BACKGROUND AND OBJECTIVE

In the Philippines, patients are constrained from accessing their own records, restricting their ability to freely choose who to seek care from. To address this, the study makes a case for the development of the health smart card in the Philippines, an integrative tool unique to each citizen carrying their lifetime medical record.

The prototype is developed using no-code programming technology and validated through a series of focus group discussions and stakeholder consultations with patients (n=4), healthcare administrators (n=4), and hospital personnel (n=13). It was then revised based on the collected insights and recommendations.

Findings report that the current facility-centric model utilizing paper records constrains patients’ access to their records due to long wait times, slow turnaround periods, constant intra- and inter-hospital transfers, and even charging of fees to acquire a copy of their own data. The health smart card alternative was widely accepted by the participants, particularly for its contribution to increasing data accessibility, patient empowerment, and advancing patient data ownership. Nevertheless, several considerations for the upscale implementation of the health smart card emerged, including creating an interoperable environment through harmonizing standards and capacity-building programs, and ensuring data security through robust cybersecurity measures. Issues on scalability and funding of the project were also raised, centering on the critical role of the government in stepping up as regulator and potential funder. Concerns over potential abuse, dataveillance, and the digital divide are tackled, highlighting the need to account for socioeconomic factors to ensure that no one is left behind in the implementation.

The study makes a case for the development and adoption of a health smart card to address the inaccessibility of records to patients. The study concludes by recommending the conduct of a pilot implementation to comprehensively demonstrate and analyze the features of the proposed scheme.

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.

Background: Long-term treatment and medication compliance are critical for managing conditions like hypertension, yet only 20% of cases are well-controlled, mainly due to socioeconomic factors. The Expanded Senior Citizens Act of 2010 offers a 20% discount on medications to improve compliance, but many seniors need to be made aware of these benefits. Evaluating satisfaction with the Act, specifically regarding its medication-related provisions, is essential for enhancing compliance and health outcomes among senior citizens. Objective: This study examined the association between satisfaction with the medication provisions of the Senior Citizens Act, the frequency of senior identification card usage, and medication compliance among hypertensive patients. Methods: We conducted a community-based cross-sectional study with 458 hypertensive senior citizens in Dasmariñas City, Cavite, Philippines. Senior citizens were randomly selected and completed a survey using a validated, self-developed questionnaire and the Hill-Bone High Blood Pressure (HB-HBP) compliance scale. We performed linear regression analysis to examine the association between their satisfaction and the use of senior citizens’ benefits on their medication compliance. Results: Senior citizens were 60-88 years old (mean 69; standard deviation [SD] 5.9). Thirty-eight percent were satisfied with the Senior Citizens Act and 49% regularly used their senior citizen card. Senior citizens scored an average of 46.82 (SD 4.96) on the HB-HBP compliance scale (possible range = 14-56), indicating high compliance. Those dissatisfied with the Senior Citizens Act were less compliant with their antihypertensive medications [B (unstandardized beta) = -1.65, 95% CI (Confidence Interval) = -2.70, -0.61]. Similarly, those who rarely or never used their senior identification cards (B = -1.54, 95% CI = -2.61, -0.48) and those who used them occasionally (B = -1.43, 95% CI = -2.57, -0.29) showed lower medication compliance compared to those who used them regularly. Conclusion Senior citizens who are satisfied with the medication provisions of the Act and regularly use their senior identification cards exhibit higher compliance with their antihypertensive medications than those with lower satisfaction and infrequent card usage. Interventions should prioritize educational sessions to inform senior citizens about the benefits of the Senior Citizens Act, including how to use their identification cards to access medication discounts effectively.
Human ; hypertension ; medication adherence ; Philippines ; satisfaction ; personal satisfaction

BACKGROUND

Advance care planning (ACP) discussions are vital, but they remain largely neglected and met with resistance in the Philippines. The general population, especially non-medical individuals, has not actively engaged in ACP. To address this, we developed the ‘ACP-READY’ program for primary care settings.

This study aimed to assess the effectiveness of ‘ACP-READY’ in facilitating the completion of Advance Directives (ADs) among non-medical personnel and identifying barriers to their completion.

A randomized, controlled, single-blind approach with a quantitative survey followed by qualitative semi-structured interviews enrolled 161 English-literate, legally competent individuals aged 18-65 from a hospital’s non-medical staff. Participants were randomly assigned to control (n=77) or intervention (n=84) groups. We initially evaluated participants’ readiness for ACP (ACPRe)1. Subsequently, both groups were instructed to complete an AD form in their preferred language, with the experimental group receiving an interactive ACP seminar. Post-test assessments gauged participants’ willingness to complete their AD. A focused-group discussion was conducted to explore their experiences.

Baseline characteristics were similar between groups. There was no statistical difference in readiness improvement and AD completion rates between the control and intervention groups. Well-worded brief instruction and comprehensive seminars were equally effective in enhancing readiness and promoting AD completion (pCONCLUSION

Concise and well-presented instruction on ACP is as effective as comprehensive seminars in promoting AD completion among medically stable individuals. Family physicians, with their longitudinal, patient-centered approach, can address some of the identified barriers.

