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Aims Although many studies have examined the predictors of medication adherence (MA), further empirical research is required to clarify the best model for predicting MA for older adults with heart failure (HF). Thus, we hypothesized a model in which information (knowledge), motivation (social support and depressive symptoms), and behavioural skills (barriers to self-efficacy) would be associated with MA in patients with HF. Methods and results Using a cross-sectional survey, 153 adults aged ≥ 65 years taking medication for HF were recruited from a university hospital in Korea. Data were collected based on the information–motivation–behavioural skills (IMB) model constructs and MA. In the hypothesized path model, self-efficacy was directly related to MA (β = −0.335, P = 0.006), whereas social support was indirectly related to MA through self-efficacy (β = −0.078, P = 0.027). Depressive symptoms were directly related to MA (β = 0.359, P = 0.004) and indirectly related to MA through self-efficacy (β = 0.141, P = 0.004). The hypothesized MA model showed a good fit for the data. Knowledge, social support, and depressive symptoms accounted for 44.3% of the variance in self-efficacy (P = 0.004). Left ventricular ejection fraction, knowledge, social support, depressive symptoms, and self-efficacy explained 64.4% of the variance in MA (P = 0.004). Conclusion These results confirmed the IMB model's suitability for predicting MA in older adults with HF. These findings may guide and inform intervention programmes designed to alleviate depressive symptoms in older adults with HF and enhance their HF knowledge, social support, and self-efficacy, with the ultimate goal of improving their MA. [ABSTRACT FROM AUTHOR]

Background: Heart rate variability (HRV) is an indicator of autonomic abnormalities. However, little is known about the role of HRV related to substance use behavior and the association between the changes in HRV and signs of relapse in substance use. Aim: The purpose of this study was to review the existing literature on autonomic response to substance use (i.e., opioids, cocaine, and methamphetamine) measured by HRV and its outcomes related to the risk factors of relapse. Methods: A systematic search of the literature was conducted using PubMed, PsychINFO, and Ovid Medline databases. The study includes full-text articles published in English from 2010 to 2020, using measures of HRV in human subjects who use substances. Results: A total of 14 studies were reviewed. Studies included outpatients with a prescription or nonprescription opioid misuse behavior with a primary diagnosis being chronic pain or substance use disorder (SUD). Significantly decreased resting HRV was found in substance users compared to healthy controls. Lower resting HRV has been significantly associated with stress, craving, and greater symptom severities in individuals with SUD and other substance dependence. HRV indices can be potential measures of homeostatic imbalance and self-regulation flexibility. Conclusion: HRV may be a useful tool for monitoring early indication of relapse so that relapse prevention measures can be implemented in a timely manner. Future studies in substance use may benefit from examining HRV in relations to substance use and relapse signs and symptoms in a larger population to guide future relapse prevention strategies. [ABSTRACT FROM AUTHOR]

