Nonadherence to medications is a significant reason why patients fail to control their blood pressure. Little work has been attempted to conceptualize medication-taking behaviors from the patient's perspective. This study examined factors that influence elderly hypertensive patients' adherence or nonadherence to prescribed medications. Using a qualitative descriptive research design, 21 hypertensive elderly people were interviewed. Two domains of adherence were identified: purposeful use of the medication for the control of patient's blood pressure and establishing and maintaining patterns of medication-taking. Two similar domains also emerged for nonadherence: purposeful and incidental. Adherence behaviors were dependent on the person's decision to take hypertension medication, access to medications, and ability to initiate treatment and maintain a medication-taking pattern. The timing and location of pills were integral parts of establishing patterns of taking medications. Inadequate access to medications or interruption of a person's pattern were associated with the incidental missing of medications.
Objectives The aim of Working Group 3 was to focus on three topics that were assessed using patient‐reported outcome measures (PROMs). These topics included the following: (a) the aesthetics of tooth and implant‐supported fixed dental prostheses focusing on partially edentulous patients, (b) a comparison of fixed and removable implant‐retained prostheses for edentulous populations, and (c) immediate versus early/conventional loading of immediately placed implants in partially edentate patients. PROMs include ratings of satisfaction and oral health‐related quality of life (QHRQoL), as well as other indicators, that is, pain, general health‐related quality of life (e.g., SF‐36). Materials and methods The Consensus Conference Group 3 participants discussed the findings of the three systematic review manuscripts. Following comprehensive discussions, participants developed consensus statements and recommendations that were then discussed in larger plenary sessions. Following this, any necessary modifications were made and approved. Results Patients were very satisfied with the aesthetics of implant‐supported fixed dental prostheses and the surrounding mucosa. Implant neck design, restorative material, or use of a provisional restoration did not influence patients’ ratings. Edentulous patients highly rate both removable and fixed implant‐supported prostheses. However, they rate their ability to maintain their oral hygiene significantly higher with the removable prosthesis. Both immediate provisionalization and conventional loading receive positive patient‐reported outcomes. Conclusions Patient‐reported outcome measures should be gathered in every clinical study in which the outcomes of oral rehabilitation with dental implants are investigated. PROMs, such as patients’ satisfaction and QHRQoL, should supplement other clinical parameters in our clinical definition of success.
Practitioners can play a pivotal role in screening clients for these factors and recommending treatment to increase the likelihood of successful weight loss maintenance.
Purpose To systematically review the evidence related to the efficacy and tolerability of selective serotonin reuptake inhibitors (SSRIs) and serotonin/norepinephrine reuptake inhibitors (SNRIs) used for the treatment of vasomotor symptoms in perimenopausal and postmenopausal women. Data sources Medline, CINAHL, and the Cochrane Library databases were searched to identify randomized controlled trials (RCTs). Eighteen trials met the criteria for review. Conclusions Results from these trials indicate that paroxetine, citalopram, escitalopram, venlafaxine, and desvenlafaxine are effective in reducing the frequency and severity of hot flashes. Fluoxetine and sertraline appear to be less effective and should be considered second‐line options for treatment. Implications for practice The SSRIs and SNRIs can reduce hot flashes by 65% and begin working within the first week. Patient response is variable and if one drug does not improve hot flashes, another can be tried after a 1‐ to 2‐week drug trial. Paroxetine, citalopram, and escitalopram appear to have the fewest adverse effects. Considering cost, paroxetine and citalopram are the most cost‐efficient.
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