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عضویت

جستجوی مقالات مرتبط با کلیدواژه "Medication adherence" در نشریات گروه "پزشکی"

  • فاطمه وفایی، ناهید رجایی*، زهرا فارسی، مسعود چهری
    مقدمه

    تبعیت دارویی در بیماران مزمن و مخصوصا بیماران قلبی-عروقی هنوز به عنوان یک چالش مطرح است و به دلیل تاثیرپذیری از عوامل مختلف، مراقبت های پرستاری انجام گرفته در این زمینه هنوز نتوانسته است این چالش را در حد مطلوب حل نماید.

    هدف

    این مطالعه با هدف تعیین تاثیر نقش پرستار رابط بر میزان تبعیت دارویی در بیماران قلبی-عروقی مراجعه کننده به اورژانس بیمارستان منتخب آجا شهر تهران انجام شد.

    مواد و روش ها

    این مطالعه تجربی که از نوع «طرح گروه کنترل فقط پس آزمون » بود که بر روی بیماران قلبی- عروقی مراجعه کننده به اورژانس بیمارستان منتخب آجا در شهر تهران در بازه ی زمانی بین آبان تا بهمن ماه 1402 انجام شد. 36 بیمار به روش هدفمند انتخاب و به صورت تصادفی ساده به دو گروه آزمون و کنترل تخصیص یافتند. گروه آزمون علاوه بر مراقبت های روتین، توسط یک پرستار رابط از طریق تماس تلفنی آموزش می دید. دو هفته بعد از اتمام مداخله تبعیت دارویی از طریق مقیاس تبعیت دارویی موریسکی مورد بررسی قرار گرفت. جهت تجزیه و تحلیل داده ها از نرم افزار آماری SPSS نسخه 19 استفاده شد. سطح معنی داری کمتر از 0/05 در نظر گرفته شد.

    یافته ها

    دو گروه از نظر مشخصات فردی تفاوت آماری معنی داری نداشتند (05/P<0). دو هفته بعد از مداخله میانگین تبعیت دارویی در گروه پرستار رابط (91/ 0± 38/ 6)، بالاتر از گروه کنترل (1/64±4/39) بود (001/P<0).

    نتیجه گیری

    با توجه به اثربخشی نقش پرستار رابط در بهبود تبعیت دارویی بیماران قلبی مراجعه کننده به بخش اورژانس پیشنهاد می شود مدیران پرستاری و متولیان سلامت جهت کمک به بیماران از این نقش پرستاران در بیمارستان ها بهره ببرند.

    کلید واژگان: بخش اورژانس, بیمار, بیماری قلبی- عروقی, پرستار, تبعیت دارویی
    Fatemeh Vafaie, Nahid Rajai*, Zahra Farsi, Masod Chehri
    Introduction

    Medication adherence remains a significant challenge for individuals with chronic illnesses, particularly those suffering from cardiovascular diseases. Despite various nursing strategies, optimal solutions to this issue have yet to be achieved.

    Objective

    This study aimed to evaluate the impact of the liaison nurse’s role on improving medication adherence among cardiovascular patients presenting to the emergency department of a selected Aja hospital in Tehran.

    Material and Methods

    This experimental study employed a post-test-only control group design in 2023. The participants were cardiovascular patients visiting the emergency department of the selected Aja hospital between November and February 2023. Thirty-six patients were purposively selected and randomly divided into experimental and control groups. The experimental group received routine care alongside training and support from a liaison nurse via telephone, while the control group only received routine care. Two weeks after the intervention, medication adherence was measured using the Morisky Medication Adherence Scale (MMAS). Data analysis was performed using SPSS version 19, with a significance level of less than 0.05.

    Results

    Baseline demographic characteristics did not differ significantly between the two groups (P<0.05). However, two weeks after the intervention, the experimental group demonstrated significantly greater medication adherence )mean score: 6.38±0.91 (compared to the control group) mean score: 4.39±1.64; P>0.001).

    Conclusion

    The findings underscore the effectiveness of the liaison nurse’s role in enhancing medication adherence among cardiac patients in the emergency department. It is recommended that nursing administrators and healthcare policymakers consider integrating the liaison nurse model into routine hospital care to support patients and improve outcomes.

    Keywords: Cardiovascular Disease, Emergency Ward, Medication Adherence, Nurse, Patient
  • Shirin Ranjbar, Firozeh Hosseini, Tayebeh Hasan Tehrani *, Soodabeh Aghababaei, Leili Tapak, Mohammadhossein Sattari
    Background

    Epilepsy is a common chronic neurological disorder in paediatrics. Most of the children with epilepsy do not properly adhere to medication regimen which leads to a lack of control over seizure and increased mortality and morbidity rate in these patients.

    Aim

    This study was conducted with aim to evaluate the effect of parent training and telephone follow-up on adherence to the medication program of children with epilepsy.

    Method

    This quasi-experimental study was conducted with participation of 72 parents of children with epilepsy who were referred to Besat Hospital of Hamadan in 2019-2021. The samples were assigned to two experimental and control groups by using random block permutation. During the first 24 hours of admission, the participants completed the researcher-made medication adherence questionnaire. A face-to-face training program and follow-up by phone were provided for the experimental group and no intervention for the control group. The questionnaire was also completed after two months. Data were analysed using SPSS software (version 22). p<0.05 was considered statistically significant.

    Results

    After the intervention, the control group showed a non-significant increase of 47.10±15.07 in medication adherence (p>0.05). However, the intervention group experienced a significant increase of 88.83±4.68 in medication adherence (p<0.001).

    Implications for Practice: 

    Parental education and telephone follow-up can be recommended as an independent action in nursing care services to improve medication adherence in children with epilepsy.

    Keywords: Children, Epilepsy, Medication Adherence, Telephone Follow-Up, Training
  • علیرضا اکبری، منصور غفوری فرد، زهرا شیخ علیپور*
    پیش زمینه و هدف

    دریافت کنندگان عضو علاوه بر مراقبت های جسمانی به مراقبت های روانی نیاز دارند و موفقیت پیوند، علاوه بر ملاحظات بالینی به حمایت های احساسی نیز وابسته است. با توجه به تاثیر احساسات بیمار در پذیرش یا رد عضو پیوندی و نقش حل مسائل روان شناختی در بقای بیماران و حفظ عضو پیوندی، مطالعه ای باهدف بررسی ارتباط بین احساس نسبت به عضو و عملکرد آن انجام شد.

    مواد و روش کار

    این مطالعه همبستگی با مشارکت 245 نفر از دریافت کنندگان کلیه و کبد در مرکز آموزشی و درمانی امام رضا (ع) انجام شد. داده ها با استفاده از دو پرسشنامه احساس نسبت به عضو پیوندی و تبعیت از رژیم دارویی بازل جمع آوری شد. نمونه گیری به روش در دسترس انجام و داده ها پس از جمع آوری با نرم افزار آماری SPSS نسخه 21 تحلیل شد.

