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Context: Hypertension is highly prevalent in Vietnam, yet the rate of controlled hypertension remains low. Knowledge about hypertension is linked to patient beliefs and medication adherence. However, there's limited data on hypertension knowledge among primary care patients in Vietnam. Aims: To evaluate the knowledge of hypertension among hypertensive patients in primary care settings in Central Vietnam and identify factors affecting their knowledge. Methods: A cross-sectional study was conducted, and a thorough examination was performed to assess hypertension knowledge and its related factors. Utilizing the Hypertension Knowledge Level Scale and Medication Adherence Report Scale, hypertension knowledge and medication adherence were evaluated. Additionally, demographic, clinical, lifestyle, and patient belief data were gathered. Statistical analyses and logistic regression models were applied to pinpoint key factors associated with hypertension knowledge. Results: In the study involving 761 participants (55.7% male), the average hypertension knowledge score was 15.0 (SD = 4.6), with only 45.3% demonstrating a high level of knowledge. Significant correlations were observed between hypertension knowledge and variables such as education level, ethnicity, home blood pressure monitoring, patient beliefs, and medication adherence. Logistic regression analysis indicated that higher education levels and belonging to the majority ethnicity were linked to enhanced hypertension knowledge. Notably, individuals with better hypertension knowledge tended to recognize the necessity of their prescribed medications. Conclusions: Hypertension knowledge among primary care patients in Central Vietnam is suboptimal, with approximately half having a high knowledge level. These findings emphasize the importance of hypertension knowledge in shaping patient beliefs, perceptions, and medication adherence. Tailored educational interventions are crucial, especially for those with lower education and minority backgrounds, to enhance hypertension management.

Adherence to antiretroviral therapy (ART) is a complex and multi-determined process that is influenced by psychosocial variables. Although international studies have pointed to the adverse impact of HIV stigma, sexual stigma, and depression on ART adherence among men who have sex with men (MSM) with HIV, less is known about this association among Brazilians. We aimed to (a) evaluate indicators of depression, stigma related to HIV and homosexuality, and adherence to ART in a sample of Brazilian MSM living with HIV; (b) assess possible correlations between the variables analyzed, and (c) assess the impact of HIV and sexual stigma and depression on ART adherence. This cross-sectional study comprised 138 Brazilian MSM living with HIV as participants. Scales used included: a sociodemographic/clinical questionnaire, the questionnaire for assessment of adherence to antiretroviral therapy (CEAT-HIV), the Beck depression inventory (BDI-II), the internalized homophobia scale, and the HIV stigmatization scale. The mean adherence score was relatively high (78.83, within a range of 17–89 points). However, we observed inadequate ART adherence (CEAT-HIV < 75) in 28 (20.2%) respondents. Participants reported high scores for internalized sexual stigma, perceived sexual stigma in the community, and HIV stigma. Symptoms of depression were identified in 48.47% of participants. We found negative correlations between depression, HIV stigma, and treatment adherence, but not between sexual stigma and ART adherence. HIV-related stigma and sexual stigma were positively correlated with depression. Our regression analysis indicated that each year of age at diagnosis of HIV increased adherence by 0.22 points, on average. Each additional BDI-II score reduced adherence to ART by 0.20 points. The high prevalence of depression, HIV stigma, and sexual stigma, and their adverse effects on ART adherence and mental health, point to the need to implement evidence-based interventions to reduce sexual and serological stigma in the general population, as well as to mitigate the negative impacts of stigma on MSM living in HIV in Brazil. They also highlight the importance of periodically screening for these variables among MSM treated in Brazilian public health services, especially among those with inadequate adherence to ART.

ABSTRACT Objectives: to develop a responsive website focused on treatment adherence for adult users living with HIV. Methods: technological study conducted between August and October 2020, in the light of Pierre Lévy’s theoretical-philosophical framework, using the Double Diamond Process methodology associated with the five stages of The Elements of User Experience framework. Results: it was developed the responsive website Positive Care (Positive o Cuidado), composed of an initial presentation screen and 13 other screens named: Family Health and You; Undetectable = Untransmissible; Antiretroviral Drugs; Routine Tests; Vaccination; Antiretroviral Delivery; Drug Interactions; Combined Prevention; Support Services; Healthy Life; Family and Reproductive Planning; Covid 19; and Questions, Curiosities, and Myths. Final Considerations: the responsive website was developed based on the software design and programming process and has requirements/functionalities with the potential to strengthen the collective intelligence about HIV and, consequently, to promote treatment adherence by its users.

Abstract Objective: to evaluate the use of a renal health application by kidney transplant recipients. Method: a retrospective, observational study with a sample composed of individuals registered in the kidney transplant section of the application from July of 2018 to April of 2021. Demographic data, data entry, time of use, weight, blood pressure, blood glucose, creatinine, medication schedules, appointments, and tests were the variables collected. Descriptive analysis of the data was performed. Results: eight hundred and twenty-three downloads of the application were identified, and 12.3% of those were registered as kidney transplant recipients, the majority from southeastern Brazil (44.9%), 36±11 years old, and female (59.1%). Of the sample, 35.1% entered information such as creatinine (62%), weight (58.2%), and blood pressure (51.8%). Most used the application for one day (63.3%) and 13.9% for more than one hundred days. Those who used it for more than one day (36.7%) recorded weight (69%), medication intake (65.5%) and creatinine (62%), and scheduled appointments (69%). Conclusion: the kidney transplant recipient section of the Renal Health application generated interest in the young population, but showed low adherence throughout the assessed months. These results offer a relevant perspective on the implementation of mHealth technologies in kidney transplantation.

ABSTRACT The aim of this study was to evaluate health care quality and medication adherence in people living with human immunodeficiency virus in specialized care services. This is a cross-sectional, evaluative study, with a quantitative approach, carried out in ten services in Pernambuco. Two instruments were validated and analyzed by statistical tests were used and 306 adults and their service managers participated. The quality standard was equivalent for most indicators. Only in the countryside, the indicators referring to the availability of antiretroviral drugs and care in the absence of medication were associated with low adherence (p-value=0.033 and p-value=0.011), the latter being a predictor for low adherence. Services with insufficient quality standards showed a 19% higher occurrence of low medication adherence. 81% of users had low adherence to antiretroviral drugs. There is a deficiency in adherence to antiretroviral drugs, and those assisted in services in the countryside have more complicating factors related to the quality of health care for satisfactory adherence.

ABSTRACT Objective To verify the influence of patients’ level of functional health literacy on adherence to antidepressant treatment. Method Cross-sectional study, carried out in pharmacies of the Municipal Health Department of Marília-SP, in 2020/2021. The functional literacy questionnaire verified the numerical and interpretative skills of patients, in the face of texts related to the health area. The adherence to the treatment was verified using the Morisky therapeutic adherence scale, and the data were analyzed by Anova-one-way and Kruskal-Wallis tests. Results A total of 150 patients participated in the study, most of them showed failures in adherence and an inadequate level of functional health literacy. However, there was no correlation between functional health literacy and treatment adherence. Conclusion Although no correlation was found between the variables, there is a need for greater investments in terms of adherence to the treatment, with strategies that consider the level of functional health literacy in these patients.

