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Objective: To identify the adherence to therapeutic regimens in patients with chronic kidney disease undergoing hemodialysis (HD). Method: This is a descriptive, cross-sectional study using a quantitative approach developed at an HD center in the south of Minas Gerais, Brazil. The study participants were 51 patients undergoing HD. Personal, socioeconomic, and objective data were collected, and the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ) was applied. The analysis was performed using simple descriptive statistics. Result: The average age was 56.7 years, and 58% of the patients were male. The percentages of non-adherence were diet (35.4%), hemodialysis (21.6%), fluid intake (15.7%), and medication (13.7%). Conclusion: Therapeutic adherence is a complex process that requires constant monitoring by a multidisciplinary team., Objetivo: Identificar a adesão ao regime terapêutico de pacientes com doença renal crônica em hemodiálise. Método: Trata-se de um estudo descritivo, transversal, com abordagem quantitativa, desenvolvido em um centro de hemodiálise situado no sul de Minas Gerais. Os participantes do estudo foram 51 pacientes em tratamento hemodialítico. Foram coletados dados pessoais, socioeconômicos, objetivos e aplicado o “Questionário de avaliação sobre a adesão do portador de doença renal crônica em hemodiálise”. A análise foi realizada por meio de estatística descritiva simples. Resultado: A média de idade foi de 56,7 anos e 58% dos pacientes foram do sexo masculino. Os percentuais de não aderência encontrados foram dieta (35,4%), hemodiálise (21,6%), ingestão de líquidos (15,7%) e medicação (13,7%). Conclusão: A adesão terapêutica é um processo complexo, e por isso necessita de acompanhamento constante pela equipe multiprofissional.

BackgroundMedication discrepancies in care transitions and medication non-adherence are problematic. Few interventions consider the entire process, from the hospital to the patient's medication use at home.AimIn preparation for randomised controlled trials (RCTs), this study aimed (1) to investigate the feasibility of recruitment and retention of patients, and data collection to reduce medication discrepancies at discharge and improve medication adherence, and (2) to explore the outcomes of the interventions.MethodParticipants were recruited from a hospital and a residential area. Hospital patients participated in a pharmacist-led intervention to establish a correct medication list upon discharge and a follow-up interview two weeks post-discharge. All participants received a person-centred adherence intervention for three to six months. Discrepancies in the medication lists, the Beliefs about Medicines Questionnaire (BMQ-S), and the Medication Adherence Report Scale (MARS-5) were assessed.ResultsOf 87 asked to participate, 35 were included, and 12 completed the study. Identifying discrepancies, discussing discrepancies with physicians, and performing follow-up interviews were possible. Conducting the adherence intervention was also possible using individual health plans for medication use. Among the seven hospital patients, 24 discrepancies were found. Discharging physicians agreed that all discrepancies were errors, but only ten were corrected in the discharge information. Ten participants decreased their total BMQ-S concern scores, and seven increased their total MARS-5 scores.ConclusionBased on this study, conducting the two RCTs separately may increase the inclusion rate. Data collection was feasible. Both interventions were feasible in many aspects but need to be optimised in upcoming RCTs.

Background: Medication non-adherence in heart failure (HF) leads to increased mortality, morbidity and healthcare costs. However, no study has investigated HF patients’ post-hospitalization medication non-adherence in Switzerland. Objectives: Our primary aim was to assess the prevalence of post-discharge medication non-adherence in patients with HF. A secondary objective was to identify differences between fully and partially adherent patients regarding selected unplanned therapy-related inpatient/outpatient cardiology visits. Methods: A non-experimental cross-sectional study was applied. The prevalence of medication adherence was assessed with a German-translated version of the Medication Adherence Report Scale (MARS-5) and analyzed descriptively. Differences between adherent and partially adherent patients’ numbers of medications, dosing per day and 180-day unplanned inpatient stays or cardiology outpatient visits were explored. Results: Of 153 recruited patients, 72 participated in the survey. Of these, 26.4 % were not fully adherent. Their most common reason was forgetfulness (23.7 %). There were no significant group differences regarding therapy-related variables or 180-day unplanned cardiology stays/visits. Conclusions: Considering that over one-quarter of surveyed HF patients were not fully medication adherent, Swiss cardiology nurses need to be sensitized to this issue and trained in adherence-enhancing interventions. Reaching acceptable adherence levels in patients with HF will require further research and action.

Treatment with medicines is the single most used method for treating patients with chronic conditions and to prevent further damage of the disease. The use of medicines is agreed upon between healthcare provider and patient and is only effective if used correctly. However, medication use is problematic for many patients and drug-related problems are common when patients do not succeed in following their treatment. Non-adherence to treatment regimens is a major drug-related problem in 44 to 77% of chronic medication users. Many evidence-based medication adherence interventions have been developed for healthcare providers to better support patients in taking their medication. These interventions are often complex, as they must be tailored to diverse patient populations, rely on close collaboration between different healthcare providers, and require continuous monitoring of non-adherent patients. This complexity means that for these interventions to be effective, they must be continuously available for patients by a multidisciplinary team of healthcare providers. As such, they need to be fully integrated into daily clinical practice systems in a (cost-)effective manner. However, so far, their implementation is often lacking. Integrating complex interventions into daily clinical practice is complex. It requires tailoring the intervention to the context in which they will be implemented, which requires using implementation strategies that fit within the context. In order to do so, detailed information about the setting and its context is required. However, current publications on interventions generally do not provide sufficient details about the implementation and the context to be reproduced in different settings. This tailoring can be supported by dissemination and implementation science methods, which offer different models and theories on implementing complex interventions into daily clinical practice. Throughout this thesis, we provide insight into how medication u

Objective: To identify the adherence to therapeutic regimens in patients with chronic kidney disease undergoing hemodialysis (HD). Method: This is a descriptive, cross-sectional study using a quantitative approach developed at an HD center in the south of Minas Gerais, Brazil. The study participants were 51 patients undergoing HD. Personal, socioeconomic, and objective data were collected, and the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ) was applied. The analysis was performed using simple descriptive statistics. Result: The average age was 56.7 years, and 58% of the patients were male. The percentages of non-adherence were diet (35.4%), hemodialysis (21.6%), fluid intake (15.7%), and medication (13.7%). Conclusion: Therapeutic adherence is a complex process that requires constant monitoring by a multidisciplinary team., Objetivo: Identificar a adesão ao regime terapêutico de pacientes com doença renal crônica em hemodiálise. Método: Trata-se de um estudo descritivo, transversal, com abordagem quantitativa, desenvolvido em um centro de hemodiálise situado no sul de Minas Gerais. Os participantes do estudo foram 51 pacientes em tratamento hemodialítico. Foram coletados dados pessoais, socioeconômicos, objetivos e aplicado o “Questionário de avaliação sobre a adesão do portador de doença renal crônica em hemodiálise”. A análise foi realizada por meio de estatística descritiva simples. Resultado: A média de idade foi de 56,7 anos e 58% dos pacientes foram do sexo masculino. Os percentuais de não aderência encontrados foram dieta (35,4%), hemodiálise (21,6%), ingestão de líquidos (15,7%) e medicação (13,7%). Conclusão: A adesão terapêutica é um processo complexo, e por isso necessita de acompanhamento constante pela equipe multiprofissional.

Objective: To identify the adherence to therapeutic regimens in patients with chronic kidney disease undergoing hemodialysis (HD). Method: This is a descriptive, cross-sectional study using a quantitative approach developed at an HD center in the south of Minas Gerais, Brazil. The study participants were 51 patients undergoing HD. Personal, socioeconomic, and objective data were collected, and the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ) was applied. The analysis was performed using simple descriptive statistics. Result: The average age was 56.7 years, and 58% of the patients were male. The percentages of non-adherence were diet (35.4%), hemodialysis (21.6%), fluid intake (15.7%), and medication (13.7%). Conclusion: Therapeutic adherence is a complex process that requires constant monitoring by a multidisciplinary team., Objetivo: Identificar a adesão ao regime terapêutico de pacientes com doença renal crônica em hemodiálise. Método: Trata-se de um estudo descritivo, transversal, com abordagem quantitativa, desenvolvido em um centro de hemodiálise situado no sul de Minas Gerais. Os participantes do estudo foram 51 pacientes em tratamento hemodialítico. Foram coletados dados pessoais, socioeconômicos, objetivos e aplicado o “Questionário de avaliação sobre a adesão do portador de doença renal crônica em hemodiálise”. A análise foi realizada por meio de estatística descritiva simples. Resultado: A média de idade foi de 56,7 anos e 58% dos pacientes foram do sexo masculino. Os percentuais de não aderência encontrados foram dieta (35,4%), hemodiálise (21,6%), ingestão de líquidos (15,7%) e medicação (13,7%). Conclusão: A adesão terapêutica é um processo complexo, e por isso necessita de acompanhamento constante pela equipe multiprofissional.