    یافته ها

    میانگین و انحراف معیار نمره کل پرسشنامه احساس، 26/69 ± 26/12 و میانگین و انحراف معیار نمره کل تبعیت از رژیم دارویی، 93/1 ± 01/1 بود. بین نمره کل احساس و هر یک از حیطه های آن با تبعیت دارویی رابطه مثبت و مستقیم وجود داشت (P<0/01, r=0/25).

    بحث و نتیجه گیری

    با توجه به ارتباط مستقیم احساس نسبت به عضو پیوندی با تبعیت از رژیم دارویی، تقویت احساس مثبت نسبت به عضو و رفع نگرانی های جسمی بیماران می تواند تاثیر مثبتی بر تبعیت آن ها و کاهش رد پیوند ناشی از عدم مصرف داروها داشته باشد.

    کلید واژگان: احساس, پیوند عضو, تبعیت دارویی
    Alireza Akbari, Mansoor Ghafouri Fard, Zahra Sheikhalipour*
    Background & Aims

    Organ transplant recipients require not only physical care but also psychological support, as the success of transplantation depends not only on clinical considerations but also on emotional support. Given the influence of patients' emotions on the acceptance or rejection of the transplanted organ and the role of addressing psychological issues in patient survival and graft retention, this study aimed to investigate the relationship between feelings toward the transplanted organ and its function.

    Materials & Methods

    This correlational study involved 245 kidney and liver transplant recipients at Imam Reza (AS) Educational and Therapeutic Center. Data were collected using two questionnaires: the Feelings Toward the Transplanted Organ Scale and the Basel Assessment of Adherence to Immunosuppressive Medications Scale. Convenience sampling was used, and the data were analyzed using SPSS version 21 after collection.

    Results

    The mean and standard deviation of the total score for the Feelings Toward the Transplanted Organ Scale were 26.12 ± 26.69, and for adherence to the medication regimen, it was 1.01 ± 1.93. There was a positive and direct correlation between the total feelings score and its subscales with medication adherence (P < 0.01, r = 0.25).

    Conclusion

    Given the direct relationship between feelings toward the transplanted organ and adherence to the medication regimen, fostering positive feelings toward the organ and addressing patients' physical concerns can have a positive impact on their adherence and reduce the risk of transplant rejection due to non-compliance with medication.

    Keywords: Feelings, Organ Transplantation, Medication Adherence
  • Andi Fitrah Ramadhanty, Andi Masyitha Irwan*, Andina Setyawati
    Background

     Medication adherence (MA) is a crucial factor in effectively managing hypertension (HTN). Southeast Asia (SEA) is one of the regions with a significant burden of HTN. Understanding MA among patients with HTN is vital to identifying gaps and potential strategies to enhance its use and effectiveness for this region. However, little is known about MA among this population. This review study aimed to identify MA strategies implemented in previous studies on older people with HTN in SEA.

    Methods

     This scoping review was conducted from 2013 to 2023 by searching the Global Medicus Index, PubMed, ScienceDirect, EBSCO, CINAHL, Wiley, Garuda, and Google Scholar and grey literature to identify the aims of this paper using keyword variations such as “elderly” OR “older people” AND “hypertension” OR “Hypertensive” OR high blood pressure” AND “medication adherence” OR “medication compliance” AND “southeast Asia”. Three reviewers independently examined the results, and the extracted data were then organized, categorized, and summarized.

    Results

     Out of 742 studies reviewed, 16 met the criteria and were included in this review. The evidence indicated that MA rates among older people with HTN in several countries in SEA were considered poor, with various reasons for non-adherence. Family support and level of knowledge were found to be the most common supportive factors for MA. Some studies demonstrated negative perceptions toward medication, with previous reviews reporting the use of herbal medicine as self-treatment due to fear of side effects of prescribed medications.

    Conclusion

     The level of adherence to prescribed medication among older people is considered low in the reviewed studies. The main reasons for non-adherence are negative perceptions toward prescribed medication, which were also expressed in some studies. Moreover, various efforts were made by individuals to improve their adherence to medication use.

    Keywords: Medication Adherence, Hypertension, Older People, Southeast Asia
  • Zahra Khademian, Nasrin Zahmatkeshan *, Mahnaz Rakhshan, Ladan Zarshenas
    Background

    Promoting adherence to treatment and self-efficacy in patients with coronary artery diseases helps to improve patient outcomes. The present study was conducted to explain the effectiveness of interventions based on information, motivation, and behavioral skills model on treatment adherence and self-efficacy in patients with coronary artery diseases.

    Methods

    This explanatory-sequential study was conducted on patients with coronary artery diseases in Shiraz, Iran. First, a quasi-experimental study was conducted on 112 patients who were randomly assigned to two intervention and control groups. The intervention consisted of ten motivational training sessions that were designed based on Information, Motivation, and Behavioral Skills (IMBS) model and continued with six months of telephone follow-up and counseling. Data were collected before, three months, and six months after the end of the intervention. Then, in the second phase, a qualitative study including 20 in-depth interviews with 18 participants from the intervention group was conducted. The data were analyzed by deductive and inductive qualitative content analysis. Finally, quantitative findings were explained with the help of qualitative findings.

    Results

    The findings showed that the mean score of treatment adherence, medication adherence, and self-efficacy in the intervention group was significantly higher than the control group 3 and 6 months after the intervention (p<0.001). The results of the qualitative phase of the study also showed that the four main categories include receiving targeted information, encouragement to care, gained self-efficacy/doubt in care, and improvement/non-improvement of treatment adherence behaviors can explain quantitative phase results.

    Conclusion

    The results showed that receiving training with effective methods, strengthening the support system, self-confidence and positive attitudes about care, and promoting self-management and proper management of emotional distress contributed to the effectiveness of the interventions. However, receiving conflicting information, limited financial resources, and the inability to face challenges were among the obstacles to strengthening self-efficacy and adherence to treatment.

    Keywords: Coronary Artery Disease, Follow-Up Studies, Iran, Medication Adherence, Motivation, Psychological Distress, Self Efficacy, Self-Management
  • سیده فاطمه موسوی مقدم*، محمدامین حیدری
    مقدمه

    تبعیت دارویی از عمده مسائل حوزه سلامتی به خصوص در بیماران مبتلا به بیماری های مزمن است. عدم تبعیت دارویی و وجود حملات تشنجی غیرقابل پیش بینی موجب می شود که بیماران مبتلا به صرع با فشارهای مختلف روانی اجتماعی روبه رو شوند؛ لذا این مطالعه با هدف بررسی تبعیت دارویی و عوامل مرتبط با آن در بیماران مبتلا به صرع در بیمارستان نمازی شیراز در سال 1401طراحی و اجرا شد.

