Improving medication adherence may have a greater influence on the health of our population than in the discovery of any new therapy. Patients are nonadherent to their medicine 50% of the time. Although most physicians believe nonadherence is primarily due to lack of access or forgetfulness, nonadherence can often be an intentional choice made by the patient. Patient concealment of their medication-taking behavior is often motivated by emotions on the part of both provider and patient, leading to potentially dire consequences. A review of the literature highlights critical predictors of adherence including trust, communication and empathy, which are not easily measured by current administrative databases. Multifactorial solutions to improve medication adherence include efforts to improve patients' understanding of medication benefits, access and trust in their provider and health system. Improving providers' recognition and understanding of patients' beliefs, fears and values, as well as their own biases is also necessary to achieve increased medication adherence and population health.
RAINEES LEARN INPATIENT MEDI-cine on the job, providing clinical care to patients as members of ward teams led by attending physicians. Although the structures of these ward teams vary by local educational heritage and hospital policy, 1,2 a prevailing trait is that attending physicians are assigned to them for only 2 continuous weeks-a duration that is half of the previous standard. 3,4 Both trainees 3 and educational leaders 5 have decried short rotations as disruptive because they truncate studentteacher relationships. Shorter rotations may nonetheless benefit the psychological health of attending physicians, whose responsibilities are oversubscribed. 4,6 In particular, if shorter rotations can lessen attending physician burnout, they may improve physicians' relationships with patients and the quality of care that patients receive. 7,8 Therefore,toweightheeffectsofshorter rotationsonpatients,trainees,andattending physicians, we first assessed whether the outcomes most proximate to policyeffects on patients, 9 as assessed by un-Author Affiliations are listed at the end of this article.
Mental disorders are the second leading cause of disease burden in terms of Years Lived with Disability (YLDs) and the sixth leading cause of Disability-Adjusted Life-Years (DALYs) in the world in 2017. Mental disorders can lead to extreme physical, psychological, social and financial burden among the caregivers. Family is a basic unit of caring for the mentally ill. Empowering the family caregivers on caring their mentally ill client at home is an effective strategy in rehabilitation as the mental health facilities are limited in India. Home based care is known to reduce burden among the caregivers. Homecare includes various components that help in caring and managing clients with Activities of Daily Living (ADL), supervision and administration of medication, recreation and leisure activity, stress management, regular follow up with mental health professional, social skill training, management of psychiatric emergencies, management of potentially harmful behaviours such as suicide and anger management. The outcome of the home care of mentally ill depends on the willingness and cooperation of the family and continuous support and monitoring by the mental health team. It is cost-effective and implies the shift of responsibility not only on the hospital but on the family caregivers and the health professionals in the community.
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