Insights into the factors that might have a negative influence on adherence are important for several reasons. Second, we used modified vote counting; however, we are aware that this type of methodology has strong limitations. Handbook of research synthesis and meta-analysis. We considered every physical chronic illness. The CCA can assume a value between 0 and 100%. Health Policy. Furthermore, the studies should analyse intentional and non-intentional adherence distinctly. The mentioned risk factors were proven to worsen hypertension and can cause complications to the cardiovascular, digestive, and urinary systems. An example of data being processed may be a unique identifier stored in a cookie. Risk of bias in the systematic reviews. A collaborative relationship, agreement on treatment tasks, and stability of the alliance are necessary elements of better treatment adherence. Third, it can support the development of individually tailored adherence-enhancing interventions. In primary studies, we considered in particular adjustment for confounding, missing data and adherence measurements, Imprecision (statistical certainty, amount of information on a certain factor [number of primary studies and SRs, effect size)]), Inconsistency (within and between SRs, e.g., due to different adherence measures). Systematic reviews of the effectiveness of quality improvement strategies and programmes. Multiple factors were identified to cause a treatment failure such as side effects of the medications, rejection of the diagnosis by patients, lack of patient understanding about their medication, noncompliance, and the cost of medication. Anna began writing extra materials to help her BSN and LVN students with their studies and writing nursing care plans. PLoS One. orland park sting soccer. > knowledge deficit related to medication compliance. Keywords: The patients diet should be high-protein, low-fat, and not hot, spicy, and gas-forming. Cookies policy. and transmitted securely. 2013;30(10):80919. Health education programs can reduce the costs associated with non-adherence. Jaam M, Ibrahim MIM, Kheir N, Awaisu A. 200, 51109, Cologne, Germany, Institute for Health Economics and Clinical Epidemiology of the University of Cologne, Gleueler Str. Diabetes Res Clin Pract. Cancer Epidemiol. 8. Tim Mathes. Risk of bias of the included SRs and their included primary studies. ROBIS: a new tool to assess risk of bias in systematic reviews was developed. Sinnott et al. Bazargan M, Smith J, Yazdanshenas H, Movassaghi M, Martins D, Orum G. BMC Geriatr. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Therefore, strict and motivated follow-up appointments followed by faithful adherence to medications are helpful in reducing the impact and complication of hypertension. Medication compliance and persistence: terminology and definitions. Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). 2009;13(2):11523. Create a quiet learning environment.Teaching should not be attempted in certain situations. The cognitive domain consists of intellectual activities and problem-solving skills, while the affective domain consists of feelings, attitudes, and beliefs. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. Medication adherence influencing factorsan (updated) overview of systematic reviews, \( \mathrm{CCA}=\frac{\left(N-r\right)}{\left(r\times c-r\right)} \), https://doi.org/10.1186/s13643-019-1014-8, http://apps.who.int/iris/bitstream/handle/10665/42682/9241545992.pdf;jsessionid=5533CE0804BE2E0722B919623C4C2E05?sequence=1.Assessed, https://www.bristol.ac.uk/media-library/sites/social-community-medicine/robis/robisguidancedocument.pdf.Assessed, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. Marital status was investigated in the SRs on Parkinson disease, inflammatory arthritis, chronic diseases, HIV, patients taking oral anticancer agents and cardiovascular conditions. Sinnott S-J, Buckley C, O'Riordan D, Bradley C, Whelton H. The effect of copayments for prescriptions on adherence to prescription medicines in publicly insured populations; a systematic review and meta-analysis. J Clin Epidemiol. In cardiovascular conditions, there was some evidence that patients not paying any co-payments are more adherent than those patients paying (any) co-payments [25, 26]. 3. Low health literacy: Implications for managing cardiac patients in practice. The psychomotor domain, on the other hand, consists of physical skills and procedures. If needed, encourage the patient to take supplements and/or replacement therapy with folic acid or iron. We did not extract any data from the discussion/interpretation; therefore, we did not consider these signalling questions in the overall judgement. 