Disagreements were resolved by discussion. In addition to knowledge, beliefs about the HF regimen were also related to compliance. Compliance in heart failure patients: the importance of knowledge and Bougioukas KI, Liakos A, Tsapas A, Ntzani E, Haidich A-B. The impact of all other therapy related factors (duration of therapy, number of tablets, intake frequency, intake at meals) was uncertain in all conditions [23, 28, 35,36,37,38,39]. This systematic review (SR) of SRs (overview) aims to identify factors that can influence the adherence of adult patients with chronic physical diseases. Knowledge plays an influential and significant part of a patient's life and recovery. In contrast, negative effect directions of higher age in chronic diseases, cardiovascular conditions and oral anticancer agents were reported [20, 21, 23, 24, 28, 39]. Thorneloe RJ, Griffiths CE, Ashcroft DM, Cordingley L. BMC Health Serv Res. 2023 BioMed Central Ltd unless otherwise stated. Nursing Care Plan: NCP Nursing Diagnosis: Noncompliance - Blogger Grimshaw J. Assess the patients current knowledge about hypertension and obstacles to learning. The Nurse practitioner, 43(8), 4955. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Sabate E. Adherence to long-therm therapies: evidence for action: Weltgesundheitsorganisation; 2003. Based on these criteria, the effects were rated as robust evidence for an impact, some evidence for an impact, probably no impact or uncertain impact. This is the American ICD-10-CM version of Z91.14 - other international versions of ICD-10 Z91.14 may differ. Second, it can support the identification of possible adherence barriers that might be eliminated. To speed up the recovery and maximize the healing process, it is advisable that the patient should refrain from moving and let the relative or caregiver act for the patients needs. J Clin Epidemiol. The impact of employment was mostly uncertain. Determinants of adherence to heart failure medication: a systematic literature review. 1. Age might have a concave relation to adherence, i.e., adherence is lowest in very young and very old people. For all factors, a summary evaluation of the influence on adherence across SRs was made. In the final phase 3, the assessor judges whether the whole SRs is at risk of bias. The study selection (title/abstract screening and full-text screening) was performed by two reviewers independently. 2018;23(3):20015. 17 Th6 2022 . Krueger K, Botermann L, Schorr SG, Griese-Mammen N, Laufs U, Schulz M. Age-related medication adherence in patients with chronic heart failure: a systematic literature review. Heart Fail Rev. knowledge deficit related to medication compliance Oosterom-Calo R, van Ballegooijen AJ, Terwee CB, te Velde SJ, Brouwer IA, Jaarsma T, et al. and transmitted securely. Tuberculosis Nursing Diagnosis and Nursing Care Plan, Disturbed Sleep Pattern Nursing Diagnosis and Care Plans, Exaggerated behavior as compensation for lack of knowledge, Verbalization of erroneous information about the condition or treatment, Inaccurate execution of newly learned tasks, Assess patients current knowledge about the new diagnosis, Determine the patients manner of learning, Encourage the patient to participate in formulating treatment plans, Encourage the patient to ask questions when necessary or when in doubt, Facilitate conversations to be a learning-friendly discourse, Identify any possible obstacle that can impede the patients way of learning, If necessary or better, use other learning materials such as writing on paper, a demonstration, or a video, Teaching methods should pick up with the patients pace on learning, Instill a positive reinforcement to help the patient comply with the treatment plan, Assess the patients receptivity to new learning skills by having a simple and return demonstration related to the treatment plan, Providing a resource material to the patient regarding the treatment plan is helpful, Inquire the patient for possible feedback to assess the ongoing teaching method. Nevertheless, we decided to use modified vote counting because we anticipated that this is the only method to harmonize the results from different types of narrative synthesizes. Gast, A., Mathes, T. Medication adherence influencing factorsan (updated) overview of systematic reviews. Our website services and content are for informational purposes only. Thus, the overall judgement of risk of bias is exclusively based on the results of phase 2 [17]. Patient Prefer Adherence. Z91.14 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2014 Mar;31(3):149-57. doi: 10.1007/s40266-014-0153-9. In all these domains, more than 50% of the SRs were at high risk of bias. Maimaris W, Paty J, Perel P, Legido-Quigley H, Balabanova D, Nieuwlaat R, et al. Moreover, patients who may seem to ignore the consequences of their condition may appear anxious or overwhelmed, disinterested in asking for more information, avoidant in eye contact with the medical personnel, and grandstanding by interrupting the medical personnel during conversation and telling them that the patient knows better. Consider cultural factors.Some cultures value strong familial influence and defer to older or male relatives for health decisions. Although the majority of