Objective: To study medication adherence and persistence among heart failure patients, assess the methods utilised for estimating medication adherence, and identify optimal adherence thresholds and their impact on clinical outcomes., Methods: A systematic search will be conducted in PubMed, Embase, CINAHL, Web of Science, and Scopus databases. Observational studies assessing medication adherence or persistence among heart failure patients via electronic healthcare databases will be included. A narrative synthesis will describe medication adherence and persistence reported and methods used to measure it. A meta-analysis will be attempted to evaluate the impact of secondary medication adherence (multiple and by drug class) on clinical outcomes, including hospitalisation, emergency visits, and mortality. The I 2 statistic will be employed to study heterogeneity and the GRADE framework to evaluate evidence certainty. This protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines and is registered with the Prospective Register of Ongoing Systematic Reviews CRD42024509542., Discussion: This study aims to evaluate medication adherence and persistence in heart failure management through electronic health databases, intending to explore widely used measurement methods and their limitations, and to identify adherence thresholds associated with improved clinical outcomes. By examining these aspects, we anticipate proposing enhancements for future research and establishing desired adherence goals. This approach highlights the expected significance of our findings in advancing patient care and research methodologies., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

A 36-year-old woman suffering from various pathologies of varying complexity, with 19 active medications in her medication plan and the result of her Morisky-Green test is that of a non-adherent patient, to whom we offer the monitoring service with monitored dosage systems (MDS).From the initial interview, we obtained the following information about her health status: she feels constantly tired, sleepy, sad, and unmotivated. She lives with her parents and hardly leaves her home.10 moderate clinically relevant interactions are detected, 8 of which can lead to clinical situations that match the patient's description.After 6 months, the patient only needs 1 opioid analgesic, instead of 3, has reduced the use of other drugs, and her health status has significantly improved.At 20 months, she has gone from using 19 drugs regularly to taking only 10 drugs. In addition, her social relationships have improved, and she no longer spends her days locked at home.The patient is very grateful to the pharmacy. For us, it is a satisfaction to provide this service and help many patients improve adherence to their treatments and health status., (Copyright SEFAC. Sociedad Española de Farmacia Clínica, Familiar y Comunitaria. This article is available from url https://www.farmaceuticoscomunitarios.org/.)

Introduction: Digital health or "e-health" is a set of applications based on information and communication technologies (ICTs) that can be used to promote self-care and medication adherence in patients with chronic diseases. The aim of this study was to carry out a review of systematic reviews (meta-review) on efficacy studies of e-health interventions to promote adherence to antiretroviral therapy (ART) in people living with HIV/AIDS., Methodology: A review of systematic reviews ("meta-review") was performed using the Medline-PubMed database on efficacy studies of e-health components to promote adherence to ART, in patients with HIV/AIDS, proposing a structured search strategy (PICO question). A selection process for systematic reviews was conducted based on inclusion and exclusion criteria. Subsequently, the corresponding data were extracted, and the analysis was accomplished in descriptive tables., Results: A total of 29 systematic reviews were identified, from which 11 were selected. These reviews comprised 55 RCTs with different e-health interventions and enrolled a total of 15,311 HIV/AIDS patients. Studies included a total of 66 comparisons (experimental group vs. control group) in indirect adherence measurements based on different measurement techniques (36 statistically significant); 21 comparisons of viral load (VL) measurements (10 statistically significant); and 8 comparisons of CD4 + cell count measurements (3 statistically significant). m-Health was the most studied component followed by the telephone call and e-learning., Conclusion: Evidence was found that supports that some e-health interventions are effective in promoting adherence to ART and improving health outcomes in patients with HIV/AIDS, although it is identified that more studies are needed for more robust evidence., Competing Interests: Declaration of competing interest The authors have declared no conflict of interest., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: Improving understanding of actual pulmonary hypertension (PH) treatment adherence patterns is crucial to properly treating these patients. We aimed to primarily assess adherence to treatments used for pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) specific therapies, identify potential factors related to it and secondly describe its treatment patterns., Methods: A 6-month observational cross-sectional study in a tertiary care hospital was conducted. Patients with PH-targeted therapy who picked it up in the ambulatory hospital pharmacy and who had been on treatment with the same drug for at least 1 year were included. Adherence was assessed as: 1) Proportion of days covered (PDC); and 2) Simplified Medication Adherence Questionnaire (SMAQ). PDC ≥80% was considered adherent. Statistical analyses were performed to evaluate the study outcomes. Logistic regressions were estimated to identify the association between baseline characteristics and factors associated with adherence. P < 0.05 indicated statistical significance., Results: A total of 63 patients with 127 different treatments were included, 71.4% were females with a mean age (SD) of 59 (15) years. PAH was the most common diagnosis (74.6%). Double therapy was used in 39.7% of patients, being the combination of Macitentan + Tadalafil and Ambrisentan + Tadalafil the most prescribed. Endothelin receptor antagonists were the most used treatment (40.2%). Adherence according to PDC was 93.7%, showing no great differences depending on the targeted drug used, and according to SMAQ 61.9%. The agreement degree of both methods was slight (65.1%; Kappa 0.12). Only female sex (OR: 0.23, 95% CI: 0.06-0.90; p = 0.035) was associated with worse adherence in the SMAQ method but not in the PDC. Adverse events were reported by a 55.6% of participants and the perception of effective treatment was high (95.2%)., Conclusions: Adherence to PH therapy differs depending on the assessment method; PDC showed greater adherence rate than SMAQ. According to SMAQ, female sex may have a negative impact on adherence in this cohort, but PDC revealed no factors influencing it. No notable differences in adherence between treatment types were found and generally patients felt the treatments were effective in controlling their disease., Competing Interests: Conflict of interest The authors declare that they have no conflict of interest., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To identify validated questionnaires to assess medication adherence, and its associated factors, in adult patients with chronic pathologies., Method: A systematic review of scientific publications that describe validated medication adherence questionnaires in PubMed and Scopus was carried out during May 2022. The search strategy combined the MeSH Heading "Medication adherence" with the keywords: "Questionnaire" and "Validation"; adding "Spanish" to rescue questionnaires in our language. Systematic reviews, meta-analyses or scientific articles with full text available in Spanish or English were selected; published from January 2000 to April 2022; that present the application and validation of a medication adherence questionnaire in adults with chronic pathologies; and publications of the initial validation of a questionnaire, recovered through bibliographic citations of the previously identified publications, even if they are prior to the year 2000. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to represent the search process, inclusion and exclusion of the retrieved publications., Results: Ninety-seven records in PubMed and 3 adding "Spanish" were retrieved; in Scopus, 334 records were retrieved and 13 with "Spanish". One hundred-eighteen records were retrieved through bibliographic citations identification. From the analysis of the previous publications, 14 validated questionnaires were identified that assess medication adherence and are applied in English and/or Spanish in adult patients with chronic pathologies. For each questionnaire, the following characteristics were described: name, authors, year of publication, dimensions (barriers and facilitators factors), number and wording of the items, response scale, form of administration, language and pathologies of the initial validation. Of the subsequent validations, only those carried out in English and/or Spanish were presented. So far, 6 questionnaires were validated in Spanish and only for certain chronic pathologies., Conclusions: 14 validated questionnaires were identified, 6 of them were validated in Spanish. They are designed to evaluate medication adherence in a comprehensive manner, being useful to be applied in hospital and community pharmaceutical services. This review provides health professionals with tools to develop and validate their own questionnaire, adapting the wording to the local language and context of the health system., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To identify validated questionnaires to assess medication adherence, and its associated factors, in adult patients with chronic pathologies., Method: A systematic review of scientific publications that describe validated medication adherence questionnaires in PubMed and Scopus was carried out during May 2022. The search strategy combined the MeSH heading "Medication adherence" with the keywords: "Questionnaire" and "Validation"; adding "Spanish" to rescue questionnaires in our language. Systematic reviews, meta-analyses, or scientific articles with full text available in Spanish or English were selected; published from January 2000 to April 2022; that present the application and validation of a medication adherence questionnaire in adults with chronic pathologies; and publications of the initial validation of a questionnaire, recovered through bibliographic citations of the previously identified publications, even if they are prior to the year 2000. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to represent the search process, inclusion and exclusion of the retrieved publications., Results: (97) records in PubMed and 3 adding "Spanish" were retrieved; in Scopus, 334 records were retrieved and 13 with "Spanish". 118 records were retrieved through bibliographic citations identification. From the analysis of the previous publications, 14 validated questionnaires were identified that assess medication adherence and are applied in English and/or Spanish in adult patients with chronic pathologies. For each questionnaire, the following characteristics were described: name, authors, year of publication, dimensions (barriers and facilitators factors), number and wording of the items, response scale, form of administration, language, and pathologies of the initial validation. Of the subsequent validations, only those carried out in English and/or Spanish were presented. So far, 6 questionnaires were validated in Spanish and only for certain chronic pathologies., Conclusions: (14) validated questionnaires were identified, 6 of them were validated in Spanish. They are designed to evaluate medication adherence in a comprehensive manner, being useful to be applied in hospital and community pharmaceutical services. This review provides health professionals with tools to develop and validate their own questionnaire, adapting the wording to the local language and context of the health system., Competing Interests: Declaration of competing interest None declared., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