Introduction:Asthma and chronic obstructive pulmonary disease (COPD) are common chronic diseases. According to the World Health Organization, asthma is one of the most common chronic diseases in children, and COPD is the third leading cause of death worldwide. Early detection and appropriate treatment can significantly improve health outcomes.Objectives:This thesis focused on medication adherence in asthma and COPD. First, we aimed to assess the consumption of asthma medications prescribed to children in Belgium. Second, we aimed to assess adherence and persistence with inhaled medications for the chronic treatment of asthma and COPD and to evaluate the factors influencing adherence. Factors examined were gender, age, device type, BIM status, employment status, region of residence, and the new medicines service (NMS) offered by pharmacists. Thirdly, we aimed to determine the expectations of COPD patients and healthcare practitioners towards a mobile application or web platform and to identify potential barriers or facilitators to the use of such digital tools. In addition, we sought to evaluate the current state of collaboration between healthcare practitioners and the impact of a technological tool.Methods:To assess the consumption of asthma medication in children in Belgium, a retrospective study was conducted using anonymized administrative data from Independent Health Insurance Funds for the period 2013-2018. For the second objective, we conducted a retrospective study on the National Institute for Health and Disability Insurance (NIHDI) database containing dispensing data for inhaled medications for the treatment of asthma and COPD from 2013 to 2016. Therapeutic adherence was assessed using the continuous multiple-interval measures of medication availability (CMA). This part was completed by a similar retrospective study on an Independent Health Insurance Funds database, enabling the analysis of new factors influencing adherence for the period 2013 to 2018. Fin, Doctorat en Sciences biomédicales et pharmaceutiques (Pharmacie), info:eu-repo/semantics/nonPublished

Purpose: This study aims to determine initiation and persistence for patients with type 2 diabetes receiving their first prescription of an antidiabetic agent and the associations with socioeconomic factors. Methods: A cohort study including 8515 patients with type 2 diabetes who were prescribed their first antidiabetic medication between 2012 and 2019 in Uppsala, Sweden, was followed during 2 years. Medical records were linked to national registers on dispensed drugs and socioeconomic data. Adherence was assessed based on patients' medication claims within 30 days of prescription (initiation) and continued claims after 24 months (persistence). Multivariable logistic regression was used to determine the associations with the socioeconomic factors age, sex, living status, country of birth, education, occupation, and income. Results: Within 30 days, 92.4% of the patients claimed their first prescription, and 64.0% were still being dispensed the initially prescribed medication after 24 months. Unemployed patients had lower initiation rates, and women had lower persistence rates. Factors associated with both low initiation and persistence were low income, young or old age, birth outside Europe, and being prescribed other diabetes drugs than metformin monotherapy. Conclusion: Socioeconomic factors have different impact on the initiation of a new medication and the persistence to treatment in type 2 diabetes. It is important to acknowledge these differences to develop appropriate interventions to improve medication nonadherence.

Purpose: Despite the benefits of adjuvant endocrine therapy (AET) for reducing recurrence and mortality risks after hormonesensitive breast cancer, AET adherence is sub-optimal for a high proportion of women. However, little is known about long-term patterns of AET adherence over the minimally recommended 5 years. Our objectives were to: (1) identify 5-year AET adherence trajectory groups; (2) describe trajectory groups according to adherence measures traditionally used (i.e., Proportion of Days Covered); and (3) explore factors associated with trajectories. Methods: We conducted a 5-year cohort study using data from a French national study that included AET dispensing data. Women diagnosed with first non-metastatic breast cancer and having at least 1 AET dispensing in the 12 months after diagnosis were included. Group-based trajectory modeling was used to identify adherence trajectory groups by clustering similar patterns of monthly AET dispensing. Multinomial logistic regressions were used to identify factors associated with trajectories. Results: Among 674 women, five AET adherence trajectory groups were identified: (1) quick decline and stop (5.2% of women); (2) moderate decline and stop (6.4%); (3) slow decline (17.2%); (4) high adherence (30.0%); and (5) maintenance of very high adherence (41.2%). Mean 5-year Proportion of Days Covered varied from 10 to 97% according to trajectories. Women who did not receive chemotherapy or a personalized care plan were more likely to belong to trajectories where AET adherence declined and stopped. Conclusion: Our results provide information on the diversity of longitudinal AET adherence patterns, the timing of decline and discontinuation and associated factors that could inform healthcare professionals.

Hypertoni är en riskfaktor för allvarliga kardiovaskulära sjukdomar. Olika läkemedelsklasser används vid behandling av hypertoni. Dessa inkluderar angiotensin omvandlade enzymhämmare, angiotensin II-receptorblockerare, kalciumkanalblockerare och tiaziddiuretika. Även om nuvarande läkemedelsterapier kan vara effektiva, är det få som kan uppnå målblodtryck. De flesta patienter med hypertoni kräver minst två antihypertensiva läkemedel för att uppnå sitt målblodtryck. Detta ledde till komplicerade behandlingsmetoder som i sin tur har blivit en stor bidragande faktor till dålig patientföljsamhet. Även om ett stort antal läkemedel finns tillgängliga för behandling, är kontrollen av blodtryck dålig på grund av patienternas dåliga följsamhet till medicinering som vanligtvis är en kombination av flera substanser. Följsamheten minskar med antalet tabletter som en patient behöver ta vilket leder till en komplicerad behandlingsstrategi. Syftet med detta examensarbete var att undersöka blodtryckssänkande effekt med en enkel tablettform Single-Pill Combination (SPC) som innehåller en kombination av flera antihypertensiva läkemedelsklasser och att undersöka patienternas följsamhet till (SPC) behandling. Metod det här arbetet är en litteraturstudie utförd i PubMed. Olika sökord användes” single-pill combination in hypertension”, “Fixed dose combination in hypertension “, “Adherence to single-pill combination in hypertension”. Sökningen filtrerades till “Randomized controlled trial”. Nya studier valdes ut som undersökte effekten av SPC och följsamhet till behandling. Resultat Studier 1,2,3 och 4 som undersökte effekten gav positiva resultat som gynnade SPC framför standardmonoterapi och placebo. SPC kunde minska blodtrycket statiskt signifikant i alla studierna. I studie 1 blev den genomsnittliga skillnaden i SBT mellan grupperna (–6,9) mm Hg med (p-värde <0,001). I studie 2 blev skillnaden i genomsnittlig 24-timmars SBT mellan SPC- och placeboperioder (–18,7) mm Hg med p-värde, Background Hypertension is a risk factor for serious cardiovascular diseases. Different drug classes are used in the treatment of hypertension. These include angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, and thiazide diuretics. Although current drug therapies can be effective, few are able to achieve target blood pressure therefore it has become well-known that most hypertensive patients require at least two antihypertensive drugs to reach their target blood pressure. This led to complicated treatment methods, which in turn has become a significant contributing factor to poor patient compliance. When two or more drug classes are combined, this contributes to improved efficacy, as different mechanisms of action work together to block different pathways to high blood pressure. This leads to lower doses of the individual components being used, which results in a reduced likelihood of side effects. Although a large number of drugs are available for treatment, there is still poor control of blood pressure due to patients' poor adherence to medication, which is usually a combination of several substances. Adherence decreases with the number of tablets a patient needs to take, leading to a complicated treatment strategy. Lower levels of adherence are associated with poorer blood pressure control. Aim The aim of the work is to investigate the blood pressure-lowering effect with a simple tablet form "Single-Pill Combination" (SPC) that contains a combination of several antihypertensive drug classes and to investigate the patients' adherence to this form of treatment (SPC). Method This work is a literature study carried out in Pubmed. Different search terms were used: "single-pill combination for the treatment of hypertension", "Fixed dose combination in hypertension", and "Adherence to single-pill combination for hypertension". The search was filtered to "Randomized controlled trial". New studies were selected that inve

Medication adherence is a key precondition of the effectiveness of evidence-based therapies. However, in real-life settings, non-adherence to medication is still very common. This leads to profound health and economic consequences at both individual and public health levels. The problem of non-adherence has been extensively studied in the last 50 years. Unfortunately, with more than 130,000 scientific papers published on that subject so far, we are still far from finding an ultimate solution. This is, at least partly, due to fragmented and poor-quality research that has been conducted in this field sometimes. To overcome this deadlock, there is a need to stimulate the adoption of best practices in medication adherence-related research in a systematic way. Therefore, herein we propose the establishment of dedicated medication adherence research Centres of Excellence (CoEs). These Centres could not only conduct research but could also create a profound societal impact, directly serving the needs of patients, healthcare providers, systems and economies. Additionally, they could play a role as local advocates for good practices and education. In this paper, we propose some practical steps that might be taken in order to establish such CoEs. We describe two success stories, i.e., Dutch and Polish Medication Adherence Research CoEs. The COST Action "European Network to Advance Best practices & technoLogy on medication adherencE" (ENABLE) aims to develop a detailed definition of the Medication Adherence Research CoE in the form of a list of minimal requirements regarding their objectives, structure and activities. We hope that it will help to create a critical mass and catalyse the setup of regional and national Medication Adherence Research CoEs in the near future. This, in turn, may not only increase the quality of the research but also raise the awareness of non-adherence and promote the adoption of the best medication adherence-enhancing interventions.

The study aimed to investigate whether a structured discharge letter and the use of the person-centred communication method Teach Back for sharing information at hospital discharge could support perceived understanding and knowledge of and adherence to prescribed medication for secondary prevention after stroke. Data from a feasibility study of a codesigned care transition support for people with stroke was used. Patients who at discharge received both a structured discharge letter and participated in the person-centred communication method Teach Back (n = 17) were compared with patients receiving standard discharge procedures (n = 21). Questionnaires were used to compare the groups regarding perceived understanding of information about medical treatment, knowledge of information about medical treatment and medication adherence at 1 week and 3 months. There was a statistically significant difference in perceived understanding of information about medical treatment (p > 0.01) between the groups in favour of those who participated in Teach Back at the discharge encounter. No differences between groups were found regarding understanding health information about medical treatment and medication adherence. The results indicate that the use of Teach Back at the discharge encounter positively impacts perceived understanding of information about medical treatment in people with stroke. However, considering the nonrandomised study design and the small sample size, a large-scale trial is needed.

