Science topic

Medication Adherence - Science topic

Voluntary cooperation of the patient in taking drugs or medicine as prescribed. This includes timing, dosage, and frequency.
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When people refer to a free version of SF-36 questionnaire -they really mean the RAND-36? Or can the SF-36 license be obtained for free?
Thanks.
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Thank you....and the answer is: I don't know, but I really want to get a free copy.
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My study focuses on comparing hospitalization rates pre- and post-enrollment in a medication adherence packaging program.
I am measuring hospitalizations for all patients for one year prior to their enrollment, and for one year following their enrollment.
I believe I am making this more complicated in my head. What statistical method would be most appropriate to use to measure my results?
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Ah, ok... so you have a number of hospitalizations (within a year pre and within a year post intervention). This can be modelled using a negative binomial model. The correlation between pre- and post intervention data from the sampe patients can be accounted for with a random intercept term (so the solution is a mixed negative binomial model).
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I am looking for a valid and reliable way to measure the medication/drug use, adherence and interactions to evaluate the efficiency of an intervention to reduce inappropriate polypharmacy. Any ideas or experiences with self-assessment questionnaires that are suitable for (older) patients with chronic diseases?
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We can measure medication use by direct and indirect methods involve patient questionnaires, patient self reports, pill counts, rates of prescription refills, assessment of patient's clinical response, electronic medication monitors, measurement of physiologic markers, or patient diaries.
We can also measure adherence by In some instances, providers might wish to measure adherence directly by measuring the concentration of drug levels in the blood. More commonly used, however, are indirect measures of adherence which include patient questionnaires, pill counts, refill rates, and clinical response.
Drug interaction can be identified by software drug interaction checker(Medscape).
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Being that the MARS was originally developed to measure medication adhere among psychiatric patients, would it be appropriate to use among another group of patients, like HIV Patients?
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Than you Peter Bai James
I think the second option will be most appropriate for me because of time constraints. Appreciated
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Being that the MARS was originally developed to measure medication adhere among psychiatric patients, would it be appropriate to use among another group of patients, like HIV Patients?
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Thanks Hussam
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Looking for some interesting papers on this topic. As of yet I've only found a few papers that discuss this.. is this an under researched area maybe?
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There are several reasons can lead to non-adherence among HIV patients including side effects of antiretroviral, poor quality life, and psychological distress is one of them. You may go through the following thesis for more understanding about the relations between adherence to HIV medications and psychological distress
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We plan to adapt MARS-10 for our small scale research but finding difficulty getting permission. Copyright clearance center only allow use of original without any adaptation, not getting much response from Elsevier and author.
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Asta R Prajapati - Sorry to come back to you on this. Still awaiting a response from the author. Please can I ask if a license was needed for use of the tool, or just an acknowledgment in any potential publication?
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I wanted to use validated scale for measuring medication adherence in my participants having type 2 diabetes.Please I wanted to know which is the best and easy in getting permission.I am thinking about Morisky 8 items MMAS-8 and BMQ belief in medicines questionnare.Thank you
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Dear Sadaf Asid, the first question always should be, what is the aim of the study resp. what kind of data / information should be assessed with a certain method / questionnaire. For some research questions short questionnaires are not the best method to get valid results. If you decided to use a questionnaire, you can use the questionnaires you mentioned - the MMAS and the BMQ; but also the MARS questionnaire can be recommended, which exists in different short forms and which has been used and validated also in diabetic populations. Secondly, you did add Injections and Insulin as keywords for your question. So I think you also want to assess medication adheence to insulin or other injectable antihyperglycemics. In this case you should mention that most of the available questionnaires are validated for oral medications and not for injectables or insulin. I think, you have done a literature search so far, but I want to recommend the following articles.
Reviews
  • Basu et al. (2019) Ci Ji Yi Xue Za Zhi. 31(2):73-80.
  • Kim et al. (2016) Diabetes Educ. 42(5):618-364.
  • Clifford et al. (2014) Curr Med Res Opin. 30(6):1071-1085.
  • Odegard PS, Capoccia K. (2007) Diabetes Educ. 33(6):1014-1029; discussion 1030-1031.
  • Hamersky et al. (2019) Diabetes Ther. 10(3):865-890.
  • McGovern et al. (2018) Diabetes Obes Metab. 20(4):1040-1043.
MARS
  • du Pon et al. (2019) Patient Prefer Adherence. 13:749-759.
  • McAdam-Marx et al. (2014) J Manag Care Spec Pharm. 20(7):691-700.
  • Stange et al. (2013) J Manag Care Pharm. 19(5):396-407.
  • Fialko et al. (2008) A large-scale validation study of the Medication Adherence Rating Scale (MARS). Schizophr Res. 100(1-3):53-59.