Gout is a disease caused by the chronic deposition of monosodium urate crystals. Its clinical presentation as an acute, self-limiting arthritis and the belief that it is a banal, self-inflicted disease have led to its poor management. Despite advances in the knowledge of the disease and the simplicity of its management, no more than 30% of patients are well treated. In Spain, the prevalence of gout is 2.5% and its incidence is increasing. In the following article we will review the pathogenesis of gout and hyperuricaemia, highlighting the greater weight of genetics and renal function over diet. We will look at the consequences of crystal deposition. Gout, in addition to its joint presentation and renal involvement, has been shown to be an independent cardiovascular risk factor. Hypouricemic therapy is the most important treatment, as it is the one that dissolves the crystals and cures the disease. This requires the sustained achievement of uricemia levels below 6mg/dl. We will also review preventive and flares treatment, as well as the role of patient education in terms of both lifestyle and dietary habits and adherence to pharmacological treatment., (Copyright © 2023 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)

ABSTRACT Objective: To analyze the association between health literacy and the adherence to the pharmacological treatment of Brazilians with arterial hypertension. Methods: Cross-sectional study with 234 participants who responded an on-line sociodemographic and clinical characterization questionnaire, in addition to evaluation of health literacy and of the adherence to their pharmacological treatment. Data were analyzed using descriptive statistics and difference and correlation tests. Results: People with post-graduation, who were actively working and did not smoke, had better health literacy results. Elders and those who were retired or lived on government subsidies adhered better to the medication treatment. There was a correlation between the numerical dimension (rs=0.189; p=0.004) and the global health literacy result (r2=0.170; p=0.009) with the adherence. Conclusions: A better numerical and global understanding of health literacy was associated with better adherence to arterial hypertension medication treatment.

Resumen: Introducción: El control de los factores de riesgo cardiovascular (CV) en la prevención secundaria tras un ictus isquémico es bajo, en parte debido a la falta de adherencia terapéutica. La polipíldora CV puede contribuir a la buena cumplimentación del adecuado tratamiento para la prevención cerebrovascular. El objetivo fue establecer cómo y en qué casos se debería administrar. Métodos: Un grupo de 8 neurólogos redactaron recomendaciones consensuadas mediante una técnica de brainstorming estructurado, basándose en su experiencia y en una revisión bibliográfica. Resultados: Los resultados atienden a la opinión de los expertos. El uso de la polipíldora CV tiene ventajas para pacientes, profesionales sanitarios y para el sistema de salud. Las situaciones clínicas más adecuadas para su uso son el ictus aterotrombótico, el lacunar, el asociado a deterioro cognitivo, el criptogénico con factores de riesgo CV y la enfermedad cerebrovascular silente. Su uso preferente incluye la sospecha de mal cumplimiento, a los pacientes polimedicados, ancianos, polivasculares o con alta carga aterotrombótica, jóvenes activos laboralmente y pacientes con preferencias por la polipíldora CV. Las opciones de administración incluyen el paso de fármacos individuales a la polipíldora CV, el inicio directo desde la fase aguda en casos particulares, a los pacientes con otra estatina o con un antagonista del receptor de la angiotensina ii, o de novo si hubiera sospecha de mala adherencia. No obstante, su uso implica realizar seguimiento del cumplimiento de los objetivos terapéuticos para ajustar la dosis. Conclusiones: Este documento es el primero en establecer recomendaciones de uso de la polipíldora CV en enfermedad cerebrovascular, aparte de sus ventajas sobre la adherencia. Abstract: Introduction: There is little control of cardiovascular (CV) risk factors in secondary prevention after an ischaemic stroke, in part due to a lack of adherence to treatment. The CV polypill may contribute to proper treatment adherence, which is necessary for CV disease prevention. This study aimed to establish how and in what cases the CV polypill should be administered. Methods: A group of 8 neurologists drafted consensus recommendations using structured brainstorming and based on their experience and a literature review. Results: These recommendations are based on the opinion of the participating experts. The use of the CV polypill is beneficial for patients, healthcare professionals, and the health system. Its use is most appropriate for atherothrombotic stroke, lacunar stroke, stroke associated with cognitive impairment, cryptogenic stroke with CV risk factors, and silent cerebrovascular disease. It is the preferred treatment in cases of suspected poor adherence, polymedicated patients, elderly people, patients with polyvascular disease or severe atherothrombosis, young patients in active work, and patients who express a preference for the CV polypill. Administration options include switching from individual drugs to the CV polypill, starting treatment with the CV polypill in the acute phase in particular cases, use in patients receiving another statin or an angiotensin ii receptor antagonist, or de novo use if there is suspicion of poor adherence. Nevertheless, use of the CV polypill requires follow-up on the achievement of the therapeutic objectives to make dose adjustments. Conclusions: This document is the first to establish recommendations for the use of the CV polypill in cerebrovascular disease, beyond its advantages in terms of treatment adherence.

