Browsing by Subject "Adherence"

Now showing 1 - 8 of 8
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    Adherence in an Optimized Program of Mindfulness Based Stress Reduction
    (2010-08) VanWormer, Arin
    Objective: Mindfulness Based Stress Reduction (MBSR) programs have been successful in treating stress across various populations, however, little is known about how to best promote adherence to MBSR program teachings. The purpose of this dissertation study was to examine adherence to MBSR practice and the feasibility of a 12-session adherence enhancement intervention in the context of an MBSR and support group program. Measures included MBSR practice time, commitment and confidence for regular MBSR practice, and stress levels. Common themes of MBSR practice experiences that may have influenced adherence to the MBSR program teachings were also explored. Design and Method: An exploratory, single-group, longitudinal research design was used with a sample of 11 women. An adherence intervention package that included self-monitoring logs, telephonic coaching, and financial incentives were implemented over an 11-week period as subjects participated in an 8-session MBSR course supplemented with 4 support group sessions (i.e., 12 sessions total over 11 weeks). In addition, a series of qualitative, semi-structured interviews were administered at weekly intervals. Findings: On average, participants with complete baseline and follow-up measures had a statistically significant 9 point (49%) increase from baseline in their MBSR practice scores from a self-report survey. In addition, logged MBSR practice time increased by a non-significant 35 minutes per day between baseline and completion. Although commitment and confidence levels remained stable during the study, results from correlation analyses indicated that higher MBSR practice survey scores were significantly associated with lower stress levels. Qualitative interviews indicated that lack of routine, lack of time, and limited personal space were the most common barriers to regular MBSR practice. Participants reported experiencing major emotional growth in regard to confronting and accepting their present stressors. Conclusions: The intervention package was feasible and acceptable to study participants, as indicated by the high degree of exposure to its components. There was also evidence indicting accelerating frequency of MBSR practice over time. However, improvements in commitment and confidence for regular MBSR practice, and stress levels were negligible. Future research should replicate the study intervention in a larger sample with more rigorous statistical controls.
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    Examining Risk Perception and its Influence on Treatment Adherence in Those with Type II Diabetes Mellitus
    (2015-06) Smith, Reid
    Examining Risk Perception and its Influence on Treatment Adherence in Those with Type II Diabetes Mellitus Reid C. Smith Background: Type 2 diabetes mellitus (T2DM), has quickly become a national epidemic. Adherence to therapies is critical in attempting to ward off complications associated with uncontrolled diabetes. Adherence to therapies remains weak even with advancements in treatment options. Predictors for nonadherence have been studied for several decades. Prescription medication risk perception has been measured and compared between people who completely abstain from medications to treat previously-diagnosed conditions and those who decide to treat using medications. Additionally, perceived risk of disease and of routine risks encountered throughout life have been related to self-care adherence in patients with T2DM. The relationship between risk perception and self-care adherence is an area needing study. Aim: The purpose of this study was to examine the relationship between perception of risk and treatment adherence in adults who have T2DM. Method: A random sample of 381 subjects being treated for T2DM completed a comprehensive Internet-based survey. Along with demographic characteristics the questionnaire contained several scales related to harm and benefit perception, perceived threat of diabetes, self-efficacy, and adherence to diabetes-related self-care treatments. Results: Significant differences were found in perceived risk of oral hypoglycemics between respondents using oral drugs for T2DM vs. those who were not. Likewise, significant differences in risk perception of oral hypoglycemics were observed between men and women. Adherence to self-care treatments was variable, with over one in three respondents having poor medication adherence, and the average number of days exercised in the week leading up to survey completion was less than three days. Adherence to some self-care treatments appears to be significantly related to risk perception. Conclusion: Individuals with T2DM perceive medications for diabetes and its related comorbidities to be of high benefit and low harm. Adherence to exercise, diet, and medication recommendations was relatively low. Results indicate a potential link between risk perceptions and adherence to diabetes-related self-care treatments. Gaining insight into how persons with T2DM perceive the harms and benefits of diabetes-related self-care treatments in relation to risks and benefits of other medical and nonmedical products and activities may help with other areas of diabetes treatment adherence research.
