• Korean Journal of Clinical Pharmacy
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• v.26 no.3
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• pp.245-253
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• 2016

Objective: This study was conducted to evaluate payer-driven medication adherence intervention program from the patient's and counselor's perspectives. Methods: Target patients for intervention were selected by retrospective adherence measures based on national health insurance claims data for hypertension, diabetes and hyperlipidemia. As a serial intervention for higher risk groups of medication non-adherence, initial direct mailing, the first direct telephone call and the second direct call or a home visit were followed. Interview approach to qualitative inquiry was used to evaluate intervention results. Results: Participants including 4 patients received telephone calls, and 4 National Health Insurance Service staff and 4 pharmacists participated as counselors were interviewed regarding their impression of the intervention program. Three major themes arose: overall perception; necessities; and suggestions for success, of the intervention. Despite short period of intervention, educational intervention by telephone counseling involving pharmacists shows potential to improve self-management of chronic disease, and pharmacist-involvement. But more sophisticated selection of target patients requiring the intervention and complementation of electronic database system would be necessary. In addition, personal disposition of counselor was revealed to be an important factor for achieving successful outcome of intervention. Conclusion: The findings suggest that the individualized counseling intervention would be an efficient option for improved medication adherence. Further researches should include longer periods of interventions, a quantitative analysis using adherence measures based on claims data and consideration of clinical benefits associated with the intervention.

• Korean Circulation Journal
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• v.52 no.1
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• pp.1-33
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• 2022

In primary prevention for cardiovascular diseases, there are significant barriers to adherence including freedom from symptoms, long latency for therapeutic benefits, life-long duration of treatment, and need for combined lifestyle changes. However, to implement more systematic approaches, the focus on adherence improvement needs to be shifted away from patient factors to the effects of the treatment team and healthcare system. In addition to conventional educational approaches, more patient-oriented approaches such as patient-centered clinical communication skills, counseling using motivational strategies, decision-making by patient empowerment, and a multi-disciplinary team approach should be developed and implemented. Patients should be involved in a program of self-monitoring, self-management, and active counseling. Because most effective interventions on adherence improvement demand greater resources, the health care system and educational or training system of physicians and healthcare staff need to be supported for systematic improvement.

• Korean Journal of Clinical Pharmacy
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• v.19 no.2
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• pp.110-119
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• 2009

Medication compliance is essential to improve person's health status through pharmacotherapy. Since separation of dispensing and prescription has been implemented, the importance of pharmacist's role on medication counseling have been emphasized, especially among outpatients. The objective of this study is to investigate the effect of patient's satisfaction with pharmacist's medication counseling on medication compliance among outpatients. We used the 2005 Korea National Health and Nutrition Survey data to examine medication compliance of persons who visited pharmacy. Ordered logistic regression analysis was conducted to assess whether patient's satisfaction with pharmacist's medication counseling was associated with medication compliance. Overall, 86.17% of study subjects(5,494) reported to take the prescribed medicines correctly and 80.54% of respondents were satisfied with pharmacist's medication counseling. Logistic regression analysis presents patient's satisfaction with pharmacist's counseling is significantly associated with medication compliance after controlling patient's characteristics(proxy-measured by age, family income, educational attainments, comorbid conditions). Interestingly, even patients who are dissatisfied with pharmacist's counseling have slightly higher odds of better compliance to medication therapy than those without pharmacist's counseling. In addition, higher educational attainments and older age groups are associated with better medication compliance. In conclusion, pharmacist's medication counseling appears to be effective in improving medication compliance. Further research that assess medication counseling in detail needs to develop strategies to improve medication adherence.

