarski, Melanie Tam, Monique A Wyatt, Norma C Ware, Jessica E Haberer
BACKGROUND: Wireless electronic adherence monitors can detect antiretroviral therapy (ART) adherence lapses and trigger interventions in real time, thus potentially avoiding unnecessary HIV viremia. Evidence about the acceptability and feasibility of these monitors and associated interventions, however, is limited. OBJECTIVE: The aim of this study was to assess the acceptability and feasibility of real-time adherence monitoring linked to text messaging (short message service, SMS) reminders and notifications to support adherence among individuals living with HIV who are taking ART in rural southwestern Uganda...
May 17, 2018: JMIR MHealth and UHealth
Carol A Forbes, Sohan Deshpande, Francesc Sorio-Vilela, Lucie Kutikova, Steven Duffy, Ioanna Gouni-Berthold, Emil Hagström
OBJECTIVES: A systematic literature review was conducted comparing different approaches estimating persistence and adherence in chronic diseases with polypharmacy of oral and subcutaneous treatments. METHODS: This work followed published guidance on performing systematic reviews. Twelve electronic databases and grey literature sources were used to identify studies and guidelines for persistence and adherence of oral and subcutaneous therapies in hypercholesterolemia, type 2 diabetes, hypertension, osteoporosis and rheumatoid arthritis...
May 17, 2018: Current Medical Research and Opinion
Johan Noble, Thomas Jouve, Lionel Rostaing, Paolo Malvezzi
Cornerstone immunosuppressive therapy currently relies on immediate-release tacrolimus, a calcineurin inhibitor (CNI) that is potentially nephrotoxic and is more diabetogenic than cyclosporine A. Two new formulations of tacrolimus have been launched: an extended-release formulation (Advagraf®/Astagraf XL®, Astellas company) and a long-lasting formulation (Envarsus®, Veloxis company). Area covered: Herein, we assess the efficacy of an extended-release formulation of tacrolimus (Advagraf®/Astagraf XL®) used in conjunction with or without an induction therapy (i...
May 14, 2018: Expert Review of Clinical Immunology
Julianna Rivich, Jocelyn McCauliff, Allison Schroeder
INTRODUCTION: The Veterans Affairs (VA) Eastern Colorado Health Care System implemented an Opioid Safety Initiative (OSI); this included multidisciplinary chart reviews of patients with chronic, non-malignant pain on high-dose opioid therapy to provide safety recommendations to prescribers through the electronic medical record. Our study objective was to evaluate the impact of these documented recommendations. Outcomes included change in total daily opioid dose, concurrent prescribing of opioids and benzodiazepines, adherence to local VA/Veterans Integrated Service Network (VISN) policy, and monitoring practices...
April 27, 2018: Addictive Behaviors
Emilio Márquez-Contreras, Lourdes de López García-Ramos, Nieves Martell-Claros, Vicente F Gil-Guillen, Sara Márquez-Rivero, Elena Pérez-López, Maria Angeles Garrido-Lopez, Celia Farauste, Adriana López-Pineda, José Joaquin Casado-Martinez, Domingo Orozco-Beltran, Jose A Quesada, Concepción Carratalá-Munuera
OBJECTIVE: To validate electronic prescriptions (e-prescriptions) as a method for measuring treatment adherence in patients with hypertension. METHODS: This prospective study initially included 120 patients treated for hypertension in primary care centers. Adherence was measured using the gold standard, the medication event monitoring system (MEMS), versus the index test, the e-prescription program, at baseline and at 6, 12, 18 and 24 months. We calculated the adherence rate using the MEMS and the medication possession ratio (MPR) for the e-prescriptions...
April 23, 2018: Patient Education and Counseling
Bobby Gheorghiu, Seema Nayani
Non-adherence to medication is a key worldwide issue and can lead to adverse patient outcomes and increased health system costs. Would a process facilitating notification of non-adherence infringe upon the autonomy of individuals or breach expectations of privacy? In contrast, patients who are not taking their medication could unknowingly be putting themselves at risk and all the while prescribers are unaware and without the opportunity to intervene. With the advent of electronic methods of medication adherence monitoring, this ethical dilemma now involves a new layer of complexity...
May 2018: Healthcare Management Forum
Katsunori Yamaura, Naoko Hayashi, Yoshihiro Imazu, Yoshitaka Yoneta, Emiko Uchida, Junko Suzuki
 There is an urgent need to promote home medical care in Japan because of the country's superaging society. Community pharmacists are expected to play an important role as part of home medical care teams. The prevalence of nail ringworm is high among home-care patients and can cause decreases in the quality of life, including difficulty in walking due to pain caused by nail deformation and inflammation around infected nails. Nail ringworm is typically treated with oral medication. However, the condition is left untreated in many elderly patients because of the risk of drug-drug interactions or concerns about severe liver damage...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
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