جستجوی مقالات مرتبط با کلیدواژه "تبعیت دارویی" در نشریات گروه "پزشکی"

Stigma, along with physical limitations due to respiratory symptoms of chronic obstructive pulmonary disease (COPD), can lead to social isolation and loneliness, poor self-management, and reduced engagement with health care providers. This study was conducted to determine the relationship between stigma and medication adherence in patients with COPD.

This correlational study was conducted on 140 patients with COPD hospitalized in Razi Hospital in Rasht city in 2023. Convenience sampling method was performed based on the inclusion criteria. Data collection tools were the demographic and clinical information form, Morisky Medication Adherence Questionnaire, and Stigma Scale for Chronic Diseases. The Data were analyzed using the Pearson correlation coefficient and multivariate regression model in SPSS-27 software.

The mean of stigma score was 73.38±24.29 and the mean of medication adherence score was 2.67 ±2.61. Pearson correlation coefficient showed a negative and statistically significant relationship between medication adherence and stigma scores in COPD patients (p=-0.591, p<0.001). In addition, based on the results of multivariate linear regression analysis, stigma, and use of drug and inhaler can predict the medication adherence score.

Based on the results of this study, the stigma in COPD patients was moderate and medication adherence was poor. Furthermore, a significant inverse relationship was observed between medication adherence and stigma scores in these patients. Therefore, it is necessary to plan interventions to prevent stigma and control stigma-related factors, such as medication non-adherence, in COPD patients.

Diabetes self-care leads to blood sugar control in diabetic patients. Adherence to medication is one of the methods of self-care. This research to improving medication adherence in type 2 diabetic patients in Zahedan based on the Health Action Process Approach model.

In this intervention study, 210 type 2 diabetic patients referred to diabetes clinics in Zahedan city in two intervention groups (105) and control group (105) were selected from the diabetes clinics of Zahedan hospitals during June and September in 2022. Sampling was done by available methods among diabetic patients. After collecting the data, a pre-test was conducted using the medication adherence questionnaire and the model constructs questionnaire. CVI = 0.7, CVR = 0.6 and Cronbach's alpha of the questionnaire was 0.97. One and three months after the educational intervention, the questionnaire on model structures and self-care behavior was completed by the patients and collected for analysis. Data were analyzed using independent t, Chi-square, and Shapiro-Wilk tests in SPSS version 23. A significance level of 0.05 was considered.

The results showed that all the Health Action Process Approach model constructs including risk perception, outcome expectancies, behavioral intention, action self-efficacy, coping self-efficacy, recovery self-efficacy, action planning and coping planning, perceived barriers, perceived benefits, and self-care behavior had significant differences in one month and three months after the educational intervention (P<0.05), which indicated the effectiveness of the education in the intervention group. However, no significant difference was observed in the control group (P < 0.05).

The intervention with the Health Action Process Approach model showed that the structures of the model after the training had a significant impact on the self-care of patients in the field of medication compliance. Appropriate programs with details in the field of automatic coping self-efficacy and action planning should be designed to promote medication adherence among patients with type 2 diabetes.

Medication non-adherence remains a significant problem in managing the global epidemic of hypertension. This study aimed to explore the factors affecting medication non-adherence from the perspectives of both patients with hypertension and healthcare providers in Mahan health centers, located in Kerman province.

Methods & Materials: 

This qualitative study utilized a conventional content analysis method within healthcare centers in Mahan city in 2022. A total of 29 participants were included in the study, selected through purposive sampling. Data were collected through in-depth semi-structured interviews, with all interviews being recorded, transcribed verbatim, and utilized as the primary data for analysis. The trustworthiness of data was evaluated in accordance with the criteria established by Guba and Lincoln criteria.