    مواد و روش ها

    پژوهش حاضر یک مطالعه توصیفی- مقطعی است که روی 320 بیمار مبتلا به صرع و با روش تصادفی ساده انجام شد. داده ها با استفاده از پرسشنامه اطلاعات جمعیت شناختی و تبعیت دارویی موریسکی جمع آوری گردیدند و در پایان با استفاده از نرم افزار SPSS نسخه 22 مورد تحلیل قرار گرفتند.

    یافته ها

    میانگین نمره مقیاس تبعیت دارویی در میان شرکت کنندگان 1/98±4/31 گزارش گردید. نتایج آزمون تی مستقل نشان داد که بین جنسیت (0/04=P)، سطح تحصیلات (0/016=P)، تاهل (0/033=P)، سابقه بیماری زمینه ای (0/039=P) با نمره مقیاس تبعیت دارویی ارتباط آماری معنی داری وجود دارد.

    نتیجه گیری

    پژوهش حاضر نشان داد که تبعیت دارویی در بیماران مبتلا به صرع در سطح پایین قرار دارد، به همین دلیل متخصصان و مراقبان سلامت باید با اتخاذ روش های آموزشی و مراقبتی متناسب با عوامل موثر بر تبعیت دارویی، جهت ارتقای سطح تبعیت دارویی در بیماران مبتلا به صرع، رویکردهای اثربخشی ایجاد نمایند.

    کلید واژگان: صرع, تبعیت بیمار, پایبندی به دارو, مطالعات مقطعی
    Seyedeh Fatemeh Moosavi Moqaddam *, Mohammadamin Heidari
    Introduction

    One of the major health issues, especially in patients with chronic diseases, is medication adherence. Patients with epilepsy face various psychosocial pressures due to non-adherence to medication and the presence of unpredictable convulsive attacks. It seems that it is important to investigate drug compliance and identify factors related to it in these patients to adopt treatment and care plans. Therefore, this study was designed and implemented to investigate drug compliance and its related factors in patients with epilepsy in Namazi Hospital (Shiraz, Iran) in 2022. 

    Methods

    The present study was a descriptive cross-sectional study. It included 320 patients with epilepsy. The data were collected using demographic information and a medication adherence questionnaire. The data were analyzed using SPSS software.

    Results

    The medication compliance scale scores of the participants were 4.31±1.98. There was a statistically significant relationship between sex (P=0.040), education level (P=0.016), marital status (P=0.033), underlying disease history (P=0.039), and medication adherence scale score.

    Conclusion

    Drug compliance in patients with epilepsy was at a low level. Therefore, it is recommended that health professionals and caregivers adopt educational and care methods appropriate to the factors affecting drug compliance, as well as evaluate effective approaches to improve the level of drug compliance in patients with epilepsy.

    Keywords: Epilepsy, Patient Compliance, Medication Adherence, Cross-Sectional Studies
  • Homa Shahkaram, Amir Sadeghi, Abbas Masjedi Arani, Maryam Bakhtiari, Amir Sam Kianimoghadam *
    Aim

    This study aimed to investigate whether transdiagnostic treatment as well as acceptance and commitment therapy (ACT) could improve treatment adherence and alleviate gastrointestinal symptoms plus perceived stress in patients suffering from irritable bowel syndrome.

    Background

    Research has shown that people with chronic diseases often have negative attitudes toward medications, especially when they also have psychiatric disorders. This, along with the complex dosing requirements and inadequate knowledge about medication adherence among irritable bowel syndrome patients, can affect the treatment efficacy.

    Methods

    A randomized clinical trial was conducted using a pre-test-post-test design. The statistical population included patients with irritable bowel syndrome referring to Taleghani Hospital in Tehran between winter 2021 and spring 2022. Convenience sampling was used to select 30 individuals, with 15 people assigned to each group. Two types of psychotherapy were provided online and individually to the participants. The desired treatments were given to the transdiagnostic treatment and ACT groups in eight weekly sessions of 45-60 minutes.

    Results

    There was no significant difference between the transdiagnostic treatment pre-test and ACT regarding perceived stress, medication adherence, and gastrointestinal symptoms (P>0.05). There was no significant difference either between the transdiagnostic treatment and ACT post-test. However, there was a significant difference between the pre-test and post-test phases of ACT regarding adherence, gastrointestinal symptoms, plus perceived stress (P<0.05) and transdiagnostic treatment regarding gastrointestinal symptoms (P<0.05).

    Conclusion

    Specialists may use transdiagnostic treatment and ACT as effective psychological treatments to alleviate gastrointestinal symptoms and perceived stress, thereby increasing treatment adherence in patients with irritable bowel syndrome.

    Keywords: Acceptance, Commitment Therapy, Medication Adherence, Irritable Bowel Syndrome, Stress, Physiological
  • Zeinab Yousefli, Mojghan Sadat Aghvamy *, Zeinab Ghahramani
    Background

     Diabetes is considered one of the most arduous chronic diseases emotionally and behaviorally. This disease is an integral part of the patient’s lives, and not paying attention to the psychological stress stemming from it, not only leads to the occurrence of psychological symptoms and frustration, but also influences self-care behaviors, such as blood sugar control, proper use of medicines, and medication regimen adherence.

    Objectives

     This study was conducted to determine the relationship between psychological stress and medication regimen adherence in patients with type 2 diabetes.

    Methods

     This descriptive-correlational study was conducted on 101 patients referring to diabetes clinics affiliated with Zanjan University of Medical Sciences in 2023. Sampling was carried out using the convenience sampling method. A demographic characteristics questionnaire, the Problems Areas in Diabetes-5 (PAID-5) Scale, and the Mo risky Medication Adherence Scale-8 (MMAS-8) were used to collect data. Data were analyzed using descriptive statistics, the Mann-Whitney U test, the Kruskal-Wallis test, and Spearman’s test, with SPSS-26 software.

    Results

     In the present research, 68.3% of the participants were female and 31.7% were male. The mean (standard deviation) stress score was 9.579 (7.448). Also, 58.4% of the participants had a stress score of ≥8, indicating high psychological stress. The mean (standard deviation) of medication adherence was 6.054 (1.874), which based on the findings, 43.6% had a poor adherence score. Spearman’s correlation coefficient showed an inverse and significant statistical relationship between psychological stress and medication adherence (p =0.002, r=-0.307).

    Conclusion

     According to the results, the higher the psychological stress of diabetic patients, the lower their medication adherence. It is suggested that targeted interventions should be designed to manage psychological stress and improve medication adherence in diabetic patients.

