UNASSIGNED: While suboptimal medication adherence remains an obstacle to the management of hypertension and diabetes in China, few studies have investigated associated factors with medication adherence on different dimensions simultaneously.
UNASSIGNED: To systematically examine associated patient, family, and community factors with suboptimal medication adherence among people with hypertension and/or type 2 diabetes in China.
UNASSIGNED: The study stratified a random sample of 622 adults aged 45 years or older with hypertension and/or type 2 diabetes from three southeast cities in China in 2019. Trained interviewers used the Morisky Green Levine Medication Adherence Scale, Self-Efficacy to Manage Chronic Disease (SEMCD) Scale, and the Family Adaptability, Partnership, Growth, Affection, and Resolve (APGAR) Scale to assess medication adherence, self-efficacy, and family function, respectively. Participants also reported their perceived satisfaction with community health services (quantity, quality, affordability, and overall acceptance). The study used the multivariable logistic regression to assess the association of patient, family, and community factors with suboptimal medication adherence.
UNASSIGNED: Among the participants, 42.9% reported suboptimal medication adherence. In the multivariable logistic regression model, male participants (odds ratio [OR] = 0.55, p = 0.001) had higher medication adherence compared to females. Having a self-efficacy score that was lower than or equal to the sample mean was significantly associated with lower adherence (OR = 1.44, p = 0.039). Participants unsatisfied with the affordability of community health services and medicine had lower adherence (OR = 2.18, p = 0.028) than those neutral or satisfied. There were no significant associations between family function and medication adherence.
UNASSIGNED: Sex, self-efficacy, and perceived affordability of community health services were important factors associated with medication adherence. Healthcare professionals are recommended to consider multiple factors and leverage services and resources in community health centers when promoting medication adherence.

UNASSIGNED: Diabetes mellitus (DM) is a chronic metabolic disorder affecting millions globally. Adherence to treatment is crucial for effective management.
UNASSIGNED: To compare clinical outcomes, specifically changes in haemoglobin A1c (HbA1c) and fasting blood sugar (FBS) levels, between DM patients who completed the pharmacist-managed Diabetes Medication Therapy Adherence Clinic (DMTAC) sessions and those who did not, and to identify risk factors associated with non-completion of DMTAC.
UNASSIGNED: This multicenter, retrospective study included patients with DM attending DMTAC at five Ministry of Health centers from January 2018 to December 2020. Patients were categorized based on their completion of DMTAC sessions: those who completed at least four sessions and those who did not as per DMTAC protocol. The changes in HbA1c and FBS levels between the groups were analyzed. Logistic regression was employed to identify risk factors for non-completion of DMTAC.
UNASSIGNED: A total of 198 patients were included, comprising 49% male with a mean age of 56.52, ±12.91 years. The complete group consisted of 49% (n=99) of the patients, while the did not complete group included 50.5% (n=100). A statistically significant reduction in FBS levels from initial to final measurements was observed in the complete group compared to the did not complete group (P=0.024). Female gender, higher education levels, and a longer duration since DM diagnosis were significantly associated with non-completion of DMTAC.
UNASSIGNED: Diabetic patients attending at least four DMTAC sessions showed potential improvements in FBS levels. To enhance attendance at DMTAC sessions, healthcare professionals should focus on patients identified with risk factors for non-completion of DMTAC.

UNASSIGNED: To analyse the improvement of adherence in non-adherent patients with uncontrolled HT, polymedicated and older than 55 years after the use, or not, of Multicompartment compliance aids (MCA).
UNASSIGNED: Longitudinal research (6 month). Levels of adherence to treatment were analysed using an adapted version of Morisky-Green test, counting of returned medication (MCA group) and blood pressure (BP) values. Site: Multicentre study in 35 community pharmacies in Spain. Participants: 195 participants (88 MCA group and 107 control group) older than 55 years, polymedicated, non-adherent to medication, with uncontrolled hypertension and using electronic prescription. Interventions: MCA group received their medication in MCA while control group received their medication as usual. Main measurements: Systolic BP/Diastolic BP was recurrently measured with a digital tensiometer in both groups.
UNASSIGNED: MCA group obtained a significant decrease in BP values compared to the control group (Systolic BP decreased by 18.3 mmHg in the MCA group vs. 9.9 mmHg in the control group and Diastolic BP by 9.9 mmHg vs. 8.9 mmHg). Both groups increased their adherence to over 90%.
UNASSIGNED: The use of MCA controlled BP levels in almost 50% of the participants. For this fact, MCA is postulated as a good tool (cost-effective, well tolerated by users, easy to use ...) to improve the adherence of patients and control their hypertension, although more studies are necessary.

