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Background and Objectives: Patients with generalized anxiety disorder have psychological problems and require therapeutic interventions. The current study aimed to determine the effectiveness of metacognitive therapy on the the believability of anxious feelings and thoughts in patients with generalized anxiety disorder. Materials and Methods: This study was a quasi-experimental pretest-posttest design with a control group. The statistical population included all outpatient psychiatric patients at the Zare Hospital Psychiatric Clinic in Sari in the fall 2023. Thirty-two individuals were selected using purposive sampling and randomly assigned into two experimental and control groups (16 individuals each). The experimental group received 8 sessions of metacognitive therapy, while the control group did not receive any intervention. Data collection was done using the Generalized Anxiety Disorder Scale by Spitzer et al. (2006) and the Believability of Anxious Feelings and Thoughts Questionnaire by Herzberg et al. (2012). Multivariate analysis of covariance were used for data analysis. Results: Metacognitive therapy had a significant effect on the believability of anxious feelings and thoughts in patients with generalized anxiety disorder (p<0.001). The mean of believability of anxious feelings and thoughts scores in the experimental group were 86.44 and 55.94 in the pretest and posttest, respectively. This effectiveness was observed across all dimensions of believability of anxious feelings and thoughts with an effect size of 0.869 on the overall (p<0.001 ). Conclusion: The results of this study indicate that metacognitive therapy is effective in improving the believability of anxious feelings and thoughts in patients with generalized anxiety disorder. Therefore, it is recommended this approach be used to enhance the mental health of these patients. [ABSTRACT FROM AUTHOR]

Background and objectives: Diabetes self-care leads to blood sugar control in diabetic patients. Adherence to medication is one of the methods of self-care. This research to improving medication adherence in type 2 diabetic patients in Zahedan based on the Health Action Process Approach model. Materials and Methods: In this intervention study, 210 type 2 diabetic patients referred to diabetes clinics in Zahedan city in two intervention groups (105) and control group (105) were selected from the diabetes clinics of Zahedan hospitals during June and September in 2022. Sampling was done by available methods among diabetic patients. After collecting the data, a pre-test was conducted using the medication adherence questionnaire and the model constructs questionnaire. CVI = 0.7, CVR = 0.6 and Cronbach's alpha of the questionnaire was 0.97. One and three months after the educational intervention, the questionnaire on model structures and self-care behavior was completed by the patients and collected for analysis. Data were analyzed using independent t, Chi-square, and Shapiro-Wilk tests in SPSS version 23. A significance level of 0.05 was considered. Results: The results showed that all the Health Action Process Approach model constructs including risk perception, outcome expectancies, behavioral intention, action selfefficacy, coping self-efficacy, recovery self-efficacy, action planning and coping planning, perceived barriers, perceived benefits, and self-care behavior had significant differences in one month and three months after the educational intervention (P<0.05), which indicated the effectiveness of the education in the intervention group. However, no significant difference was observed in the control group (P < 0.05). Conclusion: The intervention with the Health Action Process Approach model showed that the structures of the model after the training had a significant impact on the self-care of patients in the field of medication compliance. Appropriate programs with details in the field of automatic coping self-efficacy and action planning should be designed to promote medication adherence among patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background & Aim: Medication adherence is one of the important health issues and key aspects of the desired quality of care in patients with diabetes, and one of the important factors affecting it is their health literacy. Therefore, the present study was conducted with the aim of determining the relationship between the level of health literacy and medication adherence in type 2 diabetes patients who referred to comprehensive health centers in Gorgan city during 2023. Materials & methods: This study was conducted cross-sectional on 400 patients with type 2 diabetes who referred to comprehensive health centers in Gorgan city in 2023. The data was collected by stratified sampling method according to the volume and in each stratum of the convenience type. Moriski medication adherence questionnaires (MMAS-8) and short version health literacy questionnaire (HELIA-SH) were used. Data were analyzed in SPSS software using independent t-test, chi-square, analysis of variance and Pearson correlation. Results: The average score of medication adherence and the total score of health literacy were 4.06 ± 1.46 and 36.47 ± 3.53, respectively. Among the participants in the study, only 8.20% of patients had high compliance and 16.80% had moderate compliance, and the rest (75%) had poor drug compliance. Patients' medication adherence had a direct and significant relationship with basic health literacy skills (P=0.004, r=0.14) and decision-making skills (P=0.003, r=0.15). Conclusion: The findings of this study showed that the majority of patients had poor medication adherence and the level of health literacy was related to the dimensions of medication regimen adherence in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background and purpose: Many patients fail to reach the expected results, even with the very considerable strides forward in the treatment of hypertension (HTN). They undergo serious complications after this condition remains uncontrolled. Patients' perceptions regarding the importance of Islamic self-care may be the occasion for managing chronic diseases. The present study aimed to investigate the effectiveness of the Islamic self-care model on blood pressure (BP) and medication adherence (MA) among older adults living with HTN. Materials and methods: Utilizing a randomized controlled trial in 2019 in Amol City of Iran, 60 elderly patients suffering from high blood pressure were assigned to two intervention and control groups in the form of random block allocation. Then, their BP and MA were measured using a dial sphygmomanometer and Morisky questionnaire, respectively. Designed for four weeks, the intervention group participated in an HTN-management education program, putting much emphasis on proper nutrition within the framework of the Islamic self-care model and gaining divine satisfaction. Simultaneously, the control group received a similar scientific HTN management and medication adherence education program. Following the re-measurement of BP and MA in both groups, the data were analyzed using descriptive statistical tests, Chi-square, Fisher, independent-samples t-test, and analysis of covariance. Results: In the pre-intervention phase, there was no significant difference between the two groups in the mean BP indices and MA. At the post-intervention, results revealed a significant reduction in the average systolic blood pressure (133.125±8.95) and diastolic (78.33±61.4) of the Islamic self-care group compared to systolic blood pressure (141.33±10.16) and diastolic (82.0±4.27) in the control group (P>0.001). Also, there was a significant improvement in the MA score in the Islamic self-care group (1.07±1.01) compared to the control group (2.43±1.38) (P

Fateme Nekooyan , Fatemeh Nazari * , Shahla Abolhasani , Mohammad Javad Tarrahi Background and Objective: Physical disability caused by multiple sclerosis (MS) increases MS patients' need for support from others. Medication adherence is one of the main success factors in the treatment of chronic diseases, which is influenced by various factors. This study aimed to determine the relationship between perceived social support and medication adherence in patients with MS. Methods: This descriptive-analytical study was conducted on 110 patients (70 women and 40 men) aged 39±9 years with MS who visited the 2 medical training centers of Isfahan University of Medical Sciences (Kashani and Al-Zahra), Isfahan, Iran during 2021. After sampling by the systematic random method, the data were collected by interviews and using Zimmet's Perceived Social Support Scale (MSPSS) and the Morisky Medication Adherence Scale (MMAS-8). Results: The mean and standard deviation of the scores of medication adherence and perceived social support were 6.10±1.72 and 62.83±14.97, respectively. According to the Pearson correlation coefficient, perceived social support did not show any significant relationship with medication adherence (r=0.185, P=0.053). Perceived social support showed a statistically significant relationship with income satisfaction (F=4.54, P=0.01), the pattern of clinical course (F=2.95, P=0.03), difficulty in accessing medical care (t=-2.29, P=0.02), and clinical symptoms, including motor (t=-3.72, P=0.001), balance (t=-3.23, P=0.002), and urinary disorders (t=-2.53, P=0.01). Conclusion: Perceived social support in patients with MS did not cause medication adherence.