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    Medication Adherence of Patient Assistance Program Recipients: A Pilot Study
    (University of Minnesota, College of Pharmacy, 2012-10) Conley, Christian S.; Hughes, Peter J.
    Purpose: Evaluate medication adherence of prescription assistance program recipients at an inner-city clinic. Methods: Surveys were administered at enrollment and 6 months following enrollment to patients who were either recipients of at least one patient assistance program (PAP) or had prescription benefits through Alabama Medicaid. Data on patient demographics, Morisky Medication Adherence Survey (MMAS) scores, mean possession ratio (MPR), and drug classes were collected for 6 months. Results: The baseline MMAS score concluded that both the PAP group and Alabama Medicaid group were highly motivated and highly knowledgeable regarding adherence to prescribed medications. After 6 months, administration of the same MMAS instrument resulted in a category change in the PAP group from highly motivated and knowledgeable to low motivation and high knowledge. The Medicaid MMAS adherence category did not change from baseline after 6 months. The 6-month mean MPR for the PAP and Medicaid groups were 0.542 and 0.823, respectively. Conclusion: Providing free or low-cost medication plus customary counseling should not be the sole interventions for the uninsured patient. In this study, PAP recipient MMAS score change and low mean MPR suggest that additional interventions are needed to ensure that PAP recipients adhere to prescribed therapies.
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    The medication experience of people living with HIV: From the understanding of the meanings of medication to the development of a conceptual framework of medication experience.
    (2012-06) Alves, Mateus Rodrigues
    This is a study investigating the medication experience of people living with HIV/AIDS and the influences on the patient's relationship with medications. The study was conducted from April 2011 to April 2012. The methodology of investigation was Grounded Theory. The methods included one-to-one in-depth interviews, journaling, and observations. The participants in the study were nine people living with HIV. The results suggest that there are two dimensions of experiences associated with HIV drug therapy. One is the life disruption and the other is the meaning that the patient ascribes to medications. The results of this study are presented as a theoretical visual model. The model intends to show the complexities of living with HIV and the factors influencing the patient's relationship with medications in HIV drug therapy. The author recommends the use of narratives in patient care as a standard practice to understand the patient's medication experience. In addition, the proposed model can be used as a pedagogical tool to teach students in the health care disciplines as it portrays the complexities involved in HIV medication taking in a relatively simple manner. The findings of this study contribute to the illness experience as well as medication experience literature. Lastly, the proposed model can be applied to other illness contexts in which the use of medications is a key strategy for improving the patient's quality of life.
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    Predictors of adherence to treatment by parents in a behavioral intervention curriculum for children with autism spectrum disorders.
    (2010-05) Moore, Timothy R.
    Information on the extent to which parents of children with intellectual and developmental disabilities adhere to prescribed behavioral treatments is limited. In this treatment adherence study, parents (n=21) of children with autism spectrum disorders were surveyed regarding implementation of intervention strategies for skills instruction and problem behavior management. All parents had participated in a standardized parent training curriculum through a community service provider specializing in treatment based in applied behavior analysis for children with autism spectrum disorders and their families. Four variables were significantly correlated with reported adherence, three of which (agreement with spouse on implementation of interventions, perceived effectiveness as a behavior change agent, confidence in the intervention to produce meaningful change) were theoretically related and highly correlated (α=.71) and included in a linear regression as a single factor (labeled „assurance‟) along with the variable of perceived acceptance of the child in family and community activities. The full model explained 53% of the variance in reported adherence (p<.001), and the „assurance‟ contributed a significant amount of unique information to the model (p<.002). The implications of parent perception in explanatory frameworks for adherence are discussed and next steps in research are suggested. Key Words: adherence; parent skills training; applied behavior analysis; autism.
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    Self efficacy, self reliance, adherence to self care, and glycemic control among Cherokee with Type 2 diabetes.