literature on adherence-influencing factors is overwhelming, we could only judge the influence for many factors as uncertain. Non-adherence to medication regimens among older African-American adults. The patients diet should be high-protein, low-fat, and not hot, spicy, and gas-forming. government site. Aging, antiretrovirals, and adherence: a meta analysis of adherence among older HIV-infected individuals. First, we limited our literature search to English and German languages because there were no other language skills in our research team and no resources for translating articles. Additional sources of inconsistency that we could not control for were different definitions and measurements of influencing factors (e.g., socioeconomic status) and even more adherence measures (e.g., self-reported vs. electronic monitoring, >90% of pills taken vs. >80% vs. mean intake). 7. 6. Medication is the most frequent treatment intervention, and its success depends on patients taking their medicines in line with their prescribed regimen to yield the full benefit of the treatment. 2017;129:115. Knowledge plays a vital role in the patient's recovery and may include 3 domains namely: (1) cognitive domain, (2) affective domain, and (3) psychomotor domain. Multiple factors were identified to cause a treatment failure such as side effects of the medications, rejection of the diagnosis by patients, lack of patient understanding about their medication, noncompliance, and the cost of medication. 2008;11(1):447. The process of study selection is illustrated in the PRISMA flowchart [41] (Fig. The 21 SRs included 313 primary studies, and data from these studies were used in this evidence synthesis. The nurse may need to wait until a more opportune time to teach. Compared with domain 3, the other domains, including 1 (eligibility criteria), 2 (identification and selection of studies) and 4 (synthesis), were at higher risk of bias across studies. Ann Intern Med. Article Carney RM, Freedland KE, Eisen SA, Rich MW, Skala JA, Jaffe AS. Manage cookies/Do not sell my data we use in the preference centre. Simplify the regimen. Cite this article. Gourzoulidis G, Kourlaba G, Stafylas P, Giamouzis G, Parissis J, Maniadakis N. Association between copayment, medication adherence and outcomes in the management of patients with diabetes and heart failure. Moreover, the knowledge of influencing factors of adherence can support the development of tailored health technologies to increase adherence by treating the underlying barriers (e.g., depression treatment, reducing co-payments). Qual Saf Health Care. 176-178, 50935, Cologne, Germany, You can also search for this author in . knowledge deficit related to medication compliance. Discuss the drug therapy to the patient, including the prescribed OTC drugs and analgesics. We thank Stefanie Bhn for her support in the risk of bias assessment. Gender and racial disparities in adherence to statin therapy: a meta-analysis. Depression was analysed in patients taking oral anticancer agents, HIV infection or cardiovascular conditions. This previe The explanation for the inconsistent results of the linear analyses might also be attributed to the fact that the association is indeed non-linear. A discrete choice experiment in a community sample in Australia. Association between drug insurance cost sharing strategies and outcomes in patients with chronic diseases: a systematic review. Mathes T, Antoine S-L, Pieper D. Factors influencing adherence in hepatitis-C infected patients: a systematic review. We analysed seven potentially socioeconomic adherence-influencing factors. The evidence synthesis of the analysed factors (according to the different diseases/therapies) is presented in Table3. Provide additional resources.To support continued learning, the nurse may offer additional resources such as websites, support groups, and community resources. The 2023 edition of ICD-10-CM Z91.14 became effective on October 1, 2022. Cancer Epidemiol. Value Health. More distinct (no linear) age groups were compared in the SRs on adherence in inflammatory arthritis, chronic diseases, HIV-infected patients, patients taking oral anticancer agents and cardiovascular conditions [20, 21, 23, 28, 31, 32, 37,38,39]. Maegan Wagner is a registered nurse with over 10 years of healthcare experience. This overview includes 21 SRs on 313 individual primary studies in a broad spectrum of chronic conditions. All data in the tables were harmonized so that the influence on adherence (not non-adherence) refers to an increase in the factor regardless of whether the factor is positive (e.g., socioeconomic status) or negative (e.g., co-payments). The causes of noncompliance include side effects, knowledge deficits, and patient/therapist relationships. Privacy In particular, imprecise eligibility criteria, inadequate restrictions in the eligibility criteria, inappropriate search strategies, simple vote-counting and no protocols available were the most common reasons for the high risk of bias in these domains. Factors associated with medication adherence among patients with diabetes in the Middle East and North Africa region: a systematic mixed studies review. 11. 