Background and purpose: Many patients fail to reach the expected results, even with the very considerable strides forward in the treatment of hypertension (HTN). They undergo serious complications after this condition remains uncontrolled. Patients' perceptions regarding the importance of Islamic self-care may be the occasion for managing chronic diseases. The present study aimed to investigate the effectiveness of the Islamic self-care model on blood pressure (BP) and medication adherence (MA) among older adults living with HTN. Materials and methods: Utilizing a randomized controlled trial in 2019 in Amol City of Iran, 60 elderly patients suffering from high blood pressure were assigned to two intervention and control groups in the form of random block allocation. Then, their BP and MA were measured using a dial sphygmomanometer and Morisky questionnaire, respectively. Designed for four weeks, the intervention group participated in an HTNmanagement education program, putting much emphasis on proper nutrition within the framework of the Islamic self-care model and gaining divine satisfaction. Simultaneously, the control group received a similar scientific HTN management and medication adherence education program. Following the re-measurement of BP and MA in both groups, the data were analyzed using descriptive statistical tests, Chi-square, Fisher, independent-samples t-test, and analysis of covariance. Results: In the pre-intervention phase, there was no significant difference between the two groups in the mean BP indices and MA. At the post-intervention, results revealed a significant reduction in the average systolic blood pressure (133.125±8.95) and diastolic (78.33±61.4) of the Islamic self-care group compared to systolic blood pressure (141.33±10.16) and diastolic (82.0±4.27) in the control group (P>0.001). Also, there was a significant improvement in the MA score in the Islamic self-care group (1.07±1.01) compared to the control group (2.43±1.38) (P<0.001). Conclusion: The Islamic self-care model was found to be effective in managing the average BP and MA of patients. [ABSTRACT FROM AUTHOR]

Background and Objective: Physical disability caused by multiple sclerosis (MS) increases MS patients' need for support from others. Medication adherence is one of the main success factors in the treatment of chronic diseases, which is influenced by various factors. This study aimed to determine the relationship between perceived social support and medication adherence in patients with MS. Methods: This descriptive-analytical study was conducted on 110 patients (70 women and 40 men) aged 39±9 years with MS who visited the 2 medical training centers of Isfahan University of Medical Sciences (Kashani and Al-Zahra), Isfahan, Iran during 2021. After sampling by the systematic random method, the data were collected by interviews and using Zimmet's Perceived Social Support Scale (MSPSS) and the Morisky Medication Adherence Scale (MMAS-8). Results: The mean and standard deviation of the scores of medication adherence and perceived social support were 6.10±1.72 and 62.83±14.97, respectively. According to the Pearson correlation coefficient, perceived social support did not show any significant relationship with medication adherence (r=0.185, P=0.053). Perceived social support showed a statistically significant relationship with income satisfaction (F=4.54, P=0.01), the pattern of clinical course (F=2.95, P=0.03), difficulty in accessing medical care (t=-2.29, P=0.02), and clinical symptoms, including motor (t=-3.72, P=0.001), balance (t=-3.23, P=0.002), and urinary disorders (t=-2.53, P=0.01). [ABSTRACT FROM AUTHOR]

Introduction: Non-adherence to medication in HIV-positive patients leads to the occurrence of HIV-related diseases and ultimately reduces the quality of life and immune system function of these patients. Therefore, the present study was conducted to identify and explain the factors that influence medication non-adherence in HIV-positive Iranian patients. Material & Methods: The present applied study was conducted in 2020-2021 using the descriptive method. First, by reviewing the research literature and interviewing experts in the field of HIV treatment, the main factors influencing medication non-adherence in HIV-positive patients were identified, based on which the research questionnaire was designed. Data were collected from 590 HIV-positive patients and analyzed using exploratory factor analysis and SPSS23 and LISREL software. Findings: Four factors, namely organizational factors (16 items), individual factors (19 items), educational factors (7 items), and communication factors (7 items) were identified as effective factors for medication non-adherence in HIV-infected patients. Communication factors, individual factors, educational factors, and organizational factors with factor loadings of 0.76, 0.74, 0.73, and 0.71, respectively, had an impact on medication non-adherence in HIV-positive patients. Discussion & Conclusion: To improve medication adherence among HIV patients, behavioral disease counseling experts and therapists should pay more attention to communication factors (improving patients social support from family and friends) and individual factors (not coping with the disease state and the effects of stigma and disclosing the disease).

Background: Due to the increasing number of elderly people in Iran, as well as chronic diseases, such as diabetes, in the elderly, this study was conducted to investigate the relationship between spiritual health and hope with adherence to the medication regimens in the elderly with type 2 diabetes. Methods: This descriptive-analytical study was conducted in the diabetes clinic of 22 Bahman Hospital in Gonabad, Iran. The data were collected using the demographic information form, Herth Hope Index (HHI), Paloutzian and Ellison Spiritual Well Being Scale, and Morisky Medication Adherence Scale (MMAS) by interview method. Data were analyzed using independent t-test, analysis of variance (ANOVA), and Spearman coefficient in SPSS software. Findings: Most of the participants had high spiritual health, high hope, and low adherence to medication regimen. In addition, spiritual health was directly related to treatment adherence (P < 0.05); however, no relationship was found between hope and treatment adherence (P > 0.05). Conclusion: High hope in an elderly person cannot be a reason for good adherence to medication regimen, but for appropriate medication adherence, it is necessary for the elderly to have correct and sufficient information about their medication and treatment plan.

Introduction: Lung cancer is the leading cause of cancer mortality worldwide. In recent years, the role of psychological factors in adherence to medication in patients with lung cancer has attracted more attention. This study aimed to investigate the prediction of medication adherence based on dispositional resilience, tolerance for ambiguity and perceived social support in patients with lung cancer in Yazd. Method: This descriptive-correlational study was conducted using a cross-sectional design. The statistical population consisted of all patients with lung cancer visiting Shahid Ramezan Zadeh Radiation Therapy Center in Yazd in 2020-2021, and 120 male patients were selected using convenience sampling. Data were collected using Medication Adherence Report Scale (MARS-8), Dispositional Resilience Scale (HARDY), Ambiguity Tolerance Scale-I (MSTAT-I) and Multidimensional Scale of Perceived Social Support (MSPSS), whose validity and reliability were confirmed. Then, they were analyzed in SPSS 23 using Pearson correlation coefficient and multiple regression. Results: Results suggested a significant positive correlation between dispositional resilience and medication adherence (R=0/47), ambiguity tolerance and medication adherence (R=0/61), as well as perceived social support and medication adherence (R=0/68) (P<0/001). According to the results, the predictor variables generally explained 46.3% of the variance of medication adherence. Conclusion: Based on the results, medication adherence in patients with lung cancer is predictable using dispositional resilience, ambiguity tolerance and perceived social support. [ABSTRACT FROM AUTHOR]

