Measuring Adherence to Behavioral and Medical Interventions

Vitolins, Mara Z.; Rańd, Cynthia S.; Rapp, Stéphen R.; Ribisl, Paul M.; Sevick, Mary Ann

doi:10.1016/s0197-2456(00)00077-5

Cited by 195 publications

(182 citation statements)

References 8 publications

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“…O termo adesão refere-se à exatidão com que o indivíduo segue as orientações terapêuticas 2 , devendo ser definido com parâmetros apropriados ao regime terapêutico ou comportamento de saúde sob estudo 20 . No caso das palmilhas, não há uma orientação específica sobre a quantidade de horas Tabela 2.…”

Section: Discussionunclassified

“…Apesar disso, observa-se na prática uma baixa adesão a esse tipo de tratamento. A não-adesão a uma terapia, em adição à redução dos benefícios esperados, poderá causar considerável frustração ao paciente e ao terapeuta 3 e acarretar grandes custos econômicos 3,19,20 . O aumento dos custos será conseqüência do maior tempo de afastamento das atividades ou da necessidade de buscar uma nova intervenção.…”

Section: Introductionunclassified

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Fatores associados à adesão ao uso de palmilhas biomecânicas

Guimarães¹,

Lf²,

Rocha³

et al. 2006

Rev. bras. fisioter.

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RESUMOContextualização: Os benefícios das palmilhas biomecânicas no tratamento de acometimentos nos membros inferiores têm sido relatados. No entanto, observa-se na prática uma baixa adesão ao uso dessa órtese, comprometendo os benefícios que poderiam ser proporcionados. Objetivo: Investigar os fatores relacionados à adesão ao uso de palmilhas biomecânicas. Método: Participaram deste estudo 33 indivíduos (43,97 ± 14,73 anos) para os quais foram confeccionadas palmilhas biomecânicas. Um questionário contendo questões a respeito da palmilha e seu uso foi aplicado, em forma de entrevista, sendo as variáveis de estudo estabelecidas a partir dessas questões. Com base nos resultados obtidos, os indivíduos foram separados em 4 grupos, de acordo com o nível de adesão: adesão total, adesão parcial, adesão inconstante e não-adesão. Utilizou-se o teste "KruskalWallis" para investigar se esses grupos diferiam entre si em relação às variáveis pesquisadas. Coeficientes de Correlação de Spearman foram utilizados para verificar possíveis correlações entre essas variáveis e adesão. Resultados: Dos 33 participantes, 15,2% tiveram adesão total, enquanto 42,4% abandonaram a palmilha. Comparando-se os 4 grupos de adesão em relação às variáveis pesquisadas, observou-se diferença significativa para conforto da palmilha (p=0,003), grau de melhora atribuído à palmilha (p=0,006) e grau de conhecimento sobre o problema (p<0,002). Correlações significativas (r s =0,58; p<0,001 e r s =0,50; p<0,01) foram observadas entre adesão e conforto e grau de melhora atribuído à palmilha, respectivamente. Conclusão: Resultados do presente estudo revelaram que conforto e grau de melhora atribuído à palmilha podem influenciar na adesão ao uso dessas órteses, constituindo-se fatores importantes para o sucesso do tratamento.Palavras-chave: palmilhas biomecânicas, adesão, órtese. ABSTRACT Factors Related to Compliance with Biomechanical Insole UseBackground: The benefits of biomechanical insoles for treating lower limb impairment have been reported. However, in clinical practice, low compliance with the use of such orthoses has been observed, which detracts from the possible benefits. Objective: To investigate the factors related to compliance with biomechanical insole use. Method: Thirty-three subjects (aged 44 ± 14.7 years) for whom biomechanical insoles had been molded took part in this study. A questionnaire asking about the insoles and their use was applied through interviews. The study variables were established from these questions. Based on the results obtained, the participants were divided into four groups according to their compliance level: full compliance, partial compliance, irregular compliance and non-compliance. The Kruskal-Wallis test was utilized to assess differences between these groups regarding the variables investigated. Spearman correlation coefficients were utilized to investigate possible relationships between these variables and the compliance. Results: Among the 33 participants, 15.2% were fully compliant, while 42.4% abandoned...

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Section: Discussionunclassified

Section: Introductionunclassified

Fatores associados à adesão ao uso de palmilhas biomecânicas

Guimarães¹,

Lf²,

Rocha³

et al. 2006

Rev. bras. fisioter.

