We rated the overall risk of bias for eight SRs as low and for 13 SRs as high. Medication costs were analysed in patients with inflammatory arthritis and patients taking oral anticancer agents. In particular, the influence of different ethnic groups probably depends on the country/region since an ethnic minority in one region could be an ethnic majority in another region However, although ethnic minorities are different ethnic groups in different countries, we believe that all ethnic minorities likely face similar adherence challenges independent of the country they live in. Intentional and unintentional medication non-adherence in African Americans: insights from the Jackson Heart Study. The decision to exclude studies that were reported in this way was made because the results could have been highly biased by selective reporting otherwise. Nursing Diagnosis: Deficient Knowledge related to lack of information regarding the disease process or condition secondary to gastrointestinal reflux disease (GERD) as evidenced by presence of preventable complications, verbalization of problems, and request for information. PLoS One. The mentioned risk factors were proven to worsen hypertension and can cause complications to the cardiovascular, digestive, and urinary systems. Review the patients surgery along with the performance of the procedure and the future expectations. We performed the search of the electronic databases on June 13, 2018. 2014;67(4):36875. The nurse should wait until the patient can concentrate on what is presented to them without interruption. Food like dark-green leafy vegetables, fish, meat, poultry, eggs, milk, and fortified breakfast meals are sufficient to replenish the body with nutrients needed for hematopoiesis. 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). She has worked in Medical-Surgical, Telemetry, ICU and the ER. Risk of bias of the included SRs and their included primary studies. Sabate E. Adherence to long-therm therapies: evidence for action: Weltgesundheitsorganisation; 2003. J Psychosom Res. We analysed seven potentially socioeconomic adherence-influencing factors. 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. All data generated or analyzed during this study are included in this published article [and its supplementary information files]. Available from: URL: http://apps.who.int/iris/bitstream/handle/10665/42682/9241545992.pdf;jsessionid=5533CE0804BE2E0722B919623C4C2E05?sequence=1.Assessed 28.11.2018. knowledge deficit related to medication compliance. Mathes T, Jaschinski T, Pieper D. Adherence influencing factors - a systematic review of systematic reviews. HHS Vulnerability Disclosure, Help This overview is reported according to the Preferred Reporting Items for Overviews of systematic reviews (OoSRs), including the harms checklist [13]. Google Scholar. 2016;90:1032. Nursing Diagnosis: Deficient Knowledge related to lack of exposure/recall, misinterpretation of information, or denial of diagnosis secondary to hypertension as evidenced by inaccurate follow-through of instructions and verbalized inaccurate information. Discuss the drug therapy to the patient, including the prescribed OTC drugs and analgesics. It is important to note that Deficient Knowledge Nursing Diagnosis and Knowledge Deficit Nursing Diagnosis have the same meaning. Finally, 21 SRs were included in this overview [20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40]. BMJ Open. 10. In addition to these pre-defined eligibility criteria, a further criterion was defined post hoc during study selection. We chose the following factors: age, gender, ethnic status, education, employment, financial status/income, marital status/not living alone, social support, measure of intake complexity (e.g., number of tablets, number of medications, frequency of intake), duration of therapy, duration of disease, comorbidity, co-payments, medication costs and insurance status (insured/not insured). Health Policy Institute. Keywords: Would you like email updates of new search results? Such reasons may include cognitive impairment, fear of actually experiencing medication side effects, failure to understand instructions regarding plan (e.g., difficulty understanding a low-sodium diet), impaired manual dexterity (e.g., not taking pills because unable to open container), sensory deficit (e.g., unable to read written The evidence synthesis of the analysed factors (according to the different diseases/therapies) is presented in Table3. A total of 28% of all patients thought they had to drink more in case of thirst. Privacy Phase 1 aims to assess the relevance of the SR. For this purpose, the relevance of the research question should be assessed. orland park sting soccer. 2009;13(2):11523. Patients with low health literacy can have trouble maintaining a treatment plan and are more likely to end up back in the hospital. Our overview has some methodological limitations. Moreover, keeping the device/s dust- and contaminant-free reduces the risk of infection at the fractured area. knowledge deficit related to medication compliance. The same seems to be true for disease duration. Provided by the Springer Nature SharedIt content-sharing initiative. 