    Keywords: Psychological Stress, Medication Adherence, Type 2 Diabetic Patients
  • سمیه باحور، مرضیه ضیایی راد*
    زمینه و هدف

    انگ در کنار محدودیت های فیزیکی ناشی از علایم تنفسی بیماری مزمن انسدادی ریوی (COPD) میتواند منجر به انزوای اجتماعی و تنهایی، ضعف خودمدیریتی و کاهش مشارکت با مراقبین بهداشتی شود. مطالعه حاضر با هدف تعیین ارتباط انگ و تبعیت دارویی در بیماران مبتلا به COPD انجام شد.

    روش کار

    این مطالعه همبستگی با مشارکت 140 نفر از بیماران مبتلا به COPD بستری در بیمارستان رازی شهر رشت در سال 1402 انجام گردید. نمونه گیری به صورت در دسترس و بر اساس معیارهای ورود انجام شد. جهت جمع آوری داده ها از فرم اطلاعات جمعیت شناختی و بالینی، پرسشنامه تبعیت از درمان دارویی موریسکی و همکاران و مقیاس انگ برای بیماری های مزمن استفاده شد. داده ها با استفاده از نرم افزار SPSS-27 و آزمونهای ضریب همبستگی پیرسون و رگرسیون چندگانه تجزیه و تحلیل شد.

    یافته ها

    میانگین نمره انگ مشارکت کنندگان، 24/29±73/38 و تبعیت دارویی 2/61±2/67 بود. آزمون ضریب همبستگی پیرسون، ارتباط معکوس و معناداری را بین تبعیت دارویی و انگ در بیماران با COPD نشان داد (0/001> p , 0/591 = p). همچنین بر اساس نتایج تحلیل رگرسیون خطی چندمتغیره، انگ و سابقه مصرف دارو و اسپری، توان پیش بینی تبعیت دارویی را داشتند.

    نتیجه گیری

    بر اساس نتایج مطالعه حاضر، انگ در بیماران مبتلا به COPD در سطح متوسط و وضعیت تبعیت دارویی آنان در سطح ضعیف بود. همچنین همبستگی معکوس و معناداری بین تبعیت دارویی و انگ در این بیماران مشاهده شد. در نتیجه برنامه ریزی جهت انجام مداخلات پیشگیری از انگ و کنترل عوامل مرتبط با آن همانند عدم تبعیت دارویی در این بیماران ضروری به نظر می رسد.

    کلید واژگان: انگ, تبعیت دارویی, بیماری مزمن انسدادی ریوی
    S Bahoor, M Ziaeirad*
    Background

    Stigma, along with physical limitations due to respiratory symptoms of chronic obstructive pulmonary disease (COPD), can lead to social isolation and loneliness, poor self-management, and reduced engagement with health care providers. This study was conducted to determine the relationship between stigma and medication adherence in patients with COPD.

    Methods

    This correlational study was conducted on 140 patients with COPD hospitalized in Razi Hospital in Rasht city in 2023. Convenience sampling method was performed based on the inclusion criteria. Data collection tools were the demographic and clinical information form, Morisky Medication Adherence Questionnaire, and Stigma Scale for Chronic Diseases. The Data were analyzed using the Pearson correlation coefficient and multivariate regression model in SPSS-27 software.

    Results

    The mean of stigma score was 73.38±24.29 and the mean of medication adherence score was 2.67 ±2.61. Pearson correlation coefficient showed a negative and statistically significant relationship between medication adherence and stigma scores in COPD patients (p=-0.591, p<0.001). In addition, based on the results of multivariate linear regression analysis, stigma, and use of drug and inhaler can predict the medication adherence score.

    Conclusion

    Based on the results of this study, the stigma in COPD patients was moderate and medication adherence was poor. Furthermore, a significant inverse relationship was observed between medication adherence and stigma scores in these patients. Therefore, it is necessary to plan interventions to prevent stigma and control stigma-related factors, such as medication non-adherence, in COPD patients.

    Keywords: Stigma, Medication Adherence, Chronic Obstructive, Pulmonary Disease
  • Mohammadbaqer Saberi-Zafarghandi, Samira Masoumian *, Hooman Yaghmaeizadeh, Mahboubeh Beyhaghi, Somayeh Pouladi, Mitra Zahirian Moghadam
    Background

    The aim of this study was to investigate the role of psychological variables in medication adherence in OCD. 

    Methods

    This descriptive and correlational study was carried out at Tehran Institute of Psychiatry in Tehran. The statistical population of the present study includes all OCD patients referred to the Tehran Institute of Psychiatry. The participants were selected by available sampling method. The patients completed the demographic questionnaire, Yale Brown Obsessive-Compulsive Disorder Scale-Second Edition (Y-BOCS-II), Vancouver Obsessional Compulsive Inventory (VOCI), Medication Adherence Rating Scale (MARS), Drug Attitude Questionnaire (DAI-10), Multidimensional Scale of Perceived Special Support (MSPSS), Coping strategies scale of Lazarus and Folkman (WOCQ), and Temperament and Character Inventory (TCI). Multiple Linear Regression (MLR) was used to analyze the data. 

    Results

    The variable of education status (r=0.18) had a positive relationship and the variable of hospitalization history (r=-0.26) had a negative relationship with medication adherence. Medication adherence is only negatively associated with obsessive thoughts (r=- 0.18, r=-0.20). Duration of drug use (r=0.27), attitude to treatment (r=0.25) and social support (r=0.54) had a positive relationship with medication adherence. Among the various dimensions of temperament and character, four dimensions of harm avoidance (r=-0.29), reward dependence (r=-0.44), persistence (r=-0.20) and self-transcendence (r=0.32) had a significant correlation with medication adherence. Variables of social support, reward dependence, persistence, harm avoidance and education status had the highest regression effect on medication adherence. 

    Conclusion

    Medication adherence is one of the behaviors that predicts successful treatment and reduces the negative side effects and severity of the OCD.

    Keywords: Medication Adherence, Obsessive-Compulsive Disorder, Psychiatry
  • مبینا خلیل نژاداواتی، قدرت الله عباسی*، پژمان هادی نژاد
    زمینه و هدف

    بیماران مبتلا به اختلال اضطراب فراگیر دارای مشکلات روان شناختی می باشند و نیاز به مداخلات درمانی دارند. پژوهش حاضر با هدف تعیین اثربخشی درمان فراشناختی بر باورپذیری افکار و احساسات اضطرابی در بیماران مبتلا به اختلال اضطراب فراگیر انجام شد.

    مواد و روش ها

    این پژوهش نیمه تجربی با طرح پیش آزمون-پس آزمون با گروه کنترل بود. جامعه آماری شامل کلیه بیماران روان پزشکی سرپایی کلینیک روان درمانی بیمارستان زارع شهر ساری در پاییز سال 1402 بود که با روش نمونه گیری هدف مند، تعداد 32 نفر انتخاب و به صورت تصادفی در دو گروه (16 نفره) آزمایش و کنترل جایگزین شدند. گروه آزمایش، 8 جلسه درمان فراشناختی دریافت نمودند و گروه گواه مداخله ای دریافت نکرد. جمع آوری داده ها با استفاده از مقیاس اختلال اضطراب فراگیر Spitzer و همکاران (2006) و پرسش نامه باورپذیری افکار و احساسات اضطرابی Herzberg و همکاران (2012) انجام شد. جهت تجزیه وتحلیل داده ها از تحلیل کوواریانس چند متغیره استفاده شد.