11. To heal properly, it is important to have the patient cooperate with any responsible clinical personnel in managing fracture. This education promotes competent self-care and gradual independence from the clinicians care. knowledge deficit related to medication compliance. The following conditions and medications were considered: chronic non-malignant pain [35], cardiovascular diseases (e.g., coronary artery disease, hypertension, diabetes mellitus) [21,22,23,24,25,26, 29, 30, 33, 37], Parkinson disease [36], hepatitis C [27], oral anticancer agents [28, 39], inflammatory arthritis [38], HIV/AIDS [31, 32, 34] and chronic diseases [20]. ROBIS: tool to assess risk of bias in systematic reviews: guidance on how ro use ROBIS; 2016. Buy on Amazon, Silvestri, L. A. Provide positive reinforcement.When a patient displays adequate learning such as recalling the action of a medication or demonstrating how to use a device, the nurse should provide positive reinforcement and praise. This overview includes 21 SRs on 313 individual primary studies in a broad spectrum of chronic conditions. The explanation for the inconsistent results of the linear analyses might also be attributed to the fact that the association is indeed non-linear. Overall, positive as well as negative effect directions were reported in all included SRs, and the evidence was therefore judged to be uncertain. Syst Rev 8, 112 (2019). If you would like to change your settings or withdraw consent at any time, the link to do so is in our privacy policy accessible from our home page.. The evidence for an impact was mostly judged as uncertain for this factor. A knowledge deficit in HF patients was also found in the study of De Geest et al., 28 in which 82% reported a knowledge deficit on HF symptoms and 42% on diet prescriptions. official website and that any information you provide is encrypted Deane KHO'L. Assessment. Repetition and reinforcement is a strategy that solidifies information. 3. Buy on Amazon. 2013;43(1):1828. There was no published protocol for this overview. Have the patient learn by assessing current knowledge on the diagnosis, disease process, possible aggravating factors, and necessary treatment. We anticipated that these parameters would lead to a higher sensitivity compared with the search for the previous overview version. Provided by the Springer Nature SharedIt content-sharing initiative. Medication costs were analysed in patients with inflammatory arthritis and patients taking oral anticancer agents. In addition, the impact of social support was uncertain in all SRs [23, 28, 30, 37, 38]. Surgery induces inflammation and prompts for extensive healing, so having a diet full of components promoting healing can speed up the recovery. 2007;14(4):40816. In two conditions (cardiovascular conditions and Parkinson disease), some evidence of an impact was found, and the impact of the other four conditions/medications was uncertain [20, 23, 24, 28, 35,36,37,38,39]. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. 2013;126(4):357.e7357.e27. Bookshelf NurseTogether.com does not provide medical advice, diagnosis, or treatment. Mathes T, Pieper D, Antoine S-L, Eikermann M. Adherence influencing factors in patients taking oral anticancer agents: a systematic review. She has worked in Medical-Surgical, Telemetry, ICU and the ER. Cite this article. A knowledge deficit is a nursing diagnosis that happens when a patient doesn't have the information or the ability to understand the information necessary to continue their health care plan. Some evidence for higher adherence in women was noted exclusively in cardiovascular conditions [21, 23, 33, 37]. 2014;67(10):107682. Pieper D, Buechter R, Jerinic P, Eikermann M. Overviews of reviews often have limited rigor: a systematic review. Some evidence for a negative impact of co-payments on adherence in inflammatory arthritis, chronic diseases and cardiovascular conditions exists [20, 22, 23, 25, 26, 38]. Although the majority of literature on adherence-influencing factors is overwhelming, we could only judge the influence for many factors as uncertain. