Medication Adherence, Barriers to Adherence and Treatment Satisfaction with Antiretroviral Therapy Among Adolescents Living with HIV in Lagos, Nigeria

The advent of antiretroviral therapy (ART) in controlling Human Immunodeficiency Virus (HIV) disease has been quite effective in ensuring that infected people can enjoy healthy, long, and productive lives. Medication adherence is an essential part of patient care, especially among patients with HIV, as it greatly determines the effectiveness of treatment. Few studies have explored factors influencing medication adherence and treatment satisfaction among adults, with little focus on adolescents. Objectives: To assess medication adherence, treatment satisfaction and factors influencing adherence to ART medication among adolescents living with HIV in Lagos, Nigeria. Methods: This descriptive, cross-sectional study was conducted among diagnosed and registered adolescents aged 10-19 years living with HIV and receiving treatment at eight selected antiretroviral centres in Lagos state, Nigeria. A total of 203 adolescents were recruited in stages, and data were collected using an interviewer-administered semi-structured questionnaire. Results: There was a low level of adherence as only 59/203 (29.1%) of the respondents adhered to ART. Depression, perceived stigma, being away from home, side effects of drugs, pill burden, and forgetfulness were some factors identified as barriers to adherence. The respondents were most satisfied with the effectiveness of the medication and least satisfied with the side effects. Conclusions: Medication adherence among adolescents was relatively low; the level of satisfaction with ART medication is an entity that significantly impacts adherence

Head and Neck Cancer Survivors’ Perceptions of Cancer Treatment and Posttraumatic Growth

@#Introduction: Cancer patients’ perception on the treatment they received is vital to determine their adherence to cancer treatment, but important data on how this variable affects posttraumatic growth (PTG) experience by cancer patients is lacking. This cross-sectional study aimed to evaluate the degree of PTG among a cohort of head and neck cancer (HNC) survivors who were within first year of diagnosis and determined the association between perception of cancer treatment received (expectation and satisfaction with cancer treatment received and the feeling about the adverse effects) and PTG controlling for socio-demographic and clinical characteristics. Methods: HNC survivors were recruited from two oncology referral centres, and they were administered socio-demographic and clinical characteristics questionnaire, the Malay version of the Cancer Therapy Satisfaction Questionnaire (CTSQ) (to assess the satisfaction, expectation and feeling about the adverse effects of cancer treatment received) and the Malay version of the Posttraumatic Growth Inventory-Short Form (PTGi-SF) (to measure the degree of PTG). Results: A total of 200 HNC survivors participated in the study. The mean total PTGI-SF score was 39.5 (standard deviation [SD] = 9.3). Greater degree of positive expectation of cancer treatment and satisfaction with cancer treatment received significantly contributed to higher level of PTG, whereas feeling about side effects of treatment was not associated with PTG, after controlling for socio-demographic and clinical characteristics. Conclusion: Incorporating psychosocial interventions (such as education on cancer treatment and counselling) into the treatment regimen may facilitate development of PTG and hence, safeguard the mental well-being of HNC patients.

Hypoglycemia frequency and treatment satisfaction in patients receiving insulin analogues for treatment of type 1 diabetes mellitus

ABSTRACT Objective: The aim of this study was to evaluate the frequency of hypoglycemia and the treatment satisfaction in patients with type 1 diabetes (T1D) using insulin analogues. Subjects and methods: This observational retrospective study included 516 adult patients with T1D from 38 cities in Southern Brazil. Demographics and clinical data were collected using a self-report questionnaire. Hypoglycemia was defined as an event based on either symptoms or self-monitored blood glucose < 70 mg/dL. Treatment satisfaction was evaluated using the Diabetes Treatment Satisfaction Questionnaire status version (DTSQs) and with a specific question with scores ranging from 0-10. Common mental disorders were assessed using the General Health Questionnaire (GHQ-12). Results: Overall, the mean age was 38 ± 14 years and 52% of the participants were women. The median diabetes duration was 18 years. The scores for insulin analogue treatment satisfaction were higher than those for previous treatments. DTSQ scores had a median value of 32 (interquartile range 29-35) and remained unchanged over time. The percentage of patients with hypoglycemia (including severe and nocturnal) was comparable across groups divided according to duration of use of insulin analogues. Most patients (n=395, 77%) screened positive for common mental disorders. Conclusions: Patient satisfaction with insulin analogue treatment was high and remained unchanged with time. Episodes of hypoglycemia also remained unchanged over time among patients using insulin analogues.

