• Journal of Preventive Medicine and Public Health
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• v.56 no.6
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• pp.504-514
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• 2023

Objectives: This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes. Methods: This study investigated patients with new prescriptions for hypertension and diabetes in Korea in 2019 with using data collected from general health screenings. A multilevel logistic regression model was applied to explore the relationship between patients' first prescribing institution and their medication adherence, defined as a medication possession ratio (MPR) over 80%. Results: The overall adherence rates were 53.7% and 56.0% among patients with hypertension and diabetes, respectively. The intra-class correlation coefficients were 13.2% for hypertension and 13.8% for diabetes (p<0.001), implying that the first prescribing institution had a significant role in medication adherence. With clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes). Among individual-level variables, female sex, older age, higher insurance premium level, and residing in cities were positively associated with adherence in both the hypertension and diabetes samples. Conclusions: This study showed that the prescribing institution had a significant relationship with medication adherence. When the first prescribing institution was a clinic, newly diagnosed patients were more likely to adhere to their medication. These results highlight the important role played by primary care institutions in managing mild chronic diseases.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9225-9232
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• 2014

Ensuring adherence to chemotherapy is important to prevent disease progression, prolong survival and sustain good quality of life. Capecitabine is a complex chemotherapeutic agent with many side effects that might affect patient adherence to treatment. This cross sectional study aimed to determine adherence to capecitabine and its contributing factors among cancer outpatients in Malaysia. One hundred and thirteen patients on single regime capecitabine were recruited from Hospital Sultan Ismail and Hospital Kuala Lumpur from October 2013 to March 2014. Adherence was determined based on adherence score using validated Medication Compliance Questionnaire. Patient socio-demographics, disease, and treatment characteristics were obtained from medical records. Satisfaction score was measured using the validated Patient Satisfaction with Healthcare questionnaire. The mean adherence score was 96.1% (standard deviation: 3.29%). The significant contributing factors of adherence to capecitabine were Malay ethnicity [${\beta}=1.3$; 95% confidence interval (CI): 0.21, 2.43; p value=0.020], being female [${\beta}=1.8$; 95%CI: 0.61, 2.99; p value=0.003]), satisfaction score [${\beta}=0.08$; 95%CI: 0.06, 1.46; p value=0.035], presence of nausea or vomiting [${\beta}=2.3$; 95%CI: 1.12, 3.48; p value <0.001] and other side effects [${\beta}=1.45$; 95%CI: 0.24, 2.65; p value=0.019]. Adherence to capecitabine was generally high in our local population. Attention should be given to non-Malay males and patients having nausea, vomiting or other side effects. Sufficient information, proactive assessment and appropriate management of side effects would improve patient satisfaction and thus create motivation to adhere to treatment plans.

• The Journal of the Korean Society for Microbiology
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• v.21 no.4
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• pp.407-415
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• 1986

This study investigated whether a correlation exists between environmental physical and biochemical factors and adherence of Candida albicans to human buccal epithelial cells by using normal and UV-irradiated strains. The results were as follows: 1. The percentage of germ tube forming activities of normal Candida albicans was 91.5% and UV-irradiated Candida albicans was 15.0%. The $LD_{50}$ of normal strains in mice were $1.0{\times}10\;cells/ml$, but could not be observed in the UV-irradiated strains even with $1.0{\times}10\;cells/ml$. It demonstrated that the virulence is decreased in the UV-irradiated strain. 2. The adherence of normal Candida albicans to human buccal epithelial cells($166{\pm}29{\sim}207{\pm}17\;cells$/100 epithelial cells) was significantly greater than UV-irradiated Candida albicans($99{\pm}21{\sim}131{\pm}25\;cells$/100 epithelial cells). 3. Candida albicans cultured at $37^{\circ}C$ adhered to buccal epithelial cells($166{\pm}16{\sim}207{\pm}17\;cells$/100 epithelial cells) in greater numbers than cultured at $25^{\circ}C$($80{\pm}15{\sim}143{\pm}22\;cells$/100 epithelial cells). 4. On comparison of the adherence of viable and nonviable(heat-killed) Candida albicans to human buccal epithelial cells, the nonviable Candida albicans demonstrated poorer adherence than viable Candida albicans. 5. Adherence in vitro of Candida albicans to human epithelial cells appeared to be effected by the pH. The adherence ability was maximum increased at pH 7.0($187{\pm}22\;cells$/100 epithelial cells) other than experimental pH. 6. The adherence was proportional to the incubation time and the Candida cell concentration in the suspension. 7. A strong correlation was shown between germ tube forming activity and increased adherence of Candida albicans to human epithelial cells, indicating that germ tube forming activity were responsible for candidal virulence.

