BACKGROUND: Although bisphosphonate is effective for the prevention and treatment of osteoporosis, poor medication compliance is a key-limiting factor. We determined whether alarm clock could improve compliance with weekly bisphosphonate in patients with osteoporosis, by comparing with age- and gender-matched control group. METHODS: Fifty patients with osteoporosis were recruited and participated in alarm clock group. Patients were asked to take orally weekly risedronate for 1 year, and received alarm clock to inform the time of taking oral bisphosphonate weekly. Using the propensity score matching with age and gender, 50 patients were identified from patients with osteoporosis medication. We compared the compliance with bisphosphonate using medication possession ratio (MPR) between two groups. RESULTS: Although there was no significant difference of baseline characteristics between both groups, the mean MPR (0.80±0.33) of alarm clock group was higher than that (0.56±0.34) of control group (P<0.001). CONCLUSIONS: Alarming could improve the compliance with weekly oral bisphosphonate in patients with osteoporosis.
Compliance* ; Humans ; Medication Adherence ; Osteoporosis* ; Patient Compliance ; Propensity Score ; Risedronate Sodium

"All-causes discontinuation" refers to discontinuation of treatment for any reason, and medication adherence is an important component of this measure. Similar to our previous results, we found that almost 30% of patients with first-episode psychosis (FEP) discontinue medication in the first 9 months of treatment, a finding that has important implications for long-term outcomes. Many newer second-generation antipsychotics have not been studied in FEP. The self-reported Drug Attitude Inventory may help identify patients at heightened risk for medication discontinuation. In addition to vigilant monitoring for and adequate treatment of psychopathology and medication side effects, Relapse Prevention Therapy and the use of long-acting injectable agents may be effective interventions decrease discontinuation rates in FEP. There is currently no consensus on how long a patient should remain on an antipsychotic medication following remission of FEP. Studies are needed to identify predictors of which patients in remission from FEP are less likely to relapse when medication is discontinued. Taken together, our findings presented here underscore the importance of addressing medication discontinuation both as a means of preventing long-term morbidity and enhancing remission and functional recovery in FEP.
Antipsychotic Agents ; Consensus ; Humans ; Medication Adherence ; Patient Compliance ; Polytetrafluoroethylene ; Psychopathology ; Psychotic Disorders ; Recurrence ; Schizophrenia

OBJECTIVETo study the relationship between compliance with anti-hypertension therapy and assessment of quality of health care in hypertensive patients in community.

METHODSAccording to multi-stage cluster random sampling, we selected two communities from 36 streets in certain areas of Shanghai respectively using random number method on May, 2013, 72 communities in total, then we randomly selected 25 patients who were archived in the community health center from each community of the street.We conducted 1 800 questionnaires in total in which 1 172 patients were under medication study. The Morisky Medication Adherence Scale was used to evaluate medication compliance while the Patient Assessment of Chronic Illness Care Scale was applied to measuring the quality of patient's self-reported health service. The Spearman rank correlation analysis was used to evaluate the relationship between assessment of quality of health care for chronic illness and compliance with anti-hypertension therapy. Binary logistic analysis was applied to evaluate the factors which influenced patient's medicine compliance.

RESULTSThere were 567(48.4%) respondents with good compliance. Age less than or equal to 65 accounted for 43.3% (245 people) while age greater than 65 accounted for 56.7% (321 people). The average scores of total and difference dimensions remained at a low level, ranging from 1.97 to 2.67 out of 5. The Assessment of quality of health care score was (2.67 ± 1.33)scores, in which the highest score of the dimensions was patient activation which was (2.56 ± 1.41)scores and the lowest was follow-up / collaboration which was (1.97 ± 1.49)scores. The Spearman rank correlation analysis showed that negative association between accumulate points of patient medicine compliance and patient activation was found (rs = -0.09, P < 0.01). The result of binary logistic analysis indicated that medication adherence of age greater than 65 was 1.49 times (95%CI: 1.11-2.00) higher than age less than or equal to 65. The patient activation was a protective factors of good medicine adherence (OR = 1.35, 95%CI:1.14-1.59).

CONCLUSIONSThe medicine adherence of hypertension patients in community medication compliance is not very good at the moment. The self-rated quality of health care is still relative poor. Positive activation from interaction of physicians and patients can help enhancing patient's medicine compliance.