Three categories of factors contributing to medication non-adherence among patients with hypertension were identified: ""nature of the disease and treatment," "individual and family factors," and "organizational factors." Factors related to the "nature of the disease and treatment" included the asymptomatic and chronic nature of hypertension as well as fatigue stemming from continuous drug use. "Individual and family factors" encompassed fear and internal doubts, a desire for non-pharmacological treatments, and inadequate family support. "Organizational factors" comprised high treatment costs and access to specialized services, insufficient support from treatment and care teams, and inadequate disease monitoring.

Various factors across a spectrum of influences contribute to medication non-adherence in patients with hypertension. It is crucial for healthcare providers to engage in consistent patient education regarding the nature of the condition and the importance of medication adherence to enhance compliance among patients.

Medication non-adherence is one of the major problems in hemodialysis patients. Appropriate interactive educational methods can meet the educational needs of patients. Therefore, this study aims to determine the effect of teach-back education on medication adherence in hemodialysis patients.

This is a semi-experimental study. Sixty patients undergoing hemodialysis at the dialysis unit of East Tehran Special Medical Center were studied from February 2022 to September 2023. Sampling was done by consensus and random assignment. Data collection instruments included the demographic data sheet and the 8-item Morisky Medication Adherence scale (MMAS-8). The intervention group received teach-back education in three 30- 45minute sessions during dialysis. The control group did not receive the educational intervention, and after the third session, the patients of the control group were given educational content. Four weeks later, both groups were asked to complete the medication adherence questionnaire again.  Descriptive and analytical statistics were conducted with SPSS software version 22.

Results showed that both groups were homogeneous in age, education and hemodialysis duration (P=0.07). After teach-back education, 70% of hemodialysis patients had poor medication adherence, and 26.7% and 3.3% had moderate and high medication adherence, respectively. Overall, the teach-back education had a moderate effect (effect size= 0.63) on medication adherence (P = 0.002).

Results from this study show that teach-back education improves medication adherence in hemodialysis patients. Therefore, it is suggested that this educational method be included in the care program to improve the health of patients.

Many patients fail to reach the expected results, even with the very considerable strides forward in the treatment of hypertension (HTN). They undergo serious complications after this condition remains uncontrolled. Patients' perceptions regarding the importance of Islamic self-care may be the occasion for managing chronic diseases. The present study aimed to investigate the effectiveness of the Islamic self-care model on blood pressure (BP) and medication adherence (MA) among older adults living with HTN.

Utilizing a randomized controlled trial in 2019 in Amol City of Iran, 60 elderly patients suffering from high blood pressure were assigned to two intervention and control groups in the form of random block allocation. Then, their BP and MA were measured using a dial sphygmomanometer and Morisky questionnaire, respectively.  Designed for four weeks, the intervention group participated in an HTN-management education program, putting much emphasis on proper nutrition within the framework of the Islamic self-care model and gaining divine satisfaction. Simultaneously, the control group received a similar scientific HTN management and medication adherence education program. Following the re-measurement of BP and MA in both groups, the data were analyzed using descriptive statistical tests, Chi-square, Fisher, independent-samples t-test, and analysis of covariance.

In the pre-intervention phase, there was no significant difference between the two groups in the mean BP indices and MA. At the post-intervention, results revealed a significant reduction in the average systolic blood pressure (133.125±8.95) and diastolic (78.33±61.4) of the Islamic self-care group compared to systolic blood pressure (141.33±10.16) and diastolic (82.0±4.27) in the control group (P>0.001). Also, there was a significant improvement in the MA score in the Islamic self-care group (1.07±1.01) compared to the control group (2.43±1.38) (P<0.001).

The Islamic self-care model was found to be effective in managing the average BP and MA of patients.

Medication and nutritional adherence include accurate consumption of medication and following the diet according to the recommendations provided by healthcare personnel, which leads to maintaining and promoting the health of the elderly. The present study aimed to evaluate the effect of teach-back self-management training on medication and nutritional adherence of the elderly with type 2 diabetes in the selected comprehensive health service centers in Mashhad, Iran.