• Korean Journal of Family Medicine
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• v.39 no.6
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• pp.325-332
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• 2018

Background: Hypertension is a major contributor to the global disease burden of cardiovascular and cerebrovascular disease. The aim of this study was to determine demographic and clinical factors associated with adherence to antihypertensive medication. Methods: From August 2012 to February 2015, we recruited 1,523 Korean patients with hypertension who visited family physicians. The study was conducted in 24 facilities located in urban and metropolitan areas. Of these facilities, two were primary care clinics and 22 were level 2 or 3 hospitals. Adherence was assessed using the pill count method; a cut-off value of 80% was used as the criterion for good adherence. Sociodemographic and lifestyle factors were compared between the adherent and nonadherent groups using the chi-square test for categorical variables and t-test for continuous variables. Binary logistic regression analysis was performed with medication adherence as the outcome variable. Results: Of the 1,523 patients, 1,245 (81.7%) showed good adherence to antihypertensive medication. In the multivariate logistic analysis, age ${\geq}65$ years, exercise, treatment in a metropolitan-located hospital, being on ${\geq}2$ classes of antihypertensive medication and concomitant medication for diabetes, and a family history of hypertension or cardiovascular diseases were associated with good adherence. Patients who had a habit of high salt intake were less adherent to medication. Conclusion: Multiple classes of antihypertensive medications, concomitant medication, and exercise were associated with good adherence to antihypertensive medication, and high salt intake was associated with poor adherence to antihypertensive medication. These factors should be considered to improve hypertension control.

• Korean Journal of Community Nutrition
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• v.28 no.3
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• pp.220-234
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• 2023

Objectives: This study aimed to assess the adherence to dietary guidelines among college students in the post-COVID-19 era and examine the changes in their dietary habits as the learning environment transitioned from remote to in-person classes. Methods: We conducted a survey involving 327 college students in Daejeon from March to April 2023. The survey questionnaires included various factors, including age, gender, type of residence, frequency of use of delivery food, convenience food, and eating out. In addition, we investigated the extent of adherence to the dietary guidelines for Koreans and the degree of dietary changes following the post-COVID-19 shift in class format were investigated. For comparative analysis of the level of adherence to dietary guidelines in relation to dietary habit changes, an ANOVA and a post hoc Scheffe test were employed. We also performed a multiple linear regression analysis to identify dietary factors influencing the level of adherence to dietary guidelines. Results: The study revealed a high rate of convenience food consumption and a low rate of homemade food intake among students. There was a marked increase in the consumption of processed foods, convenience foods, dining out, sweet foods, high-fat fried foods, beverages, and alcohol following the transition from online to in-person classes. When examining adherence to Korean dietary guidelines, the highest scored practice was 'Hydration', and the lowest was 'Breakfast habit'. Increased consumption of convenience foods, late-night snacks, and dining out were negatively correlated with adherence levels to dietary guidelines, specifically correlating with 'Healthy weight', 'Hydration', 'Breakfast habit', and the total score of adherence. The adoption of 'regular meals' was positively associated with increased adherence levels to dietary guidelines. Conclusions: The transition from remote to in-person classes post-COVID-19 led to increased intake of convenience foods, dining out, sweet foods, high-fat fried foods, and alcohol. The rise in convenience food and late-night snack consumption negatively influenced several aspects of the dietary guidelines adherence, thereby suggesting the need for strategies to encourage healthy dietary habits among college students.