The study aimed to investigate whether a structured discharge letter and the use of the person-centred communication method Teach Back for sharing information at hospital discharge could support perceived understanding and knowledge of and adherence to prescribed medication for secondary prevention after stroke. Data from a feasibility study of a codesigned care transition support for people with stroke was used. Patients who at discharge received both a structured discharge letter and participated in the person-centred communication method Teach Back (n = 17) were compared with patients receiving standard discharge procedures (n = 21). Questionnaires were used to compare the groups regarding perceived understanding of information about medical treatment, knowledge of information about medical treatment and medication adherence at 1 week and 3 months. There was a statistically significant difference in perceived understanding of information about medical treatment (p > 0.01) between the groups in favour of those who participated in Teach Back at the discharge encounter. No differences between groups were found regarding understanding health information about medical treatment and medication adherence. The results indicate that the use of Teach Back at the discharge encounter positively impacts perceived understanding of information about medical treatment in people with stroke. However, considering the nonrandomised study design and the small sample size, a large-scale trial is needed.

This thesis investigates the potential of Mobile Augmented Reality (MAR) for improving medication adherence. Empirical research was conducted by interviewing patients, pharmacists, and a homecare worker. Based on insights and findings, an onboarding concept called MedinAR was developed through sketching and prototyping, with the aim of refining the idea and understanding the user experience. MedinAR leverages MAR to offer new ways of accessing and consuming medication information, making it more accessible to users. The concept, explored through four prototypes, focuses on onboarding for new medication regimes, providing an interaction flow for users to scan pill bottles, receive digital information in the physical space, and finally receive guidance on the appropriate placement of medication in the pillbox according to their medication regime. Further research is required to assess the technology's meaningful adoption, but the study's results underscore the importance of further exploring new supportive tools for medication adherence.

Hypertoni är en riskfaktor för allvarliga kardiovaskulära sjukdomar. Olika läkemedelsklasser används vid behandling av hypertoni. Dessa inkluderar angiotensin omvandlade enzymhämmare, angiotensin II-receptorblockerare, kalciumkanalblockerare och tiaziddiuretika. Även om nuvarande läkemedelsterapier kan vara effektiva, är det få som kan uppnå målblodtryck. De flesta patienter med hypertoni kräver minst två antihypertensiva läkemedel för att uppnå sitt målblodtryck. Detta ledde till komplicerade behandlingsmetoder som i sin tur har blivit en stor bidragande faktor till dålig patientföljsamhet. Även om ett stort antal läkemedel finns tillgängliga för behandling, är kontrollen av blodtryck dålig på grund av patienternas dåliga följsamhet till medicinering som vanligtvis är en kombination av flera substanser. Följsamheten minskar med antalet tabletter som en patient behöver ta vilket leder till en komplicerad behandlingsstrategi. Syftet med detta examensarbete var att undersöka blodtryckssänkande effekt med en enkel tablettform Single-Pill Combination (SPC) som innehåller en kombination av flera antihypertensiva läkemedelsklasser och att undersöka patienternas följsamhet till (SPC) behandling. Metod det här arbetet är en litteraturstudie utförd i PubMed. Olika sökord användes” single-pill combination in hypertension”, “Fixed dose combination in hypertension “, “Adherence to single-pill combination in hypertension”. Sökningen filtrerades till “Randomized controlled trial”. Nya studier valdes ut som undersökte effekten av SPC och följsamhet till behandling. Resultat Studier 1,2,3 och 4 som undersökte effekten gav positiva resultat som gynnade SPC framför standardmonoterapi och placebo. SPC kunde minska blodtrycket statiskt signifikant i alla studierna. I studie 1 blev den genomsnittliga skillnaden i SBT mellan grupperna (–6,9) mm Hg med (p-värde <0,001). I studie 2 blev skillnaden i genomsnittlig 24-timmars SBT mellan SPC- och placeboperioder (–18,7) mm Hg med p-värde, Background Hypertension is a risk factor for serious cardiovascular diseases. Different drug classes are used in the treatment of hypertension. These include angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, and thiazide diuretics. Although current drug therapies can be effective, few are able to achieve target blood pressure therefore it has become well-known that most hypertensive patients require at least two antihypertensive drugs to reach their target blood pressure. This led to complicated treatment methods, which in turn has become a significant contributing factor to poor patient compliance. When two or more drug classes are combined, this contributes to improved efficacy, as different mechanisms of action work together to block different pathways to high blood pressure. This leads to lower doses of the individual components being used, which results in a reduced likelihood of side effects. Although a large number of drugs are available for treatment, there is still poor control of blood pressure due to patients' poor adherence to medication, which is usually a combination of several substances. Adherence decreases with the number of tablets a patient needs to take, leading to a complicated treatment strategy. Lower levels of adherence are associated with poorer blood pressure control. Aim The aim of the work is to investigate the blood pressure-lowering effect with a simple tablet form "Single-Pill Combination" (SPC) that contains a combination of several antihypertensive drug classes and to investigate the patients' adherence to this form of treatment (SPC). Method This work is a literature study carried out in Pubmed. Different search terms were used: "single-pill combination for the treatment of hypertension", "Fixed dose combination in hypertension", and "Adherence to single-pill combination for hypertension". The search was filtered to "Randomized controlled trial". New studies were selected that inve

The prevalence of non-communicable diseases has risen sharply in recent years, particularly among older individuals who require complex drug regimens. Patients are increasingly required to manage their health through medication adherence and self-care, but about 50% of patients struggle to adhere to prescribed treatments. This study explored the relationship between interest in medication adherence, health literacy, and self-care and how it changed during the COVID-19 pandemic. We used Google Trends to measure relative search volumes (RSVs) for these three topics from 2012 to 2022. We found that interest in self-care increased the most over time, followed by health literacy and medication adherence. Direct correlations emerged between RSVs for medication adherence and health literacy (r = 0.674, p < 0.0001), medication adherence and self-care (r = 0.466, p < 0.0001), and health literacy and self-care (r = 0.545, p < 0.0001). After the COVID-19 pandemic outbreak, interest in self-care significantly increased, and Latin countries showed a greater interest in self-care than other geographical areas. This study suggests that people are increasingly interested in managing their health, especially in the context of the recent pandemic, and that infodemiology may provide interesting information about the attitudes of the population toward chronic disease management.

Medication adherence is a key precondition of the effectiveness of evidence-based therapies. However, in real-life settings, non-adherence to medication is still very common. This leads to profound health and economic consequences at both individual and public health levels. The problem of non-adherence has been extensively studied in the last 50 years. Unfortunately, with more than 130,000 scientific papers published on that subject so far, we are still far from finding an ultimate solution. This is, at least partly, due to fragmented and poor-quality research that has been conducted in this field sometimes. To overcome this deadlock, there is a need to stimulate the adoption of best practices in medication adherence-related research in a systematic way. Therefore, herein we propose the establishment of dedicated medication adherence research Centres of Excellence (CoEs). These Centres could not only conduct research but could also create a profound societal impact, directly serving the needs of patients, healthcare providers, systems and economies. Additionally, they could play a role as local advocates for good practices and education. In this paper, we propose some practical steps that might be taken in order to establish such CoEs. We describe two success stories, i.e., Dutch and Polish Medication Adherence Research CoEs. The COST Action "European Network to Advance Best practices & technoLogy on medication adherencE" (ENABLE) aims to develop a detailed definition of the Medication Adherence Research CoE in the form of a list of minimal requirements regarding their objectives, structure and activities. We hope that it will help to create a critical mass and catalyse the setup of regional and national Medication Adherence Research CoEs in the near future. This, in turn, may not only increase the quality of the research but also raise the awareness of non-adherence and promote the adoption of the best medication adherence-enhancing interventions.

Medication adherence is a key precondition of the effectiveness of evidence-based therapies. However, in real-life settings, non-adherence to medication is still very common. This leads to profound health and economic consequences at both individual and public health levels. The problem of non-adherence has been extensively studied in the last 50 years. Unfortunately, with more than 130,000 scientific papers published on that subject so far, we are still far from finding an ultimate solution. This is, at least partly, due to fragmented and poor-quality research that has been conducted in this field sometimes. To overcome this deadlock, there is a need to stimulate the adoption of best practices in medication adherence-related research in a systematic way. Therefore, herein we propose the establishment of dedicated medication adherence research Centres of Excellence (CoEs). These Centres could not only conduct research but could also create a profound societal impact, directly serving the needs of patients, healthcare providers, systems and economies. Additionally, they could play a role as local advocates for good practices and education. In this paper, we propose some practical steps that might be taken in order to establish such CoEs. We describe two success stories, i.e., Dutch and Polish Medication Adherence Research CoEs. The COST Action "European Network to Advance Best practices & technoLogy on medication adherencE" (ENABLE) aims to develop a detailed definition of the Medication Adherence Research CoE in the form of a list of minimal requirements regarding their objectives, structure and activities. We hope that it will help to create a critical mass and catalyse the setup of regional and national Medication Adherence Research CoEs in the near future. This, in turn, may not only increase the quality of the research but also raise the awareness of non-adherence and promote the adoption of the best medication adherence-enhancing interventions.