A 6-month self-efficacy intervention was compared with attention-control intervention on physical activity, clinical outcomes, and mediators immediate postintervention and 6-month postintervention in 182 older adults with knee osteoarthritis and hypertension using a randomized controlled trial design. The intervention group received six weekly individual physical therapy sessions for lower-extremity exercise and fitness walking and nine biweekly nurse telephone counseling sessions. The attention-control group received six weekly and nine biweekly nurse telephone sessions on health topics. Lower-extremity exercise was assessed by e-diary; fitness walking was assessed by accelerometer and e-diary; blood pressure was assessed by automated monitor; function was assessed by performance-based tests and questionnaires; and pain, self-efficacy, and outcome expectancy were assessed by questionnaires. Self-reported lower-extremity exercise and fitness walking, function, pain, self-efficacy, and outcome expectancy showed significant group or group by time effects favoring intervention. The intervention did not improve physical activity by accelerometer and blood pressure. Mean minutes of fitness walking fell short of the 150 min/week goal. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To determine the effectiveness of nurse‐led interventions on medication adherence, medication knowledge and clinical outcomes in adults taking medication for metabolic syndrome. Background: Despite the significance of interventions designed to improve medication adherence, a systematic review of nurse‐led intervention studies for metabolic syndrome is lacking. Design: A systematic review and meta‐analysis of randomised controlled trials. Methods: The study was conducted following the PRISMA guidelines checklist. PubMed, EMBASE, PsychINFO, CINAHL, Cochrane CENTRAL and other manual sources were searched in May 2021.The quality assessment was conducted using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Comprehensive Meta‐Analysis 3.0 was used to calculate the pooled effect sizes with 95% confidence intervals. Results: This review included 20 studies of nurse‐led medication adherence interventions in 6017 adults at risk for metabolic syndrome. The pooled effect size using the random effects model indicated that nurse‐led interventions had a significantly moderate impact on enhancing medication adherence and medication knowledge and improving selected clinical outcomes of available studies in nurse‐led intervention groups compared with control groups. Duration of intervention (median 12 weeks), mode of delivery (group vs. individual) and using multiple strategies influenced outcomes of nurse‐led medication adherence interventions. The results revealed that interventions of moderate‐ to high‐quality studies were more likely to show significant improvements in medication adherence than those of low‐quality studies. Conclusion: The meta‐analyses showed that nurse‐led interventions may enhance medication adherence and knowledge and improve clinical outcomes of this population. Relevance to Clinical Practice: The findings may contribute to evidence‐based information about nurse‐led intervention and its selection of appropriate interventions for improving medication adherence in this population. Patient or public contribution: Patients or the public were not directly involved in this review. [ABSTRACT FROM AUTHOR]

Purpose: The opioid crisis has contributed to the mortality, morbidity, and rising healthcare costs in the United States. Buprenorphine (BUP) is an effective medication for opioid use disorder. The aims of this quality assurance evaluation of a BUP program were to (a) evaluate the clinic's performance in illicit opioid abstinence and (b) identify patient risk and resilience characteristics to improve patient success in recovery with BUP. Methods: A retrospective chart review of open (n = 35) and closed (n = 21) cases and a cross-sectional survey in open cases were completed. Adults (aged ≥18 years) who completed 6 months of BUP treatment at a psychiatric clinic were included. Clinical performance was measured with percentages of opioid-negative urine and completed monthly urine drug tests (UDTs) for the first 6months. Open cases were surveyed regarding risk and resilience characteristics (frequency of opioid cravings and triggers, therapy participation, and coping skills). Descriptive statistics, t test, and chi-square test were used to analyze data. Results: Average opioid-negative urine was significantly higher in open cases than closed cases (88.57% vs. 74.82%; t = 2. 885, p = .004). There was no significant association between open cases (61.4%) and closed cases (73.8%) in completed monthly UDT. Opening and closing of cases stabilized with mandatory monthly UDT. Most individuals reported therapy participation, minimal opioid cravings, and use of distraction to cope with chronic-pain-induced cravings. Conclusions/Implications: This clinic met benchmarks leading to improved substance recovery. Recommendations include regular evaluations of UDT, cravings, and chronic pain; therapy participation; and continuous quality assurance activities. [ABSTRACT FROM AUTHOR]

This study examined the psychometric properties of the Korean version of the Patient Knowledge Questionnaire-Osteoarthritis (PKQ-OA-K). A cross-sectional survey was conducted with 157 adults with osteoarthritis from the outpatient clinic at a university hospital in Korea. The overall correct answer rate for the PKQ-OA-K was 60.4%; notably, the drug therapy subscale had the lowest median score percentage (42.9%). For structural validity, exploratory factor analysis identified the PKQ-OA-K as two-dimensional, explaining 52.4% of the total variance. Confirmatory factor analysis showed that the two-factor model adequately fit the data. The PKQ-OA-K was positively correlated with education level (r = 0.24) and osteoarthritis outcomes (r = 0.17), thus verifying the hypotheses of construct validity. The intraclass correlation coefficient for test-retest reliability was 0.52; alpha was 0.44. The PKQ-OA-K has excellent validity but imperfect reliability for adults with osteoarthritis. This study recommends cautious use of the PKQ-OA-K to assess Korean patients' knowledge of osteoarthritis. [ABSTRACT FROM AUTHOR]