Absorbable suture anchors for treating femoroacetabular impingement syndrome combined with acetabular labral tears / 中国组织工程研究

BACKGROUND: Metal anchors are not easily accepted by patients as permanent foreign bodies, so bioabsorbable anchors have been gradually applied in orthopedics in recent years. OBJECTIVE: To evaluate the effectiveness of absorbable suture anchors for repairing femoroacetabular impingement syndrome combined with acetabular labral tears. METHODS: Eighty patients with femoroacetabular impingement syndrome combined with acetabular labral tears admitted in Beijing Shijitan Hospital Affiliated to Capital Medical University from February 2014 to February 2016 were selected, and all were treated by absorbable suture anchors under arthroscopy. The Harris hip score, and the Visual Analogue Scale score at baseline, postoperative 1 and 3 months were recorded and compared to assess the effectiveness. The complications and material-host reaction were recorded. The treatment satisfaction was evaluated. The study was approved by the Ethical Committee of Beijing Shijitan Hospital and all patients and their families signed the informed consents. RESULTS AND CONCLUSION: (1) The Harris hip scores at 1 and 3 years postoperatively in 80 patients with femoroacetabular impingement syndrome combined with acetabular labral tears were significantly higher than those at baseline, and the Visual Analogue Scale scores were significantly lower than those at baseline (P 0. 05). (3) None appeared with anchor drop off, cartilage injury or material-host reaction. In summary, the method of absorbable suture anchors under arthroscopy has the advantages of minimal invasion, reliable fixation, simple operation, no metal implants, and significant clinical effect to treat femoroacetabular impingement syndrome combined with acetabular labral tears.

Treatment satisfaction among diabetics attending a tertiary care hospital of Rohtak, Haryana: a cross-sectional study

Background: The epidemic of diabetes mellitus is rising globally due to urbanization, population growth, aging, obesity and sedentary life style. Treatment satisfaction is defined as the individual’s rating of important attributes of the process and outcomes of his/her treatment experience and it represents an important outcome as it is related to adherence and willingness to continue treatment.Methods: A cross-sectional descriptive hospital-based study was conducted at endocrinology OPD attached to Pt. B.D. Sharma PGIMS Rohtak, Haryana from May 2014 to April 2015. Five hundred diabetics (type 1 and 2) were recruited for the study. Patients registered on the day of interview were selected using systematic random sampling. A predesigned, pretested, semi-structured schedule which included socio-demographic variables of the study subjects along with information about family history of diabetes was filled by interviewing the study subjects in their vernacular language individually. DiabMedSat was used to assess the treatment satisfaction.Results: Nearly two third of the study participants were treated on oral hypoglycaemic agents (76.2%) followed by subjects treated on insulin+OHA (21.4%). 2.4% of the study subjects were on treatment with insulin alone. 87.8% of female subjects were satisfied with their treatment as compared to 86.3% of their male counterparts.Conclusions: Treatment satisfaction has a positive influence on quality of life of the study subjects as those who are satisfied tend to better adhere to their drug regimen thereby achieving a desirable glycaemic control and averting the complications associated with the disease thereby leading to a healthier life.

Evaluation of the effect of various factors on patient compliance among patients visiting Govt Dental College and Hospital, Srinagar

Background: Patient compliance plays a decisive role in the outcome of periodontal therapy. Although a number of reports have studied patient compliance and its variables during supportive periodontal therapy, there is a paucity of literature on factors affecting compliance to active periodontal therapy. Moreover, as health beliefs largely stem out of social/religious/ethnic convictions, population specific compliance studies are highly relevant. It is foreseeable, that early identification of compliance-affecting variable will enable institution of a timely and personalized patient education/ motivation programme. Aim: To elucidate factors which affect patient compliance during active periodontal therapy in patients visiting Government dental college and hospital, Srinagar. Materials and methods: 150 patients were included in the study for performance of active periodontal therapy (scaling and root planing) over 3-5 visits every 5 days. They were subjected to pre-validated questionnaire to assess their sociodemographic factors, oral health awareness (OHA) and treatment satisfaction (TS). Results: Sociodemographic factors (education, emplyoyment and gender), OHA and most of all TS were found to influence patient compliance in the given population. Conclusion: Certain sociodemographic factors have a bearing on patient compliance and may be assessed as predictors of compliance to therapy. As treatment satisfaction has a profound effect on the patient‟s willingness to return for treatment, it should be an objective of the overall clinical practice. Roobal Behal, Suhail Majid Jan, Huda Hussain. Evaluation of the effect of various factors on patient compliance among patients visiting Govt. Dental College and Hospital, Srinagar. IAIM, 2018; 5(8): 55-63. Page 56 Pertinently, the crucial role of the periodontist in patient education and management should be realized and utilized to achieve predictable compliance.

