Asthma Adherence
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Asthma Adherence
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Author :
language : en
Publisher:
Release Date : 1999
Asthma Adherence written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999 with Asthma categories.
Asthma Adherence
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Author :
language : en
Publisher:
Release Date : 2005
Asthma Adherence written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2005 with Asthma categories.
Practical guide designed to assist those involved in asthma care to understand more about adherence and the factors affecting it, both as a patient issue and an asthma management issue.
Treatment Adherence In Asthma And Attention Deficit Hyperactivity Disorder Adhd Personality Traits Beliefs About Medication And Illness Perception
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Author : Maria Emilsson
language : en
Publisher: Linköping University Electronic Press
Release Date : 2017-11-02
Treatment Adherence In Asthma And Attention Deficit Hyperactivity Disorder Adhd Personality Traits Beliefs About Medication And Illness Perception written by Maria Emilsson and has been published by Linköping University Electronic Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-11-02 with categories.
Adherence to medication in asthma and attention deficit hyperactivity disorder (ADHD) is important because medication may prevent serious consequences, possibly with lifelong effects. Several factors have been identified that influence adherence to medication in these disorders, but the importance of personality traits, beliefs about medication and illness perception has been insufficiently explored. The overall aim of this thesis was to study adherence to medication in asthma and ADHD, and in particular factors associated with adherence. The participants (n=268) in Study I were recruited epidemiologically and consisted of young adults with asthma, aged 22 years (±1 year). Impulsivity and, in men Antagonism and Alexithymia were associated with low adherence among respondents with regular asthma medication (n=109). The participants (n=35) in Study II were recruited from primary care clinics and consisted of adults (mean age 53 years). In men, Neuroticism was associated with low adherence, but Conscientiousness with high adherence. Beliefs about the necessity of medication were positively associated with adherence behaviour in women. In the total sample, a positive necessity-concern differential of beliefs predicted higher adherence. The participants in Study III, IV (n=101) and V (n=99) were recruited from Child and Adolescent Psychiatric clinics and consisted of adolescents with ADHD on long-term ADHD medication. Study IV assessed the reliability and validity of Swedish translations of the Beliefs about Medicines Questionnaire-specific (BMQ-Specific) and Brief Illness Perception Questionnaire (B-IPQ) for use in adolescents with ADHD. Exploratory Principal Component Analysis (PCA) loadings of the BMQ-Specific items confirmed the original components, the specific-necessity and specific-concerns. The exploratory PCA for B-IPQ revealed two components; the first one, B-IPQ Consequences, captured questions regarding perceptions of the implication of having ADHD (items 1, 2, 5, 6 and 8) and the second one, B-IPQ-Control, the perceptions of the ability to manage the ADHD disorder (items 3, 4 and 7). Adherence correlated positively with BMQ-necessity-concern differential but negatively with beliefs about medication regarding concerns and side effects as well as Antagonism. Adolescents with more beliefs in the necessity, but with less concerns and side effects were less intentionally non-adherent. Adolescents with more perceptions that ADHD affected life showed less unintentional non-adherence. Negative Affectivity was associated with beliefs in the necessity of medication, but also with concern about medication and side effects. Negative Affectivity was positively associated with perceived consequences in life caused by ADHD and less control over ADHD. Hedonic Capacity was associated with less concerns about medication. In conclusion: In asthma and ADHD, adherence was associated with personality and beliefs about medications treatment. The personality traits showed numerous associations with perception about ADHD and beliefs about asthma and ADHD medication. This thesis increases our understanding of these person-related underlying factors of non-adherence, which may enable targeted actions intended to turn non-adherence into adherence as well as to identify individuals at risk for non-adherence. The Swedish translation of BMQ-Specific and B-IPQ proved to be valid and reliable, suggesting that the scales are useful in clinical work to identify risks of low adherence and to increase knowledge about how adolescents perceive ADHD. Följsamhet till läkemedelsbehandling vid astma och ADHD (attention deficit hyperactivity disorder) är viktigt eftersom optimal behandling kan förebygga allvarliga och livslånga konsekvenser. Flera faktorer som påverkar följsamhetsbeteendet har tidigare identifierats exempelvis ekonomiska faktorer, men vikten av personlighetsdrag, uppfattning om läkemedel och sjukdomsuppfattning har tidigare inte undersökts tillräckligt. Det övergripande syftet för avhandlingen var att studera följsamhet till läkemedel hos personer med astma och ADHD och i synnerhet påverkande faktorer. Avhandlingen utgörs av fem delstudier. Personlighet kan beskrivas