Poor adherence to oral and topical medication in 3096 dermatological patients as assessed by the Morisky Medication Adherence Scale-8.
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ABSTRACT:
SUBMITTER: Furue M
PROVIDER: S-EPMC4303916 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Background and objectivesPoor adherence to medications is one of the major public health challenges. Only one-third of the population reported successful control of blood pressure, mostly caused by poor drug adherence. However, there are relatively few reports studying the adherence levels and their associated factors among Chinese patients. This study aimed to study the adherence profiles and the factors associated with antihypertensive drug adherence among Chinese patients.MethodsA cross-sectional study was conducted in an outpatient clinic located in the New Territories Region of Hong Kong. Adult patients who were currently taking at least one antihypertensive drug were invited to complete a self-administered questionnaire, consisting of basic socio-demographic profile, self-perceived health status, and self-reported medication adherence. The outcome measure was the Morisky Medication Adherence Scale (MMAS-8). Good adherence was defined as MMAS scores greater than 6 points (out of a total score of 8 points).ResultsFrom 1114 patients, 725 (65.1%) had good adherence to antihypertensive agents. Binary logistic regression analysis was conducted. Younger age, shorter duration of antihypertensive agents used, job status being employed, and poor or very poor self-perceived health status were negatively associated with drug adherence.ConclusionThis study reported a high proportion of poor medication adherence among hypertensive subjects. Patients with factors associated with poor adherence should be more closely monitored to optimize their drug taking behavior.
| S-EPMC3636185 | biostudies-literature
Project description:BackgroundThis systematic review examined the reliability and validity of the Morisky Medication Adherence Scale-8 (MMAS-8), which has been widely used to assess patient medication adherence in clinical research and medical practice.MethodsOf 418 studies identified through searching 4 electronic databases, we finally analyzed 28 studies meeting the selection criteria of this study regarding the reliability and validity of MMAS-8 including sensitivity and specificity. Meta-analysis for Cronbach's ?, intraclass correlation coefficient (ICC), sensitivity and specificity to detect a patient with nonadherence to medication were performed. The pooled estimates for Cronbach's ? and ICC were calculated using the random-effects weighted T transformation. A bivariate random-effects model was used to estimate pooled sensitivity and specificity.FindingsThe pooled Cronbach's ? estimate for type 2 diabetes group in 7 studies and osteoporosis group in 3 studies were 0.67 (95% Confidence Interval(CI), 0.65 to 0.69) and 0.77 (95% CI, 0.72 to 0.83), respectively. With regard to test-retest, the pooled ICC for type 2 diabetes group in 3 studies and osteoporosis group in 2 studies were 0.81 (95% CI, 0.75 to 0.85) and 0.80 (95% CI, 0.74 to 0.85). For a cut-off value of 6, the pooled sensitivity and specificity in 12 studies were 0.43 (95% CI, 0.33 to 0.53) and 0.73 (95% CI, 0.68 to 0.78), respectively.ConclusionsThe MMAS-8 had acceptable internal consistency and reproducibility in a few diseases like type 2 diabetes. Using the cut-off value of 6, criterion validity was not enough good to validly screen a patient with nonadherence to medication. However, this study did not calculated a pooled estimate for criterion validity using the higher values than 6 as a cut-off value since most of included individual studies did not report criterion validity based on those values.
| S-EPMC5667769 | biostudies-literature
Project description:ObjectiveTo assess the internal consistency and factorial validity of the adapted French 8-item Morisky Medication Adherence Scale in assessing adherence to noninsulin antidiabetic drug treatment.Study design and settingIn a cross-sectional web survey of individuals with type 2 diabetes of the Canadian province of Quebec, self-reported adherence to the antidiabetes drug treatment was measured using the Morisky Medication Adherence Scale-8. We assessed the internal consistency of the Morisky Medication Adherence Scale-8 with Cronbach's alpha, and factorial validity was assessed by identifying the underlying factors using exploratory factor analyses.ResultsA total of 901 individuals completed the survey. Cronbach's alpha was 0.60. Two factors were identified. One factor comprised five items: stopping medication when diabetes is under control, stopping when feeling worse, feeling hassled about sticking to the prescription, reasons other than forgetting and a cross-loading item (i.e. taking drugs the day before). The second factor comprised three other items that were all related to forgetfulness in addition to the cross-loading item.ConclusionCronbach's alpha of the adapted French Morisky Medication Adherence Scale-8 was below the acceptable value of 0.70. This observed low internal consistency of the scale is probably related to the causal nature of the items of the scale but not necessarily a lack of reliability. The results suggest that the adapted French Morisky Medication Adherence Scale-8 is a two-factor scale assessing intentional (first factor) and unintentional (second factor) non-adherence to the noninsulin antidiabetes drug treatment. The scale could be used to separately identify these outcomes using scores obtained on each of the sub-scales.