This experimental study was conducted on 104 type 2 diabetic patients who were randomly divided into intervention and control groups. In the intervention group, self-management training was provided by return training method, and in the control group, routine training was provided. To collect data, the Moriski medication adherence questionnaire and the Midas dietry compliance questionnaire were completed before and after the intervention. Data analysis was performed using SPSS statistical software (version 20), and Chi-square, Fisher, independent t-test, and paired t-test.

Based on the findings of the present research, the mean scores of the medication and nutritional adherence in the two groups before the intervention were not significantly different (P<0.05). However, after the intervention, medication and nutritional adherence of the intervention group was significantly increased compared to the control group (P<0.05).

The use of teach-back self-management training is suggested as an effective method in increasing medication and nutritional adherence of the elderly with type 2 diabetes

Multiple sclerosis is the most common neurological disease in the world and third cause of disability in chronic disease. One of the dimension to treatment of MS is adherence drugs that need development of an instrument.  This study aimed to evaluate the reliability and validity of treatment adherence drugs tool in patient with multiple sclerosis (MS) based on the theory of planned behavior.

This cross-sectional study in 2021-2022 that was carried out on 269 patients with MS were referred to Sina Hospital in Tehran city with a random sample.  Through quantitative and qualitative face validity, content validity index, with a 10-member panel of experts examined to judge the quality and reliability by determining the internal agreement (Cronbach's alpha coefficient) and was approved estimates.

The mean age of patients was 35.04±9.63 years and mean age of morbidity was 32.48±9.6 years. After reviewing the results validity, content validity index less than limit the questions to be revised and the necessary changes were made in the narrative process is repeated until the desired amount of content validity index of more than 0.62 reliability content was more than 0.79. Test-retest and reliability with more than 0.7 was confirmed. The mean of Cronbach's alpha coefficient was 0.87.

The results of this study provided good evidence of valid and reliable tools to assess treatment adherence drugs in patients with MS based on the theory of planned behavior.

medication adherence is one of the most critical issues in the physical and mental illness treatment field that has received little attention in Iran. Low adherence to medication leads to poor clinical outcomes in patients and increases mortality and healthcare costs. One of the components that can affect the patient's adherence to medication is the discharge program. The purpose of this article is to review of medication adherence of cardiac patients using the IDEAL discharge model.

This review article, was searched in the databases of the Nursing Index, PsychInfo, Proquest, and Scopus. Articles were searched from 1990 to 2020 using the keywords of medication adherence, patient, discharge model, and IDEAL.

This study reviewed 10 of the 26 articles that met the inclusion criteria. The data indicate a positive and significant relationship between the use of the IDEAL discharge model and the medication adherence of cardiac patients. Discussion and

It is suggested that education and use of the IDEAL discharge model be considered by executive and educational managers in the field of nursing so that in the coming years we will see an increase in patient medication adherence and reduce problems caused by ignoring this importance in society.

Increasing life expectancy has led to a significant increase in the growth rate of the elderly population. In parallel with this increase, the elderly is affected by various diseases and required to use various drugs. Consumption of a large number of drugs can cause various injuries and problems for the elderly contrary to what is expected, so this study aims to investigate polypharmacy management strategies in the elderly.

By reviewing the database of SID, IranDoc, Google scholar, PubMed, Medline, Scopus, Cochrane Library, Science Direct and using the keywords "elderly/older adults", "management", "drug adherence" and "polypharmacy"; all articles examining polypharmacy management strategies in the elderly, were examined by PRISMA checklist and included in the study. Electronic search was performed in the period 2015-2022.

Among the 20 reviewed articles it was identified the use of strategies such as; Physician-pharmacist interaction, educating the elderly about self-medication hazards, informing the elderly about herbal medicine limitations, using electronic tools to monitor the process of drug use and using protocols and guidelines for prescribing, can surprisingly reduce the number of medications in the elderly medication regimen and made it much easier to take medication in this age group.