Resumen: Objetivo: Evaluar la influencia del resultado de la prueba rápida de diagnóstico para la identificación del antígeno estreptocócico en infecciones faringoamigdalares pediátricas, en términos de mejora de la adherencia a la terapia antibiótica. Diseño: Ensayo clínico comunitario de dos grupos de estudio con asignación aleatoria. Emplazamiento: Centros de atención primaria de Cataluña Central. Participantes: En el estudio se incluyeron a pacientes de tres a 15 años por muestreo consecutivo, que fueron atendidos por sospecha de infección faringoamigdalar en las consultas pediátricas entre noviembre del 2010 y febrero del 2011. De 557 pacientes que satisficieron los criterios de inclusión, se hizo seguimiento a 519. Intervención: El grupo control siguió el algoritmo diagnóstico y terapéutico habitual. Al grupo de intervención, se le realizó adicionalmente la prueba diagnóstica rápida de detección del antígeno estreptocócico y se indicó tratamiento según el resultado. Mediciones principales: Evaluación de la adherencia, los motivos de no adherencia y los factores de riesgo sociodemográficos mediante una encuesta telefónica. Resultados: Se prescribió antibiótico al 65,6% y los pediatras del grupo control fueron más propensos a recetar antibióticos que los del grupo intervención (88,5 vs. 45,5%, p< 0,001). El 64,8% de los pacientes siguió las indicaciones del tratamiento, siendo la causa principal de no adherencia no cumplir el horario (25,6%). La adherencia terapéutica fue superior en el grupo de intervención (68%) que en el de control (62,9%), no existiendo una diferencia significativa. Conclusiones: La prueba rápida del diagnóstico para la identificación de estreptococo, complementaria al uso de los criterios Centor evita la prescripción innecesaria de tratamiento antibiótico, aunque no ha demostrado mejorar la adherencia terapéutica. Abstract: Objective: To evaluate the influence of the result of a rapid streptococcal antigen test in paediatric pharyngotonsillitis infections, in terms of improvement of antibiotic therapy adherence. Design: Randomized community clinical trial with two study groups. Location: Primary Care Centers in Central Catalonia. Participants: Patients aged from 3 to 15 years, who were attended at paediatric consultations on suspicion of pharyngotonsillitis caused by an infection between November 2010 and February 2011 (both included), were included in the study on a consecutive basis. 557 patients met the inclusion criteria and 519 were evaluated. Intervention: The control group received the usual diagnostic-therapeutic algorithm. Rapid streptococcal antigen test was additionally performed to experimental group participants and it was indicated the more convenient treatment. Main measurements: Antibiotic adherence, non-adherence causes and socio-demographic risk factors were evaluated via telephone survey. Results: Antibiotics were prescribed to 65.6% and paediatricians of the control group were more likely to prescribe antibiotic than the ones in the intervention group (88.5% vs 45.5%, p< 0.0001). 64.8% followed doctor's treatment orders, being failure following medication scheduling the main cause of non-adherence (25.6%). Medication adherence was higher in the experimental group (68%) than in the control group (62.9%) but no significant differences were found. Conclusion: Rapid strep test, complementing the use of Centor Criteria avoids unnecessary antibiotics prescriptions, but had not been proven to be effective in increasing medication adherence.

ABSTRACT Objective: To characterize the self-reported adherence of patients with cardiovascular diseases to the use of new oral anticoagulants and to identify factors related to adherence to these drugs. Method: This is a descriptive, correlational, and cross-sectional study, carried out with outpatients. The collection of sociodemographic, clinical, and adherence data, through the Measurement of Adherence to Treatments, was made through telephone calls. Descriptive, correlation, and multiple linear regression analyses were used. Results: A total of 120 patients using new anticoagulants for 32.3 months, on average, participated in the study. More than half of the sample consisted of women, who were professionally inactive, with a mean age of 70.1 years and a mean family income of 6.7 minimum wages. The mean adherence score was 5.7, in a possible range between 1 and 6, indicating medication adherence. Inactive employment status, female sex, higher family income, and follow-up at a public outpatient clinic were related to greater adherence to these medications. Conclusion: The patients showed high adherence to new anticoagulants. Employment status, sex, family income, and type of outpatient follow-up were related to medication adherence, and should be considered in the design of interventions for this public.

Heart failure is a prevalent syndrome with high mortality rates, representing a significant economic burden in terms of healthcare. The lack of systematic information about the treatment and adherence of patients with heart failure limits the understanding of these aspects and potentially the improvement of clinical outcomes., Objective: To describe the clinical characteristics, therapeutic management, adherence, persistence, and clinical results, as well as the association between these variables, in a cohort of patients with heart failure in Andalusia., Design: This study will be an observational, population-based, retrospective cohort study. Data of patients discharged from an Andalusian hospital with a diagnosis of heart failure between 2014 and 2023 will be extracted from the Andalusian population health database., Analysis: The statistical analysis will incorporate the following strategies: (1) Descriptive analysis of the characteristics of the population cohort, adherence measures, and clinical outcomes. (2) Bivariate analyses to study the association of covariates with adherence, persistence, and clinical results. (3) Multivariate logistic regression and Cox regression analysis including relevant covariates. (4) To evaluate changes over time, multivariate Poisson regression models will be used. By conducting this comprehensive study, we aim to gain valuable insights into the clinical characteristics, treatment management, and adherence of heart failure patients in Andalusia, as well as to identify factors that may influence clinical outcomes. These findings could be critical both for the development of optimised strategies that improve medical care and quality of life of patients and for mitigating the health burden of HF in the region., Competing Interests: Declaration of competing interest None declared., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: In the context of the advancement of antiretroviral therapy and, as the characteristics of people living with HIV progress toward an aging population, understanding the causes of treatment interruption becomes crucial. The aim of the study was to determine the change in reasons for antiretroviral treatment discontinuation for 12 years. Secondarily, compare annual antiretroviral regimen discontinuation rate and factors associated., Methods: We conducted an analysis using data from people living with HIV who were receiving antiretroviral therapy and discontinued it for any reason. The study included people with HIV infection who visited an outpatient hospital pharmacy clinic from January 2010 to December 2021. Two periods were differentiated for the analysis: 2010-2015 and 2016-2021. The reasons for antiretroviral treatment discontinuation followed classification described by Swiss cohort. In the context of this study, it is pertinent to note that the term 'interruption' will be consistently used in this article to refer to the act of switching or stopping antiretroviral treatment. To examine factors associated with antiretroviral therapy discontinuation, we utilized Kaplan-Meier methods and Cox proportional models., Results: We included 789 people living with HIV, predominantly male (81,5%). The main reason for discontinuation was clinical decision (50.2%) followed by adverse effects (37.9%). Focusing on clinical decision, we observed a trend change that went from antiretroviral treatment simplification regimen (56.1%) in the first part of the period analyzed to the therapeutic optimization (53.6%) in the second half. Furthermore, factors that were statistically significantly associated with antiretroviral treatment discontinuation were people with HIV ≥50 years (HR 1.60; 95%CI 1.25-2.04), post-discontinuation single-tablet regimen (HR 1.49; 95%CI 1.06-2.11) and antiretroviral drug classes., Conclusions: Over the 12 years there has been a change in the main cause of antiretroviral treatment discontinuation, currently therapeutic optimization being the main reason. Integrase inhibitors-based regimens and singletablet regimen strategies were less likely to be discontinued than others antiretroviral drug classes, allowing for better clinical management due to the efficacy profile, especially in people living with HIV ≥50 years with comorbidities., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