Introduction: The aim of this study was to evaluate intraocular lens (IOL) tilt, IOL-induced astigmatism (IIA), refractive change, and impact of capsular fibrosis on IOL position after scleral fixation of dislocated IOL using two methods: ab externo scleral suture loop fixation (group A) and a modification, embracing the continuous curvilinear capsulorhexis (group B). Methods: In this prospective randomized clinical trial conducted at St. Erik Eye Hospital, 117 patients with dislocated IOL were randomized to group A (n = 61) or B (n = 56). Patients with ordinary pseudophakia (n = 60) served as controls. IOL tilt was measured three-dimensionally with anterior segment optical coherence tomography (AS-OCT). Results: The median IOL tilt was similar with both methods (A: 7.8°; B: 8.3°; p = 0.51) but higher than in ordinary pseudophakia (5.4°; p < 0.001). Both groups showed a myopic shift, p < 0.001. In cases without capsular fibrosis, the median IOL tilt was 15.5° in group A (n = 7) and 7.0° in group B (n = 5), p = 0.19. For each degree of IOL tilt, IIA increased by 0.075 D (p < 0.001). IOL position could be measured with AS-OCT in all patients given that the IOL was visible in the pupil. Conclusion: After IOL fixation surgery, IOL tilt is higher than in normal pseudophakia. A study involving more patients without capsular fibrosis could clarify whether IOL position is better with method B in this subgroup. IAA is low, but myopic shift is common. AS-OCT is useful for IOL tilt assessment after IOL fixation surgery.

Purpose: To develop an in-depth understanding of older individuals’ attitudes and perceptions of medication management and care after discharge from hospital-to-home. Patients and Methods: A qualitative study using semi-structured interviews with selected individuals 75 years and older, discharged from hospital within the last 6–12 months, living at home, and managing their own medications. Face-to-face interviews were audio-recorded, transcribed and analyzed with thematic analysis. Results: Among the 15 respondents, mean age was 83.5 years (range 75–95 years), 67% were women, and 60% lived alone. The majority (80%) managed their medications with a pill organizer or directly from the pill boxes, while 20% used dose dispensed medications. The analysis of the data led to six themes: Medication adherence, Personal responsibility, Transitions of care, Beliefs about medications, Participation (experience of participation, willingness to participate) and Accessibility (easier to reach hospital than primary care, navigating in the care system, continuity, personal chemistry). Conclusion: The included respondents who were older individuals, living at home and managing their own medications, expressed that they were medical adherent and self-managing. Two important aspects which were seen were difficulties to reach primary care on their own initiative and the lack of continuity with the same physician over a longer period of time.

Current glaucoma treatments aim to lower intraocular pressure, often with topical ocular hypotensive medications. Unfortunately, the effectiveness of these medications depends on sustained patient adherence to regimens which may involve instilling multiple medications several times daily. Patient adherence to glaucoma medications is often low. Recent innovations in digital sensor technologies have been leveraged to confirm eyedrop medication usage in real-time and relay this information back to providers. Some sensors have also been designed to deliver medication reminders and notifications as well as assist with correct eyedrop administration technique. Here, we review recent innovations targeted at improving glaucoma medication adherence and discuss their limitations.

Influential factors causing poor adherence to antidiabetic medications and self-care practices among type 2 diabetes mellitus (T2DM) patients have not been reported before in Libya. To assess such factors that contribute to non-adherence, a single health facility, cross-sectional descriptive study was carried out on T2DM patients attending the NCDE in Tripoli/ Libya; using a pre-tested questionnaire. Crude odds ratios in the binary logistic regression were used to describe the associations between medication adherence and various independent factors using SPSS version 26. Adjusted odds ratios with their corresponding 95% confidence intervals were further generated in the multivariable analysis, to determine variables which were independently associated with medication adherence and were considered significant at a p-value of <0.05. Of the 380 study participants, only 225(67.1%) were adherent. 159(41.8%) were non-adherence to physician recommendations and were careless when taking their medication, 200(52.6%) found difficulty maintaining recommended dietary restrictions, 211(55.5%) and 97(25.5%) didn’t adhere to regular exercise or blood glucose monitoring; respectively. Factors significant association with non-adherence were; medication being taken; especially patients who were prescribed OHA and insulin ([AOR] [95% CI] = 0.214[0.073-0.632]), being careless and not taking prescribed medication as recommended ([AOR] [95% CI] = 2.880 [1.387- 5.983]), forgetfulness ([AOR] [95% CI] =0.199 [0.070- 0.570], stop taking prescribed antidiabetic medication when feeling well ( [AOR] [95% CI] = 0.153[0.058- 0.402], medications side effects ( [AOR] [95% CI]=0.382 [0.181- 0.809] and unawareness of the consequences of not adhering to medication as recommended and the consequences skipping doses ([AOR] [95% CI] = 0.146 [0.037- 0.581]). Adherence to recommended medication and self-care practices in Libya is unsatisfactory. Diabetes education, awareness programs, and regular monitori

Influential factors causing poor adherence to antidiabetic medications and self-care practices among type 2 diabetes mellitus (T2DM) patients have not been reported before in Libya. To assess such factors that contribute to non-adherence, a single health facility, cross-sectional descriptive study was carried out on T2DM patients attending the NCDE in Tripoli/ Libya; using a pre-tested questionnaire. Crude odds ratios in the binary logistic regression were used to describe the associations between medication adherence and various independent factors using SPSS version 26. Adjusted odds ratios with their corresponding 95% confidence intervals were further generated in the multivariable analysis, to determine variables which were independently associated with medication adherence and were considered significant at a p-value of <0.05. Of the 380 study participants, only 225(67.1%) were adherent. 159(41.8%) were non-adherence to physician recommendations and were careless when taking their medication, 200(52.6%) found difficulty maintaining recommended dietary restrictions, 211(55.5%) and 97(25.5%) didn’t adhere to regular exercise or blood glucose monitoring; respectively. Factors significant association with non-adherence were; medication being taken; especially patients who were prescribed OHA and insulin ([AOR] [95% CI] = 0.214[0.073-0.632]), being careless and not taking prescribed medication as recommended ([AOR] [95% CI] = 2.880 [1.387- 5.983]), forgetfulness ([AOR] [95% CI] =0.199 [0.070- 0.570], stop taking prescribed antidiabetic medication when feeling well ( [AOR] [95% CI] = 0.153[0.058- 0.402], medications side effects ( [AOR] [95% CI]=0.382 [0.181- 0.809] and unawareness of the consequences of not adhering to medication as recommended and the consequences skipping doses ([AOR] [95% CI] = 0.146 [0.037- 0.581]). Adherence to recommended medication and self-care practices in Libya is unsatisfactory. Diabetes education, awareness programs, and regular monitori

Influential factors causing poor adherence to antidiabetic medications and self-care practices among type 2 diabetes mellitus (T2DM) patients have not been reported before in Libya. To assess such factors that contribute to non-adherence, a single health facility, cross-sectional descriptive study was carried out on T2DM patients attending the NCDE in Tripoli/ Libya; using a pre-tested questionnaire. Crude odds ratios in the binary logistic regression were used to describe the associations between medication adherence and various independent factors using SPSS version 26. Adjusted odds ratios with their corresponding 95% confidence intervals were further generated in the multivariable analysis, to determine variables which were independently associated with medication adherence and were considered significant at a p-value of <0.05. Of the 380 study participants, only 225(67.1%) were adherent. 159(41.8%) were non-adherence to physician recommendations and were careless when taking their medication, 200(52.6%) found difficulty maintaining recommended dietary restrictions, 211(55.5%) and 97(25.5%) didn’t adhere to regular exercise or blood glucose monitoring; respectively. Factors significant association with non-adherence were; medication being taken; especially patients who were prescribed OHA and insulin ([AOR] [95% CI] = 0.214[0.073-0.632]), being careless and not taking prescribed medication as recommended ([AOR] [95% CI] = 2.880 [1.387- 5.983]), forgetfulness ([AOR] [95% CI] =0.199 [0.070- 0.570], stop taking prescribed antidiabetic medication when feeling well ( [AOR] [95% CI] = 0.153[0.058- 0.402], medications side effects ( [AOR] [95% CI]=0.382 [0.181- 0.809] and unawareness of the consequences of not adhering to medication as recommended and the consequences skipping doses ([AOR] [95% CI] = 0.146 [0.037- 0.581]). Adherence to recommended medication and self-care practices in Libya is unsatisfactory. Diabetes education, awareness programs, and regular monitori

BACKGROUND: New oral oncology medications bring novel challenges when patients are initiating treatment. Rates of primary medication nonadherence (PMN), the rate at which a medication is prescribed but not obtained, of up to 30% have been reported for oral oncology medications. More research is needed to identify causes and develop strategies for health system specialty pharmacies (HSSPs) to improve cancer treatment initiation rates. OBJECTIVE: To evaluate the rate and reasons for PMN to specialty oral oncology medications in an HSSP setting. METHODS: We performed a multisite retrospective cohort study across 7 HSSP sites. Patients were included if they had an orally self-administered oncology medication referral generated by the health system of the affiliated specialty pharmacy between May 1, 2020, and July 31, 2020. Data collected at each site using pharmacy software and the electronic health record were deidentified and aggregated for analysis. After identifying unfilled referrals within a 60-day fill window, a retrospective chart review was performed to identify final referral outcomes and reasons for unfilled referrals. Referral outcomes were categorized as unknown fill outcomes (because of being referred to another fulfillment method or if received for benefits investigation only), filled by the HSSP, or not filled. The primary outcome was PMN for each PMN-eligible referral and secondary outcomes included reason for PMN and time to fill. The final PMN rate was calculated by dividing the number of unfilled referrals by total referrals with a known fill outcome. RESULTS: Of 3,891 referrals, 947 were PMN eligible, representing patients with a median age of 65 years (interquartile range = 55-73), near equal distribution between male and female (53% vs 47%), and most commonly with Medicare pharmacy coverage (48%). The most referred medication was capecitabine (14%), and the most common diagnosis was prostate cancer (14%). Among PMN-eligible referrals, 346 (37%) ha