Patients’ Expectations Of Orthodontic Treatment During Their Initial Visit: A Questionnaire Study

Aim: The aim of this study was to assess the patients’ expectations from orthodontic treatment in order to provide optimal treatment based on their expectations resulting in patient satisfaction. Materials and methods: A prevalidated questionnaire was used to measure the patients’ responses, which included questions about expectations of their initial visit, the type of orthodontic treatment expected, problems associated with treatment, duration and frequency of attendance, benefits and complications of treatment. Descriptive analyses were used to calculate the responses of the patients. Results: This study showed that improved dento-facial appearance and gain in confidence were the most common expectations among the patients’ in both the genders. Conclusions: Measuring patients’ expectations from orthodontic treatment before initiation of treatment by the orthodontists might lead to more satisfaction and less disappointment.

Kangle Decoction for erectile dysfunction with liver-qi stagnation and kidney deficiency / 中华男科学杂志

<p><b>Objective</b>To observe the clinical efficacy of Kangle Decoction in the treatment of erectile dysfunction (ED) with liver-qi stagnation and kidney deficiency.</p><p><b>METHODS</b>A total of 79 ED patients with liver-qi stagnation and kidney deficiency were randomly assigned to an experimental group (aged ［36.62±8.05］ yr and with a disease course of ［18.15±6.41］ mo) and a control group (aged ［37.44±8.10］ yr and with a disease course of ［17.51±6.79］ mo), the former treated orally with Kangle Decoction at 0.5 dose bid while the latter with Cialis at 10 mg qd alt, both for 8 weeks. Before treatment, after 4 and 8 weeks of medication, and at 4 weeks after drug withdrawal, we obtained the scores of the patients in the International Index of Erectile Function-5 (IIEF-5), Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), and Short-Form Psychological and Interpersonal Relationship Scales (SF-PAIRS), and compared the indexes between the two groups of patients.</p><p><b>RESULTS</b>The IIEF-5 score was dramatically increased in both the treatment and control groups after 4 weeks (13.40±2.42 and 16.00±2.68) and 8 weeks of medication (18.60±3.50 and 18.59±3.80) and at 4 weeks after drug withdrawal (17.00±3.05 and 13.95±2.61) as compared with the baseline (10.78±2.28 and 10.77±2.33) (P<0.05 ), even higher in the treatment than in the control group after drug withdrawal (P<0.05 ). The EDITS scores in the treatment and control groups were (28.88±3.31 and 28.90±3.31) after 4 weeks of intervention, (29.68±3.30 and 29.13±3.32) after 8 weeks of intervention, and (29.20±2.92 and 26.82±3.23) at 4 weeks after drug withdrawal, all significantly higher in the former than in the latter group after drug withdrawal (P<0.05 ). The sexual self-confidence score (SSCS), sexual spontaneity score (SSS), and sexual time-concern score (STCS) were all improved in the treatment and control groups after medication as compared with the baseline (P<0.05 ), even higher in the former than in the latter group after drug withdrawal (P<0.05 ).</p><p><b>CONCLUSIONS</b>Kangle Decoction has a definite efficacy in the treatment of ED with liver-qi stagnation and kidney deficiency, with few adverse reactions and long-term post-withdrawal effect, and therefore deserves a wide clinical application.</p>

The Well-Being and Treatment Satisfaction of Diabetic Patients in an Outpatient Setting at a General Hospital in Korea / 임상당뇨병

