1.Effects of the distribution of product samples to patients and physicians by pharmaceutical companies
Frances Lois U. Ngo ; Monet M. Loquias ; Mac Ardy J. Gloria
Philippine Journal of Health Research and Development 2022;26(3):63-72
Background:
Distribution of product samples is a typical and traditional marketing and promotion strategy used by pharmaceutical companies. However, issues have been raised about their influence on physicians' prescribing behavior and patients' health outcomes.
Objectives:
This study aimed to determine the effects of the distribution of product samples on physicians' prescribing behavior and adherence to patients' treatment regimens. It also sought to provide policy recommendations on product sample distribution and the administrative order on pharmaceutical promotion.
Methodology:
The study involved a descriptive design. The study sites were Manila City, Cebu City, and Davao City. Data were collected using focus group discussions, key informant interviews, and surveys among patients and physicians. Content analysis was performed to analyze qualitative data, while descriptive statistics and measures of association were conducted to analyze quantitative data.
Results:
A total of four FGDs were conducted with one FGD for each stakeholder group, and 846 patients and 286 physicians answered the study questionnaire. About half (48.0%) of the patients received product samples; 75.8% had low medication adherence. Product sample distribution was not significantly associated with patients' adherence (p=0.150). The majority of the physicians (69.2%) received product samples. There was no significant association between product sample distribution and physicians' prescribing behavior (p=0.111). It was found, however, that the distribution of product samples was significantly associated with the other physicians' prescribing behavior (p=0.009). The issues identified included the influence of medical representatives on physicians' prescribing behavior, incapacity of the poor and marginalized population to complete their treatment regimen due to lack of supply of product samples, and mentality of patients that product samples have better quality.
Conclusion
This study emphasized that the regulation of product sample distribution was justifiable since this might negatively influence professional behavior affecting rational prescribing and the use of medicines. Furthermore, the distribution of product samples did not directly translate to increased patients' medication adherence. Should the distribution of samples be continuously practiced, the provision of product samples should be strictly followed, and the distribution should be regulated and monitored to prevent the occurrence
of violative practices.
Medication Adherence
2.Effect of SMS reminders to medication adherence among hypertensives in an outpatient clinic: A 12-week two-arm, parallel group randomized clinical trial.
Penny Joy H. Barbadillo ; Yahya-Mar M. Alip ; Hans Mathew Lua
The Filipino Family Physician 2024;62(1):67-78
BACKGROUND
There has been a growing prevalence of hypertension and its associated diseases. Medication adherence is one of the primary factors of uncontrolled blood pressure in patients and non-adherence to medication can result in morbidity and mortality for the patient and increased financial strain on the healthcare system. With the wide availability of mobile phones, using short messaging system (SMS) reminders as an intervention has shown promising results in improving medication adherence. The present study aims to see if SMS reminders can help improve medication adherence among hypertensive patients seen in the out-patient department.
OBJECTIVETo determine the effect of short messaging system reminders on the medication adherence among hypertensive patients seen in the outpatient department of Cebu South Medical Center (CSMC) in a 12-week trial period.
METHODSThis was a two-arm parallel group, double blind, randomized clinical trial using short text messaging reminder to hypertensive patients conducted last October 4, 2023 to December 27, 2023 at CSMC Outpatient Clinic under Family Medicine Service. A two-part questionnaire composed of baseline clinical variables and the Hill-bone Medication Adherence Scale (HBMAS) (Kim, et al 2000) was utilized pre- and post-intervention. STATA Software was used to analyze the date with intention to treat analysis. Descriptive statistics was computed for dichotomous variables while continuous variables were expressed as means and measured before and after intervention. The mean HB-MAS scores pre intervention and post-intervention per group were compared using the Wilcoxon signed rank test, while scores between intervention and control groups pre- and post-intervention were analyzed using the Wilcoxon rank-sum test with 95% confidence intervals (CIs), with two-sided p values reported and statistical significance set up at p < 0.05.
RESULTSA total of 102 patients were enrolled in the study (51 in intervention group and 51 in control group) with no dropouts. There was no significant difference between the baseline and post intervention medication adherence scores in both the intervention and control groups, however, there was a significant difference of the scores between the intervention and control groups post intervention (p = 0.001). There was also noted improvement of the blood pressure among participants in the intervention group, with lower blood pressures post-intervention on average (120/80 mmHg) compared to baseline (130/90 mmHg), while participants in the control group still exhibited high blood pressure (130/90 mmHg) post-intervention.