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Medication Adherence Rating Scale developed by Katherine Thompson et al, 2000
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hi, i have similar topic research about adherence measurement in schizophrenia outpatient. can you explain me how to obtain the scale and scoring procedures for the Medication Adherence Rating Scale?
thank u
best regard
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Dear collegues,
For my research I am looking for the format Medication Adherence Questionnaire (MAQ) and Medication Adherence ormReport Scale (MARS). I am interested in both the validated questionnaire and the rate scale. Can you help me?
Kind regards
Janneke Speksnijder
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As MMAS-8 is copyrighted, and the authors does not give permision to use it , is there any validated Medication Adherence Scale/ tool which is free to use in research or academic purposes?
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MARS developed by prof. Rob Horne
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I want to find the relation between adherence to medication which are categorical variable Adherence AND non-adherence and number of medication which is discrete variables. Could i use logestic regression or one-way ANOVA 
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I think spearman is between two categorical. I need the correlation between categorical and number 1,2,3 and so on
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I'm having difficulties finding studies that used a quantative approach to analyze  limited English proficiency or language barrier as a factor of medication adherence.  I need enough studies to do a meta-analysis to study if there is consistency in the published literature about an association between language barrier and medication adherence. 
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No-its not
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Dear researchers and collaborators
I conducted a study with purpose of “evaluation of psychometric properties of X Scale…”. “X scale” is a scale that has been designed and it is still being used to assessment of depression in especial patients.
In this study, one of demographic variables is " history of depression disorder: Yes/No” and other variable is "History of Antidepressant use: Yes/No”.
Now, I want to know that can I determinate criterion (predictive validity) validity by ROC?
For instance, I assess sensitivity and specificity, accuracy and cutoff point for scores of X scale according to " history of depression disorder: Yes/No”.
The results showed:
Area Under the Curve: .478,   p value: .453,   CI95%: .42-.53
The score of positive cutoff point with the Sensitivity (52%) and the Specificity (51%) was 105.5.
According to the results, can it be concluded that predictive validity of X scale don’t fulfill?
I want to know your opinion in this subject and interpretation
Thanking you in anticipation
Hamid   
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I agree with Stephen Joy. You only need the two questions "yes" or "no" to establish that the person has had a history of depression. To know whether the person is now depressed, you need a different measurement instrument systematically asking about current symptomatology.
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Do support and training programs for older adults with frailty work? I'm looking for literature to support/refute this comment. I'm thinking of lifestyle advice and self-management strategies to improve medication adherence, improve mobility, navigate the health care system, etc. 
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With a right balance of support and education, i would think so. Heterogeneity among older adults make it more challenging. In a pilot study completed with pre-frail older people (75+ nonMaori and 60+Maori), we notice that support, particular transport, seem to be more important for those who are frailer and have lower SES.  We will be writing up the findings in the next month. 
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Specifically searching for use cases and publications related to medication therapy management (MTM), medication adherence/compliance, interoperability, or examples where the use of i2b2 de-identified data could be compared to identified patient data.
I currently work as a resident pharmacist for a community pharmacy integrated within a large 340-b hospital. I have been given access to i2b2 data through Cerner as a potential source of data. I'm in the early stages of project/research planning and would like to get as many inputs as possible. 
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Dr Kelly Cochran at UMKC has expertise in ambulatory care MTM reporting and meaningful use. You probably know of her.
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I would like to use Morisky scale to measure adherence and compare the result with therapeutic drug monitoring .There is a validated Arabic version of morisky scale so if I get the copyrights from prof. Morisky should I
1. conduct pilot study ?what is the sample
2. conduct Construct validity
3. test-retest reliability
4. Known group validity
5. Sensitivity and specificity
And after that I compare with therapeutic drug monitoring or no
thank you
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This scale is copyright protected,permission is required
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in adherence measure why Hill Bone questionnaire is valid and used  in assessment of adherence in black population ?
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Perhaps, 
There are some universal concepts irrespective of ethnicity. However one should be aware of often vivid differences due to cultural and ethnic differences hence any questionnaire should be used with some caution. Also it would be interesting to test measures used previously among Whites to see if they are invariant across other ethnic groups.
Regards
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study 1: one sample, repeated measures design
1 IV (intervention: yes or no)
1 within group IV (time point post-intervention@ month 1, month 2, month 3, -6)
2 dependent variables: medication adherence and disease state-specific lab
2 covariates: baseline medication adherence and disease state-specific lab (pre-intervention)
For study #1, is MANCOVA appropriate? If so, what are the assumptions and how can I test them?
study 2: two samples, repeated measures design
1 between-group IV (control and intervention)
1 within-group IV (time point post-intervention@ month 1, month 2, month 3, -6)
2 dependent variables: medication adherence and disease state-specific lab
2 covariates: baseline medication adherence and disease state-specific lab (pre-intervention)
For study #2, is MANOVA appropriate? If so, what are the assumptions and how can I test them?
