Medication adherence for persons with spinal cord injury and dysfunction from the perspectives of healthcare providers: A qualitative study

Guilcher, Sara J T; Everall, Amanda; Patel, Tejal; Packer, Tanya; Hitzig, Sander L.; Lofters, Aisha

doi:10.1080/10790268.2019.1637644

Cited by 9 publications

(4 citation statements)

References 37 publications

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“…Although acute and long-term secondary complications are more common in SCI patients, chronic complications seriously affect the life health of patients ( 16 ). Thus, the prevention and therapy of chronic secondary complications in SCI patients is of great significance to ameliorate the life quality of suffers.…”

Section: Discussionmentioning

confidence: 99%

Chronic intermittent hypobaric hypoxia ameliorates osteoporosis after spinal cord injury through balancing osteoblast and osteoclast activities in rats

et al. 2023

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IntroductionAs a common complication of spinal cord injury (SCI), most SCI patients suffer from osteoporosis. In our previous study, chronic intermittent hypobaric hypoxia (CIHH) could promote bone fracture healing. We speculated that it may act a role in the progression of osteoporosis. The current study purposed to explore the role of CIHH in the osteoporosis triggered by SCI in rats.MethodsA SCI-induced SCI model was established by completed transection at T9-T10 spinal cord of Wistar rats. One week after SCI, the rats were conducted to CIHH treatment (PB = 404 mmHg, Po2 = 84 mmHg) 6 hours a day for continuously 7 weeks.ResultsThe results of X-radiography and Micro-CT assessment demonstrated that compared with sham rats, the areal bone mineral density (BMD), bone volume to tissue volume, volumetric BMD, trabecular thickness, trabecular number, and trabecular connectivity were decreased. Trabecular bone pattern factor, trabecular separation, as well as structure model index were increased at the distal femur and proximal tibia of SCI rats, which were effectively reversed by CIHH treatment. Histomorphometry showed that CIHH treatment increased bone formation of SCI rats, as evidenced by the increased osteoid formation, the decreased number and surface of TRAP-positive osteoclasts. Furthermore, ELISA and real time PCR results showed that the osteoblastogenesis-related biomarkers, such as procollagen type 1 N-terminal propeptide, osteocalcin in serum, as well as ALP and OPG mRNAs in bone tissue were decreased, while the osteoclastogenesis-related biomarkers, including scleorostin in serum and RANKL and TRAP mRNAs in bone tissue were increased in SCI rats. Importantly, the deviations of aforementioned biomarkers were improved by CIHH treatment. Mechanically, the protective effects of CIHH might be at least partly mediated by hypoxia-inducible factor-1 alpha (HIF-1α) signaling pathway.ConclusionThe present study testified that CIHH treatment ameliorates osteoporosis after SCI by balancing osteoblast and osteoclast activities in rats.

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Section: Discussionmentioning

confidence: 99%

Chronic intermittent hypobaric hypoxia ameliorates osteoporosis after spinal cord injury through balancing osteoblast and osteoclast activities in rats

et al. 2023

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“…Individuals with stroke have reported challenges with their overall medication management, including understanding, medication-taking self-efficacy, and medication burden [17][18][19][20]. Medication self-management can be impacted by patient, provider, and system level factors [21], including, but not limited to, the number of medications prescribed, complexity of medication regimens, receipt of medication education/ instructions, cost, medication-related supports (e.g., pillboxes and blister packs), healthcare provider knowledge, access to interventions, and structure of the healthcare system [4,22,23]. Further to this, a stroke may result in residual deficits that impact an individual's ability to self-manage their medications.…”

Section: Introductionmentioning

confidence: 99%

Medication self-management interventions for persons with stroke: A scoping review

et al. 2023

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The use of multiple medications is common following a stroke for secondary prevention and management of co-occurring chronic conditions. Given the use of multiple medications post-stroke, optimizing medication self-management for this population is important. The objective of this scoping review was to identify and summarize what has been reported in the literature on interventions related to medication self-management for adults (aged 18+) with stroke. Electronic databases (Ovid Medline, Ovid Embase, EBSCO CINAHL, Ovid PsycINFO, Web of Science) and grey literature were searched to identify relevant articles. For inclusion, articles were required to include an adult population with stroke undergoing an intervention aimed at modifying or improving medication management that incorporated a component of self-management. Two independent reviewers screened the articles for inclusion. Data were extracted and summarized using descriptive content analysis. Of the 56 articles that met the inclusion criteria, the focus of most interventions was on improvement of secondary stroke prevention through risk factor management and lifestyle modifications. The majority of studies included medication self-management as a component of a broader intervention. Most interventions used both face-to-face interactions and technology for delivery. Behavioural outcomes, specifically medication adherence, were the most commonly targeted outcomes across the interventions. However, the majority of interventions did not specifically or holistically target medication self-management. There is an opportunity to better support medication self-management post-stroke by ensuring interventions are delivered across sectors or in the community, developing an understanding of the optimal frequency and duration of delivery, and qualitatively exploring experiences with the interventions to ensure ongoing improvement.

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“…Less than 1% of individuals with severe SCI experience full neurological recovery. Moreover, SCI can have chronic implications with constant management and lifestyle readjustments [ 1 , 2 ]. There is currently no effective FDA-approved treatment for SCI; therapies are largely directed toward management of motor impairments and associated symptoms.…”

Section: Introductionmentioning

confidence: 99%

The Pathophysiology of Osteoporosis after Spinal Cord Injury

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Drasites

Zaman

et al. 2021

IJMS

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Spinal cord injury (SCI) affects approximately 300,000 people in the United States. Most individuals who sustain severe SCI also develop subsequent osteoporosis. However, beyond immobilization-related lack of long bone loading, multiple mechanisms of SCI-related bone density loss are incompletely understood. Recent findings suggest neuronal impairment and disability may lead to an upregulation of receptor activator of nuclear factor-κB ligand (RANKL), which promotes bone resorption. Disruption of Wnt signaling and dysregulation of RANKL may also contribute to the pathogenesis of SCI-related osteoporosis. Estrogenic effects may protect bones from resorption by decreasing the upregulation of RANKL. This review will discuss the current proposed physiological and cellular mechanisms explaining osteoporosis associated with SCI. In addition, we will discuss emerging pharmacological and physiological treatment strategies, including the promising effects of estrogen on cellular protection.

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Medication adherence for persons with spinal cord injury and dysfunction from the perspectives of healthcare providers: A qualitative study

Cited by 9 publications

References 37 publications

Chronic intermittent hypobaric hypoxia ameliorates osteoporosis after spinal cord injury through balancing osteoblast and osteoclast activities in rats

Chronic intermittent hypobaric hypoxia ameliorates osteoporosis after spinal cord injury through balancing osteoblast and osteoclast activities in rats

Medication self-management interventions for persons with stroke: A scoping review

The Pathophysiology of Osteoporosis after Spinal Cord Injury

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