Improving Adherence Persistence: A Review Assessment of Interventions Description of Steps Toward a National Adherence Initiative

Krueger, Kem P.; Felkey, Bill G.; Berger, Bruce A.

doi:10.1331/154434503322642598

Cited by 102 publications

(76 citation statements)

References 49 publications

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“…Written and oral education (on the disease, management algorithm and medications) has been shown to increase adherence by approximately 6%-25% [33] . Written information is more effective when verbally reinforced.…”

Section: Strategies To Improve Adherencementioning

confidence: 99%

Prevalence, predictors, and clinical consequences of medical adherence in IBD: How to improve it?

Lakatos¹

2009

WJG

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Inflammatory bowel diseases (IBD) are chronic diseases with a relapsing-remitting disease course necessitating lifelong treatment. However, non-adherence has been reported in over 40% of patients, especially those in remission taking maintenance therapies for IBD. The economical impact of non-adherence to medical therapy including absenteeism, hospitalization risk, and the health care costs in chronic conditions, is enormous. The causes of medication non-adherence are complex, where the patient-doctor relationship, treatment regimen, and other disease-related factors play key roles. Moreover, subjective assessment might underestimate adherence. Poor adherence may result in more frequent relapses, a disabling disease course, in ulcerative colitis, and an increased risk for colorectal cancer. Improving medication adherence in patients is an important challenge for physicians. Understanding the different patient types, the reasons given by patients for non-adherence, simpler and more convenient dosage regimens, dynamic communication within the health care team, a self-management package incorporating enhanced patient education and physician-patient interaction, and identifying the predictors of nonadherence will help devise suitable plans to optimize patient adherence. This editorial summarizes the available literature on frequency, predictors, clinical consequences, and strategies for improving medical adherence in patients with IBD.

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Section: Strategies To Improve Adherencementioning

confidence: 99%

Prevalence, predictors, and clinical consequences of medical adherence in IBD: How to improve it?

Lakatos¹

2009

WJG

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“…Based on these findings, we have taken steps within our disease management program to have case managers assess medication adherence and potential barriers when clinical goals are not being reached. The barriers now monitored and addressed include patient knowledge and perception of therapy benefit (26,29).…”

Section: Mpr and Ldl Cholesterol Goal Attainmentmentioning

confidence: 99%

Adherence to Statin Therapy and LDL Cholesterol Goal Attainment by Patients With Diabetes and Dyslipidemia

et al. 2005

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OBJECTIVE -The purpose of this study was to assess the relationship between adherence to statin therapy and LDL cholesterol goal achievement in patients with diabetes and dyslipidemia.RESEARCH DESIGN AND METHODS -The records of patients being medically treated for dyslipidemia in a managed care diabetes program from January 2001 to December 2002 were used to assess LDL cholesterol goal attainment (Ͻ100 mg/dl) and to compute a 9-month medication possession ratio (percentage of days when medication was available [MPR], beginning with the first prescription in the database).RESULTS -A total of 653 patient records was analyzed. The average MPR was significantly higher for men than for women (0.75 vs. 0.66, P Ͻ 0.05). Overall, 44% (n ϭ 290) of the patients achieved an LDL cholesterol level Ͻ100 mg/dl (52% of men and 37% of women, P Ͻ 0.05). A significant correlation emerged between MPR and plasma LDL cholesterol (P Ͻ 0.001), and MPR was significantly higher in patients who achieved the LDL cholesterol target than in those who did not (0.82 vs. 0.61, P Ͻ 0.05).CONCLUSIONS -Although statins are highly effective for decreasing LDL cholesterol levels in patients with dyslipidemia, including those with diabetes, failure to reach LDL cholesterol targets remains common. Adherence to statin therapy, as reflected by MPR, is closely related to LDL cholesterol goal attainment in patients with diabetes and dyslipidemia. The probability of goal achievement appears to increase substantially when the MPR is Ͼ0.80. Pharmacy records can be used to identify patients who are poorly compliant with statin therapy and at high risk for failure to attain LDL cholesterol goals. Because outcomes are directly related to patients' medication-taking behavior, when clinical goals (such as serum cholesterol levels) are not being reached, adherence should be the first item assessed by the clinician. Diabetes Care 28:595-599, 2005

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“…Therefore, this subpopulation is considered a target for optimization of MA policies [8]. Different kinds of interventions have been tested to improve patient adherence, ranging from simple adjustments in the medication regimen to complex multidisciplinary interventions [9][10][11][12][13]. However, interventions to improve medication compliance for chronic conditions appear to be less effective and a combination of multifaceted interventions is considered the most effective strategy [14].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of motivational interviewing to improve therapeutic adherence in patients over 65 years old with chronic diseases: A cluster randomized clinical trial in primary care

Moral

Torres

Ortega

et al. 2015

Patient Education and Counseling

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Please cite this article as: Moral RR, Torres LAP, Ortega LP, Larumbe MC, Villalobos AR, García JAF, Rejano JMP, Effectiveness of motivational interviewing to improve therapeutic adherence in patients over 65 years old with chronic diseases: A cluster randomized clinical trial in primary care, Patient Education and Counseling (2015), http://dx.doi.org/10. 1016/j.pec.2015.03.008 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Page 1 of 28A c c e p t e d M a n u s c r i p t 1 1  The most common intervention used by doctors is to prescribe drugs.  Related to this is the problem of poor medication adherence.  Motivational Interviewing, is an interview style designed to promote behavioural changes.  Motivational Interviewing is a patient-centered methods that can be used to improve medication adherence en primary care.Page 2 proportion of subjects changing to adherence was 7.6% higher in the EG (p<0.001).Therapeutic adherence was higher for patients in the EG (OR=2.84), women (OR=0.24) and those with high educational levels (OR=3.93). Conclusion:A face-to-face motivational approach in primary care helps elderly patients with chronic diseases who are being treated by polypharmacy to achieve an improved level of treatment adherence than traditional strategies of providing information and advice.Practice Implications: MI is a patient-centered approach that can be used to improve medication adherence in primary care. Trial RegistrationThis trial is registered at ClinicalTrials.gov (NCT01291966).

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Improving Adherence Persistence: A Review Assessment of Interventions Description of Steps Toward a National Adherence Initiative

Cited by 102 publications

References 49 publications

Prevalence, predictors, and clinical consequences of medical adherence in IBD: How to improve it?

Prevalence, predictors, and clinical consequences of medical adherence in IBD: How to improve it?

Adherence to Statin Therapy and LDL Cholesterol Goal Attainment by Patients With Diabetes and Dyslipidemia

Effectiveness of motivational interviewing to improve therapeutic adherence in patients over 65 years old with chronic diseases: A cluster randomized clinical trial in primary care

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