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. In the case that the included SR performed only a narrative synthesis, we used modified vote counting to extract the results. Kim J, Bushnell CD, Lee HS, Han SW. Effect of adherence to antihypertensive medication on the long-term outcome after hemorrhagic stroke in Korea. A combination of support, guidance, and empathy can increase the patients success in achieving a complete lifestyle change. Assess health literacy. The electronic literature research resulted in 4849 hits after removal of duplicates (including hits from the previous search). Bushman B, Wang M. Vote-counting procedures in meta-analysis. Discuss the patients dietary needs. The CCA is a value that indicates the proportion of overlapping primary studies. Studies that analysed age as a continuous linear variable and studies that dichotomized age showed inconsistent results. Manage cookies/Do not sell my data we use in the preference centre. We tried to prevent strong heterogeneity by focusing on factors for which we assumed homogeneity across different conditions and considering only implementation adherence to oral drugs. In addition to the electronic searches, we crosschecked the references of all included SRs. RN, BSN, PHNClinical Nurse Instructor, Emergency Room Registered NurseCritical Care Transport NurseClinical Nurse Instructor for LVN and BSN students. In patients taking oral anticancer agents, there was some evidence that middle-aged people (approximately 4560) are more adherent than very old (>75years) and younger people (<45years) [28]. Systematic reviews of the effectiveness of quality improvement strategies and programmes. The patient needs to be involved in the decision-making process for treatment because factors such as medication dosage, pill burden, and regimen complexity influence adherence. Among patients with chronic diseases and patients taking oral anticancer agents, there was some evidence that a better financial status has a positive influence on adherence [20, 39]. If you would like to change your settings or withdraw consent at any time, the link to do so is in our privacy policy accessible from our home page.. Sitting down, maintaining eye contact, appearing calm and unrushed, and encouraging questions will give the patient confidence to engage. Alsabbagh MHDW, Lemstra M, Eurich D, Lix LM, Wilson TW, Watson E, et al. This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment. PLoS Med. Z91.14 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. For co-payments (any co-payment and higher co-payments), the effect direction was almost always negative. Broekmans S, Dobbels F, Milisen K, Morlion B, Vanderschueren S. Medication adherence in patients with chronic non-malignant pain: is there a problem? The main cause for downgrading due to imprecision was insufficient reporting, which prevented us from adequately assessing the results. Cutler RL, Fernandez-Llimos F, Frommer M, Benrimoj C, Garcia-Cardenas V. Economic impact of medication non-adherence by disease groups: a systematic review. In studies on adherence, the information can help with the identification of relevant participants [46] or the development of adherence risk prediction models [47]. An official website of the United States government. Balfour L, Tasca GA, Kowal J, Corace K, Cooper CL, Angel JB, et al. 2013;43(1):1828. The patients ability to measure BP at home enhances ones awareness to hypertension and reinforces adherence to medical regimen. Patients over age 65 have a lower health literacy than those of younger ages. Moher D, Liberati A, Tetzlaff J, Altman DG. It would be prudent to educate the patient about the presence of hypertension, as well as giving insights of the possible change in lifestyle. 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]. 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/. Considering this information together with the socioeconomic factors and age suggests that there is a social gradient in adherence behaviour. Emphasize to the patient the very importance of adhering to standard treatments to hypertension and consistent follow-up appointments. We performed a systematic literature search in MEDLINE (via PubMed) and Embase (via Embase). Home; Uncategorized; knowledge deficit related to medication compliance; Posted on June 29, 2022; By . Springer Nature. Accessibility Encourage questions.Patients should feel safe to ask questions without judgment or fear of embarrassment. Impacts of other mental and physical comorbidities were uncertain. Buy on Amazon. F. A. Davis Company. Unless otherwise indicated, all described methods were specified before conducting the overview. However, for most factors, the evidence was not conclusive due to the risk of bias, inconsistency or imprecision. 2012;18(10):105361. Some evidence for a positive impact was exclusively noted in HIV-infected patients [32, 34]. Surgery induces inflammation and prompts for extensive healing, so having a diet full of components promoting healing can speed up the recovery. Straining the body causes increased intraabdominal pressure, thus it increases reflux of stomach contents. 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]. Buy on Amazon, Silvestri, L. A. FOIA Association between drug insurance cost sharing strategies and outcomes in patients with chronic diseases: a systematic review. For all meta-analyses, we extracted pooled effect estimates with 95% confidence intervals, tests and measures for statistical heterogeneity, the number of included studies and the number of patients included in the meta-analyses. This optional phase was skipped in this overview because the relevance was already completely covered by the eligibility criteria. BMC Fam Pract. witoniowska-Lonc N, Polaski J, Mazur G, Jankowska-Polaska B. Int J Environ Res Public Health. Co-payments (any or higher) have a negative impact on adherence. On the other hand, it should be considered in the interpretation of the findings that the influence of a factor might vary between region/setting. 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]. 