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The question is not clear. Can you please attach samples for each set of data?
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Would anyone help advise on papers about conceptual framework/models of consumer's reasoning process with regard to purchasing, using and complying with medications?
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Hello
I do not think that you address the good person. If you read attentively the works in which I participate, you would have been able to read that we lead works from what the patients organize, theorize and about the way it impacts on the healthcare, not according to top down abstract models but rather botton up
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What innovative ways can one use to promote consistent uptake of HIV testing among Marps without the fear of stigmatization from the community or other healthcare providers in Sub-Saharan Africa?
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Train members of the  MARPS' community to promote HIV/STI Testing. There are very interesting interventions proven to be effective DEBIs (deffusion of evidence based interventions), Best of lucks ! Mariana 
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Health-based self-efficacy OR a medical adherence scale would be particularly useful since this is for a sample of chronically ill children aged 10-17. Illness type varies so it has to apply to all conditions. Thank you!
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No, nobody can do this.  This is because self-efficacy is just another word for power, or will, and it motivates achievement.  The only achievement that is rated in young children is grades.  So you have power, curiosity, and assertiveness combined in part at young ages, at least to raters of most scales.   see www.motivatelearning.com
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At times patients who are discharged fail to fill their medications and it is a matter of concern, what steps are required to improve the filling.
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Hi, after my span of almost 15 years in hospital pharmacy settings, I have come across  a number of possible reasons why patients do NOT have their discharge prescriptions filled from hospital after a stay in hospital and reasons why they may delay or not fill prescriptions from their community pharmacies (particularly after a hospital stay):
A/ Looking specifically at why patients may not have their hospital discharge medication dispensed: Patients have been known to not fill discharge meds for the following reasons: 1. Lack of education/ counseling on the importance of those meds; 2. time issues to just wanting to get home after a hospital stay and not wanting to wait extra time for discharge meds to be dispensed; 3. Number of days of medications issued via discharge varies in each hospital. Some hospitals dispense between 5 days up to a week's worth of medications and the patient then still needs to obtain further supplies via their community pharmacies. Some prefer to just obtain their whole supply of meds from their community pharmacies. 4. Some hospitals do not even supply the full list of the meds that the patient is currently on. For example, some hospitals in Australia will only supply the 'newly prescribed medication' that the patient has had during the recent stay in hospital and will not supply their regular medications. This becomes confusing for some patients as some may think that the other medications that have not been supplied, may not be as important or may be perceived as not needed in future. 
B/ Looking specifically at why patients may delay non-filling of prescription medication from their community pharmacies after a hospital stay: 1. issues of non-adherence; 2. Lack of time; 3. Cognitive impairment issues; 4. Lack of education/counseling by the health care practitioner regarding the importance of each medication for their continued health; 5. Money issues and cannot afford the cost for the full list of monthly prescription medications (One big concern: Some patients may try to decide which medications are perceived to be more important for their health and therefore only have some medications filled at any given time!)
Of course, the above lists are not limited to these points...
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I am conducting a qualitative study on HIV/AIDS medication adherence and compliance and seek contributions on how to gather relevant information.
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From your question, you indicate that adherence to HIV and AIDS medicines in Nigeria is high and there are some factors that have been shown to contribute to that, i believe you want to establish which factors may be adapted into strategies for sustained high adherence.
Since you want to conduct a qualitative research, interview with the patients, health care providers, managers, caregivers and community organization representatives (such as support groups and home based care groups)  may be the way to go. You could use semi-structured questionnaires and focused group discussions and your questions should include some of the factors identified to result in high adherence and seek from the participants what they should be done. In your interviews you should have representation in terms of gender, age and if possible, duration on therapy. 
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Patient counselling is very important of medication management and compliance can be improved by effective counselling.
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No.. In our hospital (basically its a 1200 bedded tertiary care teaching hospital) where we come across at least 300 out patients per day it is difficult to dispense the drug, no question of counseling.
So we have took an initiative and started a patient counseling center exactly opposite to the dispensing chamber, and the diploma students were placed in the dispensing counter under the supervision of registered pharmacists... Doctor of Pharmacy students were placed in the patient counseling center under the supervision of Ph.D scholars.
Now the patients gets the medicines in the counter and reaches the counseling center where we provide the counseling for 5-20min for a patient depending on the diagnosis and treatment. We do even provide them with patient information leaflets.
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One of my advisers has suggested that the data collection method using drawings is called projective techniques. I am not familiar with this and am starting to read some literature. Basically, I would also do an interview but I would use drawings as a springboard of discussion with the child. I would like to see medication adherence "through their eyes".
I am not familiar with the technique and would appreciate any input from anyone especially the pool of expert qualitative researchers around here. Thank you!