Heart failure is a prevalent syndrome with high mortality rates, representing a significant economic burden in terms of healthcare. The lack of systematic information about the treatment and adherence of patients with heart failure limits the understanding of these aspects and potentially the improvement of clinical outcomes., Objective: To describe the clinical characteristics, therapeutic management, adherence, persistence and clinical results, as well as the association between these variables, in a cohort of patients with heart failure in Andalusia., Design: This study will be an observational, population-based, retrospective cohort study. Data of patients discharged from an Andalusian hospital with a diagnosis of heart failure between 2014 and 2023 will be extracted from the Andalusian population health database., Analysis: The statistical analysis will incorporate the following strategies: 1) Descriptive analysis of the characteristics of the population cohort, adherence measures, and clinical outcomes. 2) Bivariate analyses to study the association of covariates with adherence, persistence and clinical results. 3) Multivariate logistic regression and Cox regression analysis including relevant covariates. 4) To evaluate changes over time, multivariate Poisson regression models will be used. By conducting this comprehensive study, we aim to gain valuable insights into the clinical characteristics, treatment management, and adherence of heart failure patients in Andalusia, as well as to identify factors that may influence clinical outcomes. These findings could be critical both for the development of optimized strategies that improve medical care and quality of life of patients and for mitigating the health burden of HF in the region., (Copyright © 2024. Publicado por Elsevier España, S.L.U.)

Introduction: Digital health or "e-Health" is a set of applications based on Information and Communication Technologies that can be used to promote self-care and medication adherence in patients with chronic diseases. The aim of this study was to carry out a review of systematic reviews (meta-review) on efficacy studies of e-Health interventions to promote adherence to antiretroviral therapy in people living with HIV/AIDS., Method: A review of systematic reviews ("meta-review") was performed using the Medline-PubMed database on efficacy studies of e-Health components to promote adherence to antirretroviral therapy, in patients with HIV/AIDS, proposing a structured search strategy (PICO question). A selection process for systematic reviews was conducted based on inclusion and exclusion criteria. Subsequently, the corresponding data were extracted, and the analysis was accomplished in descriptive tables., Results: A total of 29 systematic reviews were identified, from which 11 were selected. These reviews comprised 55 randomized controlled therapies with different e-Health interventions and enrolled a total of 15,311 HIV/AIDS patients. Studies included a total of 66 comparisons (experimental group vs. control group) in indirect adherence measurements based on different measurement techniques (36 statistically significant); 21 comparisons of viral load measurements (10 statistically significant); and 8 comparisons of CD4+ cell count measurements (3 statistically significant). m-Health was the most studied component followed by the telephone call and e-Learning., Conclusions: Evidence was found that supports that some e-Health interventions are effective in promoting adherence to antirretroviral therapy and improving health outcomes in patients with HIV/AIDS, although it is identified that more studies are needed for more robust evidence., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: It is known that non-adherence to psychiatric medications has harmful consequences for both patients and society., Objective: To collect information on the incidence of non-adherence, and the factors and causes affecting adherence to psychopharmacological treatment in patients with severe and persistent mental disorders., Methods: A systematic review of scientific articles on adult patients (>17 years) published in the last five years (2015-2020) on specialised databases such as PubMed, Scopus, Scielo and BioMed. Original articles from indexed journals with an impact factor >0.5, in English or Spanish, with an analytical, prospective, retrospective, cross-sectional and randomised design were included. Once the articles were identified, they were analysed, extracting the information necessary to answer the research questions., Results: Fifteen articles were included. Of these, 40% (n = 6) were published in 2020, 20% (n = 3) were produced in China and 53.3% (n = 8) had an observational design. A total of 5,837 patients were included, of which 50.6% were men (n = 2,955), with moderate adherence (n = 10; 66.7%) reported in 10 investigations. Non-adherence varies from 7.7% to 60.6%. The factors that affect adherence are specific to the patient (age and sex), their family support network, and related to the disease or the treatment. The main cause of non-adherence is lack of insight., Conclusions: Adherence to treatment with psychotropic drugs is multifactorial. Access to mental health services should be improved, with an emphasis placed on patient education and providing greater knowledge of mental illness. Interventions to promote education and interaction with the psychiatrist could be beneficial., (Copyright © 2022 Asociación Colombiana de Psiquiatría. Published by Elsevier España, S.L.U. All rights reserved.)

ABSTRACT Objective: To analyze actions promoting adherence to tuberculosis treatment that are being carried out by nurses in different countries. Method: Scoping review with selection of articles on the subject in LILACS, MEDLINE, IBECS, BDENF, SciELO, CINAHL, Embase, Web of Science, and Scopus databases. Results: Forty studies, published between 2009 and 2020, allowed the identification of nursing actions in two thematic categories. In the category “Nursing care: TB patients’ specific needs to promote adherence to treatment”, actions involving clinical aspects, professionals’ knowledge and skills, educational and relational processes were identified. In the category “The role of nursing in coping with the social determinants of health to promote adherence to treatment”, interventions related to the strengthening of family and community support, the inclusion of socioeconomic issues in care plans, and respect for cultural differences were highlighted. Conclusion: Nursing work directed to the adherence to disease treatment requires the development of technical, ethical and, above all, political skills, aiming to increase the success of the actions carried out by these professionals.

Introduction and Objectives: Prior studies have not determined whether the effect of dual antiplatelet therapy (DAPT) cessation on the subsequent risk of major adverse cardiac events (MACE) varies by the choice of P2Y 12 -inhibitor after acute coronary syndrome (ACS)., Methods: We performed a prespecified subanalysis of a multicenter, prospective registry of ACS patients discharged on ticagrelor or clopidogrel between 2015 and2019. Nonadherence to DAPT was categorized as physician-guided discontinuation and disruption due to adverse effects, nonadherence, or bleeding. The association between DAPT cessation and 1-year MACE was analyzed using multivariate time-updated Cox models with inverse probability of censoring weighted estimators., Results: Out of 2180 patients, 174 (8.3%) prematurely discontinued DAPT (physician-guided, n=126; disruption, n=48). Nonadherent patients were older and had more comorbidities than those on DAPT. Compared with physician-guided discontinuation, disruption occurred earlier after discharge and was more frequent with ticagrelor than with clopidogrel. In time-varying analysis, DAPT cessation was associated with an increased risk of MACE ( adjusted HR, 1.32, 95%CI, 1.10-1.76), largely driven by disruption ( adjusted HR, 1.47, 95%CI, 1.22-1.73). There was an exponential increase in MACE risk after DAPT cessation within 90 days after ACS, especially after disruption of ticagrelor compared with clopidogrel (P interaction <.001). After adjustment for DAPT duration, this interaction was not statistically significant on the additive scale (relative excess risk due to interaction 0.12, 95%CI,-0.99-1.24)., Conclusions: In this all-comers registry, 1 in 12 patients prematurely discontinued DAPT within 1 year after ACS. Compared with physician-recommended discontinuation, disruption resulted in a significantly higher risk of MACE. After adjustment for DAPT duration, this association was not moderated by the choice of P2Y 12 -inhibitor. Clinical trial registered at ClinicalTrials.gov (Identifier: NCT02500290)., (Copyright © 2023 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Abstract Objective: To analyze the association between adherence to antihypertensive treatment and frailty syndrome in hypertensive older adults. Method: A descriptive, cross-sectional study with a quantitative approach with older adults. The data collection took place between November 2017 and March 2018, evaluating sociodemographic information, adherence to antihypertensive treatment, lifestyle and frailty through the Edmonton Frail Scale. The Kruskal-Wallis test and the Chi-squared test were used for data analysis, considering a 95% confidence interval and a significance level of p