OBJECTIVES: Heart failure (HF) is a progressive syndrome that marks the end-stage of heart diseases, and it has a high mortality rate and significant cost burden. In particular, non-adherence of medication in HF patients may result in serious consequences such as hospital readmission and death. This study aims to identify predictors of medication adherence in HF patients. In this work, we applied a Support Vector Machine (SVM), a machine-learning method useful for data classification. METHODS: Data about medication adherence were collected from patients at a university hospital through self-reported questionnaire. The data included 11 variables of 76 patients with HF. Mathematical simulations were conducted in order to develop a SVM model for the identification of variables that would best predict medication adherence. To evaluate the robustness of the estimates made with the SVM models, leave-one-out cross-validation (LOOCV) was conducted on the data set. RESULTS: The two models that best classified medication adherence in the HF patients were: one with five predictors (gender, daily frequency of medication, medication knowledge, New York Heart Association [NYHA] functional class, spouse) and the other with seven predictors (age, education, monthly income, ejection fraction, Mini-Mental Status Examination-Korean [MMSE-K], medication knowledge, NYHA functional class). The highest detection accuracy was 77.63%. CONCLUSIONS: SVM modeling is a promising classification approach for predicting medication adherence in HF patients. This predictive model helps stratify the patients so that evidence-based decisions can be made and patients managed appropriately. Further, this approach should be further explored in other complex diseases using other common variables.
Heart ; Heart Diseases ; Heart Failure ; Humans ; Medication Adherence ; New York ; Patient Compliance ; Patient Readmission ; Support Vector Machine ; Surveys and Questionnaires

PURPOSE: Alfuzosin XL (Sanofi-Aventis, UroXatral(R)) has to be taken just after a meal for the best efficacy due to its specific pharmacokinetics. We studied patient compliance and associated factors with regard to the correct instructions for taking alfuzosin XL. MATERIALS AND METHODS: Alfuzosin XL was prescribed to 62 patients from February to May 2008. At the first visit, we provided a prescription for alfuzosin XL with the instructions to "take one tablet just after dinner once a day". At the second visit, we evaluated patient compliance and the factors that influenced the patient compliance for taking the alfuzosin XL. The physician explained the instructions to the patients. At the third visit, we compared the compliance and associated factors with the results from the first visit. RESULTS: A total of 50 patients completed the study. After the first visit, twenty one patients (42.0%) were not taking the alfuzosin XL according to the prescription, that is, 20 patients took alfuzosin XL before going to bed, and one patient before meals. (p<0.05) After direct instructions by a physician, 49 patients (98.0%) took the alfuzosin XL correctly. (p<0.001) CONCLUSIONS: Taking alfuzosin XL as prescribed was accomplished in only 58% of patients. When alfuzosin XL is prescribed, the physicians should be aware of the importance of providing instructions directly to patients.
Compliance ; Humans ; Meals ; Patient Compliance ; Prescriptions ; Quinazolines

Background: There has been an increasing trend in reported sexual abuse patients in the Philippines in the past 20 years. Patient evaluation is critical from health care providers and it is imperative to have an acute care protocol that heath care providers can use in managing these patients. Objective: To assess the adherence to the acute care protocol as applied to adult female sexual abuse patients who consulted at the Philippine General Hospital OB Admitting Section from March to August 2019 Methods: The study design used was an observational, cross-sectional study via descriptive analysis using a designed questionnaire. Relevant data regarding compliance to the acute care protocol was assessed from patient experience via the questionnaire after undergoing the standard services of the hospital. Data was then documented, tabulated and processed via Microsoft Excel data sheets. Results: In terms of patient perspective, 96.2 % of all cases (n=27) were provided service by OBGYNs and psychiatrists and 100% were assessed by social workers. Although stated in the protocol, legal and/or police assistance was not provided by the hospital during patient consult. Conclusion The institution was able to adhere to the acute care protocol services of patients in terms of obstetric and gynecologic, psychiatric and social worker services but not legal and/or police assistance.
Humans ; Sex Offenses ; Patient Compliance

This article is the second part of the consensus. The principle of allergic diseases treatment is "combination of prevention and treatment, four in one":environmental control can avoid or reduce allergens, which is the first choice; allergen vaccine desensitization treatment is a cause-response treatment and has been considered as the first-line treatment; targeting drugs to block allergy or anti-allergy drugs to control symptoms is a commonly used symptomatic treatment method, which needs to be used with reference to the management of chronic diseases; Health education can change patients' misconceptions, improve their initiative and compliance, change their behavior, and improve the efficacy.
Humans ; Consensus ; Allergens ; Patient Compliance