Objectives: Majority of the existing patient safety culture tools are designed for healthcare workers. Despite the claims that this patient safety tools are patient-centered, limited attention was given to the patients’ perspectives and cultural considerations in the development. Local studies are not available in extant literature that capture patient perspectives on being safe during hospitalization. The goal of the study was to develop and provide preliminary psychometric analysis on a tool that measures patients’ perception of safety culture in a hospital setting. Methods: The study was a quantitative methodological study. The instrument was developed in three phases, conceptualization and item generation through literature review, clinical observation, and focus group discussion, two rounds of expert panel review, and pilot testing. The tool was tested on 122 eligible patients admitted in a tertiary hospital. Factor analysis of the items was done to determine the underlying factor under each item. Cronbach’s alpha was used to test the degree of internal consistency of the scale. Results: The Patient Perceptions on Safety Culture in Hospital Setting Scale consists of 25 items. The analysis yielded four factors explaining a total of 69.23% of the variance in the data. Items were grouped in four dimensions: Hospital workforce (4 items), Hospital Environment (5 items), Heath Management and Care Delivery (7 items), and Information Exchange (9 items). Each factor registered a Cronbach’s alpha of 0.81, 0.78, 0.91, 0.94, respectively. The overall Cronbach’s alpha of the scale is 0.95. Conclusion The study offers preliminary evidence on the psychometric properties of a newly developed tool that measures patient perceptions on hospital safety culture. Subsequent studies on larger samples need to be conducted to determine the reliability and validity of the tool when applied to different population and contexts as well as determining valid cut-off points in scoring and interpretation.
Patient Safety ; Patient Participation

OBJECTIVE

To determine the perceptions of persons with tuberculosis (TB) and health workers on Care TB – a mobile application for the community-led monitoring (CLM) of TB services.

We used a qualitative research method. Six people with tuberculosis and ten health workers were chosen through purposive sampling for semi-structured interviews. The narrative data produced from the interviews were subjected to qualitative content analysis in order to uncover salient themes and patterns.

The community-led monitoring mobile application was shown to be acceptable both to TB healthcare providers and patients. It enhances information access and streamlines the process of reporting care barriers. The application also allows persons with TB to interact with one another, potentially eliminating stigma and discrimination. Potential challenges to implementing the CLM program include issues with internet connectivity, costs, and human resources.

This study provides preliminary evidence of the acceptability and perceived feasibility of a mobile application for the community-led monitoring of TB services. For the CLM initiative to be scaled up across the country, more financial and technical support is required.

Background and Objective: In the Philippines, patients are constrained from accessing their own records, restricting their ability to freely choose who to seek care from. To address this, the study makes a case for the development of the health smart card in the Philippines, an integrative tool unique to each citizen carrying their lifetime medical record. Methods: The prototype is developed using no-code programming technology and validated through a series of focus group discussions and stakeholder consultations with patients (n=4), healthcare administrators (n=4), and hospital personnel (n=13). It was then revised based on the collected insights and recommendations. Results: Findings report that the current facility-centric model utilizing paper records constrains patients’ access to their records due to long wait times, slow turnaround periods, constant intra- and inter-hospital transfers, and even charging of fees to acquire a copy of their own data. The health smart card alternative was widely accepted by the participants, particularly for its contribution to increasing data accessibility, patient empowerment, and advancing patient data ownership. Nevertheless, several considerations for the upscale implementation of the health smart card emerged, including creating an interoperable environment through harmonizing standards and capacity-building programs, and ensuring data security through robust cybersecurity measures. Issues on scalability and funding of the project were also raised, centering on the critical role of the government in stepping up as regulator and potential funder. Concerns over potential abuse, dataveillance, and the digital divide are tackled, highlighting the need to account for socioeconomic factors to ensure that no one is left behind in the implementation. Conclusion The study makes a case for the development and adoption of a health smart card to address the inaccessibility of records to patients. The study concludes by recommending the conduct of a pilot implementation to comprehensively demonstrate and analyze the features of the proposed scheme.
health smart card ; patient empowerment ; patient participation ; Philippines

INTRODUCTION: Hypertension is a major risk factor for cardiovascular diseases, with adherence to treatment often influenced by socioeconomic status. This study assessed adherence to hypertension medication among patients in Quezon City across economic classes from August to October 2023. METHODS: An analytical cross-sectional design was employed, surveying 116 hypertensive Filipinos aged 18-64 years using the Brief Medication Questionnaire-1 (BMQ-1) and socioeconomic classifications based on multiples of the poverty line. RESULTS: Findings revealed that 50.9% of respondents were adherent or probably adherent to treatment, while 49.1% exhibited low or probable low adherence. Those who are low adherent and probable low adherent are 1.399 times more likely to belong to the “Low Income and Below.”, though this association was not statistically significant. CONCLUSION Adherence to hypertension treatment among the respondents was suboptimal, particularly among the lower-income groups. While the association between socioeconomic status and adherence was not statistically significant, the findings underscore the need for interventions targeting financial barriers and improving healthcare accessibility. Addressing these challenges can enhance adherence levels and reduce the burden of hypertension and cardiovascular risks across socioeconomic strata.
Cardiovascular diseases ; hypertension ; prescription drugs ; medication adherence ; developing countries

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.

To 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.

This 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.

A 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.

Given 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.

BACKGROUND

Hypertension is one of the top causes of death globally. Among Filipinos with hypertension, only 27% have their condition under control with treatment.

To determine the level of medication adherence of chronic hypertensive adult patients in Cebu South Medical Center.

Descriptive 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.

Out 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.

Medication 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.