ABSTRACT Objective: To investigate the association between social support, adherence to HIV anti-retroviral therapy, and clinical and sociodemographic factors. Method: A cross-sectional study conducted from July 2016 to August 2018 in a specialized outpatient clinic in southern Brazil. Individual interviews were conducted for the application of the following instruments: Questionnaire for the Evaluation of Adherence to Anti-retroviral Treatment (CEAT-HIV) and Social Support Scale for People Living with HIV/AIDS. The Spearman bivariate correlation test was used for analysis purposes. Results: Among the 168 participants, the mean social support score was 3.53 points (SD = 0.66), and 64.9% (n = 109) of the respondents had insufficient adherence. There was a significant association (p < 0.05) between emotional social support and the following adherence domains: antecedents of non-adherence behaviors and doctor-patient communication. Conclusions: Social support is associated with antecedents of non-adherence behaviors and doctor-patient communication.

ABSTRACT Objectives: Describe the importance of guidelines provided during pharmaceutical consultation about compliance with medication therapy based on interviews with polymedicated elderly patients. Methods: A qualitative methodological study carried out during consultations with 40 elderly patients of both genders at the Health Care Center for Elderly Patients and Caregivers. The study used the technique of content analysis, applying a questionnaire with two open questions. Results: Two categories and eight subcategories emerged after the transcription of interviews and exhaustive reading of the data. The category “Pharmaceutical consultation as an education instrument for the self-care of polymedicated elderly patients” presented the highest frequency. The subcategory with the highest frequency was “Concern of elderly patients about self-care”. Final Considerations: In the case of polymedicated elderly patients, pharmaceutical consultation is an important education instrument which, through the provision of pharmaceutical guidelines, allows the minimization of concerns about pharmacotherapy, contributing to compliance and self-care.

Objective: to verify the association between the health-related quality of life of chronic renal patients on hemodialysis with sociodemographic, clinical, depression and medication adherence characteristics. Method: a cross-sectional study with 183 chronic renal patients undergoing hemodialysis in the state of Rio Grande do Sul, Brazil. A sociodemographic and clinical questionnaire, Kidney Disease and Quality of Life Short-Form, Beck Depression Inventory and Morisky Medication Adherence Scale - eight items were used. Among the variables, comorbidities, complications of kidney disease and intercurrences during and after hemodialysis were evaluated. The analysis was performed with descriptive and analytical statistics. Results: 55.2% of the patients were 60 years old or older, 35.0% were hypertensive, with regular quality of life, average of 62.61. Scores below average in the dimensions of quality of life were mainly associated with repetitive infections and edema as complications of the disease, pain during hemodialysis and weakness afterwards. Low drug adherence resulted in a worse quality of life, impacting ten of the 20 dimensions evaluated and depression in all, except for patient satisfaction. Conclusion: reduced quality of life in this population is associated with depressive symptoms, complications such as repetitive infections, pain and anemia, weakness after the dialysis session and low medication adherence. Actions aimed at changing these factors can promote well-being.

Objective: To assess adherence, adverse drug reaction and Sustained Virological Response (SVR) in the therapy for hepatitis C. This follow-up retrospective observational study was conducted in a specialized center for hepatitis treatment in Southern Brazil. Methods: This research included 257 patients under hepatitis C treatment with all‐oral direct‐acting antivirals in a clinical setting from March to August 2016. The data was obtained from medical records. Adherence was measured by medicines refill and Medication Possession Ratio. Results: Of the 253 patients evaluated, 8,7% had some problem with adherence to the treatment. No cases of treatment discontinuation due to adverse drug reaction was observed. However, 1433 adverse drug reactions were identified and classified as mild, with an average of 5,6 per patient. The most frequent reactions were headache (55,7%), asthenia (47,3%), altered appetite (41,9%), dry skin (37,2%), and nausea/vomiting (35,9%). The overall SVR rate was 90,9%. Other outcomes were no response to treatment (2,0%), relapsed (2,0%), dead (0,4%), dropout (0,4%) and lost to follow-up (4,3%). In the multivariate analysis, hepatitis C virus and human immunodeficiency virus co-infection and longer treatment time were associated with higher SVR (p = 0,028 and p = 0,020, respectively). Conclusion: The treatments evaluated have high response rate and were well tolerated by the patients. Adherence to treatment proved to be adequate and contributed to the results. The care offered in a specialized center provides the appropriate management of the patients’ needs, contributing thus to a successful therapy.

Abstract Objective: To evaluate the effectiveness of home visits in a group of children and adolescents with severe asthma by using the inhalation technique score and adherence rates to drug treatment. Method: A 12-month randomized controlled trial involving patients aged between three and 17 years under regular follow-up treatment at a pediatric pulmonology outpatient clinic of a university hospital in southeastern Brazil. A group of patients received only outpatient consultations and the other group received home visits from nurses in addition to outpatient consultations. The differences between groups were analyzed through the outcomes of inhalation technique scores and treatment adherence rate. Results: Participation of 29 patients. In the intervention group, there was a statistically significant increase in inhalation technique scores (p

Introduction: HIV/AIDS is a chronic disease; therefore, recognizing which factors favor adherence to antiretroviral treatment is necessary. Objective: To determine the association between adherence to antiretroviral treatment and depression, anxiety, perception of social support and sociodemographic variables in people living with HIV/AIDS in Quindío, Colombia. Materials and methods: An observational, cross-sectional study was performed in an intentional sample of 70 adults, who were applied the Morisky-Green questionnaire, the Beck Depression Inventory, the Beck Anxiety Inventory, the Medical Outcomes Study (MOS) Social Support Survey, and a sociodemographic survey. Univariate and bivariate analyzes were performed by calculating the odds ratio to determine association (p

Introduction. Non-communicable chronic diseases represent the leading cause of death worldwide, and their prevalence is increasing due to the epidemiological transition. Despite the advances in their management, control rates are deficient, attributed to multiple factors like adherence to pharmacological treatment, one of the most significant and least studied in the Colombian population. Objective. To calculate adherence to treatment in Colombian patients with arterial hypertension, cerebrovascular disease, diabetes mellitus, asthma, chronic obstructive pulmonary disease, and dyslipidemia between 2005 and 2022. Materials and methods. We performed a systematic literature review and a meta-analysis of studies identified through the Medline and LILACS databases to quantitatively synthesize treatment adherence percentage. Results. Fourteen studies met the inclusion criteria, and 5,658 patients were analyzed. The treatment adherence was 59%, with significant heterogeneity among the included studies (95% CI= 46- 71%; I2 = 98.8%, p< 0.001). Higher adherence rates were observed for diabetes mellitus (79%; 95% CI = 65- 90%) and dyslipidemia (70%; 95% CI = 66- 74%). Adherence to arterial hypertension treatment was 51% (95 %; CI = 31- 72%). Conclusions. This systematic review showed low adherence to recommendations regarding pharmacological management in non-communicable chronic diseases, which can have implications for long-term clinical outcomes and disease burden.