UNASSIGNED: Patients` lack of adherence to pharmacological treatments has a major impact, both clinical and economical. While different methods are used to measure adherence, retrospective studies are being used more frequently as they are more objective, less prone to bias by patient perception and interfere less with patients\' lives. The electronic prescription system provides the community pharmacy with a useful tool to conduct this research.
UNASSIGNED: To measure the adherence of patients to their chronic medication considering different therapeutic drug groups and their mental health using electronic prescription information available in a database.
UNASSIGNED: An observational, ambispective and logitudinal study was developed for 300 patients. Adherence was assessed using Proportion of Days Covered (PDC) per patient and per treatment and the Morisky Green Levine test. Data on patients\' dispensed medication for the last 12 months was obtained through the electronic prescription system. Data on patient mental health was gathered using the PHQ-2 screen for depression.
UNASSIGNED: A total of 300 patients were recruited, but only 290 were included in the analysis. 25.5%; [95%CI: 20.6:30.9] were classified as polymedicated. The median PDC per patient was 0.90 (IQR: 0.73 - 1). According to the Morisky Green Levine questionnaire, 57.9% of the patients [95%CI 52.0:63.6] adhered to their treatments. Concurrence between the Morisky Green Levine test and the PDC had a kappa k=0.086.
UNASSIGNED: The electronic prescription turned out to be a useful tool to gain insight into adherence to long-term treatments measured in terms of the PDC.

UNASSIGNED: Monitoring the pharmacotherapy adherence in society is crucial for identifying occurance and causes of potential inadequate use of drugs and inform providers about the need for better customer counceling. It is necessary component of the strategic planning of the quality of healthcare services. This population- based study aimed to assess the medication intake adherence in the Republic of Serbia and the individual factors and health system variables influencing its pattern.
UNASSIGNED: We applied a cross-sectional approach to study medication intake adherence using a secondary analysis of the latest 2019 Serbian National Health Survey data. The statistical modeling of the pharmacotherapy adherence incorporated sociodemographic data, self-reported disease, and lifestyle behavior.
UNASSIGNED: In 2019, in the representative sample of 12,066 adults in Serbia, requiring prescribed medicine, 49.8% did comply with the prescribed drugs, and 50.2% do not. Participants who adhered to prescribed medication were significantly (p < 0.001) older (62.4 ± 14 years), predominantly female (55.3%), had secondary education (48.5%), resided in southern and eastern parts of Serbia (55.5%), and belonged to the lowest income quintile (21.4%). The participants most often take prescribed drugs for hypertension (64.1%) and lower back pain (30.5%), while around 20% take medication for coronary disease, diabetes mellitus, and high blood cholesterol. About 85-92% of participants with financial or general difficulties using prescribed medication.
UNASSIGNED: There is poor medication intake adherence to prescribed medication in Serbia. Gender, age, and region determine the adherence. Also, health-related and healthcare system-related factors impact the use of prescribed medication. Study findings can inform planning the counceling interventions in the target groups where improving medication adherence is necessary, as well as to enhance training of healthcare providers about pharmacotherapy adherence.