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Int J Cardiol. For the analysis of the influence of ethnic status on adherence, we considered different comparisons because the grouping in primary studies differed widely. Negative effect directions were reported for most conditions, while the results were inconsistent in hepatitis C and cardiovascular conditions [20, 21, 27, 30, 36, 37]. J Clin Epidemiol. Duration of disease was the only disease-related factor considered in this overview. Grimshaw J. 2016;10:83750. Among patients with chronic diseases and patients taking oral anticancer agents, there was some evidence that a better financial status has a positive influence on adherence [20, 39]. The authors declare that they have no financial competing interests. We defined a factor as any exposure that is not controlled by the study investigator, Outcome: Implementation adherence (correct dose, timing and/or frequency of intake) [2], Study type: SRs (definition: systematic literature search in at least one electronic database and assessment and documentation of risk of bias of included studies) of quantitative studies. Hansen RA, Kim MM, Song L, Tu W, et al. This provides baseline knowledge from which the patient can use for making informed choices. It was uncertain whether health insurance status (insured vs. uninsured) influences adherence in patients with chronic or cardiovascular conditions [23, 25]. TM was an author of two of the included SRs. Unhealthy lifestyle choices. In addition, the evidence suggests that the influence of age on medication adherence has a concave pattern, i.e., lower adherence in young age groups, increasing adherence with a peak in middle to older age groups and lower adherence in very old age groups. Institute for Research in Operative Medicine (Witten/Herdecke University), Ostmerheimer Str. Krueger K, Botermann L, Schorr SG, Griese-Mammen N, Laufs U, Schulz M. Age-related medication adherence in patients with chronic heart failure: a systematic literature review. In addition to knowledge, beliefs about the HF regimen were also related to compliance. Assess health literacy. This provides baseline knowledge from which the patient can use for making informed choices. We thank Stefanie Bhn for her support in the risk of bias assessment. Third, we only analysed therapy-unrelated factors. Manage Settings PubMed Iron supplements are given orally with meals, while the folic acid is taken orally as well with water. All data were extracted using standardized extraction forms piloted beforehand. 1998;24(1):359. Any differences between the reviewers were discussed until consensus. JBI Database System Rev Implement Rep. 2012;10(56):3596648. CAS We also found robust evidence that co-payments reduce adherence. Poor health literacy means a patient may lack an understanding of their disease, medications, and when to seek care. Have the patient and/or the caregiver monitor any sign/symptom requiring medical attention. The impact of financial status was uncertain in Parkinson disease, hepatitis C and cardiovascular conditions [21, 23, 27, 36, 37]. 2008;11(1):447. The 2023 edition of ICD-10-CM Z91.14 became effective on October 1, 2022. Ethanol, nicotine, and caffeine promotes acid production, relaxes lower esophageal sphincter, and offers more irritation to the lower esophageal mucosa so these are best to be avoided. This optional phase was skipped in this overview because the relevance was already completely covered by the eligibility criteria. presence and possible underlying causes of medication non-adherence. The main cause for downgrading due to imprecision was insufficient reporting, which prevented us from adequately assessing the results. A. Sensory-perceptual alteration related to withdrawal into self. 38 In the present study, knowledge, attitudes, and barriers related to medication adherence in older patients with CHD were investigated. Some evidence for a negative impact of mental comorbidity on medication adherence was exclusively noted in hepatitis C and cardiovascular conditions [21, 27, 30, 37]. Food and nutrition related knowledge deficit concerning appropriate amount of carbohydrate intake Food and nutrition compliance limitations, e.g., lack of willingness or failure to modify carbohydrate intake in response to recommendations from a dietitian or physician. If a patient is in pain, worried, upset, or tired then they are not in a state of mind to retain information. Moreover, the results for many factors were inconsistent. California Privacy Statement, Psychological causes such as depression and disordered eating. Discuss the significance of consistent clinical or therapy follow-up appointments to the patient. Mathes T, Antoine S-L, Pieper D. Factors influencing adherence in hepatitis-C infected patients: a systematic review. Learn how your comment data is processed. For co-payments (any co-payment and higher co-payments), the effect direction was almost always negative. The majority of healthcare noncompliance challenges include the safety of patients, patient data privacy, and billing procedures. 