Objective: To assess adherence to the recommendations for the diagnosis and management of hospitalized patients with Decompensated Heart Failure issued by the European Society of Cardiology in 2021 at a Coronary Care Unit at a fourth-level hospital in the city of Bogotá., Materials and Methods: A descriptive cross-sectional study was conducted, including hospitalized patients in the Coronary Care Unit at Hospital San José in Bogotá, with a primary diagnosis of Decompensated Heart Failure, from September 2021 to January 2023. Patient data were collected from medical records. Adherence to the Decompensated Heart Failure guidelines was described in the study., Results: High adherence was observed for laboratory tests and medication prescriptions recommended by the 2021 European Society of Cardiology guidelines. However, there was low adherence to the request for thyroid function tests, troponin, and iron studies. The cause of heart failure and decompensation was adequately recorded. The most common cause of decompensation was acute coronary syndrome. Regarding the hemodynamic profile on admission, the majority presented as Stevenson B. Pharmacological adherence to Class I recommendations showed high compliance in prescribing beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and Angiotensin Receptor-Neprilysin Inhibitors. However, lower adherence was observed for Sodium-glucose co-transporter two inhibitors and Mineralocorticoid receptor antagonists., Conclusions: Variable adherence rates were recorded, emphasizing satisfactory compliance with class I recommendations for certain medications and laboratory tests. It is necessary to improve adherence in the request for paraclinicals, especially in thyroid function tests and ferrokinetic profiles., Competing Interests: Conflictos de interés: Los investigadores no encontraron ningún conflicto de interés en la participación de este proyecto

Objective to adapt and validate the Instrumental Expressive Social Support Scale (IESS) in a sample of older people. Method methodological study. The sample of 964 community-dwelling older people was randomly divided into two groups. The first group was used as a calibration sample to study the number of factors underlying social support through Principal Axis Factoring, and the second group as a validation sample to test the “best fit” model through Confirmatory Factor Analysis. Results exploratory Factor Analysis suggested a three-factor solution, which was confirmed by Confirmatory Factor Analysis. The factors were similar to those in the pre-existing dimensions of the original instrument and were named as Sense of control (α = 0.900), Financial support (α = 0.802), Familiar and socio-affective support (α = 0.778). Confirmatory Factor Analysis showed acceptable fit. The model’s goodness-of-fit indexes were satisfactory (χ2/df = 5.418; CFI = 0.903; NFI = 0.884; RMSEA = 0.098). The convergent validity was supported by associations between social support and medication adherence and positive affect. The discriminant validity was evidenced by association with negative affect. The reliability analysis showed high values of internal consistency. Conclusion the instrument proved to be a valid measure for the assessment of social support in older people.

Introducción. Según la Organización Mundial de Salud, el cumplimiento del tratamiento de la tuberculosis puede definirse como el grado en que la toma de los medicamentos por parte de un paciente coincide con el tratamiento prescrito. La suma de los pacientes curados y de quienes finalizan el tratamiento (estrategia de observación directa), son indicadores pragmáticos del cumplimiento del tratamiento. Objetivos. Determinar la relación entre el cumplimiento del tratamiento contra la tuberculosis y los factores sociodemográficos, económicos y clínicos, y los relacionados con los medicamentos, tanto de índole objetiva como subjetiva, en pacientes mayores de 18 años. Materiales y métodos. Se hizo un estudio descriptivo transversal de 174 registros de pacientes del programa de control de la tuberculosis y de 15 entrevistas semiestructuradas hechas a los pacientes que no cumplían con el tratamiento durante el periodo comprendido entre junio de 2012 y junio de 2013. Resultados. El cumplimiento del tratamiento en pacientes con tuberculosis pulmonar fue de 94,8 % y fue mayor en los pacientes del régimen contributivo (p=0,035). El incumplimiento del tratamiento fue de 5,2 %. La intolerancia a los medicamentos fue mayor en el grupo de quienes no cumplieron el tratamiento. La falta de apoyo familiar, el abandono del trabajo, el impacto económico y la insatisfacción con la oportunidad de la atención en la institución de salud, fueron factores importantes a la hora de incumplir el tratamiento. Conclusiones. El régimen de afiliación al sistema de salud y la tolerancia a los medicamentos fueron los factores objetivos relacionados con el cumplimiento del tratamiento y, la carga social y económica de la enfermedad, el factor subjetivo.

Introduction: Non-adherence to antihypertensive treatment is a problem that has been identified and studied. The occurrence of adverse reactions is a common cause of it, but the role of sexual dysfunction has not been well studied. Objective: To describe the behavior of the adherence to antihypertensive treatment and its relation to the onset of sexual disorders. Method: A prospective descriptive study was conducted with 102 patients from 2 doctor’s offices of the XX Aniversario Polyclinic in Santa Clara. A survey was performed in order to define sociodemographic variables, concomitant diseases, organ damage and antihypertensive treatment. The improved Morisky-Green-Levine test was used to evaluate adherence to treatment. Adverse reactions were considered in depth, especially sexual disfuctions. Results: It was found that 45.1% (46 out of 102 patients) did not adhere to the prescribed therapy. Abandonment of treatment due to adverse reactions (45, 97.8%) was the main cause. There was no difference in the adherence to treatment between sexes or between age groups. The most common adverse reactions included fatigue (49%), sexual dysfunction (39.2%), headache (39.2%) and hypotension (39.2%). Conclusions: The number of hypertensive patients without adherence to drug therapy is very high, without regard to sex or age. The onset of sexual disorders is one of the adverse reactions that lead to this situation.

Resumo OBJETIVO Identificar os fatores associados à autoaplicação de insulina em adultos com Diabetes Mellitus. MÉTODO Estudo transversal desenvolvido no município de Viçosa-MG, que avaliou 142 pacientes. A coleta de dados foi realizada entre abril e julho de 2013 mediante entrevista no domicílio do participante. Regressão logística múltipla foi utilizada. RESULTADO A prevalência de autoaplicação de insulina foi de 67,6%, apresentando associação com idade entre 57 e 68 anos (OR = 0,3; IC95%: 0,1 - 0,9), conviver com companheiro e filhos (OR = 2,5; IC95%: 1,1 - 5,0), ter 9 anos ou mais de estudo (OR = 8,4; IC95%: 1,9 - 37,9), morar em área não coberta pela Estratégia Saúde da Família (ESF) (OR = 2,8; IC95%: 1,1 - 7,0). CONCLUSÃO Autoaplicação de insulina mostrou-se associada à idade, escolaridade, situação conjugal e cobertura da ESF. O reconhecimento desses fatores pode contribuir para o desenvolvimento de estratégias para adesão à autoaplicação de insulina.