BACKGROUND: Improving treatment success rates among multi drug-resistant tuberculosis (MDR-TB) patients is critical to reducing its incidence and mortality, but adherence poses an important challenge. Video-based direct observed therapy (vDOT) may provide adherence benefits, while addressing the time and cost burden associated with community treatment supporter (CTS)-DOT. This study explored experiences of patients, family members and healthcare workers with different DOT modalities for adherence support in Eswatini.
METHODS: Between April 2021 and May 2022, thirteen men and five women with MDR-TB, ten healthcare workers, and nine caregivers were purposively sampled to include a range of characteristics and experiences with DOT modalities. Data were generated through individual in-depth interviews and a smartphone messaging application (WhatsApp). Data coding was undertaken iteratively, and thematic analysis undertaken, supported by Nvivo.
RESULTS: Four themes emerged that reflected participants\' experiences with different DOT modalities, including stigma, efficiency, perceived risks of TB acquisition, and patient autonomy. vDOT was appreciated by patients for providing them with privacy and shielding them from stigmatisation associated with being seen in TB clinics or with community treatment supporters. vDOT was also seen as more efficient than CTS-DOT. Health workers acknowledged that it saved time, allowing them to attend to more patients, while many patients found vDOT more convenient and less expensive by removing the need to travel for in-person consultations. Health workers also appreciated vDOT because it reduced risks of TB acquisition by minimising exposure through virtual patient monitoring. Although many patients appreciated greater autonomy in managing their illness through vDOT, others preferred human contact or struggled with making video recordings. Most family members appreciated vDOT, although some resented feeling removed from the process of supporting loved ones.
CONCLUSIONS: vDOT was generally appreciated by MDR-TB patients, their family members and health workers as it addressed barriers to adherence which could contribute to improved treatment completion rates and reduced workplace exposure. However, patients should be offered an alternative to vDOT such as CTS-DOT if this modality does not suit their circumstances or preferences.

BACKGROUND: There is increasing evidence in favor of enhancing adherence to antiretroviral therapy (ART) in people living with HIV (PLHIV) through mobile health (mHealth) assessment and intervention. The study aims to establish the willingness to adopt mobile phone technology to enhance adherence to ART among PLHIV.
METHODS: The Researchers adopted a cross-sectional survey. Systematic sampling was employed in selecting 237 PLHIV in the HIV clinic for adults at Ido-Ekiti\'s Federal Teaching Hospital, Nigeria. Data collection was via a 33-item semi-structured questionnaire administered by the interviewer. Information collected via the questionnaire included details on ownership of mobile phone technology, its usage, and willingness to use it to improve adherence to HIV medication. Descriptive statistics coupled with multivariate regression was employed in analyzing data, with the level of significance at 5%.
RESULTS: The respondent\'s had a mean ±SD age of 46.6 ±10 years. Most of the participants were female (77.6%), and have been on ART for over 2years (88.2%). The vast majority of study participants 233 (98.3%) owned a mobile phone. 168 (70.9%) of them were willing to embrace mHealth interventions on medication adherence. Some of the factors influencing the respondent\'s willingness to receive the intervention were older age (OR = 0.05, 95%Cl:[0.01-0.24]), having formal education (OR = 7.12, 95%Cl:[3.01-16.53]), being diagnosed over 10years ago (OR = 15.63, 95%Cl:[3.02-80.83]) and previous use of phone to send text messages, record video, access the internet, send email and search the internet for health-related information (OR = 2.2, 95%Cl:[1.2-3.9]; OR = 1.8, 95%Cl:[1.0-3.2]; OR = 2.5, 95%Cl:[1.4-4.7]; OR = 2.7, 95%Cl:[1.2-5.5] and OR = 2.0, 95%Cl:[1.0-3.8]) respectively.
CONCLUSIONS: Many of the PLHIV had a cellphone and expressed willingness on their part to use it in receiving reminders to take their medication. Older age, formal education and internet users were significantly more willing to get reminders to take their medication.