• Korean Journal of Clinical Pharmacy
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• v.33 no.4
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• pp.254-260
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• 2023

Background: Adherence to antiretroviral treatment (ART) is crucial for maintaining the HIV-RNA suppression in patients living with HIV/AIDS. This study aims to analyze the risk factors contributing to low medication adherence among individuals with HIV/AIDS by analyzing data from the Korean HIV/AIDS cohort study. Methods: The dependent variable is ART medication adherence. The depressive symptom and anxiety scores were collected as main independence variables. Covariates included gender, age, transmission route, alcohol and smoking information, and antiviral treatment regimen details. To predict the relationship between ordinal dependent variables and independent variables, an ordered logistic regression analysis was conducted, and odds ratios (OR) were calculated. Results: The results of the ordered logistic regression analysis showed that female was associated with a higher risk of low medication adherence (OR=2.91, 95% CI=1.08, 7.83). Among the subjects who were non-smokers and non-drinkers, the risk of low medication adherence was lower (OR=0.36, 95% CI=0.18, 0.70). Depending on the ART treatment group, individuals taking integrase inhibitor had a lower risk of medication adherence (OR=0.31, 95% CI=0.13, 0.76), and those experiencing depressive symptoms were related with a higher risk of low medication adherence (OR=1.97, 95% CI=1.12, 3.46). Conclusions: The encouragement and emotional support of healthcare professionals are essential for patients living with HIV/AIDS who experience depressive symptoms to maintain ART adherence. Additionally, further research is needed to ensure that HIV/AIDS infected female with concurrent depressive symptoms can achieve appropriate ART therapeutic effect.

• The Journal of the Korean Society for Microbiology
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• v.17 no.1
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• pp.75-85
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• 1982

In order to demonstrate the effect of specific serum IgG antibody on the adherence of Streptococcus mutans to smooth surface and the mechanism of effective adherence inhibition by IgG antibody, in the present study authors obtained purified IgG from different immunogen preparations of S. mutans NCTC 10449(serotype c) and observed the effect of each IgG preparation on the adherence of each S. mutans strain cultured in different conditions. In addition, the present study was undertaken to observe the cross-reactivity of IgG and the effect of sucrose concentration on the adherence of S. mutans in vitro non-growth condition. The adherence of S. mutans to glass surface was effectively inhibited by serum IgG antibody. At the same IgG concentrations, anti-2% fructose grown/1N NaCl washed S. mutans NCTC 10449 cell showed greater adherence inhibitory effect to S. mutans strains than anti-2% sucrose grown and anti-S. mutans NCTC 10449 cell wall, and the greater inhibitory effects of IgG preparations were observed in assay using 2% fructose grown S. mutans cell preparations than using 0.1% sucrose grown cell preparations. These results suggest that the more effective adherence inhibition by serum IgG antibody is due to the reaction with S. mutans cell surface antigens rather than glucan and cell-associated glucosyltransferase. The greatest adherence inhibitory effect of IgG to S. mutans strains was observed on homologous NCTC 10449 strain and the inhibition cross-reactivities were observed between serotype c, e, and f strains. More pronounced cross-reactivity of adherence inhibition of IgG to S. mutans was observed in assay using anti-2% fructose grown/1N NaCl washed cell than using other IgG preparations, and observed in assay using 2% fructose grown S. mutans cell preparations than 0.1% sucrose grown cell preparations. It was interested that low, but adequate concentration of reactive IgG antibody significantly increased the adherence ability of S. mutans. This result may be due to the formation of small cell aggregates resulted in a increase in the numbers of organisms which adhered to glass surface. The adherence of S. mutans to glass surface was possible in the absence of glucan-synthetic activity. Low level of sucrose significantly increased the adherence ability of S. mutans to glass surface, but excessive amount of sucrose induced large cell aggregates resulted in a decrease in the numbers of organism which adhered.