som grundläggande egenskaper som kännetecknar likheter och skillnader mellan individer, den så kallade egenskapsteorin. Personlighet kan beskrivas utifrån fem grundläggande personlighetsdrag: känslomässig instabilitet, utåtriktning, öppenhet, vänlighet och målmedvetenhet, den så kallade fem-faktor modellen. När det gäller uppfattning om läkemedel så vägs uppfattningen om nödvändigheten av läkemedelsbehandlingen för att kontrollera sjukdomen mot oron för läkemedlens negativa effekter-biverkningar. Följsamhetsbeteendet beror på vilken uppfattning som dominerar. Uppfattning om sjukdom påverkas bland annat av personens uppfattning om hur mycket sjukdomen påverkar personens liv och sjukdomens varaktighet. Resultaten av denna avhandling visar att följsamheten var högre hos tonåringar med ADHD än hos vuxna med astma. Följsamheten till astma- och ADHD-medicinering var signifikant associerad med uppfattning att läkemedel var nödvändigt såväl som personlighetsdragen, särskilt antagonism. Följsamheten var inte associerad med ålder eller kön. Med anledning av att kön är relaterad till andra faktorer bör det beaktas i utredning av följsamhet till läkemedel. Personlighetsdraget känslomässig instabilitet, var relaterat till många uppfattningar om läkemedlen och sjukdomsuppfattningar. Avhandlingen visar på sambandet mellan vissa personrelaterade faktorer och följsamhet till läkemedel, hos personer med astma och ADHD. Den svenska översättningen av frågeformulären: Uppfattning om läkemedel (BMQ-Specific) och Uppfattning om ADHD (B-IPQ) visade sig ha god kvalitet för användning i kliniska utvärderingar och forskning som involverar ungdomar med ADHD.
Identifying Predictors Of Medication Adherence In Adult Patients With Asthma
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Author : Sarah E. Voorhees
language : en
Publisher:
Release Date : 2017
Identifying Predictors Of Medication Adherence In Adult Patients With Asthma written by Sarah E. Voorhees and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017 with Psychology categories.
Asthma is a chronic respiratory illness that has become major public health concern due to its rapid increase in prevalence and increasing economic burden. Asthma management, which includes asthma control, perceived control of asthma and medication adherence, has been documented to be extremely poor. One of the main reasons for poor management includes low rates of medication adherence. The primary goal of this research study was to identify factors related to medication adherence that can eventually be integrated into clinical practice. Identifying these factors would help increase adherence rates and decrease the burden of asthma on individuals as well as the entire population. The current study examined how individual variables are related to medication adherence in patients with asthma. Research has indicated that patients with high perceived stress are less likely to adhere to a prescribed medication regimen. Social problem-solving, which is the affective, cognitive and behavioral way individuals approach real world problems, is related to the management of various chronic conditions and may moderate the relationship between perceived stress and adherence outcomes. Adult asthma patients for this study were recruited from two different medical sites: an allergy and asthma private practice located in New Jersey and Drexel Pulmonary Medicine located in Philadelphia, PA. Self-report data was collected from participants (N = 104) including demographic information, asthma control, perceived control of asthma, perceived stress, social problem-solving behaviors and medication adherence. Additional patient information was gathered using patient medical and pharmacy records. Bivariate correlational analyses demonstrated positive associations between perceived stress and dysfunctional social problem-solving tendencies and negative associations between perceived stress and self-report adherence. Lower perceived stress was also associated with more adaptive social problem-solving tendencies and higher asthma control. Lower perceived control of asthma was associated with the dysfunctional social problem-solving dimensions and higher pharmacy reports of adherence. Analyses also revealed relationships between higher self-report adherence and more adaptive problem-solving abilities. A hierarchical regression analysis revealed that lower perceived control of asthma was predictive of higher pharmacy refill adherence rates. Social problem-solving did not significantly moderate the relationship between perceived stress and medication adherence. Exploratory analyses indicated that lower self-reports of adherence, lower perceived control of asthma, and more maladaptive problem-solving tendencies were all predictive of higher perceived stress. Additionally, a one-way analysis of variance (ANOVA) was conducted to examine differences among racial and ethnic groups. Individuals who identified as White reported greater self-report adherence, less perceived stress, better social problem-solving abilities, higher perceived control of asthma, and better objective control of asthma, as compared to other racial and ethnic groups. Results suggest integrative medical and psychosocial treatments should be adapted for individuals of various racial and ethnic backgrounds. Interventions that target social problem-solving abilities and perceived stress may be particularly beneficial for improving patient's ability and perceived ability to successfully manage their asthma.