Polypharmacy is one of the problems that many elderly people face today. This phenomenon can cause various damage to the health status of these people in the long term. Examining the strategies that can prevent polypharmacy in the elderly, can greatly maintain and improve the health index in the elderly, so the attention of the health care system in the community and also groups of the elderly, especially nurses in this field, to this issue is essential.

Objectives :

Many older patients use medicinal plants, assuming that they are safe and without side effects. The present study aims to investigate the relationship between the use of medicinal plants and medication adherence in the elderly patients with chronic diseases.

Methods & Materials:

 In this descriptive cross-sectional study, 358 patients aged ≥60 years with chronic diseases were selected by a convenience sampling method. Data collection instrument was a three-part questionnaire assessing demographic information, history of using medicinal plants, and medication adherence using the Morisky medication adherence scale (MMAS). The data were entered into SPSS v.21 and analyzed using one-way analysis of variance, Chi-square test, independent t-test and logistic regression.

Results:

 The mean age of participants was 69.44±8.13 years and 52.23% were female. The majority of them were married (87.68%) with a junior high school education (71.64%).The overall mean score of MMAS was 5.48 (poor adherence). The percentage of patients with a history of taking medicinal plants in the last year with the prescription of physician was 41.34% (n=148) while the percentage of those used medicinal plants without the physician’ prescription was 27.3% (n=98). The mean of MMAS score in the groups who used medicinal plants was lower than in the group with no history of using medicinal plants (P=0.001). The number of used medicinal plants, the frequency of using medicinal plants, and the duration of chronic disease had a statistically significant relationship with the medication adherence (P <0.05).

Conclusion:

 Due to the high consumption of medicinal plants in the elderly with chronic diseases and its relationship with poor medication adherence, it is necessary to educate them about the correct use of medicinal plants, their side effects, herb-drug interactions, the need to inform the doctor about use of medicinal plants, and adherence to medication.

unhealthy lifestyle can increase the incidence of new cases of colorectal cancer as well as the recurrence rate and mortality in patients with colorectal cancer. This study was conducted to determine the effect of implementing a lifestyle-based support program on adherence to the treatment regimen in colorectal cancer survivors.

In this two-group randomized clinical trial, 66 survivors who met the inclusion criteria were included in the study and then randomly assigned to the experimental and control groups. In this study, the experimental group received six sessions of face-to-face training each session for 30 minutes individually and based on the specific needs of each patient in the clinic at two-week intervals and based on different dimensions of colorectal cancer and patients' problems. They received routine care, including referrals to quarterly clinic visits, tests, diagnostic tests, and educational pamphlets. Morisky Drug Adherence Questionnaire were completed by patients before and 2 months after the intervention. Data were analyzed using SPSS software version 16 and descriptive statistics (frequency, mean, standard deviation) and inferential statistics (Chi-square, Fisher's exact test, independent t-test).

Adherence to the treatment regimen before and after the intervention was significantly different in the intervention and control groups (P<0.001).

Interventions such as implementing a lifestyle-based support program can improve adherence to treatment, so it can be provided as a patient education in the form of lifestyle modification to colorectal cancer survivors.

Diabetes is the most common chronic metabolic disease in the world and one of its control principles is the patient's adherence to the physician's treatment recommendations. This study aimed to determine the adherence to medication treatment and related factors in type 2 diabetic patients referring to the Diabetes Clinic of Shahid Beheshti Hospital, Hamadan, Iran, in 2020.

The present cross-sectional study was conducted on 284 patients with type 2 diabetes referring to the Diabetes Clinic of Shahid Beheshti Hospital. The data collection tool was a researcher-made questionnaire whose validity and reliability were confirmed in a pilot study. Data were analyzed in Stata software (version 11) at the significance level of 0.05.

Most of the patients were women (64.08%) and urban dwellers (79.08%). The mean age of the patients was obtained at 54.78 years, and 47.89% of the patients had poor medication adherence. Patients' medication adherence showed a statistically significant relationship with gender, marital status, education, physician's respectful behavior, respect for patient privacy, physician skill, the satisfaction of the physician, a history of other diseases, and a history of hypertension (P<0.05).