Methamphetamine (MA) use is associated with HIV transmission among men who have sex with men (MSM) and lapses in medication adherence. Contingency Management (CM) is effective in reducing MA use, but studies of CM to support adherence to HIV prevention or treatment are limited. We conducted a pilot trial of a CM intervention to reduce MA use and improve PrEP/ART adherence among MSM prescribed a tenofovir (TFV)-based regimen for HIV prevention or treatment. Participants were randomly assigned to receive escalating incentives for either MA abstinence or TFV adherence (based on point-of-care urine testing), and to a monitoring schedule of either 2 or 3 visits/week for 4 weeks. 19 MSM were randomized to either CM for MA use or CM for PrEP/ART adherence (median age: 38; IQR: 28-46) and 15 were living with HIV. Participants attended 95.7% (67/70) of scheduled visits in the 2x/week arm and 74.8% (74/99) in the 3x/week arm. TFV adherence was higher among participants in the TFV adherence arm with 93.5% (n = 72/77) of urine samples positive for TFV, compared to 76.6% (n = 49/64) in the MA abstinence arm (p = 0.007). Participants in the MA abstinence arm had more urine samples negative for MA metabolites (20.3%, n = 13/64) than those receiving CM for TFV adherence (6.5%, n = 5/77; p = 0.021). A CM model for MA abstinence and PrEP/ART adherence using twice-weekly visits and urine testing for MA and TFV for MSM who use MA is feasible and potentially effective as an integrated harm reduction strategy.

IntroductionIncreasing administrative workload is linked with lower quality of patient care and physician burnout. Conversely, models involving pharmacists can positively impact patient care and physician well-being. Research has consistently demonstrated that pharmacist-physician collaboration can improve outcomes for chronic diagnoses. Pharmacist-managed refill services may improve provider workload measures and clinical outcomes.MethodsThis was an evaluation of a pharmacist-managed refill service at a Federally Qualified Health Center (FQHC). Under collaborative practice agreement, pharmacists addressed refill requests and recommended interventions. Data analysis evaluated effectiveness of the model, including clinical interventions, and involved descriptive statistics and qualitative approaches.ResultsAverage patient age was 55.5 years old and 53.1% were female. Turnaround time was within 48 h for 87.8% of refill encounters. During an average of 3.2 h per week, pharmacists addressed 9.2% (n = 1683 individual requests in 1255 indirect patient encounters) of the total clinic refill requests during the 1-year study period. In 453 of these encounters (36.1%), pharmacists recommended a total of 642 interventions. 64.8% of these were need for appointment (n = 211) or labs (n = 205). Drug therapy problems and medication list discrepancies were identified in 12.6% (n = 81) and 11.9% (n = 76) of encounters, respectively.Discussion and conclusionsThe results of this study are consistent with previous literature demonstrating the value of interprofessional collaboration. Pharmacists addressed refills in an efficient, clinically effective manner in an FQHC setting. This may positively impact primary care provider workload, patients' medication persistence, and clinical care.

Introduction: The aim of this study was to evaluate intraocular lens (IOL) tilt, IOL-induced astigmatism (IIA), refractive change, and impact of capsular fibrosis on IOL position after scleral fixation of dislocated IOL using two methods: ab externo scleral suture loop fixation (group A) and a modification, embracing the continuous curvilinear capsulorhexis (group B). Methods: In this prospective randomized clinical trial conducted at St. Erik Eye Hospital, 117 patients with dislocated IOL were randomized to group A (n = 61) or B (n = 56). Patients with ordinary pseudophakia (n = 60) served as controls. IOL tilt was measured three-dimensionally with anterior segment optical coherence tomography (AS-OCT). Results: The median IOL tilt was similar with both methods (A: 7.8°; B: 8.3°; p = 0.51) but higher than in ordinary pseudophakia (5.4°; p < 0.001). Both groups showed a myopic shift, p < 0.001. In cases without capsular fibrosis, the median IOL tilt was 15.5° in group A (n = 7) and 7.0° in group B (n = 5), p = 0.19. For each degree of IOL tilt, IIA increased by 0.075 D (p < 0.001). IOL position could be measured with AS-OCT in all patients given that the IOL was visible in the pupil. Conclusion: After IOL fixation surgery, IOL tilt is higher than in normal pseudophakia. A study involving more patients without capsular fibrosis could clarify whether IOL position is better with method B in this subgroup. IAA is low, but myopic shift is common. AS-OCT is useful for IOL tilt assessment after IOL fixation surgery.

Purpose: To develop an in-depth understanding of older individuals’ attitudes and perceptions of medication management and care after discharge from hospital-to-home. Patients and Methods: A qualitative study using semi-structured interviews with selected individuals 75 years and older, discharged from hospital within the last 6–12 months, living at home, and managing their own medications. Face-to-face interviews were audio-recorded, transcribed and analyzed with thematic analysis. Results: Among the 15 respondents, mean age was 83.5 years (range 75–95 years), 67% were women, and 60% lived alone. The majority (80%) managed their medications with a pill organizer or directly from the pill boxes, while 20% used dose dispensed medications. The analysis of the data led to six themes: Medication adherence, Personal responsibility, Transitions of care, Beliefs about medications, Participation (experience of participation, willingness to participate) and Accessibility (easier to reach hospital than primary care, navigating in the care system, continuity, personal chemistry). Conclusion: The included respondents who were older individuals, living at home and managing their own medications, expressed that they were medical adherent and self-managing. Two important aspects which were seen were difficulties to reach primary care on their own initiative and the lack of continuity with the same physician over a longer period of time.

Medication adherence is a key precondition of the effectiveness of evidence-based therapies. However, in real-life settings, non-adherence to medication is still very common. This leads to profound health and economic consequences at both individual and public health levels. The problem of non-adherence has been extensively studied in the last 50 years. Unfortunately, with more than 130,000 scientific papers published on that subject so far, we are still far from finding an ultimate solution. This is, at least partly, due to fragmented and poor-quality research that has been conducted in this field sometimes. To overcome this deadlock, there is a need to stimulate the adoption of best practices in medication adherence-related research in a systematic way. Therefore, herein we propose the establishment of dedicated medication adherence research Centres of Excellence (CoEs). These Centres could not only conduct research but could also create a profound societal impact, directly serving the needs of patients, healthcare providers, systems and economies. Additionally, they could play a role as local advocates for good practices and education. In this paper, we propose some practical steps that might be taken in order to establish such CoEs. We describe two success stories, i.e., Dutch and Polish Medication Adherence Research CoEs. The COST Action "European Network to Advance Best practices & technoLogy on medication adherencE" (ENABLE) aims to develop a detailed definition of the Medication Adherence Research CoE in the form of a list of minimal requirements regarding their objectives, structure and activities. We hope that it will help to create a critical mass and catalyse the setup of regional and national Medication Adherence Research CoEs in the near future. This, in turn, may not only increase the quality of the research but also raise the awareness of non-adherence and promote the adoption of the best medication adherence-enhancing interventions.

Introduction: The aim of this study was to evaluate intraocular lens (IOL) tilt, IOL-induced astigmatism (IIA), refractive change, and impact of capsular fibrosis on IOL position after scleral fixation of dislocated IOL using two methods: ab externo scleral suture loop fixation (group A) and a modification, embracing the continuous curvilinear capsulorhexis (group B). Methods: In this prospective randomized clinical trial conducted at St. Erik Eye Hospital, 117 patients with dislocated IOL were randomized to group A (n = 61) or B (n = 56). Patients with ordinary pseudophakia (n = 60) served as controls. IOL tilt was measured three-dimensionally with anterior segment optical coherence tomography (AS-OCT). Results: The median IOL tilt was similar with both methods (A: 7.8°; B: 8.3°; p = 0.51) but higher than in ordinary pseudophakia (5.4°; p < 0.001). Both groups showed a myopic shift, p < 0.001. In cases without capsular fibrosis, the median IOL tilt was 15.5° in group A (n = 7) and 7.0° in group B (n = 5), p = 0.19. For each degree of IOL tilt, IIA increased by 0.075 D (p < 0.001). IOL position could be measured with AS-OCT in all patients given that the IOL was visible in the pupil. Conclusion: After IOL fixation surgery, IOL tilt is higher than in normal pseudophakia. A study involving more patients without capsular fibrosis could clarify whether IOL position is better with method B in this subgroup. IAA is low, but myopic shift is common. AS-OCT is useful for IOL tilt assessment after IOL fixation surgery.

Purpose: To develop an in-depth understanding of older individuals’ attitudes and perceptions of medication management and care after discharge from hospital-to-home. Patients and Methods: A qualitative study using semi-structured interviews with selected individuals 75 years and older, discharged from hospital within the last 6–12 months, living at home, and managing their own medications. Face-to-face interviews were audio-recorded, transcribed and analyzed with thematic analysis. Results: Among the 15 respondents, mean age was 83.5 years (range 75–95 years), 67% were women, and 60% lived alone. The majority (80%) managed their medications with a pill organizer or directly from the pill boxes, while 20% used dose dispensed medications. The analysis of the data led to six themes: Medication adherence, Personal responsibility, Transitions of care, Beliefs about medications, Participation (experience of participation, willingness to participate) and Accessibility (easier to reach hospital than primary care, navigating in the care system, continuity, personal chemistry). Conclusion: The included respondents who were older individuals, living at home and managing their own medications, expressed that they were medical adherent and self-managing. Two important aspects which were seen were difficulties to reach primary care on their own initiative and the lack of continuity with the same physician over a longer period of time.