CONCLUSIONGiven the widespread availability of mobile devices and the increased awareness generated by social media, it may be easier to put interventions in place that improve drug adherence. Through the use of easily accessible technology, this study helps patients remember to take their prescription by offering straightforward reminders that can help them overcome these obstacles to medication adherence.
Medication Adherence
3.Medication Adherence in Korean Hypertensive Patients.
Korean Journal of Family Medicine 2018;39(6):323-324
No abstract available.
Humans
;
Medication Adherence*
4.Severity and factors associated with depressive symptoms among type 2 diabetic patients in Vietnam
Kien Tran Nguyen ; Hoa Phuong Nguyen ; Kris Van den Broeck ; Johan Wens
Journal of the ASEAN Federation of Endocrine Societies 2023;38(2):28-34
Background:
Diabetes and psychiatric disorders often co-occur. The prevalence of depression in a person with diabetes is two times higher than that of the general population. During the last decade, the prevalence of diabetes in Vietnam has nearly doubled. However, there is little data regarding depressive symptoms among people with diabetes. Therefore, this study aims to explore the level of depressive symptoms and its associated factors among patients with type 2 diabetes mellitus in Hanoi, Vietnam.
Methodology:
A cross-sectional study was conducted among 519 patients diagnosed with type 2 diabetes at the Agricultural General Hospital, one of the largest primary care hospitals for diabetes in Hanoi, Vietnam. Patient Health Questionnaire-9 (PHQ-9) was used to assess the severity of depressive symptoms. Multivariate Tobit and logistic regression models were applied to examine factors associated with the severity of depressive symptoms and medication adherence
Results:
Approximately 45.2% of participants were identified as having depressive symptoms at different levels. The proportion of patients with mild, moderate, moderately severe, and severe depressive symptoms is 36.0%, 7.6%, 1.4%, and 0.2% respectively. Regarding the treatment process, patients being treated for their diabetes for a longer time were more likely to have depressive symptoms. DDepression was positively linked to currently drinking alcohol (Coef = 1.04;
95% CI = 0.30-1.78), having comorbidities (Coef = 1.08; 95% CI = 0.15; 2.01) and having irregular physical activities (Coef = -1.28; 95% CI = -2.18; -0.38). Patients with severe depressive symptoms (higher PHQ-9 score) were more likely to be non-adherent to their medications in the last month (AOR = 1.30; 95% CI = 1.17; 1.46).
Conclusion
Our study shows that a high percentage of patients with diabetes have depressive symptoms. There is a strong association between having depressive symptoms and non-adherence to medications in the last month. To reduce the risk of developing depressive symptoms, depression should be screened at the initial treatment process and patients should be advised to avoid alcohol and to engage in physical activities regularly.
Depression
;
Medication Adherence
;
Vietnam
5.Level of medication adherence among chronic hypertensive adults seen at the outpatient clinics of Cebu South Medical Center from June to September 2023: A cross-sectional study.
Karen Bea E. Dalena ; May Mary S. Intong-Napigkit
The Filipino Family Physician 2024;62(1):79-84
BACKGROUND
Hypertension is one of the top causes of death globally. Among Filipinos with hypertension, only 27% have their condition under control with treatment.
OBJECTIVETo determine the level of medication adherence of chronic hypertensive adult patients in Cebu South Medical Center.
METHODSDescriptive cross-sectional study, conducted at Cebu South Medical Center from June to September 2023, to 63 participants via complete enumeration using a validated two-part questionnaire that asked for patient demographics and the Hill-Bone Medication Adherence Scale adapted into Bisaya. Descriptive statistics were used.
RESULTSOut of the sixty-three (63) patients who participated in the study, there were only nine adherent respondents (30%), while the remaining majority (70%) were non adherent. The demographics showed that education and occupational background were likely to affect medication adherence. Gender had no significant effect on the level of medication adherence.
CONCLUSIONMedication non-adherence is common and prevalent among adults with chronic hypertension seen in Cebu South Medical Center. Education and occupational background affect non-adherence. Together with Local Government Units promotion of proper education on disease process and proper implementation of medical adherence, strengthening medication assistance and guidance for income-generating activities could improve adherence.