It was revealed the medication adherence rate was not satisfactory in patients with type2 diabetes. In this study, the identified causes associated with poor medication adherence included factors related to the patient, care team and health system, treatment, and disease status.

Patients’ beliefs about medicines can affect their adherence to the medicines. The aim of this study was to determine beliefs about medicines and medication adherence and its associated factors in patients with chronic diseases.

In this cross-sectional descriptive study, 268 patients with chronic diseases in 2019-2020 were included by convenience sampling method. The beliefs about medicines questionnaire and the Medication Adherence Scale were used for data collection. Data were analyzed in SPSS version 20 using One-Way Analysis of Variance (ANOVA), independent t-test and Pearson correlation coefficient at the significance level of α = 0.05.

The Mean±SD score of beliefs about medicines in terms of harms of medicines was 2.53±0.71, in benefits of medicines was 4.27±0.49 and overdose of the medicines was 3.23±0.79.There was a relationship between all three dimensions of beliefs about medicines with medication adherence (P<0.05). There was a direct relationship between the use of herbal medicine and belief in the harms of medicines (P<0.05). In addition, there was a relationship between gender and education level with belief in the benefits of the medicines (P<0.05).

Some chronic patients’ beliefs about the drug were not appropriate and they believed that the drugs were harmful and that the drugs were over-prescribed by doctors. Belief in the harms of the medicines, the benefits of the medicines, and the overdose of the medicines are associated with medication adherence in patients with chronic diseases. Patients should be encouraged to express their views on medications in order to improve patients’ beliefs about medication.

The patients with ischemic heart disease gradually stop following their treatment and self-care behaviors due to vulnerable physical conditions and high involvement in the treatment process. Therefore the present study was conducted to investigate the effect of the intervention based on protection theory on the drug complianceof the patients with ischemic heart disease.

The present study was quasi-experimental with pretest, posttest and control group design. The statistical population of the present study included the patients with ischemic heart disease at Payamabar-e-A’zam hospital in Bandar Abbas  who came there more than once in the period of March 2019 to May 2020. 16 patients with ischemic heart disease were selected through purposive sampling via paired method and randomly accommodated into experimental and control groups (each group of 8 patients). The experimental group received six ninety-minute sessions of protection motivation theory intervention during one-and-a-half months. The applied questionnaire included drug compliancequestionnaire (Morisky et.al, 2008). The data were analyzed through ANCOVA method via SPSS23 software.

The results of ANCOVA method showed that the intervention based on protection motivation theory has been effective on the drug compliancein the patients with ischemic heart disease (p<0.001) in a way that this type of intervention led to the increase of drug compliance (0.46)in these patients.

According to the findings of the present study it can be concluded that the intervention based on protection motivation theory can be used as an efficient intervention to increase drug compliance of the patients with ischemic heart disease with the emphasis on teaching correct nutrition, self-care skills, increasing awareness, and relaxation exercises.

Diabetes is an increasingly important health concern and causes serious complications. Most adolescents struggle with blood sugar changes due to the growing conditions of puberty and reduced adherence to treatment. Meanwhile, one of the problems of the health system is not following treatment among adolescents which is affected by social factors. Considering that training based on theoretical approaches is one of the most basic methods of treatment and control of chronic diseases, this study aims to influence the pattern of the parallel process developed on compliance with the diet of diabetic adolescents in Golestan province in 2019.

This classical intervention study with pre-test and post-test with two intervention and control groups was conducted on 50 diabetic adolescents in Golestan province using simple random sampling method in 2019. In the intervention group, based on the developed parallel process model, the content of the training program was presented in 5 sessions of 45 to 60 minutes as a group in groups of 5-6 people twice a week. Data analysis was performed using SPSS software version 23 with the help of descriptive statistics (table, mean, standard deviation) and inferential statistics (independent t, even t, ANOVA).