Improving Asthma Management
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Author : Tatiana Victorovna Makhinova
language : en
Publisher:
Release Date : 2016
Improving Asthma Management written by Tatiana Victorovna Makhinova and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016 with categories.
Adherence to long-term asthma controller medications is an important factor in effective asthma management. Suboptimal adherence to asthma controller medications is prevalent. This three-study dissertation presents a patient-pharmacist partnership program designed to enhance therapy adherence and provides preliminary results on the effectiveness of this program. Study one consists of two parts. First, patient-centered, asthma-specific tools addressing key asthma adherence barriers in community pharmacy settings were developed. Second, five interviews with community pharmacists were conducted and three main topics were covered. In the first topic, “use of tools and overall approach”, pharmacists reported the need for the identification of patients’ barriers and that they found the proposed tools to be helpful in identifying and addressing patients’ concerns. In the second topic pharmacists reported “barriers to implementation”, such as time and workflow, patients’ perception of the pharmacists and absence of reimbursement. The last topic included “facilitators and suggestions for implementation” and the following were suggested: identifying patients upfront based on their refill history, placing a note on filled prescriptions, raising awareness among patients, involving technicians in the process of identifying patients, having a dedicated pharmacist staff and adding the proposed approach into in-store health clinics/fairs. Study two was a cross-sectional pilot test of the developed tool for identification of patients’ barriers to adherence in community pharmacy settings. The objective was to examine the association between asthma control, adherence barriers and asthma management characteristics. Significant (p
Non Adherence To Inhaler Treatment Among Copd And Asthma Patients
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Author : Chin H. Oh-Ciernick
language : en
Publisher:
Release Date : 2019
Non Adherence To Inhaler Treatment Among Copd And Asthma Patients written by Chin H. Oh-Ciernick and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019 with categories.
"The effect of non-adherence to inhalers has a significant impact on morbidity and mortality in patients with COPD and/or asthma, as well as an increase in healthcare cost. Non-adherence to inhaler treatment is a complex multifactorial problem. The patients with asthma and chronic obstructive pulmonary disease (COPD) have a non-adherence rate up to 50 to 70% with their medication regimen. The purpose of this EBP change project was to improve inhaler adherence in patients with COPD and/or asthma by conducting follow-up calls after a face-to-face visit. A total of seven individuals voluntarily participated in the project. During the initial face-to-face visit, the participants completed a pre-test (Morisky, Green, Levine Questionnaire). The first follow-up calls were placed one week after the face-to-face visit. The second follow-up calls were placed two weeks after the first follow-up calls. During the follow-up calls, the project manager addressed any barriers that were preventing the participants from adhering to inhaler regimen such as changing the inhaler to one with a lower copay. The post-test was completed by the participants during the face-to-face follow-up visit. The post-test demonstrated an improvement in inhaler adherence of 58% among all participants, which exceeded the benchmark of 30%. Consequently, follow-up calls after the face-to-face visit improved medication adherence by providing an opportunity for healthcare providers to address barriers that may hinder patients from adhering to the medication regimen. Key words: COPD, asthma, medication, inhaler, non-adherence, follow-up calls " -- Abstract
Adherence With Preventive Medication In Childhood Asthma
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Author : Scott W. Burgess
language : en
Publisher:
Release Date : 2010
Adherence With Preventive Medication In Childhood Asthma written by Scott W. Burgess and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010 with Asthma in children categories.