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You might want to look at the HIV literature in sub-Saharan Africa for adherence to ARV drugs and children. There are a number of studies that have used arts-based methods such as drawing, photovoice, story-telling etc.
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I have wanted to explore the idea of identifying a latent variable through PCA in two questions about the timing and quantity of adherence to medication. The PCA comes out very well, including with split-sample validation, however the Cronbach alpha is very low (<0.45), which is almost to be expected as each of the two questions should act like a single-question 'sub-scale'. As this is not going to be used as a psychometric scale but just a 'composite variable', I'm wondering if I can just go ahead and use the resulting factor-variable/composite in analysis. Can any well-informed data-analysts guide me on this? Thank you. 
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Hello Rupert, here are some clues and references to interpretate Cronbach's alpha:
The Cronbach's alpha (1947, 1951) is a good measure of the internal consistency of a latent variable; Acceptable values are normally above 0.70 (Nunnally, 1978). However, relatives of 0.60 values can be accepted (Hair, Black, Anderson and Tatham, 2006), especially if the variable is measured with few items. George and Mallery (2003, p 231) propose the rules of thumb 'to interpret the following Cronbach's alpha: unacceptable <0.60; poor 0.60 to 0.69; acceptable from 0.70 to 0.79; good from 0.80 to 0.89; excellent> 0.89. It is possible that two observed variables measure a single latent variable, but this can lead to problems of identification of the conceptual model thereafter (Brown, 2006; Kline, 2005). It is advisable to have a minimum of 3 items or better 4 items (Hair, et al., 2006). The interpretation of the alpha coefficient is based on the number of items, most of items there, the more alpha coefficients may be higher yet with inter-item correlations rather average (Cortina, 1993; Worthington and Whittaker, 2006).
References:
• Brown, T. (2006). Confirmatory Factor Analysis for Applied Research. New York: The Guiford Press.
• Cortina, J.M. (1993). What is coefficient alpha? An examination of theory and applications. Journal of Applied Psychology, Vol 78(1), 98-104.
• Cronbach, L. J. (1947). Test "reliability": lts meaning and determination. Psychometrika, 12. 1 - 16.
• Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297-334.
• Georges et Mallery, (2003). SPSS for Windows step by step: A simple guide and reference. 11.0 update (4th ed.). Boston: Allyn & Bacon
• Hair, J., Black, W., Babin, B., Anderson, R., & Tatham, R. (2006). Multivariate Data Analysis (6th ed.). New Jersey: Pearson Educational, Inc.
• Kline, R. (2005). Principles and Practice of Structural Equation Modeling (2nd ed.). New York: The Guilford Press.
• Nunnally, J. C. (1978). Psychometric theory. New York: McGraw-Hill Inc.
• Worthington, R., & Whittaker, T. (2006). Scale Development Research. A Content Analysis and Recommendations for Best Practices. The Counseling Psychologist, 34(6), 806-838.
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We used the adherence 8-items morisky medication adherence scale (a validated Arabic version) to assess the medication, and we found that 90% of all rheumatoid arthritis participants (126) were medium to non adherent!
What are the possible causes of non-adherence? What can we do to improve the adherence to medication in both RA patients and other patients?
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The point Kourosh makes with regard to pain is something I think is incredibly valid as patients do not feel HPs are really taking into account the individual needs if they have failed to help alleviate pain and provide guidance, support to achieving effective pain relief . We may know that ultimately DMARDs should improve pain ref lief but a) we fail to explain this to the patient and b) the patient needs something that will relieve their pain promptly. It is the major factor that caused them to seek a medical opinion. We must do better if we are to work with the patient to achieve their ultimate aims.
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We live in a reward=money society, so why not?
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Several strategies are used to improve the adherence in the field of AIDS, taking into account several factors (socio economic conditions, treatment, patient, health system, etc.). However, factors such as drug toxicity, stigma and drug interactions also influence adherence.
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Adherence to care is influenced by a wide range of factors. Mentioned above include drug toxicity, stigma and drug interactions but at varying degrees. However, proper evaluation and adequate pre-treatment preparation are keys to successful adherence among HIV positive clients. These are practices in our HIV program in Nigeria. However, community engagement has been shown to significantly help in this direction. Community engagement provides various platforms for engaging HIV positive persons that would ensure their commitment to care. For example Case Management team system allows for one-on-one interaction between a newly diagnosed HIV positive person with an older HIV case already in care for peer support and adherence to care. Treatment buddy system through mutual linking of two same HIV positive persons for mutual support. This system is easily developed from the pool of Mother-to-Mother Support Groups. Mentor Mother system provides avenue for one-on-one and in-depth counseling that ensure adherence and retention in care. These are sustainable systems within any society, whether developed and developing.