Approaches to Patient Education: Emphasizing the Long-Term Value of Compliance and Persistence

Gold, Deborah T.; McClung, Betsy Love

doi:10.1016/j.amjmed.2005.12.021

Cited by 156 publications

(103 citation statements)

References 21 publications

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“…Providing the patient with contact information so that they can ask about any concerns and providing information about support groups and organizations might be useful 39 . Frequent monitoring of the patient and provision of feedback can improve adherence, 42 and in that context, the family physician can have an important role in supporting patients on treatment. Drug side effects or depression can also be appropriately managed by the family physician.…”

Section: Patient Supportmentioning

confidence: 99%

Patient Adherence to Aromatase Inhibitor Treatment in the Adjuvant Setting

et al. 2011

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Improvements in adjuvant systemic therapy and detection of early disease have resulted in a decline of breast cancer death rates across all patient age groups in Canada. Non-adherence to adjuvant hormonal therapy in the setting of early breast cancer may significantly affect patient outcome. Factors associated with medication adherence are complex and may be patient-related, therapy-related, and health care provider–related. To date, there is a gap in the literature concerning a comprehensive understanding of factors related to medication adherence with anti-estrogen therapy in the adjuvant setting. The literature suggests that strategies for improving adherence should focus on education of patients, assessment of the ability of patients to understand their disease and related recurrence factors, and facilitation of adherence by patients by providing adequate support and strategies for good self-management. However, more research is needed to better understand how health care providers can support women with breast cancer on oral therapy in the adjuvant setting.

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Section: Patient Supportmentioning

confidence: 99%

Patient Adherence to Aromatase Inhibitor Treatment in the Adjuvant Setting

et al. 2011

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“…Furthermore, In Lesotho and Zimbabwe, inadequate knowledge of hypertension was significantly associated with uncontrolled hypertension [13,14]. Consequently, health education comprises a critical recommendation to improving adherence to medicines in a broad range of diseases, and as such its importance should not be undercut by the findings of this study [15].…”

mentioning

confidence: 83%

Evaluation of the Functional Status Questionnaire in Heart Failure: A Sub-study of the Second Cardiac Insufficiency Bisoprolol Survival Study (CIBIS-II)

Gallanagh

Castagno

Wilson

et al. 2011

Cardiovasc Drugs Ther

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Elevated blood pressure is the leading preventable cause of cardiovascular disease (CVD) death and disability globally [1,2]. Adherence to anti-hypertensive medicines is the cornerstone to blood pressure control and subsequent reductions in CVD related death and disability [3]. However, adherence to anti-hypertensive medicines remains suboptimal globally and in sub-Saharan Africa (SSA). A recent systematic review estimated rates of non-adherence to be 45% globally, rising to 63% among African and Asian populations [4]. Furthermore, non-adherence was noted in 84% of patients with uncontrolled hypertension. Hypertension prevalence is highest in Africa (46%) compared to other regions and is expected to increase by more than 65% by 2025 [5,6]. Consequently, there is an urgent need to implement strategies to monitor and improve adherence to anti-hypertensive medicines in SSA.Chronic care delivery for hypertension and other noncommunicable diseases (NCDs) remains elusive to a majority of SSA countries where health systems have being designed primarily to address acute infective diseases, maternal and child health, and the HIV epidemic [7]. Where hypertension care is available, socio-economic barriers associated with receiving chronic care limit access and utilisation by patients, with a significant impact on decreasing adherence to medicines [8]. In recognition of this key barrier, some SSA countries have built universal healthcare delivery platforms that provide free or subsidised hypertension care and medicines to their population. However, even in these areas, adherence remains sub-optimal.In Namibia, where universal care for hypertension is provided through public health care (PHC) facilities, Nashilongo et al. assessed the levels and predictors of adherence to antihypertensive medication, and validated a modified version of the Hill-Bone scale for compliance [9]. Their study recruited 120 patients regularly receiving medication refills for hypertensive drugs in four semi-urban PHC facilities in Windhoek. The primary outcome measure was the proportion of patients with ≥80% adherence on the Hill-Bone compliance scale, predefined as acceptable adherence.The modified Hill-Bone Scale for compliance had reasonable internal consistency and construct validity for assessing adherence in this population. Mean adherence level was 77% which was lower than the pre-specified ≥80% level designating good adherence. 58% of patients had adherence levels ≤80%. Independent predictors of good adherence after multivariable logistical regression were having a treatment support buddy, never having missed a clinic appointment, and always attending follow-up visits. Although age and distance to the PHC facility were associated with good adherence on bivariate analysis, these associations were not sustained in the multivariable model. Finally, no association was found between sex, employment status, education level, presence of a comorbidity, and knowledge on hypertension medicines or complications with adherence.Several limitations of thi...

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“…[8][9][10][11] The positive effects of patient education on treatment uptake have been described previously in the literature; however, there is a paucity of data from Australasia, especially pertaining to H. pylori eradication therapy.…”

Section: Discussionmentioning

confidence: 99%