Patient Compliance in Medical Practice and Clinical Trials

Toenders, Wil

doi:10.3233/jrs-1992-35-615

Cited by 4 publications

(3 citation statements)

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“…Practically, even a carefully designed treatment plan does not yield the expected results with a lack of adherence (patients’ behaviors in terms of taking medication, following diets, or executing lifestyle changes coinciding with healthcare providers’ health and medical advice). [41] In addition to the treatment effect, lack of AFU seriously affects clinical research implementation by undermining the internal and external validities of the findings [42] , attrition bias [43] , increasing the trial’s cost and duration and delaying the acquisition of important results [9] .…”

Section: Discussionmentioning

confidence: 99%

Intervention Strategies for Improving Patient Adherence to Follow-Up in the Era of Mobile Information Technology: A Systematic Review and Meta-Analysis

Lin

2014

PLoS ONE

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BackgroundPatient adherence to follow-up plays a key role in the medical surveillance of chronic diseases and affects the implementation of clinical research by influencing cost and validity. We previously reported a randomized controlled trial (RCT) on short message service (SMS) reminders, which significantly improved follow-up adherence in pediatric cataract treatment.MethodsRCTs published in English that reported the impact of SMS or telephone reminders on increasing or decreasing the follow-up rate (FUR) were selected from Medline, EMBASE, PubMed, and the Cochrane Library through February 2014. The impacts of SMS and telephone reminders on the FUR of patients were systematically evaluated by meta-analysis and bias was assessed.ResultsWe identified 13 RCTs reporting on 3276 patients with and 3402 patients without SMS reminders and 8 RCTs reporting on 2666 patients with and 3439 patients without telephone reminders. For the SMS reminders, the majority of the studies (>50%) were at low risk of bias, considering adequate sequence generation, allocation concealment, blinding, evaluation of incomplete outcome data, and lack of selective reporting. For the studies on the telephone reminders, only the evaluation of incomplete outcome data accounted for more than 50% of studies being at low risk of bias. The pooled odds ratio (OR) for the improvement of follow-up adherence in the SMS group compared with the control group was 1.76 (95% CI [1.37, 2.26]; P<0.01), and the pooled OR for the improvement of follow-up adherence in the telephone group compared with the control group was 2.09 (95% CI [1.85, 2.36]; P<0.01); both sets showed no evidence of publication bias.ConclusionsSMS and telephone reminders could both significantly improve the FUR. Telephone reminders were more effective but had a higher risk of bias than SMS reminders.

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Section: Discussionmentioning

confidence: 99%

Intervention Strategies for Improving Patient Adherence to Follow-Up in the Era of Mobile Information Technology: A Systematic Review and Meta-Analysis

Lin

2014

PLoS ONE

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“…Noncompliance results from many factors, such as missed medication, failure to refill the prescription, a complicated regimen, problems with memory or vision, postictal confusion, denial of epilepsy and need for medication, fear of teratogenicity, concern about adverse effects of drugs, and cost of drugs. 48 In dealing with problem of noncompliance, Table 2 Causes of pseudoresistance [39][40][41][42][43][44][45] Causes of pseudoresistance in drug refractory epilepsy Management of Refractory Epilepsy Singh et al…”

Section: Ensure Compliancementioning

confidence: 99%

Management of Refractory Epilepsy

Singh

Chakravarty

Baishya

et al. 2020

International Journal of Epilepsy

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Drug refractory epilepsy, defined as a failure of adequate trials of two (or more) tolerated, appropriately chosen, and appropriately used antiepileptic drug (AED) regimens (whether administered as monotherapies or in combination) to achieve freedom from seizures, affects approximately 30% of patients with new-onset epilepsy. Persistent epileptic seizures in these patients, in addition to having deleterious effects on health, are also associated with psychosocial, behavioral, cognitive, and financial consequences. Despite availability of several new drugs, response to therapy remains poor in most of drug refractory cases. Also despite several ongoing treatment trials, ideal combination of AEDs remains to be identified. Careful attention to ruling out alternative diagnoses, optimal selection of AEDs, rational use of combination therapy, as well as attention to patient-specific factors, such as poor compliance and drug abuse, remain cornerstone of therapy. In view of poor response to polytherapy, if possible, surgical intervention should be contemplated early. In future, development of new drugs with better efficacy and tolerability and minimal drug interactions, as well as better nonpharmacological therapeutic techniques, will help in managing these patients better.

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“…Diabetes [7], asthma [8], chronic kidney disease [3], obesity [9], chronic sinusitis [10], cataract [11], and amblyopia [12]. In addition to the treatment effect [13]. AFU can seriously affect clinical research, such as by undermining the internal and external validity of the findings and causing bias, increasing the cost or duration of the trial or delaying important results [14].…”

Section: Introductionmentioning

confidence: 99%

Patient Adherence to Follow-Up in Clinical Research: A Systematic Review of Measurements, Associated Factors and Intervention Strategies

Lin¹

2015

J Clin Res Ophthalmol

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Objectives: A patient's adherence to follow-up (AFU) plays a key role in the implementation of clinical research with respect to cost and validity. Most present studies focus exclusively on some specific steps during clinical research implementation, regardless of the synthetic action of patientsociety-medicine system. The objective of the study is to provide a comprehensive systematic review of the measurements, associated factors and intervention strategies of AFU across a broad spectrum. Methods:A search was performed for studies that reported AFU in English in Medline, EMBASE, PubMed or the Cochrane Library from January 1995 to February 2014. Given the huge variety in study design and multifold complexity, a qualitative systematic review instead of meta-analysis was performed for the measurements, associated factors and intervention strategies of AFU according to Cochrane methodology.Results: A total of 125 included studies identified six measurements of AFU according to different definitions and calculations; the majority of studies used follow-up rate, with calculation methods varying in numerators but with the same denominator. The factors associated with AFU were assigned to 5 major categories, of which "individual patient characteristics" and "research design and practice setting" were most studied, with respect to having the most subcategories (12) and most related studies (76/125) respectively. The most studied type of the 3 major interventions used to improve AFU was information system and interaction improvement (56/99). Conclusions:The number of published studies regarding the measurements, associated factors and intervention strategies of AFU is increasing, which contributes to improving the final quality of clinical research. Individual patient-centered information system and interaction improvement have been gaining most attention, and would be the most important direction of development to improve patient AFU. While, the function of multiaspect environment factors and research design enhancement remain to be noticed.

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Patient Compliance in Medical Practice and Clinical Trials

Cited by 4 publications

References 0 publications

Intervention Strategies for Improving Patient Adherence to Follow-Up in the Era of Mobile Information Technology: A Systematic Review and Meta-Analysis

Intervention Strategies for Improving Patient Adherence to Follow-Up in the Era of Mobile Information Technology: A Systematic Review and Meta-Analysis

Management of Refractory Epilepsy

Patient Adherence to Follow-Up in Clinical Research: A Systematic Review of Measurements, Associated Factors and Intervention Strategies

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