BACKGROUND: Hypertension is a major contributor to the global disease burden of cardiovascular and cerebrovascular disease. The aim of this study was to determine demographic and clinical factors associated with adherence to antihypertensive medication. METHODS: From August 2012 to February 2015, we recruited 1,523 Korean patients with hypertension who visited family physicians. The study was conducted in 24 facilities located in urban and metropolitan areas. Of these facilities, two were primary care clinics and 22 were level 2 or 3 hospitals. Adherence was assessed using the pill count method; a cut-off value of 80% was used as the criterion for good adherence. Sociodemographic and lifestyle factors were compared between the adherent and nonadherent groups using the chi-square test for categorical variables and t-test for continuous variables. Binary logistic regression analysis was performed with medication adherence as the outcome variable. RESULTS: Of the 1,523 patients, 1,245 (81.7%) showed good adherence to antihypertensive medication. In the multivariate logistic analysis, age ≥65 years, exercise, treatment in a metropolitan-located hospital, being on ≥2 classes of antihypertensive medication and concomitant medication for diabetes, and a family history of hypertension or cardiovascular diseases were associated with good adherence. Patients who had a habit of high salt intake were less adherent to medication. CONCLUSION: Multiple classes of antihypertensive medications, concomitant medication, and exercise were associated with good adherence to antihypertensive medication, and high salt intake was associated with poor adherence to antihypertensive medication. These factors should be considered to improve hypertension control.
Cardiovascular Diseases ; Cerebrovascular Disorders ; Humans ; Hypertension ; Life Style ; Logistic Models ; Medication Adherence ; Methods ; Patient Compliance ; Physicians, Family ; Primary Health Care

BACKGROUND/AIMS: Oral mesalazine is an important treatment for ulcerative colitis (UC), and non-adherence to mesalazine increases the risk of relapse. Controlled-release (CR) mesalazine has 2 formulations: tablets and granules. The relative acceptabilities of these formulations may influence patient adherence; however, they have not been compared to date. This study aimed to evaluate the acceptabilities of the 2 formulations of CR mesalazine in relation to patient adherence using a crossover questionnaire survey. METHODS: UC patients were randomly assigned to 2 groups in a 1:1 ratio. Patients in each group took either 4 g of CR mesalazine tablets or granules for 6 to 9 weeks, and then switched to 4 g of the other formulation for a further 6 to 9 weeks. The acceptability and efficacy were evaluated by questionnaires, and adherence was assessed using a visual analog scale. The difference in acceptabilities between the 2 formulations and its impact on adherence were assessed. RESULTS: A total of 49 patients were prospectively enrolled and 33 patients were included in the analysis. Significantly more patients found the tablets to be less acceptable than the granules (76% vs. 33%, P=0.0005). The granules were preferable to the tablets when the 2 formulations were compared directly (73% vs. 21%, P=0.004), for their portability, size, and numbers of pills. The adherence rate was slightly better among patients taking the granules (94% vs. 91%) during the observation period, but the difference was not significant (P=0.139). CONCLUSIONS: CR mesalazine granules are more acceptable than tablets, and may therefore be a better option for long-term medication.
Colitis, Ulcerative ; Drug Compounding ; Humans ; Medication Adherence ; Mesalamine ; Patient Acceptance of Health Care ; Patient Compliance ; Prospective Studies ; Recurrence ; Tablets ; Ulcer ; Visual Analog Scale

PURPOSE: It has been well known that doctor-patient communication is a key to the better doctor-patient relationship. However, in Korea, there has not been much researches on the causal factors influencing the doctor-patient communication as well as on patient satisfaction and compliance. This study attempts to investigate the relationships between patient social styles and doctors' communication styles as well as patient outcomes. METHODS: Patient subjects were recruited from two mid-size local hospitals. The questionnaires consist of social styles, patient-perceived doctors' communication, and patient satisfaction/compliance measures. One hundred ninety useable data were analyzed. RESULTS: For those highly satisfied patients, patients with analytic style showed the highest percentage of viewing their doctors as highly empathic. On the other hand, for those patients with high compliance, expressive style patients showed the highest rates of regarding their doctors as highly affective. And amiable style patients are most likely to view their doctors as highly cognitive. For analytic style patients, cognitive empathy had positive effects on patient satisfaction. For amiable style patients, doctors' cognitive empathy had positive influence on patient compliance. For expressive style patients, doctors' affective empathic communication had positive effects on both patient satisfaction/compliance while cognitive had positive effects only on patient compliance. CONCLUSION: The results show that the different social styles of patients might influence on the fact how the patients perceive their doctors' communication as well as how much they are satisfied and compliant. Thus, when we as an medical educators need to realize the importance of this mechanism and bring this learning into classrooms.
Compliance ; Empathy ; Hand ; Humans ; Korea ; Learning ; Patient Compliance ; Patient Satisfaction ; Physician-Patient Relations ; Surveys and Questionnaires