BACKGROUND: The aim of this study was to assess the psychological well-being and treatment satisfaction in patients with type 2 diabetes mellitus in a general hospital in Korea. METHODS: This study included 440 type 2 diabetes patients above 20 years of age. Well-Being Questionnaire-12 (WBQ-12) and Diabetes Treatment Satisfaction Questionnaire were used to survey well-being and treatment satisfaction, respectively. WBQ-12 consists of 4 categories: negative well-being (NWB), energy (ENE), positive well-being (PWB), and general well-being (GWB). RESULTS: There were significant associations between NWB scores and women, low education, low-income, and number of hospital admissions. Significant associations were also identified between ENE scores and men, higher education, insulin nonusers, high-income, compliance with recommended exercise, number of medications, satisfaction with treatment time, and poor glycemic control. PWB scores were significantly associated with high-income, satisfaction with waiting and treatment times, compliance with recommended diet and exercise, and number of medications. GWB scores were significantly associated with men, higher education, high-income, satisfaction with waiting and treatment times, compliance with recommended exercise, and number of medications. Treatment satisfaction was significantly associated with age, satisfaction with waiting and treatment times, compliance with recommended diet and exercise, and duration of diabetes. CONCLUSION: Diabetes care requires psychosocial support in addition to medical care. Unlike Western studies, our study found that satisfaction with waiting and treatment times had a strong correlation with well-being and treatment satisfaction in diabetes patients.

Patients' Satisfaction and Quality of Sex Life in Patients Undergoing Long-term Intracavernous Injections with Trimix / 대한남성과학회지

PURPOSE: Intracaverous injections (ICI) are the standard treatment for erectile dysfunction (ED) when oral phosphodiesterase 5 inhibitors (PDE5I) fail or are contraindicated. However, many patients are wary of ICI because of aversion to the injection. We assessed patients' satisfaction and the quality of the sex life in patients undergoing long-term ICI with trimix. MATERIALS AND METHODS: One hundred five patients with ED who had used ICI with trimix for at least 6 months were enrolled in the study. We investigated the Erectile Dysfunction Inventory of Treatment Satisfaction Questionnaire (EDITS), quality of sex life, and pain on injection and erection. The EDITS questions were scored on a 0 to 4-point scale and the mean scores were multiplied by 25 to normalize the scores to a 100-point scale and to create the EDITS index. A total score > 50 was defined as "satisfied with treatment" and a score of < 50 was defined as "not satisfied with treatment." RESULTS: The mean age of the patients was 70+/-8.2 years, the mean duration of ED was 6.4+/-3.3 years, and the mean duration of ICI treatment was 50.3+/-32.6 months. Of the 105 patients, 48.5% had received PDE5I treatment prior to ICI treatment. Among the 51 patients who had received PDE5I, 72.5% (37/51) and 19.6% (10/51) discontinued PDE5I due to inefficacy and side effects, respectively. Four patients used PDE5I in combination with ICI. The mean number of injections was 2.99+/-1.26 per month and the mean dose of trimix was 0.33+/-0.14 ml per injection. The mean EDITS index was 73.7+/-14.5, and 93% of the patients were classified in the satisfaction group according to the EDITS index criteria. Patients noted an improvement in their sex life (78.1%), their relationship with their partner (68.6%), and their quality of life (65.7%) after using ICI with trimix; 92.3% of patients responded that they were ready to recommend ICI with trimix to their friends. The mean scores for pain on injection and erection were 1.04/10 and 0.98/10, respectively. CONCLUSIONS: In spite of long-term treatment, ICI with trimix met the expectations of patients. ICI with trimix is revealed as easy, effective, and tolerable treatment. ICI with trimix should be positively recommended when PDE5I fails or is contraindicated.

Characteristics of MMPI Finding in Low Back Pain Patients / 신경정신의학

OBJECTIVE: The goal of this study was to examine whether MMPI scores could discriminate between normal group and exaggerated pain group and predict treatment prognosis in exaggerated pain group. METHODS: For psychological evaluation, MMPI was administered to 37 low back pain patients and 36 normal controls. MMPI findings in two groups were compared, using t-test and discriminant function analysis. Nineteen patients of exaggerated low back pain group contacted by telephone were questioned about treatment satisfaction degree. And satisfaction group(9 patients)nd dissatisfaction group(6 patients)s MMPI findings were compared. RESULT: Hy, Hs, D scale scores in exaggerated pain group were higher than in control group. In discriminant function analysis by Hs, Hy, and D, percent of correctly classified 'gouped' cases was 74%. Discriminant function of Hy scale was the highest and that of D scale was the lowest. In satisfaction degree study, no finding was significant. CONCLUSION: MMPI findings were effective in discriminating between exaggerated pain group and normal control group. Further researches will need more structured and comprehensive approach.