Background and Objective: The level of patient adherence to treatment and medication orders is one of the important factors influencing the effectiveness of medical treatments. The aim of this study is to investigate the relationship between doctor-patient communication skills and the level of adherence to medication orders after discharge from the hospital. Methods: This cross-sectional study was conducted on 284 patients admitted to the surgery and urology departments of Shahid Beheshti Hospital in Babol, where at least 48 hours had passed since their admission. Patients completed two questionnaires of doctor-patient communication skills (range 21-70) and Burton communication skills (range 18-90) in the hospital. Then, two weeks after discharge, the patients answered the two questionnaires of general adherence and the Morisky Medication Adherence Scale online or by telephone contact, and the results were analyzed. Findings: The mean age of the participating patients was 50.65±18.20 years and the score of general adherence to treatment orders was 24.26±5.77 (range 7-30) and medication adherence was 8.54±2.91 (range 1-11). 222 patients (78.2%) had high adherence to treatment orders. Stepwise regression analysis showed that doctors’ communication skills were a positive factor in medication adherence (p

Objectives Hypertension is the most common cause of stroke and kidney failure in the elderly and medication adherence is vital in controlling complications. This study aims to determine the effect of the Johnson model-based program on medication adherence among the elderly with hypertension. Methods & Materials The present study was a clinical trial that was performed on the elderly with hypertension referred to the Shahid Aval comprehensive health service center in Isfahan City, Iran. Through the convenience sampling method, 70 older adults were selected and randomly divided into intervention and control groups. For the intervention group, 6 sessions of a family-based medication adherence program were performed based on the Johnson model. Demographic characteristics questionnaire and sphygmomanometer were used to collect data. Data were analyzed by SPSS version 22 statistical software using independent t test, Chi-square, and repeated measures analysis of variance (ANOVA). Results No difference was observed between the two groups in terms of the distribution of demographic characteristics. Mean systolic and diastolic blood pressure before the intervention in the group were not significantly different, but immediately and three months after the intervention in the intervention group, it was significantly lower than the control group(P

The aim of this study was to the effectiveness of stress inoculation therapy on alexithymia and medication adherence of cardiovascular patients. The quasi-experimental research design was pretest-posttest and follow-up with the nonequivalent control group. The statistical population of this study included all patients with coronary heart disease who referred to the specialized heart hospital in Urmia in 2022 who had referred to this center for medical services. The sample size consisted of 40 people from the mentioned community who were selected by available sampling method and placed in two experimental and control groups. The research instruments included The Toronto Alexithymia Scale (1994) and the Morisky Medication Adherence Scale-8 (2008). The results showed that stress inoculation therapy had a significant effect on improving alexithymia and medication adherence in the post-test and follow-up stages. The findings of the present study show that stress inoculation therapy can improve alexithymia and medication adherence in cardiovascular patients.

Introduction: Non-adherence to medication in HIV-positive patients leads to the occurrence of HIV-related diseases and ultimately reduces the quality of life and immune system function of these patients. Therefore, the present study was conducted to identify and explain the factors that influence medication nonadherence in HIV-positive Iranian patients. Material & Methods: The present applied study was conducted in 2020-2021 using the descriptive method. First, by reviewing the research literature and interviewing experts in the field of HIV treatment, the main factors influencing medication nonadherence in HIV-positive patients were identified, based on which the research questionnaire was designed. Data were collected from 590 HIV-positive patients and analyzed using exploratory factor analysis and SPSS23 and LISREL software. Findings: Four factors, namely organizational factors (16 items), individual factors (19 items), educational factors (7 items), and communication factors (7 items) were identified as effective factors for medication non-adherence in HIV-infected patients. Communication factors, individual factors, educational factors, and organizational factors with factor loadings of 0.76, 0.74, 0.73, and 0.71, respectively, had an impact on medication non-adherence in HIV-positive patients. Discussion & Conclusion: To improve medication adherence among HIV patients, behavioral disease counseling experts and therapists should pay more attention to communication factors (improving patients social support from family and friends) and individual factors (not coping with the disease state and the effects of stigma and disclosing the disease). [ABSTRACT FROM AUTHOR]

Objectives Hypertension is the most common cause of stroke and kidney failure in the elderly and medication adherence is vital in controlling complications. This study aims to determine the effect of the Johnson model-based program on medication adherence among the elderly with hypertension. Methods & Materials The present study was a clinical trial that was performed on the elderly with hypertension referred to the Shahid Aval comprehensive health service center in Isfahan City, Iran. Through the convenience sampling method, 70 older adults were selected and randomly divided into intervention and control groups. For the intervention group, 6 sessions of a family-based medication adherence program were performed based on the Johnson model. Demographic characteristics questionnaire and sphygmomanometer were used to collect data. Data were analyzed by SPSS version 22 statistical software using independent t test, Chi-square, and repeated measures analysis of variance (ANOVA). Results No difference was observed between the two groups in terms of the distribution of demographic characteristics. Mean systolic and diastolic blood pressure before the intervention in the group were not significantly different, but immediately and three months after the intervention in the intervention group, it was significantly lower than the control group(P<0.05). Conclusion Johnson's model-based program was effective in lowering hypertension in the elderly. Therefore, the method used in the present study is proposed to older adults and elderly care nurses as a simple, non-invasive, low-cost, and effective method of reducing hypertension. [ABSTRACT FROM AUTHOR]

Background: Hypertension is one of the leading causes of death and physical disabilities. The ankle-brachial index (ABI) is one of the useful indicators of blood pressure with the ability to show the risk of peripheral artery disease. This study aims to investigate the relationship between medication adherence and the ABI lavue in patients with hypertension. Methods: In this descriptive cross-sectional study, 250 patients with hypertension referred to medical health centers in Karaj, Iran were enrolled using a convenience sampling method. To collect data, a demographic form and the 8-item morisky medication adherence scale (MMAS-8) were used. Also, the ABI was measured manually using an acoustic Doppler probe. Data were analyzed in SPSS software, v. 25. Findings: The Mean±SD of the right and left ABI were 1.055±0.134 and 1.036±0.113, respectively. The Mean±SD of MMAS-8 score was 5.88±1.74. It was found that 127 patients (50.8%) had low adherence level, 68 (27.2%) had moderate adherence level, and only 55 (22%) had high adherence level. There was a positive significant correlation between patients’ medication adherence and the ABI value. Moreover, a statistically significant difference was observed in the mean scores of the ABI in patients with three different levels of medication adherence. Conclusion: The medication adherence is poor among hypertensive patients in Karaj. It is related to the ABI such that with the decrease of medication adherence, the ABI value decreases. Therefore, adherence to medication regimen in patients with hypertension can be effective in preventing arterial complications.

