Patient Prefer Adher
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Patient Prefer Adher · Jan 2017
Confidence in correct inhaler technique and its association with treatment adherence and health status among US patients with chronic obstructive pulmonary disease.
Improper use of bronchodilators is associated with poor disease control, nonadherence to long-term therapy, and poor clinical outcomes. Our current understanding of factors associated with correct inhaler use and adherence is limited. We measured physician-and patient-reported confidence in device usage and associations with treatment adherence and COPD-related health status. ⋯ Low confidence in inhaler usage was associated with lower adherence and poor COPD-related health status. Choice of inhaler device tailored to patients' ability to use specific devices and ongoing education to support optimal inhaler usage may improve patient confidence and enhance both adherence and health status.
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Patient Prefer Adher · Jan 2017
Getting patients in the door: medical appointment reminder preferences.
Between 23% and 34% of outpatient appointments are missed annually. Patients who frequently miss medical appointments have poorer health outcomes and are less likely to use preventive health care services. Missed appointments result in unnecessary costs and organizational inefficiencies. Appointment reminders may help reduce missed appointments; particular types may be more effective than other types. We used a survey with a discrete choice experiment (DCE) to learn why individuals miss appointments and to assess appointment reminder preferences. ⋯ The number of missed appointments and reasons for missing appointments are consistent with prior research. Patient-centered appointment reminders may improve appointment attendance by addressing some of the reasons individuals report missing appointments and by meeting patients' needs. Future research is necessary to determine if preferred reminders used in practice will result in improved appointment attendance in clinical settings.
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Patient Prefer Adher · Jan 2017
A randomized trial of individual versus group-format exercise and self-management in individuals with Parkinson's disease and comorbid depression.
Depression is common in people with Parkinson's disease (PD), and exercise is known to improve depression and PD. However, lack of motivation and low self-efficacy can make exercise difficult for people with PD and comorbid depression (PD-Dep). A combined group exercise and chronic disease self-management (CDSM) program may improve the likeli-hood that individuals will engage in exercise and will show a reduction in depression symptoms. The purpose of this study was to compare changes in depression in PD-Dep between individual versus group exercise plus CDSM and to examine participant adherence and perception of the interventions. ⋯ Both group CDSM plus exercise and self-guided CDSM plus exercise can improve depression in PD-Dep. These findings suggest that development of a remotely delivered group-based CDSM format plus manualized exercise program could be useful for this population.
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Patient Prefer Adher · Jan 2017
EditorialComing full circle in the measurement of medication adherence: opportunities and implications for health care.
There is little debate that medication nonadherence is a major public health issue and that measuring nonadherence is a crucial step toward improving it. Moreover, while measuring adherence is becoming both more feasible and more common in the era of electronic information, the reliability and usefulness of various measurements of adherence have not been well established. This paper outlines the most commonly used measures of adherence and discusses the advantages and disadvantages of each that depend on the purpose for which the measure will be used. ⋯ Less robust measures were found to be commonly misapplied and subsequently misinterpreted in population-level analyses. Adherence assessment and measurement were rarely integrated into standard patient care practice patterns. Successful scalable and impactful strategies to improve medication adherence will depend on understanding how to efficiently and effectively measure adherence.
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Patient Prefer Adher · Jan 2017
Addressing the elephant in the room: a possible new way to increase patient adherence to medical advice.
Lack of patient adherence to medical advice (PAMA) is recognized as an area of interest. None of the previous initiatives to improve PAMA, such as patient centered care and shared decision making, have proved to be successful in terms of improving patient adherence. The aim of the present study is to assess beliefs about priorities in public health care, and adherence to medical advice, to establish a novel approach to increase PAMA. ⋯ Although technical and methodological interventions in health care have, to some extent, improved PAMA, medical adherence is still low. In the present study, it is shown that integrating either national expertise or collaborated messages with other health professions and patient organizations' recommendations in everyday care may help improve patients adherence to medical advice. A minor change in how treatment suggestions are presented could improve PAMA.