Adherence
Adherence to Guidelines of Antibiotic Prophylactic use in Surgery: A Prospective Cohort Study in North West Bank, Palestine
Thu, 2015-01-29 09:59 — Samar MusmarBackground
Surgical site infection is a major contributor to increased mortality and health care costs globally which can be reduced by appropriate antibiotic prophylactic use. In Palestine, there is no published data about preoperative antibiotic use. This study aims to find the pattern of antimicrobial prophylaxis use by evaluating time of the first dose, antibiotic selection and duration after surgery in three governmental hospitals in North West Bank/ Palestine during 2011.
Methods
After approval of Institutional Review Board, a prospective cohort study included a total of 400 abdominal, orthopedic, and gynecological operations which were performed during study period. Trained clinical pharmacists observed selected 301 operations and followed the patient’s files for the three intended study parameters. Compliance of prophylactic antibiotic administration was evaluated according to published guidelines of the American Society for Hospital Pharmacist. Data were analyzed using SPSS version 16 applying descriptive methods. Relationship between guideline compliance and selected operation factors such as type of surgery, patient care unit, and hospital shift, in addition to provider’s age, gender, experience, and specialization were examined applying chi square test. The statistically significant factors with p < 0.01 were further analyzed using logistic regression model.
Results
Overall compliance for the studied parameters was very low (2%); only 59.8% received their first dose in appropriate time, 18.5% had appropriate antibiotic selection, and 31.8% of patients received antibiotic in appropriate duration. The OBGYN department had much better compliance regarding timing and duration of antibiotic use (P < 0.001), however the proper antibiotic selection was best adhered to for the abdominal surgeries (OR = 3.64, P = 0.002). Male providers were statistically significantly much less adherent to the timing of antibiotic dose (OR = 0.28, p < 0.001), but better adherent in antibiotic selection (OR = 0.191, p = 0.028). Anesthetic technicians showed higher compliance than nurses in timing and duration of antibiotic use.
Conclusions
Lack of guidelines explains the low adherence to appropriate surgical antibiotic prophylaxis in Palestine, with high rate of broad spectrum antibiotic use, long duration and inappropriate time of first dose .We recommend adopting guidelines for prophylaxis and training all health care providers accordingly.
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Beliefs about Medicines and Self-Reported Adherence among Patients With Chronic Illness: a Study in Palestine
Tue, 2014-09-30 13:00 — Sa'ed H. A. ZyoudBackground: Identifying factors associated with adherence is
of great value in clinical practice. The objective of this study was to
investigate medication adherence, beliefs about medicines held by people with
chronic illness and whether beliefs influence medication adherence. Methods:
The study was carried out at primary health care clinic of the Palestinian
Medical Military Services in Nablus, Palestine. The beliefs about medicines
questionnaire was used to assess beliefs and Morisky medication adherence scale
was used to assess adherence.
Results: A total of 187 patients were interviewed. Most participants (79.6%)
agreed or strongly agreed that their medications were necessary for their
current health. However, 58.2% of the participants were concerned about having
to take their medicines on a regular basis and 57.8% were concerned about
becoming dependent on their medicines. None of the demographic and clinical
variables was significantly associated with medication adherence. However,
multivariate analysis showed that patients who had higher beliefs about
medication necessity had higher odds (1.107 [1.023-1.197]) of being adherent.
On the other hand, patients who had higher concern beliefs had lower odds
(0.908 [0.845-0.975]) of being adherent.
Conclusions: Beliefs about medicines are a major contributing factor to
medication adherence.
Beliefs about Medicines and Self-Reported Adherence among Patients With Chronic Illness: a Study in Palestine
Tue, 2014-09-30 12:49 — Adham S. Abu TahaBackground: Identifying factors associated with adherence is
of great value in clinical practice. The objective of this study was to
investigate medication adherence, beliefs about medicines held by people with
chronic illness and whether beliefs influence medication adherence. Methods:
The study was carried out at primary health care clinic of the Palestinian
Medical Military Services in Nablus, Palestine. The beliefs about medicines
questionnaire was used to assess beliefs and Morisky medication adherence scale
was used to assess adherence.