Asthma is the most common chronic disease of childhood. Preventive asthma medication has been shown to decrease lung inflammation and improve both disease control and quality of life. Sub-optimal adherence with preventive medication is common. Non-adherence has been linked with significant morbidity and increased healthcare utilisation, both leading to increased overall healthcare costs. This thesis contributes to the body of evidence regarding adherence by: 1. Validating an electronic monitoring device (EMD) designed to measure adherence. 2. Exploring factors association with non-adherence in young children with asthma. 3. Examining the accuracy of subjective measures of adherence including parent report and physician s estimate of adherence. 4. Demonstrating that a novel spacer incorporating an incentive device (Funhaler) does not increase adherence in young children with asthma. 5. Demonstrating that measuring adherence and providing feedback about medication usage during a consultation increases adherence in children with poorly controlled asthma. An EMD, the Smartinhaler, was shown to accurately record actuations with a pressurised metered dose inhaler. It compared favourably with a previously validated device, the Doser. An observational study involving 50 young children with asthma found that the reported level of adherence by their parents correlated poorly with data from an EMD even when the question was phrased in a non-judgemental fashion and prefaced by a normalising statement. An estimate of adherence by the child's treating physician was shown to be no more likely to correctly identify non-adherence than would be expected by chance alone. Factors associated with non-adherence were explored and adherence was found to correlate inversely with the degree to which carers reported finding parenting stressful. A novel spacer incorporating an incentive device (spinning disk and whistle), the Funhaler, has been reported to be to be associated with increased adherence based on parental report. This thesis includes a randomised controlled trial involving 44 children comparing adherence with preventive medication by those using the Funhaler and a control group using a standard spacer. No difference was found between the two groups in terms of adherence or disease control over a period of three months. Measuring adherence using an EMD and providing feedback regarding this data during the subsequent consultation was evaluated in a randomised controlled study involving 26 children with poorly controlled asthma. The mean adherence in the group receiving feedback with regard to their adherence was found to be 21% higher than adherence by children in the control group whose measured adherence remained unknown to them, their parents and their treating physician.
Interventions To Modify Health Care Provider Adherence To Asthma Guidelines
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Author : U. S. Department of Health and Human Services
language : en
Publisher: CreateSpace
Release Date : 2013-07
Interventions To Modify Health Care Provider Adherence To Asthma Guidelines written by U. S. Department of Health and Human Services and has been published by CreateSpace this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-07 with Medical categories.
Asthma is a respiratory disease characterized by variable and recurring symptoms, airflow obstruction, bronchial hyper-responsiveness, and inflammation of the airways. In the U.S., an estimated 24.6 million people (8.2 percent) currently have asthma. Students with asthma miss more than 14 million school days every year due to illness. In 2005, there were approximately 679,000 emergency room visits in the U.S. due to asthma in children under 15 years of age. Currently, asthma is the third leading cause of hospitalization among children in this age group. Furthermore, certain U.S. population subgroups have higher prevalence rates of asthma in comparison with the national average: children (9.6 percent), poor children (13.5 percent), non-Hispanic African American children (17.0 percent), women (9.7 percent), and poor adults (10.6 percent). Following asthma guideline treatment recommendations improves clinical outcomes in a variety of pediatric populations, including high-risk populations, such as inner-city, poor, and/or African American populations. The available evidence suggests that most people with asthma can be symptom-free if they receive appropriate medical care, use inhaled corticosteroids when prescribed, and modify their environment to reduce or eliminate exposure to allergens and irritants. Despite the evidence of improved outcomes associated with adherence to guidelines, their long-term existence (more than 20 years) and widespread availability, health care providers do not routinely follow asthma guideline recommendations. In one study, only 34.2 percent of patients reported receiving a written asthma action plan, while only 68.1 percent had been taught the appropriate response to symptoms of an asthma attack. In the same study, only about one third of children or adults were using long-term asthma controller medicine such as inhaled corticosteroids. Health care providers do not appropriately assess asthma control in most children, resulting in substandard care. Minority children are up to half as likely as Caucasian children to receive inhaled steroids. The significance of these studies is that suboptimal outcomes persist, such as twofold higher rates of emergency room visits for African American children compared with their Caucasian counterparts. With the lack of adherence to guideline recommendations, attention has been focused on why best practices are not followed (i.e., adhered to) by health care providers. The objective of our systematic review was to assess whether interventions targeting health care providers improve adherence to asthma guideline recommendations for asthma care and if these interventions subsequently improve clinical outcomes for patients. We also sought to determine whether any observed changes in asthma care processes directly improve clinical outcomes. This report has provided an organized systematic review of provider-focused interventions to improve asthma care and outcomes. Therefore, this report should provide a context in which to organize different types of interventions, their relative impact on a variety of outcomes, and considerations for what and how future studies should be planned. Our specific Key Questions (KQs) are listed below. KQ1: In the care of pediatric or adult patients with asthma, what is the evidence that interventions designed to improve health care provider adherence to guidelines impact health care process outcomes (e.g., receiving appropriate treatment)? KQ2: In the care of pediatric or adult patients with asthma, what is the evidence that interventions designed to improve health care provider adherence to guidelines impact clinical outcomes (e.g., hospitalizations, patient-reported outcomes such as symptom control)? KQ3: In the care of pediatric or adult patients with asthma, what is the evidence that interventions designed to improve health care provider adherence to guidelines impact health care process outcomes that then affect clinical outcomes?
