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Improving Adherence (improving + adherence)
Selected AbstractsBehavioral Facilitation of Medical Treatment for Headache,Part II: Theoretical Models and Behavioral Strategies for Improving AdherenceHEADACHE, Issue 9 2006Jeanetta C. Rains PhD This is the second of 2 articles addressing the problem of noncompliance in medical practice and, more specifically, compliance with headache treatment. The companion paper describes the problem of noncompliance in medical practice and reviews literature addressing compliance in headache care (Behavioral Facilitation of Medical Treatment for Headache,Part I: Review of Headache Treatment Compliance). The present paper first summarizes relevant health behavior theory to help account for the myriad biopsychosocial determinants of adherence, as well as patient's shifting responsiveness or "readiness for change" over time. Appreciation of health behavior models may assist in optimally tailoring interventions to patient needs through instructional, motivational, and behavioral treatment strategies. A wide range of specific cognitive and behavioral compliance-enhancing interventions are described, which may facilitate treatment adherence among headache patients. Strategies address patient education, patient/provider interaction, dosing regimens, psychiatric comorbidities, self-efficacy enhancement, and other behavioral interventions. [source] Behavioral Facilitation of Medical Treatment of Headache: Implications of Noncompliance and Strategies for Improving AdherenceHEADACHE, Issue 2006Jeanetta C. Rains PhD Clinical recommendations were gleaned from a review of treatment adherence published in the regular issue of Headache (released in tandem with this supplement). The recommendations include: (1) Nonadherence is prevalent among headache patients, undermines treatment efficacy, and should be considered as a treatment variable; (2) Calling patients to remind them of appointments and recalling those who miss a scheduled appointment are fundamentally the most cost-effective adherence-enhancing strategies, insofar as failed appointment-keeping acts as a ceiling on all future treatment and adherence efforts; (3) Simplified and tailored medication regimens improve adherence (eg, minimized number of medications and dosings, fixed-dose combinations, cue-dose training, stimulus control); (4) Screening and management of psychiatric comorbidities, especially depression and anxiety, is encouraged; (5) The concept of self-efficacy as a modifiable psychological process often can be employed to predict and improve adherence. [source] Improving Adherence to Abnormal Pap Smear Follow-UpJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 1 2001Priscilla DeRemer Abercrombie RN Objective: To gain a better understanding of factors that affect follow-up and the strategies that have been found to improve follow-up after an abnormal Papanicolaou (Pap) smear test. Data Sources: A computer-based search of the literature was conducted using MEDLINE with the keywords adherence, nonadherence, compliance, Follow-up, and abnormal Pap smears. Study Selection: Research studies published between 1985 and 1999 in the English language were included. If relevant studies were cited in the articles reviewed, these studies also were reviewed. A total of 25 studies were reviewed. Data Extraction: A critical review of these studies was conducted, with special attention to implications for clinical practice as well as future research. The studies fell into two groups: factors associated with nonadherence and strategies developed to improve adherence. Data Synthesis: A number of factors were identified that affect adherence to follow-up among women with abnormal Pap smears. Some of these factors involve characteristics of the woman, such as demographics, social support, lack of understanding, and fear. Factors that pertain to the health care system, such as inconvenient clinic hours, male providers, and insensitive staff, also were identified. A number of strategies have been successful in improving follow-up, including telephone counseling, educational programs, and economic incentives. Conclusions: Nurses play a crucial role in Facilitating adherence to recommendations for follow-up. They can identify women at risk for poor follow-up, increase awareness of the factors that affect follow-up, and implement strategies shown to be successful in improving adherence. Future research should take into account the rnultifactoral nature of adherence as well as the patient's perspective. In addition, studies should be designed with special attention to generalizability and should include women from populations most at risk for cervical cancer. [source] Premixed insulin treatment for type 2 diabetes: analogue or human?DIABETES OBESITY & METABOLISM, Issue 5 2007Alan J. Garber The progressive nature of type 2 diabetes makes insulin initiation a necessary therapeutic step for many patients. Premixed insulin formulations containing both basal and prandial insulin (so called biphasic insulin) are often prescribed because they are superior to long- or intermediate-acting insulin in obtaining good metabolic control. In addition, they are considered as an attractive alternative to classical basal-bolus therapy as fewer daily injections are required. Premixed insulin formulations include conventional (e.g. biphasic human insulin 70/30, or 30/70 in European countries, BHI 30) and newer premixed human analogues (e.g. biphasic insulin aspart 70/30, or 30/70 in Europe, BIAsp 30; insulin lispro mix 75/25,Mix 75/25, or Mix 25/75 in Europe). Like conventional premixed human insulin, premixed insulin analogues contain a fixed proportion of soluble, rapid-acting insulin analogue, with protaminated analogue comprising the remainder. Unlike conventional premixes, analogue premixes have more physiological pharmacokinetic and therapeutically more desirable pharmacodynamic profiles than premixed human insulin. Consequently, postprandial glycaemic control is better with premixed insulin analogues than with premixed human insulin. In nontreat-to-target registration trials, the lowering of haemoglobin A1c with premixed insulin analogues was not inferior to that seen with premixed human insulin. Minor hypoglycaemia was similar for premixed analogue and premixed human insulins, while major hypoglycaemia appears to be rare with either formulation. The occurrence of adverse events, other than hypoglycaemia, was also similar between various premix insulins. The premixed insulin analogues, BIAsp 30 and Mix 75/25, like the fast-acting analogues from which they are derived, also allow flexible injection timing, relative to meal timing, thus improving adherence, compliance and quality of life compared with premixed human insulin. Overall, the evidence suggests that premixed insulin analogues are cost effective and have useful advantages over premixed human insulin for the treatment of type 2 diabetes. [source] Adherence with drug therapy in the rheumatic diseases Part two: measuring and improving adherenceMUSCULOSKELETAL CARE, Issue 3 2005Dr Jackie Hill PhD, MPhil Abstract Part one of this review highlighted the problem of high rates of non-adherence with drug therapy in the rheumatic diseases. Part two addresses the problem of assessing adherence to drug therapy, focuses on factors affecting medication taking and discusses interventions that can help to improved adherence. Copyright © 2005 John Wiley & Sons, Ltd. [source] | ||||||||||