Results: A total of 187 patients were interviewed. Most participants (79.6%)
agreed or strongly agreed that their medications were necessary for their
current health. However, 58.2% of the participants were concerned about having
to take their medicines on a regular basis and 57.8% were concerned about
becoming dependent on their medicines. None of the demographic and clinical
variables was significantly associated with medication adherence. However,
multivariate analysis showed that patients who had higher beliefs about
medication necessity had higher odds (1.107 [1.023-1.197]) of being adherent.
On the other hand, patients who had higher concern beliefs had lower odds
(0.908 [0.845-0.975]) of being adherent.
Conclusions: Beliefs about medicines are a major contributing factor to
medication adherence.
Beliefs about Medicines and Self-Reported Adherence among Patients With Chronic Illness: a Study in Palestine
Tue, 2014-09-30 11:49 — Professor Waleed M. SweilehBackground: Identifying factors associated with adherence is
of great value in clinical practice. The objective of this study was to
investigate medication adherence, beliefs about medicines held by people with
chronic illness and whether beliefs influence medication adherence. Methods:
The study was carried out at primary health care clinic of the Palestinian
Medical Military Services in Nablus, Palestine. The beliefs about medicines
questionnaire was used to assess beliefs and Morisky medication adherence scale
was used to assess adherence.
Results: A total of 187 patients were interviewed. Most participants (79.6%)
agreed or strongly agreed that their medications were necessary for their
current health. However, 58.2% of the participants were concerned about having
to take their medicines on a regular basis and 57.8% were concerned about
becoming dependent on their medicines. None of the demographic and clinical
variables was significantly associated with medication adherence. However,
multivariate analysis showed that patients who had higher beliefs about
medication necessity had higher odds (1.107 [1.023-1.197]) of being adherent.
On the other hand, patients who had higher concern beliefs had lower odds
(0.908 [0.845-0.975]) of being adherent.
Conclusions: Beliefs about medicines are a major contributing factor to
medication adherence.
Adherence to Medications and Associated Factors: a Cross-Sectional Study among Palestinian Hypertensive Patients
Tue, 2014-08-05 08:18 — Rowa' Jamal Al-RamahiObjective To assess adherence of
Palestinian hypertensive patients to therapy and to investigate the effect of a
range of demographic and psychosocial variables on medication adherence.
Methods
A questionnaire-based, cross-sectional descriptive study was undertaken at
a group of outpatient clinics of the Ministry of Health, in addition to a group
of private clinics and pharmacies in the West Bank. Social and demographic
variables and self-reported drug adherence (Morisky scale) were determined for
each patient.
Results Low adherence with medications was present in 244 (54.2%) of the
patients. The multivariate logistic regression showed that younger age
(<45 years), living in a village compared with a city, evaluating
health status as very good, good or poor compared with excellent,
forgetfulness, fear of getting used to medication, adverse effect, and dissatisfaction
with treatment had a statistically significant association with lower levels of
medication adherence (P < 0.05).
Conclusions Poor adherence to medications was very common. The findings
of this study may be used to identify the subset of population at risk of poor
adherence who should be targeted for interventions to achieve better blood
pressure control and hence prevent complications. This study should encourage
the health policy makers in Palestine to implement strategies to reduce
non-compliance, and thus contribute toward reducing national health care
expenditures. Better patient education and communication with healthcare
professionals could improve some factors that decrease adherence such as forgetfulness
and dissatisfaction with treatment.