Background and Objective: Medication adherence has a critical role to play in the control and treatment of Acquired Immunodeficiency Syndrome (AIDS). The present research aimed to develop, implement, and evaluate an interventional program to promote medication adherence among AIDS patients referred to Behavioral Diseases Counseling Centers in Kermanshah using the I-Change model. Materials and Methods: The present research was conducted based on a quasi-experimental design on a total of 150 AIDS patients in Kermanshah in 2021. They were randomly selected and assigned to intervention and control (n=75 in each group) groups. The intervention development was based on the I-Change model needs assessment and intervention mapping approach. The collected data was evaluated before and three months after the implementation intervention. Data were analyzed in SPSS software (version 16). Results: The mean age of patients was 39.11±6.07 years (range: 22-51 years). After implementing the intervention, the intervention group obtained significantly higher mean scores in regular medication adherence behaviors (P

Objectives Many older patients use medicinal plants, assuming that they are safe and without side effects. The present study aims to investigate the relationship between the use of medicinal plants and medication adherence in the elderly patients with chronic diseases. Methods & Materials In this descriptive cross-sectional study, 358 patients aged ≥60 years with chronic diseases were selected by a convenience sampling method. Data collection instrument was a three-part questionnaire assessing demographic information, history of using medicinal plants, and medication adherence using the Morisky medication adherence scale (MMAS). The data were entered into SPSS v.21 and analyzed using one-way analysis of variance, Chi-square test, independent t-test and logistic regression. Results The mean age of participants was 69.44±8.13 years and 52.23% were female. The majority of them were married (87.68%) with a junior high school education (71.64%).The overall mean score of MMAS was 5.48 (poor adherence). The percentage of patients with a history of taking medicinal plants in the last year with the prescription of physician was 41.34% (n=148) while the percentage of those used medicinal plants without the physician’ prescription was 27.3% (n=98). The mean of MMAS score in the groups who used medicinal plants was lower than in the group with no history of using medicinal plants (P=0.001). The number of used medicinal plants, the frequency of using medicinal plants, and the duration of chronic disease had a statistically significant relationship with the medication adherence (P

Background and Objective: Diabetes is the most common chronic metabolic disease in the world and one of its control principles is the patient's adherence to the physician's treatment recommendations. This study aimed to determine the adherence to medication treatment and related factors in type 2 diabetic patients referring to the Diabetes Clinic of Shahid Beheshti Hospital, Hamadan, Iran, in 2020. Materials and Methods: The present cross-sectional study was conducted on 284 patients with type 2 diabetes referring to the Diabetes Clinic of Shahid Beheshti Hospital. The data collection tool was a researcher-made questionnaire whose validity and reliability were confirmed in a pilot study. Data were analyzed in Stata software (version 11) at the significance level of 0.05. Results: Most of the patients were women (64.08%) and urban dwellers (79.08%). The mean age of the patients was obtained at 54.78 years, and 47.89% of the patients had poor medication adherence. Patients' medication adherence showed a statistically significant relationship with gender, marital status, education, physician's respectful behavior, respect for patient privacy, physician skill, the satisfaction of the physician, a history of other diseases, and a history of hypertension (P

Background & Aims: Epidemiological changes have made chronic diseases increasingly important. Hypertension is also known as a chronic disease. The high prevalence of hypertension has made the disease a significant health problem in communities. Spiritual health has been proposed as one of the health indicators and predictors of self-care in chronic diseases. This study aimed to determine the relationship between spiritual health and adherence to the treatment regimen in patients with hypertension. Materials & Methods: In this descriptive correlational study, 121 patients with hypertension were selected by continuous sampling method from cardiac clinics affiliated with Iran University of Medical Sciences, Iran, in 2020. The study data were collected through demographic information form and validated Ellison and Paloutzian spiritual health and Hil-Bone diet adherence questionnaires. For data analysis, we performed the statistical tests of the Spearman, independent t test, Chi-square, and analysis of variance in SPSS version 16. Results: This study shows a significant and negative relationship between spiritual health and adherence to the treatment regimen in patients with hypertension (P=0.001, r=-0.05). Conclusion: As spiritual health increases, adherence to the treatment regimen in patients with hypertension decreases. Spiritual health in this group of patients leads to less adherence to the treatment regimen.

Background and Objectives: Patients’ beliefs about medicines can affect their adherence to the medicines. The aim of this study was to determine beliefs about medicines and medication adherence and its associated factors in patients with chronic diseases. Methods: In this cross-sectional descriptive study, 268 patients with chronic diseases in 2019-2020 were included by convenience sampling method. The beliefs about medicines questionnaire and the Medication Adherence Scale were used for data collection. Data were analyzed in SPSS version 20 using One-Way Analysis of Variance (ANOVA), independent t-test and Pearson correlation coefficient at the significance level of α = 0.05. Results: The Mean±SD score of beliefs about medicines in terms of harms of medicines was 2.53±0.71, in benefits of medicines was 4.27±0.49 and overdose of the medicines was 3.23±0.79.There was a relationship between all three dimensions of beliefs about medicines with medication adherence (P

Background & Aim: Epilepsy is the most common chronic neurological disease after headache. About half of the patients with epilepsy do not properly adhere to medication regimens, which leads to a lack of control over seizures, increased treatment costs, and even increased mortality rate in these patients. The aim of this study was to determine the effect of telephone education on medication adherence in patients with epilepsy. Methods & Materials: In this quasi-experimental study, 60 patients referred to neurology clinic of Valiasr Hospital in Zanjan in 2019 were selected by the convenience sampling method, and were randomly divided into either control or experimental groups. The Morisky drug adherence Questionnaire was used for data collection. At the beginning of the study and after completing the questionnaires, a face-to-face training session was held for the study participants. Then, telephone education was performed for the experimental group for two months and no intervention for the control group. Two months after the intervention, all the patients completed the questionnaire again. Finally, the collected data were analyzed through the SPSS software version 25 using descriptive (mean and standard deviation) and inferential statistics (Chi-square, Fisherchr('39')s exact test, independent t-test and paired t-test). Results: Before the intervention, there was no statistically significant difference between the two groups in terms of individual characteristics and medication adherence scores (P

Objectives Many older patients use medicinal plants, assuming that they are safe and without side effects. The present study aims to investigate the relationship between the use of medicinal plants and medication adherence in the elderly patients with chronic diseases. Methods & Materials In this descriptive cross-sectional study, 358 patients aged ≥60 years with chronic diseases were selected by a convenience sampling method. Data collection instrument was a three-part questionnaire assessing demographic information, history of using medicinal plants, and medication adherence using the Morisky medication adherence scale (MMAS). The data were entered into SPSS v.21 and analyzed using one-way analysis of variance, Chi-square test, independent t-test and logistic regression. Results The mean age of participants was 69.44±8.13 years and 52.23% were female. The majority of them were married (87.68%) with a junior high school education (71.64%).The overall mean score of MMAS was 5.48 (poor adherence). The percentage of patients with a history of taking medicinal plants in the last year with the prescription of physician was 41.34% (n=148) while the percentage of those used medicinal plants without the physician' prescription was 27.3% (n=98). The mean of MMAS score in the groups who used medicinal plants was lower than in the group with no history of using medicinal plants (P=0.001). The number of used medicinal plants, the frequency of using medicinal plants, and the dura- tion of chronic disease had a statistically significant relationship with the medication adherence (P <0.05). Conclusion Due to the high consumption of medicinal plants in the elderly with chronic diseases and its relationship with poor medication adherence, it is necessary to educate them about the correct use of medicinal plants, their side effects, herb-drug interactions, the need to inform the doctor about use of medicinal plants, and adherence to medication. [ABSTRACT FROM AUTHOR]

Introduction: Schizophrenia is a chronic and disabling mental disorder and medication non-adherence remains a significant challenge for the patients and psychiatrists. The present study aimed to assess the impact of short-message service (SMS) on medication adherence in schizophrenic patients as compared with the control group. Methods: A total of 63 patients with schizophrenia were assigned to the intervention group (N= 32) and the control group (N= 31). The patients in the intervention group received a daily SMS that read, ‘‘Please remember to take your medication” at 8:00am and 8:00pm. Medication adherence was assessed by the self-report Medication Adherence Rating Scale (MARS) at baseline and in the 3rd month, and the 6th month. Results: Patients receiving SMS had a significantly greater improvement in medication adherence compared with the control group in the 3rd month, but there was no significant difference in the 6th month. Conclusion: The results of the present study showed that text message reminder for medication intake is an effective and feasible strategy for enhancing medication adherence in patients with schizophrenia.