BACKGROUND: In the last decade, a fundamental shift in the treatment of cystic fibrosis (CF) took place due to the introduction of CF transmembrane conductance regulator (CFTR) modulators. Adequate medication adherence is a prerequisite for their effectiveness, but little is known about adherence to CFTR modulators. We aimed to assess the extent of medication adherence to CFTR modulators in patients with CF and assess which characteristics are associated with adherence.
METHODS: A systematic review following PRISMA guidelines was performed. Studies needed to report adherence to CFTR modulators. Main outcomes were: 1) level of medication adherence and 2) associations of demographic and/or clinical characteristics with adherence.
RESULTS: In total, 4082 articles were screened and 21 full-text papers were assessed for eligibility. Ultimately, seven studies were included. Most studies were retrospective and focused on adherence to ivacaftor or lumacaftor-ivacaftor with only one focusing on elexacaftor-tezacaftor-ivacaftor. The majority used pharmacy refill data with adherence determined with the proportion of days covered (PDC) or the medication possession ratio (MPR). One study additionally used electronic monitoring and patient self-reported adherence. Adherence was 0.62-0.99 based on pharmacy data (PDC or MPR), 61% via electronic monitoring and 100% via self-report. Age <18 years appeared to be associated with good adherence, as was a higher lung function.
CONCLUSIONS: Despite the wide variety of adherence methods used, adherence to CFTR modulators is suboptimal, based on objective measures such as pharmacy refill data or electronic monitoring. CFTR modulator adherence measurement and definitions requires more standardisation with a preference for objective and granular methods.

Limited therapeutic options are available for patients with multidrug-resistant HIV. This report describes a 38-year-old female who was perinatally infected with HIV-1 and treated with 14 different antiretroviral regimens over 27 years, gradually leading to 4-class drug resistance. Despite various attempts to obtain sustained viral suppression, including the off-label administration of intravenous foscarnet and enfuvirtide, and thorough follow-up with 16 viral genotyping/phenotyping from 1999 to 2021, viral control was not maintained. Recently, the introduction of a regimen with fostemsavir and lenacapavir resulted in long-term viral suppression.

UNASSIGNED: Many insulin users ration doses due to high out-of-pocket costs. Starting January 2020 with Colorado, 25 states and the District of Columbia enacted laws that cap insulin copayments.
UNASSIGNED: To estimate the association of Colorado\'s $100 copayment cap with out-of-pocket spending, medication adherence, and health care services utilization for diabetes-related complications.
UNASSIGNED: In this cohort study using Colorado\'s All-Payer Claims Database, nonelderly insulin users with type 1 diabetes were analyzed from January 2019 to December 2020. Outcome changes were compared in the prepolicy and postpolicy period among individuals continuously enrolled in state-regulated and non-state-regulated plans using difference-in-differences regressions. Subgroup analyses were conducted based on individuals\' prepolicy spending (low: never ≥$100 out-of-pocket vs high: ≥$100 out-of-pocket cost at least once). Data were analyzed from June 2023 to May 2024.
UNASSIGNED: Enrollment in state-regulated health insurance plans subject to the copayment cap legislation.
UNASSIGNED: Adherence to basal and bolus insulin treatment was evaluated using the proportion of days covered measure, out-of-pocket spending reflected prescription cost for a 30-day supply, and health care utilization for diabetes-related complications was identified using primary diagnosis codes from medical claims data.
UNASSIGNED: The panel included 1629 individuals with type 1 diabetes (39 096 person-months), of which 924 were male (56.7%), 540 (33.1%) had 1 or more comorbidities, and the mean (SD) age was 40.6 (15.9) years. Overall, the copayment cap was associated with out-of-pocket spending declines of $17.3 (95% CI, -$27.3 to -$7.3) for basal and $11.5 (95% CI, -$24.7 to $1.7) for bolus insulins and increases in adherence of 3.2 (95% CI, 0.0 to 6.5) percentage points for basal and 3.3 (95% CI, 0.3 to 6.4) percentage points for bolus insulins. Changes in adherence were associated with increases within the prepolicy high-spending group (basal, 9.9; 95% CI, 2.4 to 17.4 percentage points; bolus, 13.0; 95% CI, 5.1 to 20.9 percentage points). The policy was also associated with a mean reduction of -0.09 (95% CI, -0.16 to -0.02) medical claims for diabetes-related complications per person per month among high spenders, a 30% decrease.
UNASSIGNED: In this cohort study of Colorado\'s insulin copayment cap among individuals with type 1 diabetes, the policy was associated with an overall decline in out-of-pocket spending, an increase in medication adherence, and a decline in claims for diabetes-related complications only among insulin users who spent more than $100 in the prepolicy period at least once.