• Journal of Korean Society of Health-System Pharmacists
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• v.35 no.4
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• pp.418-429
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• 2018

Background : To improve medication adherence in elderly patients, the role of pharmacists in teambased services has been highlighted in the literature. However, not much is known about the role and the service elements involved in comprehensive geriatric programs in South Korea. This study was designed to describe the current status of medication adherence in geriatric patients based on the comprehensive geriatric assessment program and analyze the predictive factors for medication adherence in a tertiary teaching hospital. Methods : A retrospective cohort study was performed using electronic medical records of 247 patients from March 1st, 2015 to August 31st, 2015. Medication adherence and the types of non-adherence were also collected. Predictive factors for adherence were evaluated by including factors related to demographics, medications, illness, and patterns of medical usage. Results : The mean age of the study population was 81.2 years (range 65~98 years) and they were taking 9.7 drugs on an average (SD 5.0 drugs). The overall rate of non-adherence was 34%. About 48% of the patients had any forms of assistance in the medication administration. The most common type of non-adherence was "self-adjustment". The multivariate analyses revealed that age (adjusted odds ratio, 0.87 [95% CI, 0.80-0.96]; p 0.05) and the number of inappropriate medications (adjusted odds ratio, 0.59 [95% CI, 0.40-0.89]; p 0.05) were strong predictors for non-adherence. Conclusions : These results indicate that strategic considerations of the predictors of non-adherence should be improved in medication counseling services targeting elderly patients.

• Journal of Preventive Medicine and Public Health
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• v.56 no.3
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• pp.238-247
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• 2023

Objectives: Low adherence to antiretroviral (ARV) therapy in pregnant women with human immunodeficiency virus (HIV) increases the risk of virus transmission from mother to newborn. Increasing mothers' knowledge and motivation to access treatment has been identified as a critical factor in prevention. Therefore, this research aimed to explore barriers and enablers in accessing HIV care and treatment services. Methods: This research was the first phase of a mixed-method analysis conducted in Kupang, a remote city in East Nusa Tenggara Province, Indonesia. Samples were taken by purposive sampling of 17 people interviewed, consisting of 6 mothers with HIV, 5 peer facilitators, and 6 health workers. Data were collected through semi-structured interviews, focus group discussions, observations, and document review. Inductive thematic analysis was also performed. The existing data were grouped into several themes, then relationships and linkages were drawn from each group of informants. Results: Barriers to accessing care and treatment were lack of knowledge about the benefits of ARV; stigma from within and the surrounding environment; difficulty in accessing services due to distance, time, and cost; completeness of administration; drugs' side effects; and the quality of health workers and HIV services. Conclusions: There was a need for a structured and integrated model of peer support to improve ARV uptake and treatment in pregnant women with HIV. This research identified needs including mini-counseling sessions designed to address psychosocial barriers as an integrated approach to support antenatal care that can effectively assist HIV-positive pregnant women in improving treatment adherence.

• Journal of Preventive Medicine and Public Health
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• v.57 no.3
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• pp.212-222
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• 2024

Objectives: Epilepsy is a chronic disease that requires long-term treatment and intervention from health workers. Medication adherence is a factor that influences the success of therapy for patients with epilepsy. Therefore, this study aimed to analyze the role of pharmacists in improving the clinical outcomes of epilepsy patients, focusing on medication adherence. Methods: A scoping literature search was conducted through the ScienceDirect, PubMed, and Google Scholar databases. The literature search included all original articles published in English until August 2023 for which the full text was available. This scoping review was carried out by a team consisting of pharmacists and neurologists following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews and the Joanna Briggs Institute guidelines, including 5 steps: identifying research questions, finding relevant articles, selecting articles, presenting data, and compiling the results. Results: The literature search yielded 10 studies that discussed pharmacist interventions for patients with epilepsy. Five articles described educational interventions involving drug-related counseling with pharmacists. Two articles focused on similar pharmacist interventions through patient education, both verbal and written. Three articles discussed an epilepsy review service, a multidisciplinary intervention program involving pharmacists and other health workers, and a mixed intervention combining education and training with therapy-based behavioral interventions. Conclusions: Pharmacist interventions have been shown to be effective in improving medication adherence in patients with epilepsy. Furthermore, these interventions play a crucial role in improving other therapeutic outcomes, including patients' knowledge of self-management, perceptions of illness, the efficacy of antiepileptic drugs in controlling seizures, and overall quality of life.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.12
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• pp.5993-6000
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• 2012