Background and aim: Coronary artery disease is one of the most common forms of cardiovascular disease. Angioplasty is a common technique for its treatment. Adherence is an important factor in preventing the progression of coronary heart disease in patients undergoing angioplasty. Therefore, the present study was conducted in order to determine the medication adherence in patients undergoing repeat angioplasty in Shaheed Rajaei Cardiovascular Medical and Research Center in 2021. Methods: This cross-sectional study, was performed on 92 patients referring to Shaheed Rajaei cardiovascular medical and research center undergoing coronary artery restenosis following repeat angioplasty. Patients were selected with convenience sampling. The instruments used in this study included the demographic information scale and the Medication Adherence Rating Scale )MARS(. Results: The mean of patients' age was (60.60±6.53) and the majority of the patients were males (55%), and mostly under diploma (34%). The mean score of professional self-concept was 3.04±1.21. The intentional medication noncompliance with the mean of (2.82±0.96) was higher than unintentional medication noncompliance with the mean of (0.23±0.47). There was inconsistency between adherence to Medication and demographic information, which indicates the fact that medication non-adherence, was not seen in the whole study population. Conclusion: Considering that almost the majority of patients did not have medication adherence after angioplasty and were referred for repeat angioplasty, therefore, nurses should help with the prevention of repeat angioplasty through the use of appropriate measures influencing adherence to the therapeutic plan at discharge from the hospital. [ABSTRACT FROM AUTHOR]

Background & Aim: Medicinal nonadherence prevents the achievement of therapeutic goals in cardiovascular patients. Training is essential to increase medicinal adherence. Therefore, the present study compared the effect of two teach-back and pictorial training methods on the medication adherence in heart failure patients. Methods: This quasi-experimental study was performed on 210 heart failure patients in Hamadan Heart Hospital in 2019. Patients were selected by convenience sampling and randomly assigned to one of three groups of Teach-back, pictorial, and control training. Training sessions were held in three sessions on three consecutive days. Data were collected using demographic and medication adherence questionnaire (MMAS-8) before, immediately and 6 weeks after training. ANOVA, ANCOVA and Repeated measures ANOVA statistical tests were used. Results: There was no statistically significant difference between the three groups in medicinal adherence at baseline. Immediately after training, medication adherence was significantly higher in teach-back and pictorial groups than the control group (P0.05). Conclusion: Teach-back training helps maintain medicinal adherence in heart failure patients. Therefore, it is recommended that nurses use this training method to improve medicinal adherence in these patients.

Background: Resistant hypertension is defined when the blood pressure remains elevated above the therapeutic target levels despite the use of three antihypertensive agents including calcium channel blocker (CCB), renin-angiotensin system (RAS) blocker and a diuretic. These drugs should be used at maximally tolerated doses and white coat effect and non-adherence should also be excluded. In this article, by describing a case of resistant hypertension, we discuss a diagnostic and therapeutic approach to resistant hypertension. Case Presentation: A 59 years old man, known case of diabetic nephropathy with a serum creatinine level of 1.2 mg/dL and proteinuria of about 3300 mg in 24 hours referred to Hypertension Clinic of Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, for evaluation of resistant hypertension. The patient was under treatment by losar-H, diltiazem, and furosemide, which are not appropriate combinations of antihypertensive agents. The ambulatory blood pressure monitoring (ABPM) of the patient revealed daytime and nighttime hypertension and also the non-dipping status of blood pressure. Dihydropyridine CCB was prescribed in combination with RAS blocker (Exforge 50 mg/ 160 mg) and the diuretic was changed to thiazide-like agents. In the next step, spironolactone and carvedilol were added for better control of blood pressure. The patient referred to the sleep clinic for polysomnography and evaluation of obstructive sleep apnea. Following three months prescription of these medications, ABPM revealed relatively appropriate control of blood pressure, so the average 24-hour blood pressure decreased from 157/91 mm Hg to 136/83 mm Hg. Conclusion: The complications and mortality of hypertension would be increased dramatically in patients with resistant hypertension. So, an appropriate diagnostic and therapeutic approaches should be considered for these patients. Choosing appropriate diuretic agents would be important in the management of resistant hypertension.

Introduction and purpose: Poor medication adherence may result in adverse outcomes, such as a higher rate of hospitalization and increased costs of healthcare. In this regard, the present study was designed to determine the relationship between cognitive status and medication adherence among elderly patients with hypertension. Methods: In this cross-sectional study, 180 elderly patients with hypertension were selected from Imam Reza Hospital in Amol, Iran, (2018) using convenience sampling. Cognitive impairment and medication adherence were assessed using the Cognitive State Test and Morisky Medication Adherence Scale, respectively. The data were analyzed by SPSS software (version 16) using the independent t-test, Chi-square test, and logistic regression. Results: Out of 180 participants, 66.1% (n=119) of them were female. The mean age of the patients was 72.87±7.63 years. The mean values of medication adherence and cognition score were reported as 5.21±2.29 and 26.03±3.21, respectively. There was no significant relationship between medication adherence and total cognition score (P=0.322). Medication adherence was two times higher among those who were reported with no anxiety, compared to those who suffered from anxiety (β=-0.67; odds=0.51; P=0.008). The obtained results also showed medication adherence increased twelve times with one unit increase of verbal fluency. Moreover, medication adherence enhanced eight times with one unit increase of abstract thinking and judgment. Conclusion: The subdomains of cognition, such as verbal fluency, as well as abstract thinking and judgment, had a significant relationship with medication adherence in elderly patients with hypertension. In this regard, it is suggested to assess cognitive status among elderly patients with hypertension and design appropriate interventions.

Background & Aim: Epilepsy is the most common chronic neurological disease after headache. About half of the patients with epilepsy do not properly adhere to medication regimens, which leads to a lack of control over seizures, increased treatment costs, and even increased mortality rate in these patients. The aim of this study was to determine the effect of telephone education on medication adherence in patients with epilepsy. Methods & Materials: In this quasi-experimental study, 60 patients referred to neurology clinic of Valiasr Hospital in Zanjan in 2019 were selected by the convenience sampling method, and were randomly divided into either control or experimental groups. The Morisky drug adherence Questionnaire was used for data collection. At the beginning of the study and after completing the questionnaires, a face-to-face training session was held for the study participants. Then, telephone education was performed for the experimental group for two months and no intervention for the control group. Two months after the intervention, all the patients completed the questionnaire again. Finally, the collected data were analyzed through the SPSS software version 25 using descriptive (mean and standard deviation) and inferential statistics (Chi-square, Fisher's exact test, independent t-test and paired t-test). Results: Before the intervention, there was no statistically significant difference between the two groups in terms of individual characteristics and medication adherence scores (P>0.05); But two months after the intervention, a statistically significant difference was observed in the mean score of medication adherence between the two control and experimental groups so that the patients in the experimental group had higher scores of medication adherence (P<0.001). Conclusion: The results of this study showed the usefulness of using the telephone education method in improving the medication adherence of patients with epilepsy. Therefore, it is recommended that this method be used in the training program for these patients. In addition, further studies are needed on the comparison of the effectiveness of telephone education with other methods of telemedicine such as cyberspace and online education. [ABSTRACT FROM AUTHOR]