2014;14:203. Adherence to evidence-based secondary prevention pharmacotherapy in patients after an acute coronary syndrome: a systematic review. Such reasons may include cognitive impairment, fear of actually experiencing medication side effects, failure to understand instructions regarding plan (e.g., difficulty understanding a low-sodium diet), impaired manual dexterity (e.g., not taking pills because unable to open container), sensory deficit (e.g., unable to read written This is particularly true for the influencing factors education, employment, different medications, duration of disease and gender. In . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking. To ensure an objective assessment, the risk of bias assessment of these SRs was performed by a reviewer other than TM. 4. knowledge deficit related to medication compliance . Gender and racial disparities in adherence to statin therapy: a meta-analysis. The process of study selection is illustrated in the PRISMA flowchart [41] (Fig. Review the patients surgery along with the performance of the procedure and the future expectations. 2013;39(6):61021. systematic review on factors associated with medication non-adherence in Parkinsons disease. Non-adherence is a multifactorial problem. The evidence synthesis of the analysed factors (according to the different diseases/therapies) is presented in Table3. As an Amazon Associate I earn from qualifying purchases. volume8, Articlenumber:112 (2019) Review the pathology, prognosis, and future expectations of the patient. Pieper D, Antoine S-L, Mathes T, Neugebauer EAM, Eikermann M. Systematic review finds overlapping reviews were not mentioned in every other overview. Intra-abdominal pressure contributes to GERD, so eating less food decreases intra-abdominal pressure. Inform the patient about the risks of interaction with the crowd or those with infections, as well as the importance of a clean environment. High-fat food increases the time for the food to stay in the stomach, as well as hot, spicy, and gas-forming foods which are irritants to the esophagus so it is best to avoid such foods. More distinct (no linear) age groups were compared in the SRs on adherence in inflammatory arthritis, chronic diseases, HIV-infected patients, patients taking oral anticancer agents and cardiovascular conditions [20, 21, 23, 28, 31, 32, 37,38,39]. TM was also an author of two of the included SRs. Value Health. 9. 2018;23(3):20015. We selected SRs according to the following predefined inclusion criteria: Patients: Adult patients (16years) with physical chronic diseases. None of the therapy-related (but not therapy-specific) factors showed evidence for a strong impact on adherence. Brown MT, Bussell JK. The impact of employment was mostly uncertain. New York: Russell Sage Foundation; 2009. p. 20720. Proper bone healing takes a month, or even a year, if managed properly with appointments with physical therapists or physicians depending on the situation. Moreover, the knowledge of influencing factors of adherence can support the development of tailored health technologies to increase adherence by treating the underlying barriers (e.g., depression treatment, reducing co-payments). For clinical practice, this information can help identify and select patients who require support for being adherent. select all that apply: A. isolation B. daily activities C. consistency D. medications E. adequate rest D, E It is important to note that Deficient Knowledge Nursing Diagnosis and Knowledge Deficit Nursing Diagnosis have the same meaning. These factors can be divided into five different dimensions: social and economic factors, therapy-related factors, disease-related factors, patient-related factors and health care system-related factors [10, 11]. Saunders comprehensive review for the NCLEX-RN examination. Saini S, Schoenfeld P, Kaulback K, Dubinsky M. Effect of medication dosing frequency on adherence in chronic diseases. Health Policy Institute. The moderate to high risk of bias in the included SRs and the exclusion of 78 reviews due to missing quality assessment of included primary studies indicate that there is a need for more methodically sound research to provide stronger conclusions. First, we limited our literature search to English and German languages because there were no other language skills in our research team and no resources for translating articles. First, this information can support the identification of patients at high risk for non-adherence. A condition-related explanation for heterogeneity might be that many SRs seem to include symptomatic as well as asymptomatic patients. A knowledge deficit in relation to healthcare is a lack of information needed for a thorough understanding of a disease process and recommended treatments and the ability to make informed choices or carry out tasks in alignment with health maintenance.
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