Influential factors causing poor adherence to antidiabetic medications and self-care practices among type 2 diabetes mellitus (T2DM) patients have not been reported before in Libya. To assess such factors that contribute to non-adherence, a single health facility, cross-sectional descriptive study was carried out on T2DM patients attending the NCDE in Tripoli/ Libya; using a pre-tested questionnaire. Crude odds ratios in the binary logistic regression were used to describe the associations between medication adherence and various independent factors using SPSS version 26. Adjusted odds ratios with their corresponding 95% confidence intervals were further generated in the multivariable analysis, to determine variables which were independently associated with medication adherence and were considered significant at a p-value of <0.05. Of the 380 study participants, only 225(67.1%) were adherent. 159(41.8%) were non-adherence to physician recommendations and were careless when taking their medication, 200(52.6%) found difficulty maintaining recommended dietary restrictions, 211(55.5%) and 97(25.5%) didn’t adhere to regular exercise or blood glucose monitoring; respectively. Factors significant association with non-adherence were; medication being taken; especially patients who were prescribed OHA and insulin ([AOR] [95% CI] = 0.214[0.073-0.632]), being careless and not taking prescribed medication as recommended ([AOR] [95% CI] = 2.880 [1.387- 5.983]), forgetfulness ([AOR] [95% CI] =0.199 [0.070- 0.570], stop taking prescribed antidiabetic medication when feeling well ( [AOR] [95% CI] = 0.153[0.058- 0.402], medications side effects ( [AOR] [95% CI]=0.382 [0.181- 0.809] and unawareness of the consequences of not adhering to medication as recommended and the consequences skipping doses ([AOR] [95% CI] = 0.146 [0.037- 0.581]). Adherence to recommended medication and self-care practices in Libya is unsatisfactory. Diabetes education, awareness programs, and regular monitori

Background: Despite the availability of effective pharmacotherapy for the management of rheumatoid arthritis (RA), health outcomes are suboptimal due to poor adherence to the prescribed treatment. Limited research has been conducted to investigate medication non-adherence and its associated factors among patients with RA. Objective: This study aimed to assess medication adherence and to explore the factors associated with medication non-adherence among outpatients with RA in Jordan. Methods: The current cross-sectional study was conducted at outpatient rheumatology clinics at two teaching hospitals in Jordan. Variables including socio-demographics and biomedical variables, in addition to disease and medication characteristics, were collected using medical records and custom-designed questionnaire. Medication adherence was assessed using the validated 5-item Compliance Questionnaire for Rheumatology. Stepwise Logistic Regression analysis was performed to identify the factors that are independently and significantly associated with medication non-adherence. Results: A total of 261 patients participated in the study, from which, 43.3% were found non-adherent. Binary regression analysis results revealed that low monthly income (OR= 0.239, CI= 0.130-0.440, P<0.01), the presence of chronic respiratory disease (OR= 2.727, CI= 1.059-7.022, P<0.05), lower medication necessity scores (OR= 1.177, CI= 1.10-1.259, P<0.01) and higher concerns about RA medications (OR= 0.917, CI= 0.860-0.978, P<0.01) were significant and independent predictors of medication non-adherence in patients with RA. Conclusion: Future pharmaceutical care and clinical pharmacy service programs should emphasize medications benefits and minimizing medication-related concerns by selecting safe medications and providing guidance on mitigating side effects, particularly for RA patients who have low income and those who suffer from other comorbid diseases.

Introduktion: Tidigare forskning visar att det finns flera olika faktorer som bidrar till följsamhet vid läkemedelsbehandling av psykisk sjukdom, både möjligheter och svårigheter. En viktig uppgift som psykiatrisjuksköterskan har i mötet med patienter som lider av psykisk sjukdom är att psykiatrisjuksköterskan ska motivera patienten till att ta emot rekommenderad läkemedelsbehandling. Det är av värde att göra en översikt gällande aktuell forskning kring omvårdnadsmetoder och åtgärder som kan vidtas av psykiatrisjuksköterskan för att motivera patienter med psykisk sjukdom till följsamhet vid läkemedelsbehandling. Syfte: Syfte med denna studie är att undersöka hur sjuksköterskor inom psykiatrisk vård kan motivera personer med psykisk sjukdom till följsamhet vid läkemedelsbehandling. Metod: Metoden för detta examensarbete var litteraturöversikt bestående av 21 vetenskapliga artiklar, varav 14 kvantitativa, 5 kvalitativa och två med mixad metod. Vid litteratursökningenanvändes databaserna Pubmed och CINAHL. Resultat: Analysen av data resulterade i fyra kategorier (figur 3) vilket beskriver hur en sjuksköterska inom psykiatrisk vård kan motivera patienter med psykisk sjukdom tillföljsamhet vid läkemedelsbehandling. Dom fyra kategorierna blev: Den terapeutiska relationen och stöd från anhöriga vid följsamhet till läkemedelsbehandling, Psykoedukation för följsamhet till läkemedelsbehandling, Följsamhetsterapi för läkemedelsbehandling och Andra interventioner för att motivera till följsamhet vid läkemedelsbehandling. Slutsats: Det finns flera olika omvårdnadsinterventioner som specialistsjuksköterskan i psykiatrisk vård kan använda sig av för att motivera patienten att ta emot läkemedel och följa rekommenderad läkemedelsbehandling. Dessa omvårdnadsinterventioner överensstämmer med Roys anpassningsteori där Roy beskriver sjuksköterskans roll i patientens anpassningsförmåga och hur sjuksköterskan hjälper individer att hitta strategier för att hantera olika situationer samt ge, Introduction: Previous research has shown that there are several different factors that contributes to adherence to drug treatment of mental illness, both opportunities and difficulties. An important task that the psychiatric nurse has in the meeting with patients suffering from mental illness is that the psychiatric nurse should motivate the patient to accept recommended drug treatment. It is of value to make an overview of current research on the different methods and measures that can be used by the psychiatric nurse to motivate patients with mental illness to adherence to drug treatment. Aim: The aim of this study is to investigate on how nurses in psychiatric care can motivate people with mental illness to adherence to drug treatment. Method: The method for this thesis was a literature review consisting of 21 scientific articles, of which 14 quantitative, 5 Qualitative and two with mixed method. The databases Pubmed and CINAHL were used in the literature search. Results: The analysis of the data resulted in four categories (figure 3), which describes how a nurse in psychiatric care can motivate patients with mental illness to adherence to drug treatment. The four categories were: The therapeutic relationship and support from relatives to motivate adherence to drugtreatment, Psychoeducation for adherence to drug treatment, Adherence therapy for drug treatment and Other interventions to motivate adherence to drug treatment. Conclusion: There are several different nursing interventions that the specialist nurse in psychiatric care can use to motivate a patient to receive medication and follow recommended drug treatment. These nursing interventions are consistent with Roy's adaptation theory where Roy describes the nurse's role in the patient's adaptation capability and how the nurse helps individuals find strategies to handle different situations and gives individuals opportunities and support if needed.

Objective. To determine the effectiveness of a pharmaceutical intervention, based on the CMO methodology (capacity, motivation and opportunity), to decrease the prevalence of the PIMDINAC concept (potentially inappropriate medication+drug interactions+non-adherence to concomitant medication) in people living with HIV infection. Material and methods. Longitudinal prospective multicenter study, conducted between October 2021 and October 2022. Patients living with HIV older than 65 years, on antiretroviral treatment and concomitant drug prescription were included. Demographic, clinical, and pharmacotherapeutic variables were collected. Pharmaceutical care was provided for 6 months according to the CMO model in each patient. The main variable was the percentage of patients who simultaneously fulfilled the PIMDINAC concept, comparing the baseline value with the same value at the end of the study. In addition, the percentage of patient’s adherent to concomitant and antiretroviral treatment and the percentage of patients meeting the pharmacotherapeutic targets established for the prescribed medication at 24 weeks of follow-up were compared. Results. Sixty-eight patients were included. Seventy-two percent were men, with a median age of 68 years. The median number of concomitant drugs was 7. A 60.6% of the patients had polypharmacy. The prevalence of the presence of the PIMDINAC concept decreased significantly (10.3 vs. 0%). In isolation, each of the aspects also decreased significantly (p<0.031). The percentage of patients who met the objectives improved significantly from 48,5 at baseline to 88.2 (p<0.001). Conclusions. The pharmaceutical intervention based on the CMO methodology significantly decreased the prevalence of the PIMDINAC concept and increased the number of patients who achieved the objectives, optimising their pharmacotherapy., Objetivo. Determinar la efectividad de una intervención farmacéutica, basada en la metodología CMO (Capacidad, Motivación y oportunidad) para disminuir la prevalencia de criterios PIMDINAC (medicación potencialmente inapropiadainteracciones farmacológica-no adherencia a la medicación concomitante) en pacientes VIH+. Material y métodos. Estudio multicéntrico prospectivo longitudinal, realizado entre octubre-2021 y octubre-2022. Se incluyeron pacientes VIH+ ≥65 años, en tratamiento antirretroviral activo y medicación concomitante prescrita. Se recogieron variables demográficas, clínicas y farmacoterapéuticas. La intervención de atención farmacéutica se realizó durante los 6 meses de seguimiento a través de la metodología CMO. La variable principal fue la diferencia en el porcentaje de pacientes que presentaban los tres criterios PIMDINAC de forma simultánea al inicio-fin del estudio. Se analizó la variación del porcentaje de pacientes adherentes tanto al TAR y a la medicación concomitante, así como el porcentaje de pacientes que alcanzaron sus objetivos farmacoterapéuticos previamente definidos a los 6 meses de seguimiento. Resultados. Se incluyeron 67 pacientes, 72.0% varones con una mediana de edad de 68 años. El 60.6% de los pacientes tenían polifarmacia de forma basal con una mediana de fármacos de 7.0. La presencia de criterios PIMDINAC disminuyó significativamente de un 10.3 a 0%. De forma individual se redujo el porcentaje de cada criterio de forma significativa (p=0.031). Se incrementó el porcentaje de pacientes que alcanzaron sus objetivos farmacoterapéuticos (48,5% vs 88,2%; p<0.001). Conclusiones. La estrategia basada en la metodología CMO disminuye significativamente la prevalencia de los criterios PIMDINAC, así como incrementa la consecución de los objetivos farmacoterapéuticos de los pacientes, optimizando su farmacoterapia.

