BACKGROUND

Medication compliance contributes to preventing significant morbidities, such as stroke, among hypertensive patients.

This study aimed to examine the factors affecting hypertensive patients' medication compliance in Sambag II, Cebu City.

This study is an observational cross-sectional study. The study was conducted in Barangay Sambag II of Cebu City and involved 170 random, voluntary, self-reporting hypertensive patients. The Tao Yamane formula was used to determine the sample size. An interviewer-guided survey questionnaire was utilized to collect the data for the pilot study. The data were analyzed using Cronbach’s Alpha Test for internal consistency and reliability.

Three factors were shown to influence compliance with antihypertensive medications. These are the source of medication, access to medication, and symptoms experienced before intake of anti-hypertensive medications. A factor that significantly affects compliance is the source of medication, wherein hypertensive patients prefer medications from retail pharmacies compared to the free medications supplied by the local health center.

Residents of Sambag II, Cebu City preferred medications from retail pharmacies over the free medications provided by the local health center. Local health units may use this information to implement information drugs regarding the efficacy of medications provided by government agencies. Further studies are recommended to use subgroup analysis on factors influencing compliance and non-compliance to anti-hypertensive medicines.

OBJECTIVES: Gastrointestinal endoscopy plays an important role in the diagnosis and treatment of gastrointestinal diseases. The satisfaction degree of gastrointestinal endoscopy can directly affect the patient's compliance and further impact the treating effect. At present, there is no scale to evaluate the satisfaction degree of gastrointestinal endoscopy in China. This study aims to develop a satisfaction scale of gastrointestinal endoscopy suitable for national conditions and to evaluate its reliability and validity, which provides a tool for clinic to evaluate patients' satisfaction with gastrointestinal endoscopy. METHODS: The original gastrointestinal endoscopy satisfaction scale was compiled by literature review, consulting senior endoscopists and experts. Through the first round of survey about 120 patients, the original scale was analyzed and modified according to the results to get the gastrointestinal endoscopy satisfaction scale (formal scale). The formal scale was used to conduct the second round of survey about 200 patients. The reliability and validity of the scale were analyzed and evaluated according to the survey results. RESULTS: The reliability of the original scale was good but the validity was poor. The formal scale had 2 dimensions and 10 items, the Cronbach's alpha and split-half reliability were 0.889 and 0.823. The structure validity index χ²/df was 2.513, root mean square error of approximation (RMSEA) was 0.094, goodness of fit index (GFI) was 0.914, adjusted goodness of fit index (AGFI) was 0.861, comparative fit index (CFI) was 0.946, normed fit index (NFI) was 0.915. The aggregate validity was general, the discriminative validity was good, and the direct score of patients was strongly correlated with the total score of the scale. CONCLUSIONS The gastrointestinal endoscopy satisfaction scale has good reliability and validity, which can be used as a tool to evaluate patients' satisfaction with gastrointestinal endoscopy in China.
Humans ; Reproducibility of Results ; China ; Endoscopy, Gastrointestinal ; Patient Compliance ; Personal Satisfaction

Despite worldwide concern on anxiety, preventive measures in public health industries remained scarce. Previous studies found that therapeutic adherence is vital for the treatment efficacy of anxiety sufferers; polyvagal theory may address adherence issues by considering biopsychosocial perspectives. As such, this research intends to generate polyvagal-focused therapeutic guidance in line with anxiety sufferers. This study examines the effectiveness of the Creative Brain Health Intervention (CBHI), which includes expressive art therapy and neurofeedback assessments, as well as clinical hypnosis for anxiety sufferers. The study utilizes a qualitative method with a grounded theory approach to explore helpful and unhelpful factors of CBHI. The study samples were found to have minimal scores at a mild level (on anxiety or stress subscales) of eight (for the anxiety subscale) and 15 (for the stress counterpart) under DASS-21 following a screening procedure. Particularly, the samples were analyzed after CBHI through in-depth interviews for data collection. A total of 45 participants were recruited to generate the outcomes of this study, and the results show that mental healthcare can be enhanced by addressing adherence, stigma, and support through a public system and education, backed by six domains for anxiety treatment and innovative therapeutic approaches. The study recommends early intervention and prevention phases in future research to address stigmas and prevent mental disorder. Resultantly, therapeutic adherence could be enhanced with a polyvagal-focused framework CBHI established for this study. Consequently, the study suggests insights for developing therapeutic guidance to enhance adherence and prevent full-fledged anxiety complexities.
Treatment Adherence and Compliance

