Medication Adherence to Multidrug Regimens

Marcum, Zachary A.; Gellad, Walid F.

doi:10.1016/j.cger.2012.01.008

Cited by 168 publications

(127 citation statements)

References 41 publications

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“…32 In a recent systematic review, nonadherence was associated with polypharmacy when focusing on the results of higher-quality studies. 34,35 To date, all studies have shown that polypharmacy is robustly associated with nonadherence, but no study has focused on the HIV population. Nonadherence to ART is especially concerning, since it is associated with reduced effectiveness in viral suppression, allows viral resistance, and increases the risk of opportunistic diseases.…”

Section: ■■ Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Concurrent Use of Comedications Reduces Adherence to Antiretroviral Therapy Among HIV-Infected Patients

Cantudo-Cuenca¹,

Jiménez-Galán²,

González³

et al. 2014

JMCP

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BACKGROUND: The use of highly active antiretroviral therapy has significantly reduced morbidity and mortality, thus increasing life expectancy of human immunodeficiency virus (HIV)-infected individuals, transforming HIV into a chronic disease. Accordingly, there has been an increase in the number of comorbidities concomitantly present in these individuals and also an increased use of comedications, which may negatively impact antiretroviral therapy adherence. These factors can affect adherence to antiretroviral therapy. The role of the HIV clinical pharmacist is essential to achieve therapeutic objectives and enhance adherence.

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Section: ■■ Discussionmentioning

confidence: 99%

“…It is commonly accepted that there is no gold standard for measuring medication adherence. 35 Pharmacy dispensing records and the MMAS are chosen because both are practical and inexpensive; they provide quantitative and qualitative data; and they are used in clinical practice and adherence research. However, both can overestimate adherence.…”

Section: Limitationsmentioning

confidence: 99%

Concurrent Use of Comedications Reduces Adherence to Antiretroviral Therapy Among HIV-Infected Patients

Cantudo-Cuenca¹,

Jiménez-Galán²,

González³

et al. 2014

JMCP

View full text Add to dashboard Cite

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“…Önerilen tedavi rejimi reçete edilen ilaçları, diyet ve yaşam tarzı değişikliklerinin uygulanmasını da içermek-tedir. Yaşlanma ile tedaviye uyumun azalmasının, yaşlılarda görülen bilişsel fonksiyon ve bellek azalması ile görme-işitme kaybı gibi fiziksel problemlerin ortaya çıkması ile ilişkili olduğu düşünülmektedir (8,19). (21).…”

Section: Yaşlı Hastanın Tedaviye Uyumu (Adherence)unclassified

Yaşlılarda doğru ilaç kullanımı

Kerry¹

2015

Ege Tıp Dergisi

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ÖzTüm dünyada olduğu gibi ülkemizde de ortalama ve beklenen yaşam süreleri artmakta, doğum oranları azalmakta ve bununla ilişkili olarak da yaşlı nüfusun sayısı ve oranı artmaktadır. Yaşlı nüfus oranının artmasıyla yaşlılıkta sık görülen hastalıklarla daha fazla karşılaşılmaktadır. Bu durum yaşlı bireylerin sağlık hizmetine başvuruları ve sağlık harcamalarını artırmaktadır. Yaşlı hastalar tedavileri sürecinde çeşitli nedenlerle ilaca ilişkin problemler açısından yüksek risk altındadır. İlaç etkisinde yaşa bağlı olarak gelişen farmakokinetik ve farmakodinamik değişiklikler, yüksek oranda görülen çoklu ilaç kullanımı, çoklu hastalıkların varlığı ve yaşlılıkta görülen geriatrik sendromlar yaşlı bireylerde tedaviyi zorlaştırmaktadır. Yaşlılarda uygun olmayan ilaç kullanımı da oldukça yaygın görülen ciddi bir sorundur. Yaşlı hastalarda kullanımı uygunsuz ilaçlar, yaşlılarda yararlılığı düşük ve zarar verme olasılığı yüksek olan ilaçları kapsamaktadır. Bu bağlamda, önceden belirlenmiş kriterler kullanılarak uygunsuz ilaç kullanımının, polifarmasi uygulamalarının, ilaç etkileşimleri ile advers ilaç reaksiyonlarının saptanması ve engellemesinin yaşlı hastalarda güvenli ve etkili bir tedaviye katkısı olduğu unutulmamalıdır.Anahtar Sözcükler: Akılcı ilaç kullanımı, farmakokinetik, farmakodinamik, polifarmasi, yaşlanma. Abstract Life expectancy is increasing all over the world, as well as in our country. Since the birth rate is decreasing, the population of elderly is relatively increasing. The more increase in the elderly