2012;73(5):691705. Adherence is a multifactorial phenomenon that can be influenced by various factors. This overview was not registered. To heal properly, it is important to have the patient cooperate with any responsible clinical personnel in managing fracture. 2012 Jun 20;13:61. doi: 10.1186/1471-2296-13-61. If a patient is in pain, worried, upset, or tired then they are not in a state of mind to retain information. Available from: URL: https://www.bristol.ac.uk/media-library/sites/social-community-medicine/robis/robisguidancedocument.pdf.Assessed 28.11.2018. Br J Clin Pharmacol. 2011;136(3132):161621. 2011;64(4):3802. Upon eating bland and small amounts of food with water, instruct the patient to remain in upright position 1-2 hours after meal, and avoid eating 2-4 hours before bedtime. In . Overviews of SRs are always at high risk for discordant or heterogeneous results across the included SRs [42]. PLoS One. Nursing Diagnosis: Deficient Knowledge related to lack of exposure/recall, new condition or treatment, or unfamiliarity with the disease condition secondary to anemia as evidenced by inaccurate follow-through of instructions and verbalized inaccurate information. Unauthorized use of these marks is strictly prohibited. A condition-related explanation for heterogeneity might be that many SRs seem to include symptomatic as well as asymptomatic patients. In cardiovascular conditions, there was some evidence that patients not paying any co-payments are more adherent than those patients paying (any) co-payments [25, 26]. We found some evidence for a negative influence of intake of different medications in cardiovascular conditions. Non-adherence is a multifactorial problem. Part of Sinnott S-J, Buckley C, O'Riordan D, Bradley C, Whelton H. The effect of copayments for prescriptions on adherence to prescription medicines in publicly insured populations; a systematic review and meta-analysis. Schfer C, editor. Deficient knowledge is defined as the lack of cognitive information or psychomotor ability for the restoration, preservation, and promotion of health. F. A. Davis Company. (2020). 2. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Poor adherence to medication therapy is a longstanding challenge in the healthcare community and is now recognized as a public health crisis. In contrast, 2/3 of all included SRs were at high risk of bias in two or three domains [20, 21, 23, 24, 26, 30, 33, 35, 37,38,39]. vision and mission of general motors. Drugs Aging. Patientencompliance. 1 The World Health Organization reports adherence at approximately 50 percent among patients taking medications for chronic illnesses. Therefore, on the one hand, we believe that our results are widely applicable for implementation adherence to oral drugs in physical chronic diseases. PubMedGoogle Scholar. Springer Nature. Instruct the patient to avoid alcohol, smoking, and caffeinated drinks. In contrast, higher financial status and better socioeconomic position seem to have a positive impact on adherence. 2009;15:e2233. document.getElementById("ak_js_1").setAttribute("value",(new Date()).getTime()); This site uses Akismet to reduce spam. Some evidence for a positive impact was exclusively noted in HIV-infected patients [32, 34]. JBI Database System Rev Implement Rep. 2012;10(56):3596648. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. Health education programs can reduce the costs associated with non-adherence. For instance, internal fixation devices can ultimately affect the bones strength, while the intramedullary nails, rods, or plates may be removed once the physician recommended it after a long recovery. 5. Actions to resolve medication discrepancies include: A. This provides baseline knowledge from which the patient can use for making informed choices. Marital status was investigated in the SRs on Parkinson disease, inflammatory arthritis, chronic diseases, HIV, patients taking oral anticancer agents and cardiovascular conditions. statement and Most SRs were excluded because a methodological quality assessment of the included primary studies was not performed or factors other than our pre-specified influencing factors were investigated. Advise to stop taking/start taking/change administration of medications B. sharing sensitive information, make sure youre on a federal The same seems to be true for disease duration. Our overview has some methodological limitations. By using this website, you agree to our Especially in chronic conditions with long-term therapies, adherence is important to achieve target outcomes but is often low [10]. Discuss to the patient the importance of having lifestyle changes and/or quitting on risk behaviors. Daley DJ, Myint PK, Gray RJ. We included SRs on any physical chronic diseases and analysed only factors we assumed were independent of disease/therapy. Two reviewers independently selected studies according to pre-defined inclusion criteria. The number of index publications was 285 (r=285), which resulted in a primary study overlap estimated by the CCA of approximately 0.5%. 