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https://www.readbyqxmd.com/read/28630651/improving-antiretroviral-therapy-adherence-in-resource-limited-settings-at-scale-a-discussion-of-interventions-and-recommendations
#1
Jessica E Haberer, Lora Sabin, K Rivet Amico, Catherine Orrell, Omar Galárraga, Alexander C Tsai, Rachel C Vreeman, Ira Wilson, Nadia A Sam-Agudu, Terrence F Blaschke, Bernard Vrijens, Claude A Mellins, Robert H Remien, Sheri D Weiser, Elizabeth Lowenthal, Michael J Stirratt, Papa Salif Sow, Bruce Thomas, Nathan Ford, Edward Mills, Richard Lester, Jean B Nachega, Bosco Mwebesa Bwana, Fred Ssewamala, Lawrence Mbuagbaw, Paula Munderi, Elvin Geng, David R Bangsberg
Introduction: Successful population-level antiretroviral therapy (ART) adherence will be necessary to realize both the clinical and prevention benefits of antiretroviral scale-up and, ultimately, the end of AIDS. Although many people living with HIV are adhering well, others struggle and most are likely to experience challenges in adherence that may threaten virologic suppression at some point during lifelong therapy. Despite the importance of ART adherence, supportive interventions have generally not been implemented at scale...
2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28628529/appraising-viral-load-thresholds-and-adherence-support-recommendations-in-the-world-health-organization-guidelines-for-detection-and-management-of-virologic-failure
#2
Suzanne M McCluskey, Yap Boum, Nicholas Musinguzi, Jessica E Haberer, Jeffrey N Martin, Peter W Hunt, Vincent C Marconi, David R Bangsberg, Mark J Siedner
BACKGROUND: The World Health Organization defines HIV virologic failure as two consecutive viral loads >1,000 copies/mL, measured 3-6 months apart with interval adherence support. We sought to empirically evaluate these guidelines using data from an observational cohort. SETTING: The Uganda AIDS Rural Treatment Outcomes study observed adults with HIV in southwestern Uganda from the time of antiretroviral therapy (ART) initiation, and monitored adherence with electronic pill bottles...
June 15, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28623755/effects-of-adjunctive-lacosamide-on-mood-and-quality-of-life-in-patients-with-epilepsy
#3
Luba Nakhutina, Saroj D Kunnakkat, Madeleine Coleman, Catherine Lushbough, Vanessa Arnedo, Nirali Soni, Arthur C Grant
We examined the effects of adjunctive lacosamide (LCM) on mood and quality of life (QOL) in adult patients with partial-onset seizures in a prospective, controlled, single-blind study. Patients in whom LCM was added to their AED regimen for clinical indications comprised the LCM group (n=18), while the control group (n=32) comprised patients on ≥2 AEDs with anticipated stable dosing for the duration of the study. Profile of Mood States (POMS) and QOLIE-89 were used to assess mood and QOL at enrollment and 12-16weeks later...
June 14, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28619778/in-patients-with-severe-uncontrolled-asthma-does-knowledge-of-adherence-and-inhaler-technique-using-electronic-monitoring-improve-clinical-decision-making-a-protocol-for-a-randomised-controlled-trial
#4
Matshediso C Mokoka, Lorna Lombard, Elaine M MacHale, Joanne Walsh, Breda Cushen, Imran Sulaiman, Damien Mc Carthy, Fiona Boland, Frank Doyle, Eoin Hunt, Desmond M Murphy, John Faul, Marcus Butler, Kathy Hetherington, J Mark FitzGerald, Job Fm van Boven, Liam G Heaney, Richard B Reilly, Richard W Costello
INTRODUCTION: Many patients with asthma remain poorly controlled despite the use of inhaled corticosteroids and long-acting beta agonists. Poor control may arise from inadequate adherence, incorrect inhaler technique or because the condition is refractory. Without having an objective assessment of adherence, clinicians may inadvertently add extra medication instead of addressing adherence. This study aims to assess if incorporating objectively recorded adherence from the Inhaler Compliance Assessment (INCA) device and lung function into clinical decision making provides more cost-effective prescribing and improves outcomes...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28607684/a-multifaceted-quality-improvement-programme-to-improve-acute-kidney-injury-care-and-outcomes-in-a-large-teaching-hospital