RESUMO Objetivo Avaliar a associação entre os aspetos biopsicossociais e a adesão ao regime terapêutico medicamentoso dos idosos integrados nas equipes de cuidados continuados domiciliários. Métodos Estudo transversal, quantitativo com amostra constituída por 198 idosos. As entrevistas decorreram entre maio de 2012 e maio de 2013, em Portugal. Para caraterização terapêutica fez-se a coleta de dados recorrendo a dois questionários e uma entrevista. Análise dos dados feita pelo programa Statistical Package for Social Sciences, versão 20.0. Utilizou-se a estatística descritiva para apresentação dos resultados e o teste Qui-Quadrado para avaliar a associação entre variáveis. Resultados Verifica-se que 49% dos idosos não adere ao regime terapêutico medicamentoso e que o nível de adesão apresentou associação estatisticamente significativa, com estado de nutrição (p=0,002), autonomia instrumental (p=0,030) e isolamento social (p=0,046). Conclusões Conhecendo a multiplicidade de aspectos envolvidos na adesão, sugere-se que os mesmos sejam considerados nas intervenções de enfermagem promotoras de medidas de controle da terapêutica.

Objective: To know the perceptions of nurses on adherence to the use of psychoactive drugs by people with mental disorders. Methods: Exploratory qualitative study developed in 2015, through the application of semi-structured interviews with 23 nurses who worked in four psychosocial care centers in the state of Paraná. The results were analyzed using the categorical thematic analysis technique, proposed by Bardin. Results: The participants reported perceptions referring to the aspects that contribute to adherence of people with mental disorders to the use of psychopharmaceuticals, such as support from a multiprofessional team, therapeutic bond to the healthcare team, faith and spirituality, and family. The interviewees also listed the factors that hinder adherence, such as side and adverse effects, religious fanaticism and absent family. Conclusion: The knowledge of nurses on effective educational health actions oriented to people with mental disorder and their relatives should take into consideration the needs, limitations and potentialities of each individual.

ABSTRACT Objective: To evaluate adherence to self-care among people with diabetes mellitus cared for at the three levels of health care. Method: Quantitative, descriptive, cross-sectional study addressing a sample of 143 people from a city in the interior of São Paulo, Brazil from primary (45), secondary (48) and tertiary (50) units. Adherence to self-care was assessed using the "The Summary of Diabetes Self-Care Activities Measure" and "Measurement of Treatment Adherence". Results: Adherence to exercises, blood glucose monitoring, shoe inspection, and the use of insulin differed between units; better results were obtained for those in tertiary care. Conclusion: The results indicate a need for greater investment in the initial phase of treatment to improve self-care adherence. Implications for practice: The study enabled identifying the profile of individuals in terms of self-care adherence and supporting the planning of nursing interventions in diabetes mellitus.

Objective: To describe the perceptions and daily experiences of primary care (PC) physicians in dealing with the lack of therapeutic adherence in patients with cardiovascular risk, as well as their expectations and possible areas for improvement., Material and Methods: A qualitative study (within the framework of the REAAP project: Network of Experts in Adherence in Primary Care) carried out in several autonomous communities in Spain using an open-ended questionnaire completed by PC physicians and analyzed using the framework analysis method to guide the coding of the topics., Results: Eighteen physicians participated, and three main themes were identified from their responses: an approach to adherence during clinical practice, barriers that hinder the appropriate adherence, and interventions to improve it. The strategies most frequently mentioned to facilitate patients' therapeutic adherence were improving physician-patient communication and continuity of care, involving community pharmacies, and simplifying treatment by prescribing drugs in fixed combinations., Conclusions: There is no single ideal strategy to facilitate therapeutic adherence, and it is necessary to combine several interventions to optimize it. The first step is to understand the problems and the tools available. Initiatives such as the REAAP project are an important means to improve patient adherence, and for healthcare personnel to recognize the importance that this issue deserves., (Copyright © 2023 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: Evaluate the improvement in therapeutic adherence of an intervention based on telephone monitoring by the primary care pharmacist., Design: Randomized open controlled trial., Location: This study was carried out in 2021 by a multidisciplinary team working with health professionals of thirteen health centers belonging to four health districts in Community of Madrid, Spain., Participants: These were patients (60-74 years) with polipharmacy classified as non-adherent according to the Morisky-Green test. Two hundred and twenty-four patients were originally enrolled, 87 of them were non-adherents. Of these, 15 were lost and 72 were finally randomized. Seventy-one patients completed the study (33 intervention group and 38 control group)., Interventions: Patients randomized to the intervention arm were included in a follow-up telephone program consisting of an interview at months 1, 2, and 3 to improve adherence. The Morisky-Green test was repeated at month 4 to assess improvement. In the control group this test was only performed at month 4., Main Measurements: Adherence measured by Morisky-Green at baseline and at 4th month., Results: The 72.7% of patients in the intervention group became adherent while only 34.2% did in the control arm, being the difference 38.5% (95% CI: 17.1-59.9), statistically significant (P=.001)., Conclusions: After a follow-up educational-behavioral telephone intervention in non-adherent patients by the primary care pharmacist, therapeutic adherence was improved statistically significantly in the intervention group compared with the control group., (Copyright © 2023. Publicado por Elsevier España, S.L.U.)

ABSTRACT OBJECTIVE The objective of this study has been to test the ability of variables of a psychological model to predict antiretroviral therapy medication adherence behavior. METHODS We have conducted a cross-sectional study among 172 persons living with HIV/AIDS (PLWHA), who completed four self-administered assessments: 1) the Psychological Variables and Adherence Behaviors Questionnaire, 2) the Stress-Related Situation Scale to assess the variable of Personality, 3) The Zung Depression Scale, and 4) the Duke-UNC Functional Social Support Questionnaire. Structural equation modeling was used to construct a model to predict medication adherence behaviors. RESULTS Out of all the participants, 141 (82%) have been considered 100% adherent to antiretroviral therapy. Structural equation modeling has confirmed the direct effect that personality (decision-making and tolerance of frustration) has on motives to behave, or act accordingly, which was in turn directly related to medication adherence behaviors. In addition, these behaviors have had a direct and significant effect on viral load, as well as an indirect effect on CD4 cell count. The final model demonstrates the congruence between theory and data (x2/df. = 1.480, goodness of fit index = 0.97, adjusted goodness of fit index = 0.94, comparative fit index = 0.98, root mean square error of approximation = 0.05), accounting for 55.7% of the variance. CONCLUSIONS The results of this study support our theoretical model as a conceptual framework for the prediction of medication adherence behaviors in persons living with HIV/AIDS. Implications for designing, implementing, and evaluating intervention programs based on the model are to be discussed.

Abstract Objective: Analyze the actions developed in Primary Health Care (PHC) to promote adherence to tuberculosis (TB) treatment in the perception of patients and nursing team. Methods: Cross-sectional epidemiological study conducted at the PHC of Campinas-SP, through structured interviews with 18 corresponding questions on the perception of professionals (183) and patients (165). Chi-square test and Fisher's exact test were used. Results: Actions such as the promotion of autonomy and time for the patient to talk about doubts and concerns, guidance to seek information in books and/or on the Internet on the disease, and for the family to perform TB tests, undergo directly observed treatment, schedule monthly consultations, delivery of written information on treatment and incentive were actions more perceived by the professionals than patients reported receiving. Conclusions: The identification of gaps in the offer of actions for adherence to TB treatment can help health services to change and improve the practice and the epidemiological scenario of the disease.