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“…Other studies have also pointed out difficulties with compliance to very low protein diets even when individualized and intensive counseling are performed (Forget et al, 1990;Kopple et al, 1997). Compliance is a complex and incompletely understood behavioral process that is strongly influenced by the environment in which people live and the social and cultural aspects of the individual life (Vitolino et al, 2000). In the present study, although we have not evaluated the causes of the poor compliance of patients on the VLPD þ KA diet, it is likely that the difficulties were related to the restriction of animal protein origin, mainly meats, and to the increased intake of foods rich in vegetable proteins such as beans and bread as these foods are part of our population food habits.…”

Section: Discussionmentioning

confidence: 99%

Short-term effects of a very-low-protein diet supplemented with ketoacids in nondialyzed chronic kidney disease patients

et al. 2004

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Objective: To evaluate the effects on the nutritional and metabolic parameters of a very-low-protein diet supplemented with ketoacids (VLPD þ KA) in comparison with a conventional low-protein diet (LPD) in chronic kidney disease (CKD) patients. Design: Prospective, randomized, controlled clinical study. Setting: Outpatient Clinic of the Nephrology Division of Federal University of São Paulo, Brazil. Subjects: The study involved 24 patients with advanced CKD (creatinine clearance o25 ml/min) that were randomly assigned to either a VLPD þ KA (VLPD þ KA group, 12 patients) or to a conventional LPD with 0.6 g/kg/day (LPD group, 12 patients). The patients were followed for 4 months. Results: Nutritional status was adequately maintained with both diets for the studied period. Protein intake and serum urea nitrogen decreased significantly only in the VLPD þ KA group (from 0.6870.17 to 0.4370.12 g/kg/day, Po0.05; from 61.4712.8 to 43.6714.9 mg/dl, Po0.001; respectively). Ionized calcium did not change in the VLPD þ KA group but tended to decrease in the LPD group. Serum phosphorus tended to decrease in the VLPD þ KA group probably as a result of a significant reduction in dietary phosphorus (5297109 to 3737125 mg/day, Po0.05) associated to the phosphorus-binding effect of the ketoacids. No change in these parameters was found in the LPD group. Serum parathormone increased significantly only in the LPD group (from 2417138 to 4947390 pg/ml, Po0.01). The change in PTH concentration was negatively correlated with changes in ionized calcium concentration (r ¼ À0.75, P ¼ 0.02) and positively correlated with changes in serum phosphorus (r ¼ 0.71, P ¼ 0.03) only in the LPD group. Conclusion: This study indicates that a VLPD þ KA can maintain the nutritional status of the patients similarly to a conventional LPD. Besides, an improvement in calcium and phosphorus metabolism and a reduction in serum urea nitrogen were attained only with the VLPD þ KA. Thus, VLPD þ KA can constitute another efficient therapeutic alternative in the treatment of CKD patients. Sponsorship: This study was supported by CAPES, Oswaldo Ramos Foundation and Fresenius Kabi, Ltda.

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“…Whereas medication monitoring provides robust data about use of EMDs, it does not guarantee that a person has actually taken the medication. The limitations and weaknesses of electronic monitoring have been described elsewhere [46]. The cost of the technology and the logistics of using it and Note: MEMS proprietary software analyzed continuous dosing records for each patient to provide overall rates of adherence based on cap openings on a given day with days defined as beginning at 3:00 am.…”

Section: Original Researchmentioning

confidence: 99%

Desirability and feasibility of wireless electronic monitoring of medications in clinical trials

Robiner

Flaherty

Fossum

et al. 2015

Behav. Med. Pract. Policy Res.

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Medication nonadherence is a vexing problem in health care necessitating patients and health professionals' efforts to prevent, minimize, or reverse it. Research participants' inconsistent medication taking obscures treatment efficacy and adds costs to biomedical research. Electronic monitoring devices (EMDs), like the Medication Event Monitoring System (MEMS), have grown in sophistication, providing precise, timely insights into individuals' medication-taking patterns across clinical populations. This article reports on the desirability and feasibility study of using a wireless EMD in clinical research to promote adherence to clinical regimens and research protocols. Nonadherence in transplant patients has been linked to late acute rejection and graft loss. High levels of adherence (97.7 %) were documented for six renal transplant recipients for a mean of 6 months (M=196.1±71.2 days) who indicated acceptance of the technology. MEMS data confirmed the feasibility of using wireless EMDs to monitor medication use. Monitoring provides greater assurance that research studies reflect the biological impact of medications and provide a basis for targeting adherence enhancement efforts within research investigations.

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Measuring Adherence to Behavioral and Medical Interventions

Cited by 195 publications

References 8 publications

Fatores associados à adesão ao uso de palmilhas biomecânicas

Fatores associados à adesão ao uso de palmilhas biomecânicas

Short-term effects of a very-low-protein diet supplemented with ketoacids in nondialyzed chronic kidney disease patients

Desirability and feasibility of wireless electronic monitoring of medications in clinical trials

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