OBJECTIVES: Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common disease that seriously affects health. Continuous positive airway pressure (CPAP) therapy is the preferred treatment for moderate-to-severe OSAHS patients. However, poor adherence to CPAP is a major obstacle in the treatment of OSAHS. Information-motivation-behavioral (IMB) skills, as a kind of mature technology to change the behavior, has been used in various health areas to improve treatment adherence. This study aims to explore the effects of the IMB skills intervention on CPAP adherence in OSAHS patients. METHODS: Patients who were primary diagnosed with moderate-to-severe OSAHS were randomly divided into the IMB group (n=62) and the control group (n=58). The patients in the IMB group received CPAP therapy and the IMB skills intervention for 4 weeks. The patients in the control group received CPAP therapy and a usual health care provided by a registered nurse. We collected the baseline data of the general information, including age, sex, body mass index (BMI), the Epworth Sleepiness Scale (ESS) score, the Hospital Anxiety and Depression Scale (HADS) score, and indicators about disease severity [apnea-hypopnea index (AHI), percentage of time with arterial oxygen saturation SaO₂<90% (T90), average SaO₂, lowest SaO₂, arousal index]. After CPAP titration, we collected CPAP therapy-relevant parameters (optimal pressure, maximum leakage, average leakage, 95% leakage, and residual AHI), score of satisfaction and acceptance of CPAP therapy, and score of willingness to continue CPAP therapy. After 4 weeks treatment, we collected the ESS score, HADS score, CPAP therapy-relevant parameters, effective CPAP therapy time per night, CPAP therapy days within 4 weeks, CPAP adherence rate, score of satisfaction and acceptance of CPAP therapy, and score of willingness to continue CPAP therapy. Visual analog scale (VAS) of 0-5 was used to evaluate the satisfaction and acceptance of IMB intervention measures in the IMB group. RESULTS: There were no significant differences in the baseline level of demographic parameters, ESS score, HADS score, disease severity, and CPAP therapy related parameters between the IMB group and the control group (all P>0.05). There were no significant differences in score of willingness to continue CPAP therapy, as well as score of satisfaction and acceptance of CPAP therapy after CPAP titration between the IMB group and the control group (both P>0.05). After 4 weeks treatment, the ESS score, HADS score, maximum leakage, average leakage, and 95% leakage of the IMB group were significantly decreased, while the score of satisfaction and acceptance of CPAP therapy and willingness to continue CPAP therapy of the IMB group were significantly increased (all P<0.05); while the above indexes in the control group were not different before and after 4 weeks treatment (all P<0.05). Compared with the control group, the ESS score, HADS score, maximum leakage, average leakage, and 95% leakage of the IMB group after 4 weeks treatment were significantly lower (all P<0.05); the effective CPAP therapy time, CPAP therapy days within 4 weeks, score of satisfaction and acceptance of CPAP therapy, score of willingness to continue CPAP therapy of the IMB group were significantly higher (all P<0.05). The rate of CPAP therapy adherence in 4 weeks of the IMB group was significantly higher than that of the control group (90.3% vs 62.1%, P<0.05). The VAS of overall satisfaction with IMB skills intervention measures was 4.46±0.35. CONCLUSIONS IMB skills intervention measures can effectively improve the adherence of CPAP therapy in OSAHS patients, and is suitable for clinical promotion.
Continuous Positive Airway Pressure ; Humans ; Motivation ; Oximetry ; Patient Compliance ; Sleep Apnea, Obstructive/diagnosis* ; Syndrome

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

Massive transfusion protocol (MTP) was designed to improve the outcome of patients at risk of massive haemorrhage. This study focused on the prevalence, indications, factors associated with indication of MTP activation cases and twenty-four-hour mortality among those who received MTP in Hospital Universiti Sains Malaysia (USM). A retrospective cross-sectional study was performed on 110 patients for whom MTP was activated in Hospital USM. Data were extracted from the medical records and blood bank system (MyTransfusi). Descriptive statistics and logistic regression were used for statistical analysis. A total of 273,087 patients were admitted to Hospital USM and 193 patients required MTP activation during the study period. The prevalence of MTP activation was only 0.07%. This study included 110 MTP activation cases which consisted of 62 (56.3%) trauma and 48 (43.7%) non-trauma patients. The overall mean age of patients was 40.0 years old, and majority were male (66.4%). The two most common MTP activation indications were motor vehicle accidents (93.5%) and gastrointestinal bleeding (50%). Female and presence of comorbidity significantly associated with MTP activation indication. Meanwhile, no emergency procedure and non-compliance to activated MTP were significantly associated with high mortality within twenty-four-hour post MTP activation. The prevalence of MTP was low. Our result suggested that early emergency procedures and compliance towards MTP improved patient outcomes.
Compliance