2007;14(4):40816. Grading of Recommendations, Assessment, Development and Evaluation, Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Cultural Competence in Health Care: Is it important for people with chronic conditions? Chen H-Y, Saczynski JS, Lapane KL, Kiefe CI, Goldberg RJ. High-fat food increases the time for the food to stay in the stomach, as well as hot, spicy, and gas-forming foods which are irritants to the esophagus so it is best to avoid such foods. Dont overload.Too much information at once can be confusing and overwhelming. 2016;10:83750. Parkinsonism Relat Disord. This assumption is supported by the fact that especially therapy- and disease-related influencing factors, which are related to the symptomatic patients, were inconsistent. PDF MEDICATION MANAGEMENT BE SAFE & TAKE NURSE ENRICHMENT PROGRAM - Missouri We included 21 SRs on eight different conditions. 2014;67(10):107682. 2021 Mar 10;18(6):2825. doi: 10.3390/ijerph18062825. Medication: Oral drug intake (at least 50% of patient population), Exposure: Pre-specified (see the text below) potential influencing factors for adherence. The meta-analysis of Sinnott et al. This makes up the baseline information for evaluating methods for teaching. Medication: reasons and interventions for noncompliance Unhealthy lifestyle choices. The results were extracted according to the type of evidence synthesis. We anticipated that these parameters would lead to a higher sensitivity compared with the search for the previous overview version. Nachega JB, Uthman OA, Peltzer K, Richardson LA, Mills EJ, Amekudzi K, et al. Heart Lung. TM was also an author of two of the included SRs. The majority of healthcare noncompliance challenges include the safety of patients, patient data privacy, and billing procedures. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. Pieper D, Antoine S-L, Mathes T, Neugebauer EAM, Eikermann M. Systematic review finds overlapping reviews were not mentioned in every other overview. Georgetown University. Which interventions are most important for the nurse to include in the client's initial plan of care? Medication adherence influencing factorsan (updated) overview of systematic reviews, \( \mathrm{CCA}=\frac{\left(N-r\right)}{\left(r\times c-r\right)} \), https://doi.org/10.1186/s13643-019-1014-8, http://apps.who.int/iris/bitstream/handle/10665/42682/9241545992.pdf;jsessionid=5533CE0804BE2E0722B919623C4C2E05?sequence=1.Assessed, https://www.bristol.ac.uk/media-library/sites/social-community-medicine/robis/robisguidancedocument.pdf.Assessed, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. CAS In addition, the impact of social support was uncertain in all SRs [23, 28, 30, 37, 38]. Intentional non-adherence to medications by older adults. 2 Poor adherence has been . Phase 1 aims to assess the relevance of the SR. For this purpose, the relevance of the research question should be assessed. We used the Risk of Bias in Systematic Reviews (ROBIS) tool to assess the included SRs [16]. The characteristics of all included SRs are presented in Table1. If needed, encourage the patient to take supplements and/or replacement therapy with folic acid or iron. Learn how your comment data is processed. Depending on the severity of anemia, the dosages and frequency of taking supplements are variable. Any differences between the reviewers were discussed until consensus. Manage Settings The evidence for an impact was uncertain in oral-anticancer agents [39]. Repetition is key.When patients are dealing with stressful illnesses and procedures, they may not always recall or completely comprehend teaching. Third, we only analysed therapy-unrelated factors. Mathes T, Pieper D, Antoine S-L, Eikermann M. Adherence influencing factors in patients taking oral anticancer agents: a systematic review. Hickey, K. T., Masterson Creber, R. M., Reading, M., Sciacca, R. R., Riga, T. C., Frulla, A. P., & Casida, J. M. (2018). 2018;72(2):3918. However, the evidence for an impact was uncertain. Discuss the patients dietary needs. The influence of health systems on hypertension awareness, treatment, and control: a systematic literature review. The evidence for an impact of education on adherence was uncertain for most diseases/therapies. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). An example of data being processed may be a unique identifier stored in a cookie. Discuss potential benefits and harm that may result from non-adherence C. Talk to pharmacist about the problem D. Address performance/knowledge deficit E. All of the above F. All but C 4. Verbrugghe M, Verhaeghe S, Lauwaert K, Beeckman D, van Hecke A. Determinants and associated factors influencing medication adherence and persistence to oral anticancer drugs: a systematic review. J Clin Epidemiol. Hypertension. This equips the patient with knowledge, promotes compliance in treatment, and allows learning for identifying alarming signs or symptoms should there be a need for a change in medications or administration of medicine. Risk of bias across the SRs was lowest in domain 3 (data collection and study appraisal). Pieper D, Buechter R, Jerinic P, Eikermann M. Overviews of reviews often have limited rigor: a systematic review. Health Policy. Furthermore, the studies should analyse intentional and non-intentional adherence distinctly. Conclusions: Claims-based measures of medication adherence are associated with clinical outcomes in . knowledge deficit related to medication compliance

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