    یافته ها

    درمان فراشناختی بر باورپذیری افکار و احساسات اضطرابی در بیماران مبتلا به اختلال اضطراب فراگیر تاثیر معنی دار داشت (001/0>P). میانگین نمره باورپذیری افکار و احساسات اضطرابی در گروه آزمایش در پیش آزمون و پس آزمون به ترتیب 44/86 و 94/55 بود. این اثربخشی در ابعاد باورپذیری افکار و احساسات اضطرابی نیز مشاهده شد و اندازه اثر در کل ابزار 869/0 به دست آمد (001/0>P).

    نتیجه گیری

    نتایج مطالعه حاضر نشان داد درمان فراشناختی بر باورپذیری افکار و احساسات اضطرابی در بیماران مبتلا به اختلال اضطراب فراگیر موثر است. بنابراین، استفاده از این رویکرد با هدف کمک به بهبود سلامت روان این بیماران پیشنهاد می گردد.

    کلید واژگان: اختلال اضطرابی, سلامت روان, اختلال هیجانی, پای بندی به دارو
    Mobina Khalilnezhadevati, Ghodratollah Abbasi*, Pezhman Hadinezhad
    Background and Objectives

    Patients with generalized anxiety disorder have psychological problems and require therapeutic interventions. The current study aimed to determine the effectiveness of metacognitive therapy on the the believability of anxious feelings and thoughts in patients with generalized anxiety disorder.

    Materials and Methods

    This study was a quasi-experimental pretest-posttest design with a control group. The statistical population included all outpatient psychiatric patients at the Zare Hospital Psychiatric Clinic in Sari in the fall 2023. Thirty-two individuals were selected using purposive sampling and randomly assigned into two experimental and control groups (16 individuals each). The experimental group received 8 sessions of metacognitive therapy, while the control group did not receive any intervention. Data collection was done using the Generalized Anxiety Disorder Scale by Spitzer et al. (2006) and the Believability of Anxious Feelings and Thoughts Questionnaire by Herzberg et al. (2012). Multivariate analysis of covariance were used for data analysis.

    Results

    Metacognitive therapy had a significant effect on the believability of anxious feelings and thoughts in patients with generalized anxiety disorder (p<0.001). The mean of believability of anxious feelings and thoughts scores in the experimental group were 86.44 and 55.94 in the pretest and posttest, respectively. This effectiveness was observed across all dimensions of believability of anxious feelings and thoughts with an effect size of 0.869 on the overall (p<0.001).

    Conclusion

    The results of this study indicate that metacognitive therapy is effective in improving the believability of anxious feelings and thoughts in patients with generalized anxiety disorder. Therefore, it is recommended this approach be used to enhance the mental health of these patients.

    Keywords: Anxiety Disorder, Mental Health, Emotional Disturbance, Medication Adherence
  • ولید ملکی، رضا نوروززاده*، نسرین علایی
    مقدمه

    از مشکلات جدی در بیماران تحت همودیالیز عدم تبعیت دارویی می باشد. روش های آموزشی تعاملی مناسب می تواند نیازهای آموزشی بیماران را برطرف کند. این مطالعه با هدف تعیین تاثیر آموزش بازخورد محور بر تبعیت از رژیم دارویی بیماران تحت همودیالیز انجام گردید.

    روش کار

    این یک مطالعه نیمه تجربی می باشد. تعداد 60 نفر بیمار تحت درمان همودیالیز بخش دیالیز مرکز پزشکی خاص شرق شهر تهران از بهمن 1401 تا شهریور ماه 1402 مورد مطالعه قرار گرفتند. نمونه گیری بصورت در دسترس و گمارش تصادفی انجام شد. ابزار گردآوری اطلاعات شامل برگه اطلاعات جمعیت شناختی و مقیاس 8 آیتمی تبعیت دارویی موریسکی (MMAS-8) بودند. گروه مداخله آموزش بازخورد محور را حین دیالیز  طی سه جلسه هر جلسه 30 تا 45 دقیقه، دریافت کردند. گروه کنترل پس از اتمام پژوهش مداخله را دریافت نمودند. هر دو گروه 4 هفته بعد مجددا مقیاس 8 آیتمی تبعیت دارویی MMAS-8 را تکمیل کردند. داده ها با استفاده از آماره های توصیفی، آزمون های پارامتریک و نا پارامتریک در نرم افزارSPSS  نسخه 22 تجزیه و تحلیل گردید.

    یافته ها

    هر دو گروه از نظر سن، تحصیلات، مدت زمان انجام همودیالیز همگن بودند (07/0=P).  بعد از آموزش بازخورد محور 70 درصد بیماران همودیالیزی از تبعیت دارویی ضعیف، 7/26 درصد تبعیت دارویی متوسط و 3/3 درصد هم از تبعیت بالای دارویی داشتند. در مجموع آموزش خود مراقبتی بازخوردمحور  اثر متوسط (اندازه اثر 63/0) بر تبعیت دارویی نشان داد (002/0=P).

    نتیجه گیری

      نتایج مطالعه حاضر نشان داد آموزش بازخورد محور  می تواند خود مراقبتی بیماران دیالیزی را در زمینه تبعیت از رژیم دارویی بهبود بخشد. لذا پیشنهاد می شود به منظور ارتقائ سلامت بیماران  این روش آموزشی در  برنامه مراقبتی منظور شود.

    کلید واژگان: همودیالیز, تبعیت دارویی, آموزش بازخورد محور
    Valid Maleki, Reza Norouzadeh*, Nasrin Alaee
    Introduction

    Medication non-adherence is one of the major problems in hemodialysis patients. Appropriate interactive educational methods can meet the educational needs of patients. Therefore, this study aims to determine the effect of teach-back education on medication adherence in hemodialysis patients.

    Methods

    This is a semi-experimental study. Sixty patients undergoing hemodialysis at the dialysis unit of East Tehran Special Medical Center were studied from February 2022 to September 2023. Sampling was done by consensus and random assignment. Data collection instruments included the demographic data sheet and the 8-item Morisky Medication Adherence scale (MMAS-8). The intervention group received teach-back education in three 30- 45minute sessions during dialysis. The control group did not receive the educational intervention, and after the third session, the patients of the control group were given educational content. Four weeks later, both groups were asked to complete the medication adherence questionnaire again.  Descriptive and analytical statistics were conducted with SPSS software version 22.