| S-EPMC5117245 | biostudies-literature
Project description:AimsTo validate a translated and culturally adapted version of the Morisky Medication Adherence Scale for use in Spanish population, and to examine the psychometric properties of this scale in patients with type 2 diabetes mellitus in Spain.DesignThis cross-sectional study was conducted in a single university hospital in Spain. Patients diagnosed with type 2 diabetes mellitus at least 1 year before inclusion, being treated with anti-diabetic medication were included.InterventionWe used the Spanish version of the scale to measure treatment adherence.Principal measurementsthree level categorical scale is broken down into low adherence (score of <6), medium adherence (score of 6 to <8) and high adherence (score of 8). To validate the questionnaire, we measured internal consistency through Cronbach's α, confirmed construct validity through an exploratory principal component analysis and assessed test-retest reliability.Results232 patients met the inclusion criteria. The Cronbach's α coefficient was 0.40 (95% CI 0.28-0.52). The exploratory principal component analysis showed three components. The intraclass correlation coefficient was 0.718 (95% CI 0.564-0.823).Conclusionsthe Spanish version of the Morisky Medication Adherence scale showed low internal consistency, the exploratory factor analysis identified three dimensions, and the test-retest reliability was acceptable, therefore, psychometric properties of MMAS-8 are not suitable for measuring medication adherence in type 2 diabetes mellitus patients from Spain.
| S-EPMC7844132 | biostudies-literature
Project description: Not available
| S-EPMC7474121 | biostudies-literature
Project description:To determine the associations between medical, demographic, socioeconomic, and ocular factors and adherence to topical glaucoma ocular hypotensive therapy.One hundred sixteen patients with ocular hypertension or open-angle glaucoma from 2 tertiary glaucoma services participated in this prospective study. Adherence to ocular hypotensive therapy was measured using an electronic dose monitor (Travatan Dosing Aid, Alcon Laboratories Inc., Fort Worth, TX) and collected data at 3 months after enrollment. We used 3 different definitions of adherence: 1) Definition 1: the proportion of days taking the prescribed number of drops within 3 hours of the prescribed dosing time; 2) Definition 2: the proportion of days taking any drops within 3 hours of the prescribed dosing time; and 3) Definition 3: the proportion of days taking any drops within 6 hours of the prescribed dosing time. Univariate and multivariate models were used to determine the association between the 3 adherence definitions, medical, demographic, socioeconomic, and ocular factors at 3-month follow-up. The main outcome measures for this study were risk factors for poor objective medication adherence.Adherence, using Definition 1, Definition 2, and Definition 3, was 64%, 75%, and 80%, respectively. Age, total number of other eye diseases, and race were significantly associated with full treatment adherence (Definition 1), with race alone significantly predicting 11% of full treatment adherence. For Definition 2, age, income, level of education, and total number of eye diseases were significantly associated with partial adherence (3 h), again race alone significantly predicted 15% of partial adherence (any drops within 3 h). For Definition 3, race, income, level of education, and total number of other eye diseases significantly predicted partial adherence (any drops within 6 h), both race and income predicted 19% of partial treatment adherence. Significant differences for adherence rates between patients of European descent and those of African descent were found for all 3 definitions with those who were less adherent more likely to be of African descent.Electronic dose monitors provide important information regarding adherence to topical ocular hypotensive medications in glaucoma patients. Electronic dose monitors show low adherence in a significant number of participants. Future studies are needed to determine the reasons for these differences in health behaviors related to glaucoma treatment, which should guide treatment of poor adherence with glaucoma therapy.
| S-EPMC3183317 | biostudies-other
Project description:Background: the world population is aging, and the prevalence of chronic diseases is increasing. Chronic diseases affect the quality of life of patients and contribute toward increased healthcare costs if patients do not adhere to treatment. This study defines the medication adherence levels of patients with chronic diseases. Methods: an observational cross-sectional study was carried out. Patients aged 65 years and older with chronic diseases were included in this study. The medication adherence report scale was used. Results: overall, 98 patients aged 65 years and older were included. The mean age of responders was 78.65 years. Study population: 71.43% were always adherent; 9.79% often adherent; 14.89% sometimes adherent; 3.87% rarely adherent; and 1% never adherent. The internal consistency of the MARS-5I was good: Cronbach’s alfa value of 0.77. Conclusions: the MARS-5I is an effective self-report instrument to measure the medication adherence of patients. However, further studies are needed to explore factors affecting medication adherence to avoid clinical consequences for patients and high healthcare costs for healthcare facilities. Healthcare communication could be improved to ensure better transitional care.