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“…Measurement of medication adherence is complex, since most measures serve as proxies for medication-taking behavior. 2 For example, pharmacy claims data are increasingly used for conducting adherence research, although the pharmacy claim serves only as a proxy for medication consumption, and in reality it is simply measuring refills. Other methods for measurement, including self-report, pill counts, and electronic capture of pill bottle opening, also require important assumptions about the relationship between the measure and actual medication-taking.…”

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confidence: 99%

Improving Medication Adherence: Keep Your Eyes on the Prize

Marcum

Gellad

2016

J GEN INTERN MED

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M edication adherence is a set of complex health behaviors that challenges patients of all ages and health conditions. Researchers have spent decades trying to improve medication adherence, and yet these interventions have been wrought with limitations and sobering findings. The most recent Cochrane systematic review of the impact of adherence interventions found that effects were inconsistent across studies and that only a small number of interventions led to a modest improvement in both adherence and clinical outcomes. 1 The authors concluded that existing adherence interventions Bare mostly complex and not very effective.^1 In addition, the authors recommended that future research include robust study designs of feasible long-term interventions with sufficient study power to detect improvements in patientcentered clinical outcomes. 1A key issue in implementing any adherence intervention is ensuring valid measurement of adherence. Measurement of medication adherence is complex, since most measures serve as proxies for medication-taking behavior.2 For example, pharmacy claims data are increasingly used for conducting adherence research, although the pharmacy claim serves only as a proxy for medication consumption, and in reality it is simply measuring refills. Other methods for measurement, including self-report, pill counts, and electronic capture of pill bottle opening, also require important assumptions about the relationship between the measure and actual medication-taking. It is further assumed that improving medication adherence will improve process measures such as blood pressure or cholesterol control, which will in turn improve the health outcome(s) of patients including quality of life and mortality.In this issue of JGIM, Reddy and colleagues present findings on the effect of daily pill bottle alarms combined with individual or partner feedback reports on statin medication adherence.3 This 3-month, three-arm randomized clinical trial randomized 126 veterans with known coronary artery disease and poor adherence (medication possession ratio [MPR] <80 %) to one of three groups: (1) a control group that received a pill-monitoring device (i.e., a GlowCap ® bottle) with no alarms or feedback; (2) an individual feedback group that received a daily alarm and a weekly medication adherence feedback report; and (3) a partner feedback group that received an alarm and a weekly feedback report that was shared with a friend, family member, or a peer. By the end of the 3-month intervention, statin adherence was significantly higher in both the individual and partner feedback groups compared to the control arm (89 % and 86 % vs. 67 %, respectively). However, at 6 months, statin adherence did not differ among the groups (60 % and 52 % vs. 54 %).The study had a number of strengths and unique aspects. First, the use of a feedback component in the intervention arms was a novel approach. The authors were thus able to assess the impact of peer support (via social forces) or individual feedback on medication adherence behavi...

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Medication Adherence to Multidrug Regimens

Cited by 168 publications

References 41 publications

Concurrent Use of Comedications Reduces Adherence to Antiretroviral Therapy Among HIV-Infected Patients

Concurrent Use of Comedications Reduces Adherence to Antiretroviral Therapy Among HIV-Infected Patients

Yaşlılarda doğru ilaç kullanımı

Improving Medication Adherence: Keep Your Eyes on the Prize

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