    Results

    Results showed that both groups were homogeneous in age, education and hemodialysis duration (P=0.07). After teach-back education, 70% of hemodialysis patients had poor medication adherence, and 26.7% and 3.3% had moderate and high medication adherence, respectively. Overall, the teach-back education had a moderate effect (effect size= 0.63) on medication adherence (P = 0.002).

    Conclusion

    Results from this study show that teach-back education improves medication adherence in hemodialysis patients. Therefore, it is suggested that this educational method be included in the care program to improve the health of patients.

    Keywords: Hemodialysis, Medication Adherence, Teach-Back Education
  • A. Ghorbani, E. Kareem Abed, Sh. Ghiyasvandian, M. Salami*
    Aims

    Health literacy is a critical factor in achieving good health, as it plays a central role in health and healthcare. Another important factor affecting health outcomes is medication adherence, especially in patients with chronic liver disease and cirrhosis. Therefore, this study aimed to investigate the association between health literacy and medication adherence in patients with cirrhosis.

    Instruments & Methods

    This was a descriptive study on 141 cirrhosis patients from two teaching hospitals in Iraq between December 2022 and April 2023, recruited using a convenience sampling method. Data collection was carried out using three self-report questionnaires, including demographic characteristics, the All Aspects of Health Literacy Scale, and the Adherence to Refills and Medications Scale. Data analysis was performed using SPSS software version 16.

    Findings

    Most patients (92.90%) exhibited non-adherence to medication, with a medication adherence score of more than 16. Additionally, 75.88% of patients demonstrated a low level of health literacy. A positive and significant correlation was observed between medication adherence and total health literacy score (r=0.358, p<0.001).

    Conclusion

    The majority of patients exhibit low health literacy and non-adherence to medications.

    Keywords: Health Literacy, Medication Adherence, Liver Cirrhosis
  • سارا مقیمی، ابوالفضل پاینده، مریم سراجی*
    زمینه و هدف

    خودمراقبتی دیابت منجر به کنترل قند خون در بیماران دیابتی می شود. پایبندی به دارو یکی از شیوه های خودمراقبتی است. این پژوهش با هدف بهبود پایبندی به دارو در بیماران دیابتی نوع 2 شهر زاهدان بر اساس مدل رویکرد فرایند رفتار بهداشتی انجام شد.

    مواد و روش ها

    در این مطالعه مداخله ای، 210 بیمار دیابتی نوع دو مراجعه کننده به کلینیک های دیابت شهر زاهدان در دو گروه مداخله (105 نفر) و  گروه کنترل (105 نفر) از کلینیک های دیابت بیمارستان های زاهدان طی تیر تا مهرماه در سال 1401 انتخاب شدند. نمونه گیری به روش در دسترس از بین بیماران دیابتی انجام شد. پس از جمع آوری داده ها با استفاده از پرسشنامه پایبندی به دارو و پرسشنامه سازه های مدل، پیش آزمون انجام شد. 0/7 =CVI= 0/6 CVR و آلفا کرونباخ پرسشنامه 0/97 بود.  یک و سه ماه پس از مداخله آموزشی، پرسشنامه سازه های مدل و رفتار خودمراقبتی توسط بیماران تکمیل و برای تجزیه و تحلیل جمع آوری شد. داده ها با استفاده از آزمون های t مستقل، مجذور کای و Shapiro-Wilk در  SPSS نسخه 23 تجزیه و تحلیل شد. سطح معناداری 0/05 در نظر گرفته شده بود.

    یافته ها

    نتایج نشان داد که سازه های مدل رویکرد رفتار بهداشتی شامل ادراک خطر، انتظارات پیامد، قصد رفتاری، خودکارآمدی عمل، خودکارآمدی مقابله ای، خودکارآمدی بازگشت، برنامه ریزی عمل و مقابله ای، موانع درک شده، منافع درک شده و رفتار خود مراقبتی تفاوت معنی داری در یک ماه و سه ماه بعد از مداخله آموزشی داشتند (0/05>P) که نشان دهنده اثربخشی آموزش در گروه مداخله بود. اما در گروه کنترل تفاوت معنی داری مشاهده نشد (0/05 > P).

    نتیجه گیری

    مداخله با مدل رویکرد فرایند رفتار بهداشتی نشان داد که سازه های مدل بعد از آموزش تاثیر بسزایی بر  خودمراقبتی بیماران در زمینه رعایت رژیم دارویی داشت. باید برنامه های مناسبی با جزئیات در زمینه سازه خودکارآمدی مقابله ای و برنامه ریزی عمل برای ترویج رعایت رژیم دارویی در میان بیماران مبتلا به دیابت دو طراحی شود.

    کلید واژگان: آموزش, رویکرد فرایند رفتار بهداشتی, تبعیت دارویی, دیابت نوع دو
    Sara Moghimi, Abolfazl Payandeh, Maryam Seraji*
    Background and Objectives

    Diabetes self-care leads to blood sugar control in diabetic patients. Adherence to medication is one of the methods of self-care. This research to improving medication adherence in type 2 diabetic patients in Zahedan based on the Health Action Process Approach model.

    Materials & Methods

    In this intervention study, 210 type 2 diabetic patients referred to diabetes clinics in Zahedan city in two intervention groups (105) and control group (105) were selected from the diabetes clinics of Zahedan hospitals during June and September in 2022. Sampling was done by available methods among diabetic patients. After collecting the data, a pre-test was conducted using the medication adherence questionnaire and the model constructs questionnaire. CVI = 0.7, CVR = 0.6 and Cronbach's alpha of the questionnaire was 0.97. One and three months after the educational intervention, the questionnaire on model structures and self-care behavior was completed by the patients and collected for analysis. Data were analyzed using independent t, Chi-square, and Shapiro-Wilk tests in SPSS version 23. A significance level of 0.05 was considered.

    Results

    The results showed that all the Health Action Process Approach model constructs including risk perception, outcome expectancies, behavioral intention, action self-efficacy, coping self-efficacy, recovery self-efficacy, action planning and coping planning, perceived barriers, perceived benefits, and self-care behavior had significant differences in one month and three months after the educational intervention (P<0.05), which indicated the effectiveness of the education in the intervention group. However, no significant difference was observed in the control group (P < 0.05).

    Conclusion

    The intervention with the Health Action Process Approach model showed that the structures of the model after the training had a significant impact on the self-care of patients in the field of medication compliance. Appropriate programs with details in the field of automatic coping self-efficacy and action planning should be designed to promote medication adherence among patients with type 2 diabetes.

    Keywords: Education, Health Action Process Approach, Medication Adherence, Type 2 Diabetes
  • زهرا قادری نسب، پروین منگلیان شهربابکی، حمید شریفی*
    زمینه و هدف

    از مشکلات کنترل اپیدمی پرفشاری خون در جهان، عدم تبعیت دارویی است. هدف این مطالعه تبیین عوامل موثر بر عدم تبعیت دارویی از دیدگاه بیماران مبتلا به پرفشاری خون و کارکنان شاغل در مراکز بهداشتی شهر ماهان واقع در استان کرمان است.