Adherence and Satisfaction with Oral Hypoglycemic Medications: A Pilot Study in Palestine
Thu, 2013-02-14 16:32 — Professor Waleed M. SweilehOBJECTIVES:
Diabetes mellitus is a chronic progressive disease characterized by numerous health complications. Medication adherence is an important determinant of therapeutic outcome. Few studies on medication adherence have been published from the Arab countries. Therefore, the objective of this pilot study was to assess hypoglycemic medication adherence and its association with treatment satisfaction.
SETTING:
Military Medical Services clinic in Nablus, Palestine.
METHODS:
This is a cross sectional descriptive study. A convenience sample of 131 diabetic patients was studied. The 8-item Morisky Medication Adherence Scale (MMAS-8) and Treatment Satisfaction Questionnaire for Medication were used to assess adherence and treatment satisfaction, respectively. Statistical Package for Social Sciences was used for statistical analysis.
MAIN OUTCOME MEASURE:
Level of adherence, treatment satisfaction and association between adherence and treatment satisfaction among diabetic patients.
RESULTS:
According to MMAS-8, 50 patients (38.5%) had a high adherence, 58 (44.6%) had a medium adherence and 22 (16.9%) had a low adherence rate. The mean scores of satisfaction domains were 71 ± 17.6 and 95 ± 16.4 for effectiveness (EFF) and side effects (SE), respectively. Adherence score was a positively and significantly correlated with EFF satisfaction domain (P < 0.01) and age (P = 0.01). Similar significant correlation was found between adherence level and duration of illness (P = 0.047). However, adherence was not significantly associated with gender (P = 0.2), number of hypoglycemic medications (P = 0.5) or SE satisfaction domain (P = 0.2).
DISCUSSION AND CONCLUSION:
The majority of diabetic patients in this pilot study were non-adherent. Improving patients' treatment satisfaction will improve treatment adherence.
Adherence and Satisfaction with Oral Hypoglycemic Medications: A Pilot Study in Palestine
Tue, 2013-02-12 09:54 — Ansam Feras SawalhaObjectives
Diabetes mellitus is a chronic progressive disease characterized by numerous health complications. Medication adherence is an important determinant of therapeutic outcome. Few studies on medication adherence have been published from the Arab countries. Therefore, the objective of this pilot study was to assess hypoglycemic medication adherence and its association with treatment satisfaction.
Setting
Military Medical Services clinic in Nablus, Palestine.
Methods
This is a cross sectional descriptive study. A convenience sample of 131 diabetic patients was studied. The 8-item Morisky Medication Adherence Scale (MMAS-8) and Treatment Satisfaction Questionnaire for Medication were used to assess adherence and treatment satisfaction, respectively. Statistical Package for Social Sciences was used for statistical analysis.
Main
Outcome measure Level of adherence, treatment satisfaction and association between adherence and treatment satisfaction among diabetic patients.
Results
According to MMAS-8, 50 patients (38.5%) had a high adherence, 58 (44.6%) had a medium adherence and 22 (16.9%) had a low adherence rate. The mean scores of satisfaction domains were 71 ± 17.6 and 95 ± 16.4 for effectiveness (EFF) and side effects (SE), respectively. Adherence score was a positively and significantly correlated with EFF satisfaction domain (P < 0.01) and age (P = 0.01). Similar significant correlation was found between adherence level and duration of illness (P = 0.047). However, adherence was not significantly associated with gender (P = 0.2), number of hypoglycemic medications (P = 0.5) or SE satisfaction domain (P = 0.2).
Discussion and conclusion
The majority of diabetic patients in this pilot study were non-adherent. Improving patients' treatment satisfaction will improve treatment adherence.
Self-Reported Medication Adherence and Treatment Satisfaction in Patients with Epilepsy
Mon, 2013-02-11 13:00 — Manal Saleh IhbeashehSelf-Reported Medication Adherence and Treatment Satisfaction in Patients with Epilepsy
Fri, 2012-12-14 16:42 — Professor Waleed M. SweilehObjective
Reports about medication adherence and satisfaction in patients with epilepsy in Arab countries are lacking. The objective of this study was to assess medication adherence and its relationship with treatment satisfaction, number of antiepileptic drugs (AEDs) taken, and epilepsy control in a sample of Palestinian patients.