Purpose of review: Medication adherence plays an important role in improving health outcomes related to diabetes and comorbidity. The potential factors influencing medication adherence and how they contribute to health behaviors have not been synthesized to date. This review synthesized qualitative studies that identified factors influencing medication adherence among adults living with diabetes and comorbidity. Recent findings: Twenty-eight findings were extracted and synthesized into four themes: perceived support, lack of knowledge, medication issues, and the importance of routine. The findings highlight the factors that support medication adherence and areas that can be targeted to support and promote medication adherence. The findings also support the potential role of healthcare providers in supporting people living with diabetes and comorbidity to adhere to and maintain medication regimes. Summary: Several factors were identified that are amenable to intervention within the clinical practice setting and have the potential to enhance medication adherence and improve health outcomes for people living with diabetes and comorbidities. The development of acceptable and effective interventions could have a positive effect on medication adherence and health outcomes.

Objective. To determine the effectiveness of a pharmaceutical intervention, based on the CMO methodology (capacity, motivation and opportunity), to decrease the prevalence of the PIMDINAC concept (potentially inappropriate medication+drug interactions+non-adherence to concomitant medication) in people living with HIV infection. Material and methods. Longitudinal prospective multicenter study, conducted between October 2021 and October 2022. Patients living with HIV older than 65 years, on antiretroviral treatment and concomitant drug prescription were included. Demographic, clinical, and pharmacotherapeutic variables were collected. Pharmaceutical care was provided for 6 months according to the CMO model in each patient. The main variable was the percentage of patients who simultaneously fulfilled the PIMDINAC concept, comparing the baseline value with the same value at the end of the study. In addition, the percentage of patient’s adherent to concomitant and antiretroviral treatment and the percentage of patients meeting the pharmacotherapeutic targets established for the prescribed medication at 24 weeks of follow-up were compared. Results. Sixty-eight patients were included. Seventy-two percent were men, with a median age of 68 years. The median number of concomitant drugs was 7. A 60.6% of the patients had polypharmacy. The prevalence of the presence of the PIMDINAC concept decreased significantly (10.3 vs. 0%). In isolation, each of the aspects also decreased significantly (p<0.031). The percentage of patients who met the objectives improved significantly from 48,5 at baseline to 88.2 (p<0.001). Conclusions. The pharmaceutical intervention based on the CMO methodology significantly decreased the prevalence of the PIMDINAC concept and increased the number of patients who achieved the objectives, optimising their pharmacotherapy., Objetivo. Determinar la efectividad de una intervención farmacéutica, basada en la metodología CMO (Capacidad, Motivación y oportunidad) para disminuir la prevalencia de criterios PIMDINAC (medicación potencialmente inapropiadainteracciones farmacológica-no adherencia a la medicación concomitante) en pacientes VIH+. Material y métodos. Estudio multicéntrico prospectivo longitudinal, realizado entre octubre-2021 y octubre-2022. Se incluyeron pacientes VIH+ ≥65 años, en tratamiento antirretroviral activo y medicación concomitante prescrita. Se recogieron variables demográficas, clínicas y farmacoterapéuticas. La intervención de atención farmacéutica se realizó durante los 6 meses de seguimiento a través de la metodología CMO. La variable principal fue la diferencia en el porcentaje de pacientes que presentaban los tres criterios PIMDINAC de forma simultánea al inicio-fin del estudio. Se analizó la variación del porcentaje de pacientes adherentes tanto al TAR y a la medicación concomitante, así como el porcentaje de pacientes que alcanzaron sus objetivos farmacoterapéuticos previamente definidos a los 6 meses de seguimiento. Resultados. Se incluyeron 67 pacientes, 72.0% varones con una mediana de edad de 68 años. El 60.6% de los pacientes tenían polifarmacia de forma basal con una mediana de fármacos de 7.0. La presencia de criterios PIMDINAC disminuyó significativamente de un 10.3 a 0%. De forma individual se redujo el porcentaje de cada criterio de forma significativa (p=0.031). Se incrementó el porcentaje de pacientes que alcanzaron sus objetivos farmacoterapéuticos (48,5% vs 88,2%; p<0.001). Conclusiones. La estrategia basada en la metodología CMO disminuye significativamente la prevalencia de los criterios PIMDINAC, así como incrementa la consecución de los objetivos farmacoterapéuticos de los pacientes, optimizando su farmacoterapia.

Objective: This study aimed to design a persuasive game, using objective adherence data, to motivate people with asthma to adhere to their medication regimen. Methods: A participatory user-centered design approach was employed, involving end-users and other stakeholders throughout the study. The approach consisted of four phases. Semi-structured interviews and a survey were conducted to understand user needs and reasons for poor adherence (Phase 1: define). Key themes were identified, leading to the formulation of behavior change strategies and design and game requirements. Several design directions were ideated, resulting in a concept for a serious game (Phase 2: ideate). Two rounds of user-tests were performed to evaluate a prototype of the serious game in terms of usability, perceived impact on medication adherence and motivation (Phase 3: prototype and Phase 4: evaluate). Results: Findings from semi-structured interviews (n = 6) and the online survey (n = 20) revealed that people’s non-adherence was often attributed to the perception of asthma as an episodic condition, the delayed experienced effect of maintenance inhalers, and lack of knowledge regarding difference of effect between maintenance and reliever inhalers. The study used behavior change strategies to translate these insights into design requirements for the development of the narrative-based persuasive game Ademgenoot. This six-week challenge-based game combines various behavior change strategies, including personal goal setting and continuous visual feedback, as well as persuasive game design elements, such as a narrative and rewards, with the aim of enhancing motivation to adhere to their medication regimen. User-testing (n = 8; round 1 and 2) showed that Ademgenoot is feasible in clinical practice and has the potential to support people with mild asthma in adherence to their maintenance medication. Discussion: Future efforts should be directed towards a larger evaluation to assess the impact on, Applied Ergonomics and Design, Design Aesthetics

The need for MedSync mobile app and device stems from the challenges faced by elderly and busy people in medication management. Forgetfulness is a common problem among older adults who need to take multiple medications at different times of the day. Age-related cognitive decline makes it increasingly difficult to remember medication schedules. Similarly, busy people often juggle multiple responsi-bilities and may forget to take medication in the midst of their busy lives. In addition, the psychology of the human mind plays an important role in medication non-compliance. Some people have the mindset of not taking their medication due to side effects, forgetting, or simply not understanding the importance of taking their medication. The MedSync app and device address these needs by providing timely reminders and specific reminder systems. The app uses the convenience of mobile technology to send personalized notifications so that users never forget to take required medicines. The device developed complements by providing physical reminders that act as visual or auditory messages to take medication. By addressing forget-fulness and overcoming psychological barriers, MedSync offer practical solutions to improve medication adherence. These allow users, especially older and busy people, to stick to their medic tion regimens and improve their overall health and well-being.

Purpose: Few studies explored what patients initiated on blood pressure medication in primary care think about their disease and their medications. The aim of this study was to gain an understanding of hypertensive patients’ views on and experiences of hypertension and the use of antihypertensive medications. Methods: A qualitative study based on open-ended questions from a survey on medication adherence, which captured treated hypertensive patients’ perspective on their condition and treatment. Data were collected for 219 patients on antihypertensive medication, ≥ 30 years old, who consulted 25 primary health care centers in Stockholm, Sweden, during 2016. Thematic analysis with both inductive and deductive approach was applied. Results: We identified 21 codes from the data and grouped them under the World Health Organization’s five dimensions of adherence: condition-, therapy-, health care team and system-, patient-, and socioeconomic-related factors. The analyses revealed that many patients with hypertension have limited knowledge of their disease, are afraid of drug side effects and experience various issues in primary health care that may negatively impact adherence, including short doctor appointments, prescribing without communication and room for improvement in individualization of therapy and a person-centered approach. Conclusion: Many patients with hypertension have limited understanding of their hypertension and fear of adverse events from their antihypertensive medications. There is also room for improvement in how the patients are managed in primary health care. Interventions should focus on these issues to promote a better blood pressure target achievement.