    روش بررسی

    این مطالعه کیفی، به روش تحلیل محتوای قراردادی در پایگاه های بهداشتی شهر ماهان در سال 1401 با مشارکت 29 نفر که به روش نمونه گیری مبتنی بر هدف وارد مطالعه شدند، انجام گرفت. داده ها با مصاحبه نیمه ساختار یافته عمیق گردآوری شد. کلیه مصاحبه ها ضبط و کلمه به کلمه بازنویسی و به عنوان داده اصلی تجزیه و تحلیل شد. بررسی صحت علمی و اعتباربخشی داده ها براساس معیار های Guba و Lincoln صورت گرفت.

    یافته ها

    عوامل موثر بر عدم تبعیت دارویی در بیماری پرفشاری خون با سه طبقه «ماهیت بیماری و درمان» شامل بی علامت بودن و ماهیت مزمن بیماری، خسته شدن از مصرف دایمی دارو، «عوامل فردی و خانوادگی» شامل ترس و تردیدهای درونی، تمایل به درمان های غیردارویی، حمایت ناقص خانواده و «عوامل سازمانی» شامل هزینه های بالای درمان و دسترسی به خدمات تخصصی، حمایت ناقص تیم درمان و مراقبت، پیگیری نامناسب بیماری استخراج شد.

    نتیجه گیری

    عوامل متعددی با طیف متفاوت بر عدم تبعیت دارویی در این بیماران تاثیر می گذارند. لذا آموزش های منظم به بیماران درباره ماهیت بیماری و نقش رعایت رژیم دارویی می تواند به بهبود تبعیت دارویی کمک کند.

    کلید واژگان: پرفشاری خون, موانع, درمان, تبعیت دارویی
    Zahra Ghaderi Nasab, Parvin Mangolian Shahrbabaki, Hamid Sharifi*
    Background & Aim

    Medication non-adherence remains a significant problem in managing the global epidemic of hypertension. This study aimed to explore the factors affecting medication non-adherence from the perspectives of both patients with hypertension and healthcare providers in Mahan health centers, located in Kerman province.

    Methods & Materials: 

    This qualitative study utilized a conventional content analysis method within healthcare centers in Mahan city in 2022. A total of 29 participants were included in the study, selected through purposive sampling. Data were collected through in-depth semi-structured interviews, with all interviews being recorded, transcribed verbatim, and utilized as the primary data for analysis. The trustworthiness of data was evaluated in accordance with the criteria established by Guba and Lincoln criteria.

    Results

    Three categories of factors contributing to medication non-adherence among patients with hypertension were identified: ""nature of the disease and treatment," "individual and family factors," and "organizational factors." Factors related to the "nature of the disease and treatment" included the asymptomatic and chronic nature of hypertension as well as fatigue stemming from continuous drug use. "Individual and family factors" encompassed fear and internal doubts, a desire for non-pharmacological treatments, and inadequate family support. "Organizational factors" comprised high treatment costs and access to specialized services, insufficient support from treatment and care teams, and inadequate disease monitoring.

    Conclusion

    Various factors across a spectrum of influences contribute to medication non-adherence in patients with hypertension. It is crucial for healthcare providers to engage in consistent patient education regarding the nature of the condition and the importance of medication adherence to enhance compliance among patients.

    Keywords: Hypertension, Barriers, Treatment, Medication Adherence
  • Raziyeh Ghafouri *, Roxana Karbaschi, Alireza Mashhadi Hosein, Shakila Sharifian
    BACKGROUND
    Patients with cardiovascular disease need to adhere to their treatment and care recommendations to prevent the progression of their condition and improve their quality of life. In this regard, this study was conducted to develop a mobile application and test its effectiveness in improving medication adherence among persons with cardiac disease.
    METHODS
    The study was conducted in two stages. The first stage involved the preparation of the “Mobile Application for Persons with Cardiac Disease” using the cascade model. In the second stage, 121 patients who were hospitalized in the cardiac intensive care unit of Ayatollah Taleghani Medical Education Center of Tehran from March to August 2023 were enrolled. The participants were randomly assigned to either the control group (63 people) or the intervention group (58 people). The study collected data using a medication adherence questionnaire on the 7th, 14th, and 21st day after discharge and compared the results with the control group. The data were analyzed using SPSS 20.
    RESULTS
    The average age of the control group was 56.75 ± 11.38 years, and the average age of the intervention group was 57.03 ± 11.55 years. The comparison of the average medication adherence with independent t-tests showed a significant difference between the intervention and control groups on the 7th, 14th, and 21st day after discharge (P<0.01). The results of the repeated measures test in each group also showed that the difference between the groups increased over time (P<0.001).
    CONCLUSION
    The results of the study showed that the mobile application is effective in improving medication adherence among heart patients.
    Keywords: Mobile Applications, Medication Adherence, Heart Disease, Effectiveness
  • فرینا حسن پور، فاطمه مهرآور، محمدتقی بادله، زهرا سبزی، حمیده منچری*
    زمینه و هدف

    تبعیت دارویی یکی از مسائل مهم بهداشتی و ابعاد کلیدی کیفیت مطلوب مراقبت در بیماران مبتلا به دیابت است که یکی ازعوامل مهم موثر برآن وضعیت سواد سلامت آنان می باشد. بنابراین مطالعه حاضر با هدف تعیین ارتباط بین سطح سواد سلامت و تبعیت دارویی در مبتلایان به دیابت نوع دو مراجعه کننده به مراکز جامع سلامت شهرستان گرگان طی سال 1402 انجام گردید.

    مواد و روش ها

    این مطالعه به روش مقطعی و بر روی 400 بیمار مبتلا به دیابت نوع 2 که به مراکز جامع سلامت شهرستان گرگان در سال 1402 مراجعه کردند انجام گردید. داده ها به روش نمونه گیری طبقه ای متناسب با حجم و در هر طبقه از نوع در دسترس جمع آوری شد. از پرسشنامه های تبعیت از درمان دارویی موریسکی (MMAS-8) و پرسشنامه سواد سلامت نسخه کوتاه (-SH HELIA) استفاده شد. داده ها در نرم افزار SPSS و با استفاده از آزمون های تی مستقل، مجذور کای، آنالیز واریانس و همبستگی پیرسون مورد تجزیه و تحلیل قرار گرفت.