#5
Leonard Ebah, Prasanna Hanumapura, Deryn Waring, Rachael Challiner, Katharine Hayden, Jill Alexander, Robert Henney, Rachel Royston, Cassian Butterworth, Marc Vincent, Susan Heatley, Ged Terriere, Robert Pearson, Alastair Hutchison
Acute kidney injury (AKI) is now widely recognised as a serious health care issue, occurring in up to 25% of hospital in-patients, often with worsening of outcomes. There have been several reports of substandard care in AKI. This quality improvement (QI) programme aimed to improve AKI care and outcomes in a large teaching hospital. Areas of documented poor AKI care were identified and specific improvement activities implemented through sequential Plan-Do-Study-Act (PDSA) cycles. An electronic alert system (e-alert) for AKI was developed, a Priority Care Checklist (PCC) was tested with the aid of specialist nurses whilst targeted education activities were carried out and data on care processes and outcomes monitored...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28604138/ehealth-technologies-as-an-intervention-to-improve-adherence-to-topical-antipsoriatics-a-systematic-review
#6
Mathias Tiedemann Svendsen, Flemming Andersen, Klaus Ejner Andersen
BACKGROUND: Topical antipsoriatics are recommended first-line treatment of psoriasis, but rates of adherence are low. Patient support by use of electronic health (eHealth) services is suggested to improve medical adherence. OBJECTIVE: To review randomised controlled trials (RCTs) testing eHealth interventions designed to improve adherence to topical antipsoriatics and to review applications for smartphones (apps) incorporating the word psoriasis. MATERIAL AND METHODS: Literature review: Medline, Embase, Cochrane, PsycINFO, and Web of Science were searched using search terms for eHealth, psoriasis and topical antipsoriatics...
June 12, 2017: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/28598775/rheumatologists-guideline-adherence-in-rheumatoid-arthritis-a-randomised-controlled-study-on-electronic-decision-support-education-and-feedback
#7
Nienke Lesuis, Ronald F van Vollenhoven, Reinier P Akkermans, Lise M Verhoef, Marlies E Hulscher, Alfons A den Broeder
OBJECTIVES: To assess the effects of education, feedback and a computerised decision support system (CDSS) versus education and feedback alone on rheumatologists' rheumatoid arthritis (RA) guideline adherence. METHODS: A single-centre, randomised controlled pilot study was performed among clinicians (rheumatologists, residents and physician assistants; n=20) working at the study centre, with a 1:1 randomisation of included clinicians. A standardized sum score (SSS) on guideline adherence was used as the primary outcome (patient level)...
June 5, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28598210/ehealth-for-inflammatory-bowel-disease-self-management-the-patient-perspective
#8
Danny Con, Belinda Jackson, Kathleen Gray, Peter De Cruz
BACKGROUND: Electronic health (eHealth) solutions may help address the growing pressure on IBD outpatient services as they encompass a component of self-management. However, information regarding patients' attitudes towards the use of eHealth solutions in IBD is lacking. OBJECTIVE: The aim of this study was to evaluate eHealth technology use and explore the perspectives of IBD patients on what constitutes the ideal eHealth solution to facilitate self-management...
June 9, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28597176/self-management-research-of-asthma-and-good-drug-use-smaragd-study-a-pilot-trial
#9
Esther Kuipers, Michel Wensing, Peter de Smet, Martina Teichert
Background Community pharmacists play an important role in supporting patients for optimal drug use. Objective To assess the effectiveness of monitoring in asthma patients with inhaled corticosteroids (ICS) on disease control. Setting Asthma patients using ICS were invited from two intervention (IG) and two control pharmacies (CG). Method Participating patients completed questionnaires at the study start and at 6-month follow-up, including the Control of Allergic Rhinitis and Asthma Test (CARAT) questionnaire...