ANCOVA test showed a significant difference (p <0.01 and Eta = 0.25) with the elimination of the pre-test effect so that probably 25% of the post-test changes are due to training and intervention.

According to the findings, training based on the pattern of the parallel development process and follow-up after training sessions can increase compliance with the drug regimen for adolescents with diabetes. The findings of this study can be used to instruct and educate diabetic patients in clinics and medical centers.

Medicinal nonadherence prevents the achievement of therapeutic goals in cardiovascular patients. Training is essential to increase medicinal adherence. Therefore, the present study compared the effect of two teach-back and pictorial training methods on the medication adherence in heart failure patients.

This quasi-experimental study was performed on 210 heart failure patients in Hamadan Heart Hospital in 2019. Patients were selected by convenience sampling and randomly assigned to one of three groups of Teach-back, pictorial, and control training. Training sessions were held in three sessions on three consecutive days. Data were collected using demographic and medication adherence questionnaire (MMAS-8) before, immediately and 6 weeks after training. ANOVA, ANCOVA and Repeated measures ANOVA statistical tests were used.

There was no statistically significant difference between the three groups in medicinal adherence at baseline. Immediately after training, medication adherence was significantly higher in teach-back and pictorial groups than the control group (P<0.001), but there was no difference between teach back group and the pictorial group (P=0.123). Six weeks after training, medicinal adherence was significantly higher in teach-back group compared to the control and pictorial group (P<0.001). There was no significant difference between the two methods at different levels of education (P>0.05).

Teach-back training helps maintain medicinal adherence in heart failure patients. Therefore, it is recommended that nurses use this training method to improve medicinal adherence in these patients.

Poor medication adherence may result in adverse outcomes, such as a higher rate of hospitalization and increased costs of healthcare. In this regard, the present study was designed to determine the relationship between cognitive status and medication adherence among elderly patients with hypertension.

In this cross-sectional study, 180 elderly patients with hypertension were selected from Imam Reza Hospital in Amol, Iran, (2018) using convenience sampling. Cognitive impairment and medication adherence were assessed using the Cognitive State Test and Morisky Medication Adherence Scale, respectively. The data were analyzed by SPSS software (version 16) using the independent t-test, Chi-square test, and logistic regression. 

Out of 180 participants, 66.1% (n=119) of them were female. The mean age of the patients was 72.87±7.63 years. The mean values of medication adherence and cognition score were reported as 5.21±2.29 and 26.03±3.21, respectively. There was no significant relationship between medication adherence and total cognition score (P=0.322). Medication adherence was two times higher among those who were reported with no anxiety, compared to those who suffered from anxiety (β=-0.67; odds=0.51; P=0.008). The obtained results also showed medication adherence increased twelve times with one unit increase of verbal fluency. Moreover, medication adherence enhanced eight times with one unit increase of abstract thinking and judgment.

The subdomains of cognition, such as verbal fluency, as well as abstract thinking and judgment, had a significant relationship with medication adherence in elderly patients with hypertension. In this regard, it is suggested to assess cognitive status among elderly patients with hypertension and design appropriate interventions.

Patients are required to take medications to control and prevent the progression of hypertension, one of the most common chronic diseases. The widely use of cellphone text messages make it easy and convenient to enhance medication adherence The current study aimed to evaluate the effect of text message reminders on blood lipids control in patients with chronic hyperlipidemia.

The sample population in this randomized clinical trial, consisted of sixty patients divided into control and intervention groups at Imam Hossein Comprehensive Health Service Center in Borazjan in 2018. The patients in the intervention group received a daily reminder message for six weeks. Data were collected by Morisky questionnaire was completed by both groups at baseline and six weeks later. The data were analyzed by SPSS software version 25 and R version 2. 5. 3.

the results indicated a significant difference between the two groups. (p<0.001).

Sending reminder messages to patients with chronic hyperlipidemia over a six-week period is effective and leads to improved medication adherence.