2013;165(5):66578, 678.e1. Guyatt GH, Oxman AD, Schnemann HJ, Tugwell P, Knottnerus A. GRADE guidelines: a new series of articles in the journal of clinical epidemiology. Factors associated with adherence to pharmaceutical treatment for rheumatoid arthritis patients: a systematic review. Eur J Pain. D. Knowledge deficit related to medication compliance. The authors declare that they have no financial competing interests. We included SRs on any physical chronic diseases and analysed only factors we assumed were independent of disease/therapy. This method has been suggested for presenting results of quantitative synthesis and overcoming problems of simple vote counting [14, 15]. Ethanol, nicotine, and caffeine promotes acid production, relaxes lower esophageal sphincter, and offers more irritation to the lower esophageal mucosa so these are best to be avoided. Have the patient and/or the caregiver monitor any sign/symptom requiring medical attention. The results were very inconsistent, and consequently, the impact was judged as uncertain overall [20, 23, 32, 36, 38, 39]. The causes of noncompliance include side effects, knowledge deficits, and patient/therapist relationships. The https:// ensures that you are connecting to the knowledge deficit related to medication compliance. A discrete choice experiment in a community sample in Australia. Careers. 2017 Jul 25;17(1):163. doi: 10.1186/s12877-017-0558-5. Whiting P, Savovi J, Higgins JPT, Caldwell DM, Reeves BC, Shea B, et al. In addition, the impact of social support was uncertain in all SRs [23, 28, 30, 37, 38]. It is usually advised for a fracture patient to have a low-fat diet with meager amounts of protein and rich in calcium to promote healing and general well-being. Am J Manag Care. This overview is a focused updated version of an overview published by our research team in 2014 [12]. Knowledge plays a vital role in the patients recovery and may include 3 domains namely: (1) cognitive domain, (2) affective domain, and (3) psychomotor domain. Iron supplements are given orally with meals, while the folic acid is taken orally as well with water. . Hickey, K. T., Masterson Creber, R. M., Reading, M., Sciacca, R. R., Riga, T. C., Frulla, A. P., & Casida, J. M. (2018). Pieper D, Buechter R, Jerinic P, Eikermann M. Overviews of reviews often have limited rigor: a systematic review. In primary studies, we considered in particular adjustment for confounding, missing data and adherence measurements, Imprecision (statistical certainty, amount of information on a certain factor [number of primary studies and SRs, effect size)]), Inconsistency (within and between SRs, e.g., due to different adherence measures). Inform the patient about having specific limited activities. The site is secure. Categories . A condition-related explanation for heterogeneity might be that many SRs seem to include symptomatic as well as asymptomatic patients. The cognitive domain consists of intellectual activities and problem-solving skills, while the affective domain consists of feelings, attitudes, and beliefs. The evidence indicates that socioeconomic status and social support might have a positive impact on adherence and that belonging to an ethnic minority might have a negative impact on adherence. In this domain, six SRs were judged to be at high risk of bias. Cancer Treat Rev. 2018;72(2):3918. This overview includes 21 SRs on 313 individual primary studies in a broad spectrum of chronic conditions. 2009;43:41322. Learn how your comment data is processed. There are a variety of aids that may be helpful; however, the interaction with a health professional is very important, both for understanding the reason for non-adherence and for promoting adherence. Teach the patient in identifying modifiable risk factors such as obesity, high-sodium and fat diet, sedentary and stressful lifestyle, smoking, and daily alcohol drinking of more than 2 oz per day. Especially in chronic conditions with long-term therapies, adherence is important to achieve target outcomes but is often low [10]. Data were extracted by one reviewer, and completeness and accuracy were verified by a second reviewer. This site needs JavaScript to work properly. The predictive factors of older patients' knowledge, attitudes, and barriers related to medication . 1998;24(1):359. To ensure an objective assessment, the risk of bias assessment of these SRs was performed by a reviewer other than TM. In addition to the 15 newly identified relevant SRs, six SR of the previous overview were included. Definition: Insufficient or no awareness of necessary information or skill to attain or maintain a desired health status. This overview was not registered. 2009;15:e2233. The influence of the socioeconomic status was uncertain in inflammatory arthritis and patients taking oral anticancer agents [28, 38]. This provides baseline knowledge from which the patient can use for making informed choices. Available from: URL: https://www.bristol.ac.uk/media-library/sites/social-community-medicine/robis/robisguidancedocument.pdf.Assessed 28.11.2018. Daley DJ, Myint PK, Gray RJ. In addition, the corrected covered area (CCA) was calculated. Inconsistent and lack of cooperation is one of the causes of the progression of hypertension. 2014;14:203. Studies focusing on distinct age groups suggest that age does not have a linear association with adherence but that the association is rather a concave shape with an adherence peak in middle to older ages, i.e., adherence is particularly low in very young and very old persons. In . Any disagreements were discussed until consensus. The evidence for an impact was mostly judged as uncertain for this factor.
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