Hypertension ; Medication Adherence
6.The Relevant Intervention Strategies for Improving Medication Adherence of Diabetic Patients
Cliffton Akoi ; Md. Mizanur Rahman ; Mohd Syafiq Abdullah
International Journal of Public Health Research 2013;3(1):236-240
Medication adherence is very important for the effective treatment or control of various health problems, including chronic disease like diabetes mellitus (DM). However, medication non-adherence among diabetic patients on follow-up treatment is still a global health problem. This study aimed to identify factors associated with medication adherence and to determine methods on how it could be improved. A cross-sectional study was conducted on medication adherence among Malays, Iban and Melanau ethnic groups in Kota Samarahan and Sarikei, Sarawak using the Health Belief Model framework. Interviews with questionnaires, which were tested for its validity and reliability using the Cronbach’s Alpha, were conducted to collect data on the respondent’s socio-demographic and economic characteristics, and health beliefs of 442 respondents. Data was analyzed using SPSS version 17.0 for frequency distribution, measures of central tendencies, significance testing and logistic regression. The medication adherence rates were low in terms of all the treatment indicators such as amount of medication (31.7%), frequency (38.9%), duration (26%), and follow-up treatment (24.2%). The respondent’s socio-economic and economic characteristics have statistically significant association with medication adherence. The respondents adhered towards medication because they believed in its benefits. They also took their medication because they believed in the severity of DM and their susceptibility to its serious complications. The cues to action (medication taking) such as worrying about their socio-economic well-being, effectiveness of medication, and health campaign on diabetic control have influenced medication adherence. However, forgetfulness, distance of clinic, and costs of transport have caused medication non-adherence. The respondent’s health beliefs in the benefits of taking medication, perceived severity and susceptibility to DM and its serious complications have contributed towards medication adherence. Their concerns about the socio-economic well-being, effectiveness of medication, and health campaign on diabetic control were positive cues to medication taking behavior. Therefore, modifying the respondent’s related health beliefs and reinforcing the positive cues to actions are the relevant intervention strategies that could be used in improving medication adherence among diabetic patients.
Diabetes Mellitus
;
Medication Adherence
;
Malaysia
7.Medication adherence of persons with Type 2 Diabetes in Malaysia: A scoping review and meta-analysis
Cheong Lieng Teng ; Chun Wai Chan ; Pei Se Wong
Journal of the ASEAN Federation of Endocrine Societies 2022;37(1):75-82
Objective:
This is a scoping review of Malaysian scientific studies on medication adherence among persons with type 2 diabetes mellitus (T2DM).
Methodology:
We conducted a bibliographic search of PubMed, Scopus and Google Scholar using the following keywords: “medication adherence,” “drug compliance,” “DMTAC” and “Malaysia.” The search covered all publications up to 31 December 2021. Eligible articles were original studies conducted in Malaysia that measured or quantified medication adherence among persons with T2DM.
Results:
We identified 64 eligible studies published between 2008 to 2021. Most studies included patients with T2DM in ambulatory facilities. Five studies were qualitative research. The quantitative research publications included clinical trials, and cross-sectional, validation, retrospective and prospective cohort studies. Thirty-eight studies used medication adherence scales. The Morisky Medication Adherence Scale (MMAS-8, used in 20 studies) and Malaysian Medication Adherence Scale (MALMAS, used in 6 studies) were the most commonly used tools. There were 6 validation studies with 4 medication adherence scales. A meta-analysis of 10 studies using MMAS-8 or MALMAS revealed that the pooled prevalence of low medication adherence is 34.2% (95% CI: 27.4 to 41.2, random effects model). Eighteen publications evaluated various aspects of the Diabetes Medication Therapy Adherence Clinics (DMTAC).
Conclusion
This scoping review documented extensive research on medication adherence among persons with diabetes in Malaysia. The quantitative meta-analysis showed a pooled low medication adherence rate.
Diabetes Mellitus
;
Medication Adherence
;
Malaysia
8.Illness perception of patients with Type 2 Diabetes Mellitus in Veterans Memorial Medical Center - Out-Patient Department and their influence on medication adherence
Michel Katrina DJ. Tolentino ; Angeli Rosette Emperado-Uy
The Filipino Family Physician 2021;59(2):314-321
Background:
Medication adherence is important in attaining good glycemic control in diabetic patients. Low medication adherence is more prevalent in developing countries like the Philippines. Understanding patients’ perceptions and health beliefs is a strategy to improve health care practitioners’ approach for better medication adherence.
Objective:
This aims to determine illness perception of Type 2 Diabetes Mellitus patients using the Revised Illness Perception Questionnaire on Diabetes Mellitus(IPQ-R) and its influ ence on medication adherence using the Four-item Morisky Green Levine Medication Adherence Scale(MGLS) and a calendar for tracking patients’ diabetes medication intake.