Background and Objective: Adherence to antihypertension medications is an important factor in the control of hypertension. In this regard, the present study aimed to estimate the extent of medication adherence in hypertensive patients and its determinants in the special clinic of Seyed-al Shohada Cardiovascular Tertiary Hospital in Urmia, Iran. Materials and Methods: In this cross-sectional study, a total of 650 hypertensive patients were investigated during October to December 2016. In this study, two questionnaires were used to collect the data. The first questionnaire included the demographic and clinical characteristics, smoking status, family history of hypertension, and blood pressure measurements. The eight-item Morisky medication adherence scale was used to measure the extent of medication adherence of the participants. Moreover, the Chi-square test and logistic regression model were employed to identify the determinants of medication adherence. Results: Mean value of the participant age was reported as 59.5±10.4 years, and 63.5% of the subjects were female. Overall, 48%, 30.8%, and 21.2% of the subjects were reported with complete, moderate, and poor adherence, respectively. Among the investigated determinants, age (OR=1.02, 95% CI: 1.01-1.05), occupational status (OR=1.83, 95% CI: 1.19-2.83), absence of adverse effects of the drugs (OR=1.83, 95% CI: 1.02-2.71), use of two drugs (OR=1.75, 95% CI: 1.12-2.74), use of three drugs and more (OR=2.25, 95% CI: 1.30-3.88), and history of angioplasty (OR=1.80, 95% CI: 1.19-2.71) were associated with good adherence (i.e., complete and moderate) in this study. Only 39.4% of all participants had controlled level of hypertension. Conclusion: According to the obtained results, the patients with hypertension had good medication adherence. The determinants effective in medication adherence outlined in this study can help identify patients with low extent of adherence.

Introduction: Adherence of standards requires the continuous of education for nurses. Effective educational methods for increasing knowledge and enhancing skills is group discussion. The purpose is to determine the effect of education of medication by small groups discussion on nursing adherence in intensive care units of medication Standards. Methods: In this semi-experimental study the intensive care units of two hospitals that were randomly assigned as intervention and control groups 76 nurses were enrolled in the census. The medication standards checklist was designed in 25 sections and 53 questions. The researcher using the checklist, controlled each nurse’s adherence of the medication standards in four steps before and after the education, subtle and direct observation. If adherence score 1 and in non adherence score zero was earned. The education of medication standards was conducted in the intervention group by group discussion method during two sessions of two-hours. Data analysis was performed using SPSS 16 and independent t-test and paired t-test. Results: There was no statistically significant difference between the two groups in term of the rate of adherence of nurses from the medication standards before intervention (P>0.05). After intervention, nurses’ adherence significantly increased in the intervention group (87.9±2.5) compared to the control group (77.7±2.7) (P

Introduction: Medication adherence is essential to improve outcomes emanated from the disease. The increase in the complexity of the medical regimens causes poor adherence in patients with heart failure; also, the progressive nature of Heart Failure (HF) and its complicated drug regimens are mostly stressful. This study has been conducted on the HF patients at the heart hospital of Kermanshah city with the objective of finding the association between medication adherence and coping skills. Methods: The present research is a descriptive-correlative study. Research cases include 400 HF patients at Imam Ali hospital of Kermanshah in 2015 who were selected using available sampling method. The self-reported epidemiologic characteristics form of HF patients, Morisky medication adherence Questionnaire (1986) and short form of Carver Questionnaire (COPE, 1997) were utilized for data gathering. SPSS 22 software and statistical test of Pearson correlation and descriptive statistical were used to analyze the data. Results: The result showed that the majority of the studied cases (%94) had poor medication adherence. Pearson correlation data analysis revealed direct and weak statistical correlation between medication adherence and coping Skills (religion P=0.036, acceptance P=0.019, use of emotional support P=0.02, use of instrumental support P=0.001, hummer P=0.025, positive reframing P˂0.001, self-distraction P=0.002). Conclusion: Given the weakness of medication Adherence and relationship between medication adherence and coping Skills in HF patients, the application of educational and intervention programs appears to be substantial.

Background: Aging population growth is accompanied by the risk of cardiovascular diseases and hypertension. Medication nonadherence is one of the problems affecting patients, especially elderly individuals with high blood pressure. Aim: The present study aimed to determine the effect of an educational program based on the Health Belief Model (HBM) on medication adherence in older adults suffering from hypertension. Methods: This randomized controlled clinical trial was conducted on 60-year-old elderly people referring to health centers in Mashhad, Iran, during 2017. To this end, the intervention group received education on medication adherence while the control group was only subjected to typical routine services. The data were analyzed in SPSS Software (Version 20) through the independent t-test, Chi-square test, and Fisher’s exact test. Results: The mean ages of the participants in the intervention and control groups were 69.1±8.3 and 63.9±6.7 years, respectively. The post-test mean score of medication adherence obtained by the intervention group was 6.7±0.5 that was significantly higher than that of the control group (3.7±1.0) (P˂0.001). Moreover, the mean score of medication adherence in the intervention group had significantly increased in the post-test phase (P˂0.001) based on the within-group results of the paired t-test. Implications for Practice: The HBM might improve medication adherence in elderly individuals with hypertension by changing their beliefs. Therefore, it was recommended to use this model for teaching self-care to older adults suffering from chronic illnesses and also in other senior healthcare centers.

Currently, polypharmacy used in patients with chronic diseases and low adherence to therapy has been one of the serious problems faced in Brazil. The inadequacy of treatment interferes with disease control and, consequently, the quality of life, especially of seniors. This paper aims to verify the methods used to determine the medication adherenc. We chose the articles used in this study after the date of the insertion of federal law 13021/14. It was concluded that the most used questionnaires are: Haynes test; TMG; ARMS, BMQ(1), BMQ(2) and QAM-Q. Each method has negative and positive points, and in Brazil, BMQ(2) and TMG are constantly used by researchers. In contrast, there is no gold standard method; we believed that the concomitant use of assessment instruments provides greater precision in the results in assessments of adherence to drug treatment. [ABSTRACT FROM AUTHOR]

Background: Resistant hypertension is defined when the blood pressure remains elevated above the therapeutic target levels despite the use of three antihypertensive agents including calcium channel blocker (CCB), renin-angiotensin system (RAS) blocker and a diuretic. These drugs should be used at maximally tolerated doses and white coat effect and non-adherence should also be excluded. In this article, by describing a case of resistant hypertension, we discuss a diagnostic and therapeutic approach to resistant hypertension. Case Presentation: A 59 years old man, known case of diabetic nephropathy with a serum creatinine level of 1.2 mg/dL and proteinuria of about 3300 mg in 24 hours referred to Hypertension Clinic of Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, for evaluation of resistant hypertension. The patient was under treatment by losar-H, diltiazem, and furosemide, which are not appropriate combinations of antihypertensive agents. The ambulatory blood pressure monitoring (ABPM) of the patient revealed daytime and nighttime hypertension and also the nondipping status of blood pressure. Dihydropyridine CCB was prescribed in combination with RAS blocker (Exforge 50 mg/ 160 mg) and the diuretic was changed to thiazidelike agents. In the next step, spironolactone and carvedilol were added for better control of blood pressure. The patient referred to the sleep clinic for polysomnography and evaluation of obstructive sleep apnea. Following three months prescription of these medications, ABPM revealed relatively appropriate control of blood pressure, so the average 24-hour blood pressure decreased from 157/91 mm Hg to 136/83 mm Hg. Conclusion: The complications and mortality of hypertension would be increased dramatically in patients with resistant hypertension. So, an appropriate diagnostic and therapeutic approaches should be considered for these patients. Choosing appropriate diuretic agents would be important in the management of resistant hypertension. [ABSTRACT FROM AUTHOR]