    یافته ها

    میانگین نمره تبعیت از درمان دارویی و نمره کل سواد سلامت به ترتیب 01/46 ± 04/06 و 03/53 ± 36/47 بود. در بین شرکت کنندگان در مطالعه تنها 8/20 درصد بیماران تبعیت بالا و 16/80 درصد دارای تبعیت متوسط و بقیه (75درصد) تبعیت دارویی ضعیفی داشتند. تبعیت دارویی بیماران با ابعاد مهارت های پایه سواد سلامت (0/14=p= 0/004,=r) و مهارت های تصمیم گیری (r=0/15, p=0/003) ارتباط مستقیم و معناداری داشت.

    نتیجه گیری

    یافته های این مطالعه نشان داد که اکثریت بیماران تبعیت دارویی ضعیفی داشتند و سطح سواد سلامت با ابعاد تبعیت رژیم دارویی در بیماران مبتلا به دیابت نوع 2 مرتبط بود.

    کلید واژگان: تبعیت رژیم دارویی, سواد سلامت, دیابت نوع 2
    Farina Hasanpour, Fatemeh Mehravar, Mohammadtaghi Badeleh-Shamushaki, Zahra Sabzi, Hamideh Mancheri*
    Background & Aim

    Medication adherence is one of the important health issues and key aspects of the desired quality of care in patients with diabetes, and one of the important factors affecting it is their health literacy. Therefore, the present study was conducted with the aim of determining the relationship between the level of health literacy and medication adherence in type 2 diabetes patients who referred to comprehensive health centers in Gorgan city during 2023.

    Materials & methods

    This study was conducted cross-sectional on 400 patients with type 2 diabetes who referred to comprehensive health centers in Gorgan city in 2023. The data was collected by stratified sampling method according to the volume and in each stratum of the convenience type. Moriski medication adherence questionnaires (MMAS-8) and short version health literacy questionnaire (HELIA-SH) were used. Data were analyzed in SPSS software using independent t-test, chi-square, analysis of variance and Pearson correlation.

    Results

    The average score of medication adherence and the total score of health literacy were 4.06 ± 1.46 and 36.47 ± 3.53, respectively. Among the participants in the study, only 8.20% of patients had high compliance and 16.80% had moderate compliance, and the rest (75%) had poor drug compliance. Patients' medication adherence had a direct and significant relationship with basic health literacy skills (P=0.004, r=0.14) and decision-making skills (P=0.003, r=0.15).

    Conclusion

    The findings of this study showed that the majority of patients had poor medication adherence and the level of health literacy was related to the dimensions of medication regimen adherence in patients with type 2 diabetes.

    Keywords: Medication Adherence, Treatment Adherence, Health Literacy, Diabetes
  • Min Sook Bae, Hyunjong Song
    Background

    A local clinic-based chronic disease management intervention including care planning, education about disease management, monitoring, and evaluation of the achievement of objects was introduced in Korea in 2019. We evaluated the effect of the intervention on medication adherence in patients with hypertension and diabetes.

    Methods

    In 2019, a one-year retrospective case-control group study design was performed using data from the National Health Insurance Service in Korea. Propensity score matching was used to control for selection bias. Medication adherence, calculated by medication possession rate, was the dependent variable. We conducted multivariate logistic regression analyses to examine the association between participation in the intervention and medication adherence, adjusting for covariates. A control group was set as a reference for participation in the full/partial component intervention.

    Results

    The proportions of participants in the full component intervention in the experimental group were 43.2% and 42.6% for patients with hypertension or diabetes, respectively. Both these groups tended to be more medication adherent than their counterparts (hypertension OR: 1.23, 95% CI 1.03-1.45, diabetes OR: 1.64, 95% CI: 1.24-2.17).

    Conclusion

    Institutionalizing a comprehensive chronic disease management program using multidisciplinary teams in the primary care context is crucial. Also, it is necessary to refine reimbursement payment systems.

    Keywords: Primary care, Hypertension, Diabetes mellitus, Medication adherence, Patient education
  • Fatemeh Kazemi, Fahimeh Omidi, Zahra Shahmoradi, Farideh Ranjbaran, Amin Tajerian *
    Background

    Treatment adherence, the key to therapy success and patients’ quality of life, can be influenced by many factors in psychiatric patients, including self-stigma, alongside insight, illness duration, social support, health beliefs, personality, substance abuse, side effects, and life circumstances.

    Objectives

    This study aims to identify factors, particularly self-stigma, affecting treatment adherence in stable psychiatric outpatients.

    Methods

    A sample of 200 adult mental health patients in Arak, Iran, diagnosed with schizophrenia, bipolar disorder, major depressive disorder, or anxiety disorders, participated in this study. Self-stigma was assessed using the Internalized Stigma of Mental Illness (ISMI) scale, and treatment adherence was measured using the Drug Attitude Inventory (DAI-10). Data were analyzed using descriptive statistics, correlation, regression, and chi-square tests.

    Results

    Among the 200 participants (73 men and 127 women, with an average age of 35.1 years), the average stigma score was 62.8. The mean DAI-10 score was 4.8, with 172 showing positive medication attitudes. Younger, smoking, and alcohol-consuming patients showed lower treatment adherence. Higher self-stigma correlated with lower adherence, but there were no significant associations with gender, marital status, diagnosis, or diagnosis duration.

    Conclusions

    This study highlights the importance of addressing self-stigma as a barrier to treatment adherence in individuals with mental illnesses. Strategies to reduce self-stigma may improve treatment outcomes, especially among younger patients and those with substance use disorders. Further research is warranted to develop effective interventions for enhancing medication adherence in stable psychiatric outpatients.

    Keywords: Bipolar Disorder, Mental Disorders, Medication adherence, Outpatients, Schizophrenia
  • Mohammed Malih Radhi*, Kefah Zair Balat
    Objectives

    This study aimed to investigate the predictive relationship between medication adherence in light of health literacy and social support, in addition to differences in medication adherence according to different demographic characteristics.

    Methods

    In this cross-sectional descriptive study, 450 hypertensive patients visiting primary care facilities in Babil Governorate were included. A questionnaire including sociodemographic information, the Morisk medication adherence scale, the social support rating scale, and the health literacy management scale were used in this study. Data were collected and SPSS software, version 20 was used for analysis after ensuring the validity and reliability of the study tools.

    Results

    The findings showed that social support (74.9%) and treatment adherence (75.6%) were at a low level, whereas health literacy (67.8%) was at a high level. Health literacy (β=-0.708; P=0.001) and social support (β=0.220; P=0.001) were predictive factors for medication adherence. Based on gender, marital status, educational attainment, monthly income, and the length of hypertension, the results showed statistically significant differences in the level of medication adherence (P=0.001).

    Discussion

    Enhancing medication adherence in hypertensive patients is essential. The level of health literacy and social support directly and indirectly affect treatment adherence. Therefore, these aspects should be considered as effective interventions to improve medication adherence in this group of individuals suffering from chronic diseases.

    Keywords: Health Literacy, Medication Adherence, Hypertension, Social Support
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