Methods:
This was conducted at Veterans Memorial Medical Center Outpatient Department. Data was collected between December 2018 - October 2019 with 311 participants. A self-administered questionnaire for sociodemographic profile, Revised Illness Perception Questionnaire on Diabetes Mellitus (IPQ-R), a calendar for tracking patients’ diabetes medication intake, and Four-item Morisky Green Levine Medication Adherence Scale (MGLS) were used.
Results:
Patients had low Identity perception, indicating they attributed few symptoms to diabetes. They had moderate Timeline perception of diabetes as a chronic illness with an unstable cyclical course. High perception was noted in Illness Coherence, Treatment Control and Personal Control. Moderate perception was demonstrated in Consequences and Emotional Representations. Participants identified diet, hereditary, stress, own behavior and aging as Top 5 causes of diabetes. Majority had medium adherence, followed by high and low adherence levels. Medication adherence was significantly associated with income, and IPQ- R categories of Personal Control, Treatment Control, Emotional Representations and Illness Coherence.
Conclusion
Those with perceived control of their illness, better understanding, belief in efficacy of medications, distressing experiences and higher financial capabilities have better medication adherence. Health care practitioners may assess illness perceptions of diabetics, enhancing programs and improving patient-physician communication in guiding coping behaviors through patient education resulting to improved glycemic control.
Diabetes Mellitus
;
Medication Adherence
;
Outpatients
9.Barriers to adherence of maintenance medication intake among hypertensive and diabetic patients seen at the out-patient clinic of the Department of Family Medicine-East Avenue Medical Center
Digna Cuarteros-Felix ; Marie Ruth A. Echavez
The Filipino Family Physician 2020;58(1):71-78
Background:
The treatment of chronic illnesses commonly includes the long-term use of pharmacotherapy. Almost half of patients do not enjoy the full benefits of treatment because of poor adherence. The Universal Health Care Act advocates actively improving the health literacy, of every Filipino, motivating them to strictly adhere to the recommended treatment
Objective:
This study aimed to determine the barriers to adherence of maintenance medication intake among hypertensive and diabetic patients in the outpatient clinic setting
Methods:
A cross sectional study design, using the Morisky Medication Adherence Scale (MMAS-8) consisting of 8 questions, with a Cronbach alpha of 0.83 (Highly reliable). Simple random sampling was used for sampling
Results:
Out of 90 patients, 54 (60.0%) patients were adherent with their medications, while 36 (40.0%) were non-adherent. Collected social demographic profiles were analyzed to determine the barriers to the medication adherence
Conclusion
Forgetfulness, missing medication intake because they feel worse, or because they already feel fine are the identified barriers to adherence to maintenance medication intake among hypertensive and diabetic patients in the outpatient clinic setting. In this monocentric study, the focus was mainly on patient-related factors contributing to non-adherence. Future researches should assess also the Physician and the Health system related factors
Medication Adherence
;
Hypertension
;
Diabetes Mellitus
10.The Filipino adaptation of the glaucoma medication adherence self-efficacy questionnaire
Ian Ben M. Batcagan ; Nilo Vincent dG. FlorCruz II
Philippine Journal of Ophthalmology 2022;47(2):76-81
Objectives:
This study translated the Glaucoma Medication Adherence Self-Efficacy Questionnaire
(GMASQ) and tested the reliability of Filipino-adapted GMASQ.
Methods:
A Filipino-adapted GMASQ was developed using the guidelines recommended for translating a
validated health-related questionnaire into a culturally-adapted one. The methods included: (1) forward
translation, (2) back-translation, (3) review and modification, (4) pre-testing and cognitive interviewing, and (5)
final version testing. The provisional questionnaire was pre-tested on 20 glaucoma patients to determine its
value and correspondence, generating a final forward questionnaire. The final version was administered to 48
patients. Its reliability was determined by computing for the Cronbach’s α for each item, per section, and overall.
An item was removed if the α was <0.7.
Results:
Eleven (11) pre-test subjects (55%) preferred the Filipino-adapted questionnaire, 6 (20%) had no
preference, and 3 (25%) preferred the source questionnaire. The provisional Filipino-adapted GMASQ proved
to be acceptable and with no changes made, the questionnaire was marked as the final version. The medication
adherence self-efficacy scale showed Cronbach’s α of > 0.8 for all items with a section α = 0.84. The eye-drop
technique had an α > 0.7 for each item and a section α = 0.80.
Conclusion
This study provided preliminary evidence of the feasibility, acceptance and reliability of the
Filipino GMASQ.
Glaucoma
;
Medication Adherence
;
Surveys and Questionnaires