    (2012-07) Mashburn, Diana D.
    Background: Type 2 diabetes is responsible for disability and shortened life span among Native Americans. Adherence to recommendations for diet, exercise and medication is essential to optimizing outcomes. Few studies of self care have included Native American participants. Specific Aims: Among Cherokee adults, aims are to (a) describe self efficacy, Cherokee self reliance, adherence to self care recommendations and glycemic control; (b) explore the relationship between self efficacy and Cherokee self reliance; and (c) predict glycemic control from self efficacy, Cherokee self reliance, adherence to self care recommendations, and personal characteristics. Methods: The design was observational and cross-sectional. A convenience sample of 164 female and 136 male Cherokee adults with type 2 diabetes receiving care at three Cherokee Nation clinics participated. Subjects completed the Diabetes Self Efficacy Scale, Cherokee Self Reliance Questionnaire, and Summary of Diabetes Self Care Activities. Glycemic control was indexed using the most recent A1C value. Results: The average age of participants was 58.29 (SD = 12.07); they had had type 2 diabetes for an average of 9.06 years (SD = 7.85). Using exploratory maximum likelihood factor analysis with orthogonal rotation, items from self efficacy and self reliance measures loaded on separate factors. Self efficacy, years since diagnosis, age and clinic (C compared with B) were significant predictors of A1C. Conclusions: Glycemic control was only partly explained. Diabetes self care is complex. Continued research on psychosocial and educational aspects of self care is needed to better understand diabetes management and outcomes among Cherokee adults.
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    Teacher burnout factors as predictors of adherence to behavioral intervention
    (2009-12) Gaitan, Peggy E.
    It is hypothesized that factors related to teacher burnout influence treatment adherence. This study examines the relation of teacher burnout to the frequency and quality of behavioral intervention implementation. A sample of 45 general and special education teachers were trained to implement the Good Behavior Game, an intervention designed to assist teachers in the management of problem behaviors in the classroom, and asked to implement it each day for 28 weeks. Direct observation data were collected from teacher implementation of the Good Behavior Game. A multiple regression analysis was used to examine the predictive relation between three subsets of the Maslach Burnout Inventory: a) Emotional Exhaustion, b) Depersonalization, and c) Personal Accomplishment, and two indicators of adherence: a) mean frequency of implementation of the Good Behavior Game and b) Likert ratings of quality of implementation. Significant main effects were found for Emotional Exhaustion and Personal Accomplishment on Adherence. A post hoc analysis conducted to explore directional relations between independent and dependent variables resulted in the following conclusions: a) Group membership in low, moderate, or high levels of any single burnout factor was not statistically significant as an individual predictor of adherence and b) group differences exist between factors of Emotional Exhaustion and Personal Accomplishment confirming relation between high levels of exhaustion and low levels of satisfaction with personal accomplishment. Further examination of means plots determined directional relation between high levels of emotional exhaustion and greater adherence.
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    Unit-of-Use Versus Traditional Bulk Packaging
    (University of Minnesota, College of Pharmacy, 2012) So, Tiffany; Wertheimer, Albert
    Background: The choice between unit-of-use versus traditional bulk packaging in the US has long been a continuous debate for drug manufacturers and pharmacies in order to have the most efficient and safest practices. Understanding the benefits of using unit-of-use packaging over bulk packaging by US drug manufacturers in terms of workflow efficiency, economical costs and medication safety in the pharmacy is sometimes challenging. Methods: A time-saving study comparing the time saved using unit-of-use packaging versus bulk packaging, was examined. Prices between unit-of-use versus bulk packages were compared by using the Red Book: Pharmacy’s Fundamental Reference. Other articles were reviewed on the topics of counterfeiting, safe labeling, and implementation of unit-of-use packaging. Lastly, a cost-saving study was reviewed showing how medication adherence, due to improved packaging, could be cost-effective for patients. Results: When examining time, costs, medication adherence, and counterfeiting arguments, unit-of-use packaging proved to be beneficial for patients in all these terms.