Introduction: Patients are required to take medications to control and prevent the progression of hypertension, one of the most common chronic diseases. The widely use of cellphone text messages make it easy and convenient to enhance medication adherence The current study aimed to evaluate the effect of text message reminders on blood lipids control in patients with chronic hyperlipidemia. Methods: The sample population in this randomized clinical trial, consisted of sixty patients divided into control and intervention groups at Imam Hossein Comprehensive Health Service Center in Borazjan in 2018. The patients in the intervention group received a daily reminder message for six weeks. Data were collected by Morisky questionnaire was completed by both groups at baseline and six weeks later. The data were analyzed by SPSS software version 25 and R version 2. 5. 3. Results: the results indicated a significant difference between the two groups. (p<0.001). Conclusion: Sending reminder messages to patients with chronic hyperlipidemia over a six-week period is effective and leads to improved medication adherence. [ABSTRACT FROM AUTHOR]

Background: Despite the importance of psychological factors in adherence to the treatment in patients with hypertension, a few studies have been done to identify the factors affecting adherence to treatment and particularly to investigate the role of psychology factors in Iranian population. This study aimed to investigate the role of mental health in adherence to medication in patients with hypertension in rural areas of Isfahan Province, Iran. Methods: In this cross-sectional study, 300 patients with hypertension were studied. Multistage sampling was performed in health centers. Data collection tools included depression, anxiety and stress scale (DASS) short form and the Morisky 8-items medication adherence questionnaire. The odds ratio (OR) for different levels of depression, anxiety, and stress in both groups with appropriate adherence and non-appropriate adherence to treatment were determined. We used multivariate logistic regression model for statistical analysis. Findings: Patients with very severe levels of anxiety were more non-adherent to drug therapy than those with normal levels of anxiety (OR = 2.8; CI95%: 1.07-7.38). While other levels of anxiety and severity of depression and stress were not significant predictors for predicting patients' adherence to treatment. Conclusion: Understanding the severity of depression, stress, and anxiety to ensure adherence and treatment outcomes in patients with hypertension are essential. According to this study, very severe anxiety can be considered as an important predicting factor in the lack of adherence to medication.

Background and aims: Patient adherences with therapeutic regimens reduce the severity of desease negative complications and its non-adherence as a barrier to achieving the medical. The aim at this study was to determine the correlation between medication adherence and quality of life of Rheumatoid Arthritis patients in Shariati hospital in 2016. Methods: This study was descriptive-correlational that population consisted of all Arthritis patients in Shariati hospital in Tehran. 252 patients were recruited by convenience sampling. Three questionnaires were used to collect data including the demographic characteristics questionnaire, the medication adherence “CQR” and SF-36. The validity and reliability of SF-36 in similar studies and the validity and reliability of CQR by researcher was approved. Data were analyzed by SPSS. Results: The results showed the levels of medication adherence with an average of 65.86±5.85 and the quality of life of patients with an average of 51.96±9.73. Spearman correlation coefficient showed that no significant correlation between medication adherence and quality of life of patients (P=0.663, r=0.02). Medication adherence had a significant correlation between energy/fatigue subscales of quality of life (P=0.035, r=0.13). Conclusion: Due to the fact that medication adherence was not a predictor of quality of life in patients with rheumatoid arthritis Therefore, it cannot be poured programs for these patients to improve their quality of life due to medication adherence.

Background & Aim: Diabetes can not be treated, but it can be controlled by treatment regimens. Failure to adhere to therapeutic regimens leads to rapid onset of diabetes complications and undesirable metabolic control and poor clinical outcomes. The objective of this study was to assess the status of medication adherence in patients with type 2 diabetes. Materials & Methods: In this integrated review, all Persian and English articles with full text (from 2000 onwards) were reviewed for medication adherence in type II diabetic patients. These studies are available from the national and international databases SID, Magiran and Science Direct, PubMed, Google Scholar, Scopus with the keywords "compliance", "concordance" and "adherence" and finally, 53 articles were included in the study. Results: A review of 53 related articles showed that depression, financial problems, adverse drug reactions and illness, memory problems, multiple drug use and complexity of the diet were among the most important inhibitors of adherence to the diet of diabetic patients. Belief in the necessity of medications and patient support were also among the most facilitators of adherence to treatment. Conclusion: Considering the importance of medication adherence in patients with type 2 diabetes and high prevalence of non compliance with treatment, patients should be trained in this field and measures should be taken to remove medication adherence inhibitors .

Background and purpose: In hemodialysis patients, medication prescribed is essential to preserve their health and welfare, but adherence to medications is difficult. The aim of this study was to explain the experiences of patients undergoing hemodialysis about drug consumption. Materials and methods: A qualitative content analysis was conducted in Kowsar Hospital, Semnan, Iran. Twenty patients were selected using purposive sampling and semi-structured interviews were performed to obtain the relevant information. Data collection and analysis were done using Granheim and Lundman, 2004 content analysis. The accuracy and trustworthiness of the study were determined according to Lincoln and Guba criteria. Results: The main theme was "lack of adherence to medication" and the following categories: 'factors related to patients" with 'psychological dimensions', 'participation', 'lack of awareness about the benefits of drugs', and ' financial restrictions and frustration' as the sub-categories. "Factors related to medication" with 'challenges in consumption of drugs' as the sub-category. "Factors related to the health care system" with 'shortage of nurses', 'cumbersome adherence to laws and regulations' and 'adequate social support ' as the sub-categories. Conclusion: Lack of adherence to medication is a modifiable threat to health in hemodialysis patients, therefore, interventions and strategies that can motivate and promote adherence to medication could be of great benefit. So, health care authorities should take appropriate actions to improve patients’ management on adherence to medication.

Introduction: Ischemic heart disease is the main cause of death in most societies. The disease has no cure and diseases management is necessary throughout the life of the patient. Medical adherence for preventing further progression of the disease and stroke is very important. The purpose of this study is to review the effect of self-management program and telephone follow up on medical adherence in patients with ischemic heart disease. Materials and Methods: The study is a randomized controlled trial (RCT) which contains 60 patients with ischemic heart disease who are eligible for inclusion criteria. They divided randomaly into two equal control and experimental groups. All samples were examined with demographic and medical adherence questionnaire at first. The intervention group participated in the workshop of self management program during the first week after discharging. Then, it was followed up by phone for 8 weeks. Finally 3 and 6 months weeks after the last call, the questionnaire of medical adherence were fulfilled again by all samples and the results of the two different periods were compared. Results: The results showed that there is no meaningful statistical difference due to demographic characteristic and medical adherence between two groups of examination before interference. But medical adherence of the intervention group after instruction of self management program and telephone follow up increased in a meaningful way compared to pre-intervention on 3 and 6 month periods (p

