Factors associated with noncompliance with psychiatric outpatient visits
ABSTRACT Adherence to recommended services is essential for long-term effectiveness of ambulatory treatment programs, but factors associated with such adherence are not securely established. We evaluated attendance at 896 scheduled psychiatric clinic visits for 62 patients at a major psychiatric teaching hospital. Visit adherence was found to be significantly higher among patients in an acute stage of illness, those with a personality disorder, those with a post-high-school education, and those living alone. Adherence was also higher when visits were routinely scheduled, when the intervisit interval was shorter, and when the visit entailed psychotherapy rather than pharmacotherapy.
SourceAvailable from: scielo.brActa Paulista de Enfermagem 09/2006; 19(3):343-348. · 0.27 Impact Factor
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ABSTRACT: NSAIDs are the cornerstone of medical management of canine osteoarthritis (OA). Meloxicam is a daily-administered NSAID widely available in a liquid formulation and manufacturer's summary of product characteristics (SPC) advise that it is given at the lowest effective dose. Mavacoxib is a long-acting NSAID given as a monthly tablet. This study compares these drugs in the management of canine OA. In all, 111 dogs with OA of the elbow, hip or stifle were randomly assigned to receive one of these NSAIDs for a 12-week period, and to administer them as per the manufacturer's SPC. Outcomes, including ground reaction forces and three validated clinical metrology instruments, were measured at baseline, 6 and 12 weeks. Improvements were seen in all outcome measures for both groups to a similar degree, and adverse events occurred at a similar rate. There were significant improvements in outcome measures from week 6 to week 12, as well as from baseline. Long-term meloxicam dose was more important than recent dose. Clinical efficacy and adverse event rates are similar for meloxicam and mavacoxib when administered as per their UK SPC. This is relevant information for veterinary surgeons when prescribing NSAID treatment for canine OA.The Veterinary record 05/2014; 175(11). DOI:10.1136/vr.102435 · 1.63 Impact Factor
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ABSTRACT: Objective: Especially for patients with chronic diseases, adherence is an important factor that interferes with the success of treatment. There are few reports examining adherence to appointments and medication in diagnostically specific groups such as individuals with schizophrenia. This study aimed to examine the correlates of missed appointments and medication adherence in a sample of persons attending an outpatient schizophrenia follow-up program after hospital discharge. Methods: The study included 132 patients with schizophrenia. Outpatient appointments were planned to occur in the range of every 1 to 8 weeks by taking into consideration the patient’s clinical status. Patients were followed up for a period of two years to assess appointment-keeping behavior and medication adherence. Within this period, patients who did not attend more than 20% of their appointments were evaluated as the “non-attender group.” Results: The rate of patients, who have missed a scheduled appointment, was 44.7% during the chosen period. Non-attendance was related to low educational level and living alone. Before discharge of the patient, the Brief Psychiatric Rating Scale (BPRS) and the Scale for the Assessment of Positive Symptoms (SAPS) total scores were higher in the non-attender group compared to attender patients. Non-attender patients also had higher numbers of psychiatric hospitalizations and involuntary psychiatric hospitalizations and greater medication non-adherence rates. Conclusion: Sociodemographic factors and clinical features affect patient participation in the appointments. In addition, non-attendance at appointments in particular is closely linked with medication non-adherence.Bulletin of Clinical Psychopharmacology 01/2013; 23(1):57-64. DOI:10.5455/bcp.20121130085931 · 0.37 Impact Factor