Introduction: Non-adherence to antihypertensive medications is a leading cause of uncontrolled hypertension and its complications. However, data on the factors associated with non-adherence to antihypertensive medications in the communities of Sarawak, Malaysia, are limited. This study aimed to examine the prevalence and determinants of medication non-adherence among patients with uncontrolled hypertension. Methods: A cross-sectional study was conducted using the systematic sampling method in four government primary healthcare clinics in Sarawak. A self-administered questionnaire was used to obtain socio-demographic data and evaluate non-adherence. Blood pressure was measured, and relevant clinical variables were collected from medical records. Multivariate logistic regression was used to determine the determinants of medication non-adherence. Results: A total of 488 patients with uncontrolled hypertension were enrolled in this study. The prevalence of medication non-adherence was 39.3%. There were four predictors of medication non-adherence among the patients with uncontrolled hypertension: tertiary educational level (odds ratio [OR]=4.21, 95% confidence interval [CI]=1.67–10.61, P=0.010), complementary alternative medication (OR=2.03, 95% CI=1.12–3.69, P=0.020), non-usage of calcium channel blockers (OR=1.57, 95% CI=1.02–2.41, P=0.039) and 1 mmHg increase in the systolic blood pressure (OR=1.03, 95% CI=1.00–1.05, P=0.006). Conclusion Because of the high prevalence of medication non-adherence among patients with uncontrolled hypertension, primary care physicians should be more vigilant in identifying those at risk of being non-adherent. Early intervention should be conducted to address non-adherence for blood pressure control.
Patient Compliance ; Hypertension ; Primary Health Care ; Malaysia

BACKGROUND

Hypertension is one of the leading causes of cardiovascular morbidity and mortality in the Philippines. The prevalence rate of hypertension has been increasing, and this was associated with increasing comorbidities and poor control rates. The Philippine Heart Association-Council on Hypertension has been conducting the PRESYON studies since 1992 to determine the present hypertension rates. This updated PRESYON-4 aimed to know the latest numbers of hypertension cases in the country and to determine the awareness, treatment profile, and control rates of individuals afflicted with hypertension.

PRESYON-4 is a randomized, prospective, multistage, stratified, nationwide survey conducted last January to April 2021. It included 3,437 participants; 2,796 subjects were adults aged 19 years or older, and the rest of the participants were 12 to 18 years old. The prevalence of hypertension was analyzed from the survey. Anthropometric measurements, risk factors, and comorbidity assessment were also determined.

The prevalence rate of hypertension in the latest survey is 37%, with more than half of the respondents aware of their disease. Utilizing the classification of the European guidelines for hypertension, 34% had grade 1 hypertension, with 26% of participants having isolated systolic hypertension. Individuals older than 50 years are aware of their elevated blood pressure (BP), but more females are aware of their disease compared with men. Current smoking and obesity are high in the hypertensive population, whereas diabetes mellitus and angina are the more common comorbidities. Most subjects utilize the oscillometric arm BP apparatus to monitor their BP. Angiotensin receptor blockers are the most used antihypertensive medication with a high compliance rate. However, there is poor control among treated patients with hypertension, as the control rate is only 39%. The prescription of a single drug is still prevalent among Filipino hypertensive individuals.

The point prevalence of hypertension in the country is at 37% based on the analysis. The need to manage risk factors such as obesity and smoking should be part of management. A multisectoral approach in the management of hypertension should be part of the strategy to lower hypertension in the country.

Purpose: This study aimed to evaluate the level of knowledge on Standard Precautions, level of compliance to Standard Precautions, and General self-efficacy of nurses in a tertiary hospital. Also, this study aimed to identify the relationship between those variables. Design and Methods: A descriptive correlational research design was utilized in the study. 168 nurses from the tertiary hospital from Nueva Ecija, Philippines were recruited to complete a questionnaire about their knowledge and compliance to Standard Precautions and their General self-efficacy. The data was coded, encoded, and statistically analyzed using PSPP 1.2.0 (GNU Project. New York City, New York, USA). Results: Findings indicated that nurses have good knowledge and high compliance concerning standard precautions; also, findings showed that nurses have a moderate level of general self-efficacy. However, there was no remarkable relationship between the level of knowledge, level of compliance in Standard Precautions, and general self-efficacy. Conclusions Although the researcher concluded a high level of knowledge among nurses, statistical analysis showed no relationship when correlated with compliance. This concluded that knowledge of Standard Precautions does not necessarily influence compliance and its application. Also, findings inferred that a moderate level of general self-efficacy did not act upon the level of compliance of nurses to Standard Precautions.
Compliance ; Knowledge

INTRODUCTION: Acute respiratory distress syndrome (ARDS) in COVID-19 is associated with a high mortality rate, though outcomes of the different lung compliance phenotypes are unclear. We aimed to measure lung compliance and examine other factors associated with mortality in COVID-19 patients with ARDS. METHODS: Adult patients with COVID-19 ARDS who required invasive mechanical ventilation at 8 hospitals in Singapore were prospectively enrolled. Factors associated with both mortality and differences between high (<40mL/cm H RESULTS: A total of 102 patients with COVID-19 who required invasive mechanical ventilation were analysed; 15 (14.7%) did not survive. Non-survivors were older (median 70 years, interquartile range [IQR] 67-75 versus median 61 years, IQR 52-66; CONCLUSION COVID-19 ARDS patients with higher compliance on the day of intubation and a longitudinal decrease over time had a higher risk of death.
COVID-19 ; Humans ; Lung Compliance ; Phenotype ; Respiratory Distress Syndrome/therapy* ; SARS-CoV-2