The purpose of this study was to analysis instruments, identify relevant factors and analyze the effect size of intervention studies in reference to adherence among hemodialysis patients. Electronic literature searches were conducted for PubMed, CINAH, RISS, Naver academic, KISS, NDSL, Nanet, Kci, DBpia and KoreaMed. Of 437 studies identified, 37 met inclusion criteria, and 5 were used to estimate effect size. As a results, total of 11 original instruments were found, 61 factors were considered as relevant factors for adherence. Types of intervention were individual education program, self-care program using SMS, E-mail, or telephone counseling, supportive care program and drug education program. The effect size using random model effect was high (d=1.04, 95% CI: 0.60, 1.49, p<.00001).

• The Korean Journal of Food & Health Convergence
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• v.6 no.4
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• pp.17-19
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• 2020

HIV/AIDS disease still remain a global pandemic and it's management has undergone series of treatment changes and improvement although there is still no permanent cure.Dolutegravir belongs to a group of HIV drugs called integrase inhibitors. Integrase inhibitors block an HIV enzyme called integrase. By blocking integrase, integrase inhibitors prevent HIV from multiplying and can reduce the amount of HIV in the body.Dolutegravir combination based regimen has turned out to be very effective (antiviral) with negligible rare side effects on clients. This drug (Dolutegravir based regimen) combination has successfully increased the appetite for food of all the clients, unlike others and has shown to reduce viral load in the most shortest period ever. It can be deduced that development of resistant mutant virus will be reduced if not eliminated with dolutogravir based regimen.The role of Continuous adherence counseling has shown to improve clients treatment management. It is important to note that the availability of food has direct effect on the economic status or financial weight on the client. Hence the progress that is increase in body mass index (BMI) is a direct impact of the availability of food for the clients.

• Journal of Yeungnam Medical Science
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• v.40 no.2
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• pp.218-222
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• 2023

A holistic approach to diabetes considers patient preferences, emotional health, living conditions, and other contextual factors, in addition to medication selection. Human and social factors influence treatment adherence and clinical outcomes. Social issues, cost of care, out-of-pocket expenses, pill burden (number and frequency), and injectable drugs such as insulin, can affect adherence. Clinicians can ask about these contextual factors when discussing treatment options with patients. Patients' emotional health can also affect diabetes self-care. Social stressors such as family issues may impair self-care behaviors. Diabetes can also lead to emotional stress. Diabetes distress correlates with worse glycemic control and lower overall well-being. Patient-centered communication can build the foundation of a trusting relationship with the clinician. Respect for patient preferences and fears can build trust. Relevant communication skills include asking open-ended questions, expressing empathy, active listening, and exploring the patient's perspective. Glycemic goals must be personalized based on frailty, the risk of hypoglycemia, and healthy life expectancy. Lifestyle counseling requires a nonjudgmental approach and tactfulness. The art of diabetes care rests on clinicians perceiving a patient's emotional state. Tailoring the level of advice and diabetes targets based on a patient's personal and contextual factors requires mindfulness by clinicians.

• Mood & Emotion
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• v.16 no.3
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• pp.134-139
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• 2018

Objectives : Treatment for bipolar disorder is often complicated by various clinical situations. We undertook a survey of expert opinions to facilitate clinical decisions in special situations such as weight gain, metabolic syndrome, hyperprolactinemia, genetic counseling, and treatment adherence. Methods : A written survey that asked treatment strategies related to safety and tolerability, was prepared focused on weight gain, antipsychotic related hyperprolactinemia, lamotrigine related skin rash, treatment non-adherence and genetic counseling. Sixty-one experts of the review committee completed the survey. Results : In the case of weight gain related to medications, experts preferred exercise and education for diet-control. First chosen medications were lamotrigine, aripiprazole and ziprasidone. Recommendations based on expert survey results for treatment of bipolar patients in other special situations are outlined. Conclusion : With limitation of expert opinions, authors hope that results of this study provide valuable information to make clinical decisions about treatment of bipolar disorder in complicated situations.