• Journal of muscle and joint health
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• v.8 no.1
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• pp.5-26
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• 2001

Many studies have reported that regular aquatic exercise can lead to improvement of health for patients suffering from arthritis. In spite of these benefits, the adherence rate has shown as few as 26% of patients with arthritis who had completed the aquatic exercise education program. Moreover, when patients with arthritis begin an aquatic exercise, 47% withdraw within the first 6 month. No study has been found that constructs model to explain aquatic exercise adherence of patients with arthritis. The purpose of this study were to identify the factors influencing exercise adherence and to construct and test a structural model to explain aquatic exercise adherence of patients with arthritis. Hypothesized model was constructed on the basis of Bandura's social cognitive theory and literature review. Exogenous latent variables included in this model are group cohesion and barrier, endogenous latent variables are self-efficacy, outcome expectancy and self-evaluation. Empirical data used was collected through individual interviews with the structural questionnaire on 249 patients with arthritis who had completed the 6-week aquatic exercise education program of Korean Rheumatology Health Professionals Academy. The interviews were performed from September 6, 1999 through October 8, 1999. A model tested by the covariance structural analysis with LISREL 8.12a program and by descriptive statistics and correlation with SAS 6.12 program. The results are summarized as follows: First, hypothesized model showed a good fit to the empirical data. In the modified model added one new path showed a much better fit. Second, group cohesion had a direct, indirect positive effects, self-efficacy and self evaluation had a direct positive effects on exercise adherence. Barrier had a direct, indirect negative effects on exercise adherence. Outcome expectancy had a direct negative effect, indirect positive effects through self-evaluation on exercise adherence, but total effects was not significant. Total effect size of the variables were group cohesion, self-efficacy, barrier and self evaluation in order. All variables accounted for 54% of the total variance of exercise adherence in the model. In conclusion, this model confirmed to be proper in explaining of aquatic exercise adherence. Group cohesion, self-efficacy, outcome expectancy, self-evaluation, barrier contributed to the aquatic exercise adherence of patients with arthritis. The results of this study suggested that improvement of group cohesion, self-efficacy and self-evaluation, motivation of outcome expectancy through self-evaluation, and reduction of the barrier should be included in the strategy of nursing intervention for the aquatic exercise adherence of patients with arthritis.

• Research in Community and Public Health Nursing
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• v.21 no.1
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• pp.82-91
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• 2010

Purpose: The purpose of this study was to identify factors that influence medication adherence in patients with hypertension. Methods: One hundred sixty two patients with hypertension who visited the outpatient clinics of health centers in J City participated in the study. Data were collected through a questionnaire survey done from January 9 to February 25, 2008. To analyze the sample survey data, descriptive statistics, t-test, ANOVA, Scheffe's test, and multiple regression analysis were performed with SPSS/WIN 12.0. Results: Significant factors that affect medication adherence in patients with hypertension were autonomous motivation, competence, health status, and sex. These variables explained 24% of medication adherence (F=12.48, p<.001). Conclusion: The results indicate that in order to improve the medication adherence of patients with hypertension it is important to develop nursing programs that focus on autonomous motivation and competence and to give consideration to differences in health status and sex. Also further studies are needed to confirm autonomous motivation related to health behavior in patients with hypertension.

• Journal of International Academy of Physical Therapy Research
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• v.1 no.2
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• pp.79-90
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• 2010

Breast cancer is the most frequently diagnosed cancer primarily affecting women and negatively impacting the individuals, families, and the health care system. Despite the well-known benefits of exercise for breast cancer survivors, rate of physical activity declines during adjuvant therapy and may not return to pre-diagnosis levels. In addition, low levels of adherence to exercise have been observed in this cohort. The challenge is to identify strategies that are effective in promoting exercise adherence. Several of the studies use social cognitive theory as a theoretical framework to design exercise interventions that encourage adherence. Within and without this framework, they have implemented interventions within the home and gym-based environments. Strategies used to encourage adherence to exercise programs and which are readily implemented in most situations have included distribution of print materials and pedometers, as well as recommendation from the oncologist. Other strategies that may be less feasible have included provision of trainers, gym memberships, regular phone-calls, and psychologist-lead stress management sessions.