June 9, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28593266/wireless-monitoring-program-of-patient-centered-outcomes-and-recovery-before-and-after-major-abdominal-cancer-surgery
#10
Virginia Sun, Sinziana Dumitra, Nora Ruel, Byrne Lee, Laleh Melstrom, Kurt Melstrom, Yanghee Woo, Stephen Sentovich, Gagandeep Singh, Yuman Fong
Importance: A combined subjective and objective wireless monitoring program of patient-centered outcomes can be carried out in patients before and after major abdominal cancer surgery. Objective: To conduct a proof-of-concept pilot study of a wireless, patient-centered outcomes monitoring program before and after major abdominal cancer surgery. Design, Setting, and Participants: In this proof-of-concept pilot study, patients wore wristband pedometers and completed online patient-reported outcome surveys (symptoms and quality of life) 3 to 7 days before surgery, during hospitalization, and up to 2 weeks after discharge...
June 7, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28590335/technological-methods-to-measure-adherence-to-antiretroviral-therapy-and-preexposure-prophylaxis
#11
Lindsey E Garrison, Jessica E Haberer
PURPOSE OF REVIEW: The WHO's Consolidated Guidelines (2016) call for research on improved methods to proactively monitor adherence and identify those individuals who have the greatest needs for adherence support. This review aims to elucidate the latest technologies available to measure adherence to HIV antiretroviral therapy and preexposure prophylaxis against HIV infection and present their utility in various settings and populations. RECENT FINDINGS: Within the last few years, advances have been made in the features of existing technology to measure adherence (real-time electronic adherence measurements), additional approaches have been developed (digital medicine systems) and improved (short message service surveys), and point of care testing for pharmacokinetic measures are under development...
June 5, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28584853/the-presence-of-human-immunodeficiency-virus-associated-neurocognitive-disorders-is-associated-with-a-lower-adherence-to-combined-antiretroviral-treatment
#12
Susan Kamal, Isabella Locatelli, Gilles Wandeler, Asemaneh Sehhat, Olivier Bugnon, Melanie Metral, Renaud Du Pasquier, Klemens Gutbrod, Matthias Cavassini, Marie P Schneider
BACKGROUND: Human immunodeficiency virus (HIV)-associated neurocognitive disorders (HAND) are defined according to their diagnostic degrees as follows: asymptomatic neurocognitive impairment, mild neurocognitive disorder, and HIV-associated dementia. Because high adherence to combined antiretroviral therapy (cART) is required to maintain viral suppression among HIV-infected patients, it is important to investigate the impact of HAND on medication adherence. Our study hypothesis was that patients with HAND had a lower medication adherence than patients who did not have HAND...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28575381/rebellious-behaviors-in-adolescents-with-epilepsy
#13
Aimee W Smith, Constance Mara, Shannon Ollier, Angela Combs, Avani C Modi
The study aims are to (1) examine the prevalence of risk-taking (i.e., behaviors that can be categorized as rebellious or reckless) and (2) determine the influence of risk-taking on adherence, seizures, and health-related quality of life (HRQOL) in adolescents with epilepsy. An exploratory aim was to identify predictors of risk-taking. Fifty-four adolescents with epilepsy ( M  = 15.33 ± 1.46 years) and caregivers completed questionnaires on demographics, risk-taking, parent-child relations, adolescent inattention/hyperactivity, and HRQOL at four time points across 1 year...
May 30, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28575235/remote-management-of-heart-failure-using-implantable-electronic-devices
#14
John M Morgan, Sue Kitt, Jas Gill, Janet M McComb, Ghulam Andre Ng, James Raftery, Paul Roderick, Alison Seed, Simon G Williams, Klaus K Witte, David Jay Wright, Scott Harris, Martin R Cowie
Aims: Remote management of heart failure using implantable electronic devices (REM-HF) aimed to assess the clinical and cost-effectiveness of remote monitoring (RM) of heart failure in patients with cardiac implanted electronic devices (CIEDs). Methods and results: Between 29 September 2011 and 31 March 2014, we randomly assigned 1650 patients with heart failure and a CIED to active RM or usual care (UC). The active RM pathway included formalized remote follow-up protocols, and UC was standard practice in nine recruiting centres in England...
May 27, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28567555/toward-electronic-health-recording-evaluation-of-electronic-patient-reported-outcome-measures-e-proms-system-for-remote-monitoring-of-early-systemic-lupus-patients
#15
Y El Miedany, M El Gaafary, Nadia El Aroussy, S Bahlas, M Hegazi, D Palmer, S Youssef
The study aimed to assess the value of evaluation of electronic patient reported outcome measures (e-PROMs) in the assessment and management of SLE disease activity flares, its association with adherence to therapy as well as organ damage. A randomized, controlled crossover study was carried out over a 24-month duration. One hundred forty-seven SLE patients meeting the revised American College of Rheumatology (ACR) criteria were enrolled. Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) was used to assess disease activity, whereas organ damage was scored using the Systemic Lupus International Collaborating Clinics (SLICC)/ACR Damage Index...