Fast Facts Asthma
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Author : Stephen T. Holgate
language : en
Publisher: Karger Medical and Scientific Publishers
Release Date : 2013-03-27
Fast Facts Asthma written by Stephen T. Holgate and has been published by Karger Medical and Scientific Publishers this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-03-27 with Medical categories.
'Fast Facts: Asthma' delivers a clear practical message – improved asthma control can be achieved through efficient commonsense delivery of asthma care, alongside strategies that improve patient self-management and medication use. This fully updated fourth edition examines the essentials of good asthma care, distilled from the latest international guidelines and best available evidence, including: • Accurate asthma diagnosis • Identification and control of factors that increase the risk of exacerbations • Effective delivery of inhaled medication • The recommended stepwise approach to asthma treatment • Questions to ask before diagnosing refractory asthma • Inflammation-guided therapy • Recognition and treatment of acute asthma attacks • Strategies to improve adherence to asthma treatment The easy-reference format of this concise, well-illustrated handbook is ideal for general practitioners, asthma nurses, medical students and asthma educators seeking a practical overview of good asthma care that will help with individualized management plans and patient education, and improve outcomes and quality of life for the very many people living with asthma. Contents: • Pathophysiology • Epidemiology and natural history • Diagnosis and classification • Management • Refractory asthma • Acute asthma attacks • Preventing asthma attacks • Exercise-induced asthma • Developments • Useful resources
Factors Related To Medicines Adherence In Adolescents With Asthma
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Author : Nde-Eshimuni Manase Salema
language : en
Publisher:
Release Date : 2011
Factors Related To Medicines Adherence In Adolescents With Asthma written by Nde-Eshimuni Manase Salema and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011 with categories.
Asthma is one of the most prevalent chronic conditions that presents amongst adolescents. Untreated asthma can be debilitating. Hence, for many adolescents the successful management of asthma relies on taking medicines. It has been observed that non-adherence to asthma medicines is widely reported during adolescence. The unique challenges inherent to the adolescent developmental phase have been implicated in this observation. A more comprehensive understanding of the reasons influencing adherence to medicines is needed before interventions to facilitate adherence can be implemented. This thesis aimed to explore what factors influenced medicines adherence in adolescents with asthma through a systematic review of 17 adherence enhancing interventions (AEls) in adolescents taking long-term medicines; 30 in-depth semi-structured interviews with adolescents aged 13 to 19 years old, of which 13 were photo-interviews; and a quantitative analysis of 248 online surveys completed by university students with asthma aged 18 or 19 years old. The systematic review identified focussing interventions on a narrow age range, involving parent/family support for complex medicines regimens and improving access to care, as factors impacting positively on adherence. The qualitative inquiry found that forgetting, having concerns about medicines, perceiving that asthma medicines were not necessary, unwillingness to respond to asthma symptoms and being ill-equipped as an asthma self- manager, negatively impacted adherence. Adolescents also reported a variety of strategies they used to facilitate medicines-taking. Hierarchical regression analysis modelling revealed that higher medicines concerns, lower belief in the necessity for medicines, binge drinking and not usually carrying inhalers were associated with low self-reported adherence by the 8- item Morisky Medication Adherence Scale (MMAS-8). The knowledge gleaned from this thesis provides policy makers, health care practitioners, researchers, and others responsible for caring for adolescents with asthma, with new evidence to consider when engaging efforts to understand and facilitate medicines-taking in this patient group.