Methods
This cross-sectional descriptive study was carried out at Al-Makhfya Governmental Outpatient Center in Nablus, Palestine, during the summer of 2010. A convenience sampling method was used to select patients over the study period. Medication adherence was measured using the eight-item Morisky Medication Adherence Scale (MMAS); treatment satisfaction was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM 1.4). Epilepsy was arbitrarily defined as “well controlled” if the patient had had no seizures in the last 3 months and was defined as “poorly controlled” if he or she had had at least one seizure in the last 3 months.
Results
A convenience sample of 75 patients was studied. On the basis of the MMAS, 11 patients (14.7%) had a low rate, 37 (49.3%) had a medium rate, and 27 (36%) had a high rate of adherence. Adherence was positively and significantly correlated with age (P = 0.02) and duration of illness (P = 0.01). No significant difference in adherence was found between patients with well-controlled and those with poorly controlled epilepsy. Similarly, there was no significant difference in adherence between patients on monotherapy and those on polytherapy. Mean satisfaction with respect to effectiveness, side effects, convenience, and global satisfaction were 73.6 ± 20.7, 82.4 ± 29.8, 69.5 ± 15.5, and 68.4 ± 18.3, respectively. There were significant differences in mean values in the effectiveness (P < 0.01) and convenience (P < 0.01) domains, but not the side effect (P = 0.1) and global satisfaction (P = 0.08) domains among patients with different levels of adherence. Patients on monotherapy had significantly higher satisfaction in the effectiveness domain (P = 0.04) than patients on polytherapy. Similarly, patients with well-controlled epilepsy scored significantly higher in the Effectiveness (P = 0.01) and Global Satisfaction (P = 0.01) domains than those with poorly controlled epilepsy.
Conclusion
In our convenience sample, we found that adherence to and satisfaction with AEDs were moderate and were not associated with seizure control or number of AEDs.
Adherence And Satisfaction With Oral Hypoglycemic Medications: A Pilot Study In Palestine
Sun, 2011-09-25 10:37 — Sa'ed H. A. ZyoudOBJECTIVES: Diabetes mellitus is a chronic progressive disease characterized by numerous health complications. Medication adherence is an important determinant of therapeutic outcome. Few studies on medication adherence have been published from the Arab countries. Therefore, the objective of this pilot study was to assess hypoglycemic medication adherence and its association with treatment satisfaction. SETTING: Military Medical Services clinic in Nablus, Palestine.
METHODS: This is a cross sectional descriptive study. A convenience sample of 131 diabetic patients was studied. The 8-item Morisky Medication Adherence Scale (MMAS-8) and Treatment Satisfaction Questionnaire for Medication were used to assess adherence and treatment satisfaction, respectively. Statistical Package for Social Sciences was used for statistical analysis.
MAIN OUTCOME MEASURE: Level of adherence, treatment satisfaction and association between adherence and treatment satisfaction among diabetic patients.
RESULTS: According to MMAS-8, 50 patients (38.5%) had a high adherence, 58 (44.6%) had a medium adherence and 22 (16.9%) had a low adherence rate. The mean scores of satisfaction domains were 71 ± 17.6 and 95 ± 16.4 for effectiveness (EFF) and side effects (SE), respectively. Adherence score was a positively and significantly correlated with EFF satisfaction domain (P < 0.01) and age (P = 0.01). Similar significant correlation was found between adherence level and duration of illness (P = 0.047). However, adherence was not significantly associated with gender (P = 0.2), number of hypoglycemic medications (P = 0.5) or SE satisfaction domain (P = 0.2).
DISCUSSION AND CONCLUSION: The majority of diabetic patients in this pilot study were non-adherent. Improving patients' treatment satisfaction will improve treatment adherence.