May 31, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28567058/implementation-and-monitoring-of-a-gestational-trophoblastic-disease-management-program-in-a-tertiary-hospital-in-morocco-opportunities-and-challenges
#16
Imane Khachani, Mohamed Hassan Alami, Rachid Bezad
Objective. Gestational Trophoblastic Disease (GTD) management requires clear guidelines for diagnosis, treatment, and follow-up. Unequal management skills among practitioners, inadequate treatment, irregular surveillance, and drop-out are common in resource-limited settings and can lead to life-threatening complications and morbidities. To address these challenges, we implemented a GTD Management Program at the National Center for Reproductive Health in Rabat, Morocco. Methods and Program Description. In-depth review of management protocols was carried out, and concise guidelines were developed, with targeted training for physicians...
2017: Obstetrics and Gynecology International
https://www.readbyqxmd.com/read/28561689/improving-cancer-care-through-the-patient-experience-how-to-use-patient-reported-outcomes-in-clinical-practice
#17
Kathi Mooney, Donna L Berry, Meagan Whisenant, Daniel Sjoberg
Poorly controlled symptoms are common and debilitating during cancer treatment and can affect functional status and quality of life, health care resource utilization, treatment adherence, and cancer survivorship. Historically, the patient experience, including symptoms during treatment, has not been tracked or documented in the patient health record. Measurement of patient-reported outcomes (PROs), including symptoms, is an essential component to cancer care focused on the illness impact to the patient and family...
2017: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/28554917/optimisation-and-validation-of-a-remote-monitoring-system-onco-trec-for-home-based-management-of-oral-anticancer-therapies-an-italian-multicentre-feasibility-study
#18
Alessandro Passardi, Mimma Rizzo, Francesca Maines, Carlo Tondini, Alberto Zambelli, Roberto Vespignani, Daniele Andreis, Ilaria Massa, Marco Dianti, Stefano Forti, Enrico Maria Piras, Claudio Eccher
INTRODUCTION: Despite the growing number of oral agents available for cancer treatment, their efficacy may be reduced due to the lack of adherence, inappropriate adverse event self-management and arbitrary dose adjustment. The management of anticancer therapies could exponentially benefit from the introduction of mobile health technologies in a highly integrated electronic oncology system. METHODS AND ANALYSIS: We plan to customise and fine-tune an existing monitoring TreC platform used in different chronic diseases in the oncology setting...
May 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28551924/-adherence-to-oral-anti-cancer-drugs-in-hemato-oncology
#19
Sarit Ashkenazi, Juliet Dreyer, Pia Raanani, Avi Leader
Non-adherence to medical treatment is prevalent in the context of potentially life-saving treatment for diseases such as cancer. Estimates of non-adherence to oral anti-cancer therapy range between 27% and 63% in studies of cancer patients. This represents a growing challenge, due to the paradigm shift in anti-cancer treatment from parenteral chemotherapy to oral anti-cancer drugs. The importance of adherence to medical treatment is highlighted by the World Health Organization which considers non-adherence to be a major public health concern...
April 2017: Harefuah
https://www.readbyqxmd.com/read/28550756/reduction-of-medical-hospitalizations-in-veterans-with-schizophrenia-using-home-telehealth
#20
Leah R Flaherty, Karin Daniels, Jim Luther, Gretchen L Haas, John Kasckow
This study tested the hypothesis that addition of telehealth to Intensive Case Monitoring (ICM) would reduce hospital admissions in Veterans with schizophrenia or schizoaffective disorder admitted for psychiatric care in response to suicidal behavior. Participants (n =51) were randomized to ICM or ICM plus telehealth monitoring. Telehealth participants responded to daily electronic queries about depression, suicidality, and medication adherence. Comparisons revealed that participants in the telehealth group had significantly less medical hospitalizations than the control group...
May 16, 2017: Psychiatry Research
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