Abstract Background: Diabetes is one of the most common disease resulted from metabolism disorders. Thus, Studying medication adherence in patients to explain educational interventions to improve the health of these patients is necessary. Therefore, the present study aimed to assess the factors affecting medication adherence in diabetics patients based on health belief model in Arak 2014. Materials and Methods: In this analytical study, 366 diabetic patients in Arak in 2014 were selected and data were collected through a researcher made questionnaire about patients behavior in the field of medication adherence and its influencing factors based on the health belief model. Linear regression model was used to determine the predictive power of structures. Results: The mean knowledge score and the medication adherence was 31.34 and 84.34, respectively. In this study, perceived susceptibility, perceived barriers and internal action guide were as the strongest predictors of medication adherence behavior in patients and predicted their behavior variance 0.36. Between function and susceptibility and severity and perceived benefits and self- efficacy of manual internal and external action guides in the field of medication adherence with diabetes, there was a direct correlation that the highest correlation was related to the perceived susceptibility structure (r=0.42 , p

Background and Objectives: Low levels of medication adherence in patients with type 2 diabetes is one of the greatest challenges in the treatment and control of diabetes. This study was designed to determine medication adherence and its related factors in patients with type II diabetes. Materials and Methods: In this cross-sectional study, a total of 300patients with type 2diabetes records in the health centers of Tuyserkan city were randomly selected in 2015. Data collection instrument was a self-made questionnaire, which consisted of factors related to the medication adherence. Questionnaires were completed after confirmation of validity and reliability, by interviews. To analyze the data, descriptive and inferential statistics (T-test, AnOVA, Simple and multiple linear regression) were applied, using SPSS software, version 19. Results: Overall, %26.3 of patients were male and %73.7 were female. Also, %65 of patients were illiterate, %24 had some degree of symptoms, and %59.4 had poor medication adherence. There was a significant relationship between age, education, patient care and treatment expenditure, health care team and health system, therapy-related factors and condition-related factors, beliefs about illness, efficacy, and concerns about drugs and medication adherence (P < 0.05). Conclusions: This study showed that medication adherence in patients with diabetes was not suitable and individual, economical and social factors were influential.Therefore, the role of these factors must be considered when designing intervention programs.

Background & Aim: Medication adherence affects the outcome of treatment in patients with epilepsy. Non adherence to the antiepileptic drugs in patients may result in exacerbation of seizure frequencies, higher health-care system costs and higher risk of morbidity and mortality . This study aimed to assess the medication adherence and its related factors in patients with epilepsy . Methods & Materials: In this cross-sectional study, we recruited 120 patients with epilepsy from the Iran Epilepsy Association using purposive sampling method. Data were gathered using a demographic checklist and the Morisky’s modified medication adherence questionnaire. Data were analyzed in the SPSS-16 . Results: A total of 87.5%, 10.8% and 1.7% of the patients showed high, medium and low adherences, respectively. Being seizure-free for a period of time was the most cited reason of non-adherence (8.3%). There was a statistically significant relationship between the number of drugs and seizures with the medication adherence (P

Background & Aim: Medication usage is the bases of disease management in patients who undergo hemodialysis. Non-adherence to medication regimen increases the incidence of complications among the patients . The aim of this study was to investigate the effect of a cognitive-behavioral intervention on medication adherence in patients undergoing hemodialysis . Methods & Materials: In this clinical trial, 70 patients were selected from Imam Reza and Valiasr hospitals. Patients were assigned into two intervention (n=35) and control (n=35) groups. The intervention group received a cognitive-behavioral intervention including six steps: 1) Identifying the problem 2) Creating confidence and commitment 3) Increasing awareness of behavior 4) Developing and implementing the action plan 5) Evaluating the plan and 6) Maintaining the desired behavior. Adherence to medication regimen was assessed using a self-report questionnaire before and immediately after the intervention. Data were analyzed using the independent t-test . Results: At baseline, there was no significant difference in adherence to medicine regimen between the intervention (20.77 ± 4.56) and control (22.34 ± 3.65) groups (P=0.1). After the intervention, significant difference was observed between the two groups in adherence to medication regimen (P

Background and Objective: Type 2 diabetes is a metabolic disease which could be prevented using a healthy lifestyle. Non-adherence to treatment regimens in diabetes is still a public health problem, globally. This study was conducted to determine the treatment regimens adherence in Type2 diabetes in Zanjan, 2015. Materials and Methods: A cross-sectional study was conducted on 385 Type 2 diabetes patients. Data was collected using International Physical Activity Questionnaire (IPAQ), and researcher-made questionnaire for diet and drug adherence. The validity and reliability of questionnaires were assessed in good level, through conducting a pilot study. The data was analyzed using SPSS. Results: The analysis was conducted on 385 patients who had the mean age of 54.9 years. The majority of patients were female (56.4%) and married (80.5%). Most of patients were non-adherent to treatment regimens recommendations (76.9% for physical activity, 50.4% for diet, and 52.5% for medication). A significant association was found among gender, employment status, underlying disease and educational level with non-adherent patients to physical activity recommendations (P<0.05). A significant association was also not found between marital status and diet recommendations (P<0.05). The level of HbA1C was significantly associated with self-reported adherence to the treatment Regimens (P<0.05). Conclusion: There was a very low adherence with treatment regimens recommendations. Therefore necessary strategies are necessary to prevent severe complications of diabetes and achieve a better control. [ABSTRACT FROM AUTHOR]

Background and aims: Having no adherence to medication regimen in patients suffering from Epilepsy is lead to an increased mortality rate in these patients. The present study evaluated the effect of educational program on drugs self-management in patient with epilepsy. Methods: This study was a randomized clinical trial with control group. The samples (n=60) were selected from the neurology clinic of Valiasr hospital in Zanjan. The patients were randomly assigned into the intervention (n=30) and the control (n=30) groups. The intervention group received four educational sessions with the two stages of continuous care model that including epilepsy and self-management plan. All patients completed the epilepsy self-management scale pre intervention and one month post intervention. Results: There was no statistically significant difference in demographic characteristics and drugs self-management scores between two groups. After intervention there were a Significant statistical difference between the epilepsy drug self-management scores in intervention and control groups (p

Background and Aim: Self-care has a vital role in the control and prevention of complications in patients with Type-2 diabetes mellitus (T2DM), two important behaviors in self-care being medication adherence and physical activity. Regular physical activity has been shown to improve glycemic control, reduce blood pressure, reduce lipids and improve cardiorespiratory fitness in individuals with T2DM. In addition, medication adherence is a key factor in controlling and decreasing the risk of related complications. This study aimed to determine and predict the most important factors affecting the levels of physical activity and medication adherence in patients with T2DM based on the theory of planned behavior. Materials and Methods: This cross-sectional study, based on the planned behavior theory, was performed on 160 selected men and women with T2DM referring to urban health centers in Yasuj, Iran in 2016; the selection was done by random cluster sampling. Data on medication adherence and physical activity were collected using questionnaires and analyzed using SPSS version 20 software, the statistical tests being descriptive statistics, Pearson correlation coefficient and multiple linear regression; a p<0/05 was considered to indicate statistical significance. Results: Altogether, 45% and 43% of the patients had a low and medium level of physical activity, respectively, only 12% having an acceptable level. The adherence to medication was much better ─ 76% had a good adherence. As regards the planned behavior theory constructs, perceived behavior control had a significant relationship with physical activity and medication adherence. Results of multiple linear regression also showed that perceived behavior control was a predictive variable for physical activity level and medication adherence in the patients. Conclusion: Based on the findings, which indicate that the most important construct is perceived behavior control as regards medication adherence and level of physical activity, it is concluded that it is vital to strengthen the self-care component of health programs and support such programs. [ABSTRACT FROM AUTHOR]