Aims and objectives. This article is an integrative review of the evidence for mobile health Short Message Service text-messages as an innovative and emerging intervention to promote medication adherence. Authors completed this review to draw conclusions and implications towards establishing a scientific foundation for use of text-messages to promote medication adherence, thus informing clinical practice. Background. The World Health Organization has identified medication adherence as a priority global problem. Text-messages are emerging as an effective means of improving health behaviors and in some diseases to promote medication adherence. However, a gap in the literature indicates lack of evidence in guiding theories and content of text-messages, which should be synthesized prior to use in clinical practice. Design. Integrative review. Methods. CINAHL, EMBASE, Scopus, the Cochrane Library, and PubMed were searched for relevant studies between 2004 and 2014. Inclusion criteria required interventions testing textmessages to improve medication adherence to prescription oral medications. Articles were assessed for quality of methodology and measures of adherence. An integrative review process was used to perform analysis. Results. Thirteen articles meeting the inclusion criteria are included in this review. Nine of 13 studies found adherence rates improved between 15.3-17.8% when using text-messages to promote medication adherence. Text-messages that were standardized, tailored, one-or two-way, and timed either daily to medication regimen, weekly, or monthly showed improvement in medication adherence. Conclusions. This review established a scientific basis for text-messages as an intervention to improve medication adherence across multiple diseases. Future large rigorous randomized trials are needed to further test text-messaging interventions. Relevance to clinical practice. This review provides clinicians with the state of the science in regard to text-messaging interventions that promote medication adherence. A description of intervention components are provided to aid nurses in development of text-messages and in translating evidence into practice.Keywords: text messages; SMS; mHealth; medication adherence; intervention; integrative review
Summary box:This paper contributes to the wider global clinical community in the following manner. Reporting on how SMS text messages promote medication adherence rates. Providing information for nurses regarding development and content of SMS text messages to promote medication adherence.3
Despite high prevalence rates of elder abuse and neglect (EA/N), compliance with mandatory reporting remains low. A lack of practical training on EA/N has been identified as a barrier. This article describes the development, implementation, and evaluation of an innovative virtual-reality-based educational intervention intended to improve EA/N recognition and reporting among nurses and social workers providing in-home services. The educational intervention consisted of two parts, including an introductory course and advanced assessment training in virtual reality. The advanced assessment training was focused on learning to use the QualCare Scale, an instrument used to assess quality of family caregiving. Data was evaluated in terms of user satisfaction, changes in knowledge, and changes in practice. Results indicate that participants were satisfied with the content and format of the training program. Participants made gains in knowledge in identification and had 99% accuracy in their mandatory reporting decisions. Importantly, professionals reported making changes in their daily practice based on knowledge and skills learnt. Evaluation data indicate that this interdisciplinary training program was a satisfactory way to learn that produced changes in knowledge and impacted clinical practice. Few implementation barriers were encountered during this project suggesting it would be replicable.
This review provides clinicians with the state of the science in relation to combined motivational interviewing and cognitive behavioural therapy interventions that promote medication adherence. A summary of intervention components and talking points are provided to aid nurses in informing decision-making and translating evidence into practice.
Elder abuse and neglect (EA/N) affects over 1 million older adults each year, and disproportionately affects persons with dementia and older women. Home healthcare professionals are in an advantageous position to assess for, identify, and report EA/N. Lack of knowledge on EA/N risk factors, assessment tools, and mandatory reporting guidelines often prevent professionals from identifying and reporting EA/N. This article provides practical guidance on EA/N risk factors, assessment tools, and reporting responsibilities that can easily be implemented in practice.
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