| S-EPMC9100757 | biostudies-literature
Project description:ObjectiveTo explore the phenomenon of topical corticosteroid (TCS) phobia and comprehensively understand the factors driving TCS concerns, in particular pertaining to steroid addiction and withdrawal.DesignProspective qualitative study using 1:1 in-depth semistructured interviews and analysed using grounded theory.ParticipantsPatients with a prior experience of TCS use for a dermatological condition recruited from a tertiary academic dermatology clinic, or through word of mouth and online social media platforms.Results26 participants encompassing those with positive, neutral and negative opinions towards TCS were interviewed. 13 reported having topical steroid addiction or withdrawal. The drivers of TCS concerns could be categorised into seven themes: attitudes towards TCS (comprising beliefs and knowledge about TCS), availability of alternatives, treatment inconvenience, personality, patient's ongoing evaluation of clinical response to TCS, doctor-patient relationship and healthcare-seeking behaviour. Of mention, patients placed high value and trust on their own experiences with TCS, such as their perceived experienced side effects. The doctor who failed to acknowledge the patient's opinions and instead emphasised the safety of TCS was often viewed as dismissive, resulting in a deteriorating patient-doctor relationship.ConclusionProvision of knowledge and education is important but may be ineffective if the basis for TCS concern regarding safety is reasonable, or when the patient has a firmly established belief supporting his/her concern. In such instances, failure to acknowledge and respect the patient's decision to avoid TCS could worsen the doctor-patient relationship.
| S-EPMC8928312 | biostudies-literature
Project description:BackgroundOral anticoagulants for venous thromboembolism are not thoroughly managed in ambulatory settings in low-/middle-income countries, primarily because of patients' neglect of medication knowledge and adherence.ObjectivesThis study was conducted to investigate patient knowledge, adherence, and the associated factors at a Vietnamese tertiary hospital, serving as a reference for educational programs in other local and regional health care facilities.MethodsA randomly recruited cross-sectional study was conducted on patients using vitamin K antagonists (VKA) or direct oral anticoagulants (DOAC). The primary and secondary outcomes were the knowledge score (in percent) and adherence to oral anticoagulants. Student's t-tests or chi-squared tests were used to compare the crude differences in mean or proportion between patients taking VKA and DOAC. Regression models were conducted to adjust the potential confounders and determine factors associated with patient knowledge and adherence.ResultsA total of 199 patients were included. After adjusting for potential confounders, patients receiving a DOAC had similar knowledge scores and levels of adherence compared with those taking VKA, with both groups being suboptimal. Previous counseling was associated with higher knowledge. Better medication knowledge, female sex, and no history of venous thromboembolism were associated with better adherence.ConclusionGood knowledge and adherence of oral anticoagulant-taking patients remain limited in Southeast Asian clinical practice. Further studies in similar settings should examine the associations between these factors and the effectiveness of the regimens. More effective measures targeting patient knowledge and adherence should be implemented to optimize anticoagulation therapy, improve the patients' outcomes, and mitigate the associated adverse effects.
| S-EPMC9932105 | biostudies-literature
Project description:We sought to measure population-level adherence to antihyperlipidemics, antihypertensives, and oral hypoglycemics, and to develop a model for early identification of subjects at high risk of long-term poor adherence.Prescription-filling data for 2 million subjects derived from a payor's insurance claims were used to evaluate adherence to three chronic drugs over 1 year. We relied on patterns of prescription fills, including the length of gaps in medication possession, to measure adherence among subjects and to build models for predicting poor long-term adherence.All prescription fills for a specific drug were sequenced chronologically into drug eras. 61.3% to 66.5% of the prescription patterns contained medication gaps >30 days during the first year of drug use. These interrupted drug eras include long-term discontinuations, where the subject never again filled a prescription for any drug in that category in the dataset, which represent 23.7% to 29.1% of all drug eras. Among the prescription-filling patterns without large medication gaps, 0.8% to 1.3% exhibited long-term poor adherence. Our models identified these subjects as early as 60 days after the first prescription fill, with an area under the curve (AUC) of 0.81. Model performance improved as the predictions were made at later time-points, with AUC values increasing to 0.93 at the 120-day time-point.Dispensed medication histories (widely available in real time) are useful for alerting providers about poorly adherent patients and those who will be non-adherent several months later. Efforts to use these data in point of care and decision support facilitating patient are warranted.
| S-EPMC3384104 | biostudies-literature