BACKGROUND: Varenicline and oral nicotine replacement therapy (NRT) have each been shown to increase the likelihood of smoking cessation, but their combination has not been studied. In addition, smoking cessation medication adherence is often poor, thus, challenging the ability to evaluate medication efficacy. OBJECTIVE: This study examined the effects of combined varenicline and oral NRT and smartphone medication reminders on pharmacotherapy adherence and smoking abstinence among adults enrolled in smoking cessation treatment. METHODS: A 2×2 factorial design was used. Participants (N=34) were randomized to (1) varenicline + oral NRT (VAR+NRT) or varenicline alone (VAR) and (2) smartphone medication reminder messages (REM) or no reminder messages (NREM) over 13 weeks. Participants assigned to VAR+REM received varenicline reminder prompts, and those assigned to VAR+NRT+REM also received reminders to use oral NRT. The other 2 groups (VAR+NREM and VAR+NRT+NREM) did not receive medication reminders. Participants were not blinded to intervention groups. All participants received tobacco cessation counseling. Smartphone assessments of smoking as well as varenicline and NRT use (if applicable) were prompted daily through the first 12 weeks after a scheduled quit date. Descriptive statistics were generated to characterize the relations between medication and reminder group assignments with daily smoking, daily varenicline adherence, and daily quantity of oral NRT used. Participants completed follow-up assessments for 26 weeks after the quit date. RESULTS: Participants were predominantly White (71%), and half were female (50%). On average, participants were 54.2 (SD 9.4) years of age, they smoked an average of 19.0 (SD 9.0) cigarettes per day and had smoked for 34.6 (SD 12.7) years. Descriptively, participants assigned to VAR+NRT reported more days of smoking abstinence compared to VAR (29.3 vs 26.3 days). Participants assigned to REM reported more days of smoking abstinence

Background Non-adherence to medication is a common and complex issue faced by individuals undergoing hemodialysis (HD). However, more knowledge is needed about modifiable factors influence on non-adherence. This study investigated the prevalence of non-adherence, medication beliefs and symptom burden and severity among patients receiving HD in Denmark. Associations between non-adherence, medications beliefs and symptom burden and severity were also explored. Method A cross-sectional questionnaire-based multisite study, including 385 participants. We involved patient research consultants in the study design process and the following instruments were included: Medication Adherence Report Scale, Beliefs about Medication Questionnaire and Dialysis Symptom Index. Logistic regression analysis was performed. Results The prevalence of non-adherence was 32% (95% CI 27–37%) using a 23-point-cut-off. Just over one third reported being concerned about medication One third also believed physicians to overprescribe medication, which was associated with 18% increased odds of non-adherence. Symptom burden and severity were high, with the most common symptoms being tiredness/ lack of energy, itching, dry mouth, trouble sleeping and difficulties concentrating. A high symptom burden and/or symptom severity score was associated with an increased odd of non-adherence. Conclusion The study found significant associations between non-adherence and, beliefs about overuse, symptom burden and symptom severity. Our results suggest health care professionals (HCP) should prioritize discussion about medication adherence with patients with focus on addressing patient-HCP relationship, and patients’ symptom experience. Future research is recommended to explore the effects of systematically using validated adherence measures in clinical practice on medication adherence, patient-HCP communication and trust. Additionally, studies are warranted to further inve, Background: Non-adherence to medication is a common and complex issue faced by individuals undergoing hemodialysis (HD). However, more knowledge is needed about modifiable factors influence on non-adherence. This study investigated the prevalence of non-adherence, medication beliefs and symptom burden and severity among patients receiving HD in Denmark. Associations between non-adherence, medications beliefs and symptom burden and severity were also explored. Method: A cross-sectional questionnaire-based multisite study, including 385 participants. We involved patient research consultants in the study design process and the following instruments were included: Medication Adherence Report Scale, Beliefs about Medication Questionnaire and Dialysis Symptom Index. Logistic regression analysis was performed. Results: The prevalence of non-adherence was 32% (95% CI 27–37%) using a 23-point-cut-off. Just over one third reported being concerned about medication One third also believed physicians to overprescribe medication, which was associated with 18% increased odds of non-adherence. Symptom burden and severity were high, with the most common symptoms being tiredness/ lack of energy, itching, dry mouth, trouble sleeping and difficulties concentrating. A high symptom burden and/or symptom severity score was associated with an increased odd of non-adherence. Conclusion: The study found significant associations between non-adherence and, beliefs about overuse, symptom burden and symptom severity. Our results suggest health care professionals (HCP) should prioritize discussion about medication adherence with patients with focus on addressing patient-HCP relationship, and patients’ symptom experience. Future research is recommended to explore the effects of systematically using validated adherence measures in clinical practice on medication adherence, patient-HCP communication and trust. Additionally, studies are warranted to further investigate the relationship between sym

This thesis investigates the potential of Mobile Augmented Reality (MAR) for improving medication adherence. Empirical research was conducted by interviewing patients, pharmacists, and a homecare worker. Based on insights and findings, an onboarding concept called MedinAR was developed through sketching and prototyping, with the aim of refining the idea and understanding the user experience. MedinAR leverages MAR to offer new ways of accessing and consuming medication information, making it more accessible to users. The concept, explored through four prototypes, focuses on onboarding for new medication regimes, providing an interaction flow for users to scan pill bottles, receive digital information in the physical space, and finally receive guidance on the appropriate placement of medication in the pillbox according to their medication regime. Further research is required to assess the technology's meaningful adoption, but the study's results underscore the importance of further exploring new supportive tools for medication adherence.

Purpose: To develop an in-depth understanding of older individuals’ attitudes and perceptions of medication management and care after discharge from hospital-to-home.Patients and Methods: A qualitative study using semi-structured interviews with selected individuals 75 years and older, discharged from hospital within the last 6– 12 months, living at home, and managing their own medications. Face-to-face interviews were audio-recorded, transcribed and analyzed with thematic analysis.Results: Among the 15 respondents, mean age was 83.5 years (range 75– 95 years), 67% were women, and 60% lived alone. The majority (80%) managed their medications with a pill organizer or directly from the pill boxes, while 20% used dose dispensed medications. The analysis of the data led to six themes: Medication adherence, Personal responsibility, Transitions of care, Beliefs about medications, Participation (experience of participation, willingness to participate) and Accessibility (easier to reach hospital than primary care, navigating in the care system, continuity, personal chemistry).Conclusion: The included respondents who were older individuals, living at home and managing their own medications, expressed that they were medical adherent and self-managing. Two important aspects which were seen were difficulties to reach primary care on their own initiative and the lack of continuity with the same physician over a longer period of time., Norberg H, Håkansson Lindqvist M, Gustafsson M. Older Individuals’ Experiences of Medication Management and Care After Discharge from Hospital: An Interview Study. Patient Prefer Adherence. 2023;17:781-792https://doi.org/10.2147/PPA.S400039

Background: Type 2 diabetes mellitus (DM) is a chronic disease which requires long-term therapy. Medication adherence plays an important role for therapeutic success in patients with T2DM. Antidiabetic usage pattern might involve with some problems related to medication adherence. Objectives: The aim of this study was to analyze the association between antidiabetic usage pattern with medication adherence. Material and Methods: This observational study was conducted cross-sectionally involving 90 participants of T2DM  outpatient at Private Hospital in Buleleng Bali during July-September 2020. Patients were included if aged ≥18 years, received the same antidiabetic for three months before the study, signed informed consent, and provided with complete medical record data. Patients were excluded if appeared to be unwell, pregnant or breastfeeding. Demographic data and antidiabetic usage patterns were collected retrospectively based on the patient's medical records. Probabilistic Medication Adherence Scale (ProMAS) questionnaire was used to assess medication adherence. Data were analyzed with Kruskal-Wallis test. Results: The results showed that 55.6% patients were male, aged 46-65 years (61.1%), education predominantly by elementary school (37.8%), had suffered from DM for 5-10 years (46.7%), with comorbidities (50%), and without complications (77.8%). The antidiabetic usage pattern was dominated by a combination of two antidiabetics (53.3%). Most patients (42.2%) showed moderate-high medication adherence. There was no statistically significant association between antidiabetic usage pattern and medication adherence (p=0.275). Conclusions: A higher rate of medication adherence was found in patients taking combination of two antidiabetics compared to combination of three or four antidiabetics.

Background: Type 2 diabetes mellitus (DM) is a chronic disease which requires long-term therapy. Medication adherence plays an important role for therapeutic success in patients with T2DM. Antidiabetic usage pattern might involve with some problems related to medication adherence. Objectives: The aim of this study was to analyze the association between antidiabetic usage pattern with medication adherence. Material and Methods: This observational study was conducted cross-sectionally involving 90 participants of T2DM  outpatient at Private Hospital in Buleleng Bali during July-September 2020. Patients were included if aged ≥18 years, received the same antidiabetic for three months before the study, signed informed consent, and provided with complete medical record data. Patients were excluded if appeared to be unwell, pregnant or breastfeeding. Demographic data and antidiabetic usage patterns were collected retrospectively based on the patient's medical records. Probabilistic Medication Adherence Scale (ProMAS) questionnaire was used to assess medication adherence. Data were analyzed with Kruskal-Wallis test. Results: The results showed that 55.6% patients were male, aged 46-65 years (61.1%), education predominantly by elementary school (37.8%), had suffered from DM for 5-10 years (46.7%), with comorbidities (50%), and without complications (77.8%). The antidiabetic usage pattern was dominated by a combination of two antidiabetics (53.3%). Most patients (42.2%) showed moderate-high medication adherence. There was no statistically significant association between antidiabetic usage pattern and medication adherence (p=0.275). Conclusions: A higher rate of medication adherence was found in patients taking combination of two antidiabetics compared to combination of three or four antidiabetics.