Factors and issues on treatment adherence among Filipino patients with epilepsy and their caregivers

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Non-adherence to treatment in epilepsy is considered as a worldwide problem ranging from 30-50% of patients. Despite its striking magnitude, only a few studies tried to explain the factors affecting it. Moreover, a standard method to measure adherence to treatment among patients is still lacking. An in-depth analysis on adherence to treatment of patients with epilepsy, taking into factor their values, beliefs, and culture, is deemed necessary.</p><p style="text-align: justify;"><strong>OBJECTIVES:</strong> The purpose of this qualitative study is to investigate the contributory factors and issues on treatment adherence faced by Filipino patients with epilepsy and their caregivers. This study also aimed to serve as a catalyst to further stimulate local researches on treatment adherence in epilepsy.</p><p style="text-align: justify;"><strong>METHODS:?</strong>Four focus group discussions were conducted with patients and caregivers who voluntarily agreed to participate and share their experiences on dealing with epilepsy. A total of 39 participants were included. The focus group discussions, facilitated by skilled moderators, were composed of an ice breaker and a discussion on the experiences and issues faced by the participants. The discussions were transcribed and analyzed using thematic coding.</p><p style="text-align: justify;"><strong>RESULTS:</strong> Three main content categories were identified from the focus group discussions, namely, 1) accepting a life with epilepsy, 2) dealing with the disease, and 3) ensuring freedom from seizure attacks, which were further sub-categorized. From these, a number of factors affecting treatment adherence were identified and a conceptual framework was developed by the investigators.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> This study was able to demonstrate that conducting a focus group discussion was an effective means of eliciting the experiences and issues in patients and their caregivers. Several factors affecting treatment adherence such as patient-doctor relationship, financial resources, government support, adverse medication effects, religious belief, trigger avoidance, frequent reminders, and safety precautions were elucidated in this study.</p>

The efficacy and safety of coenzyme Q10 in preventing the progression of early Parkinson's disease: A meta-analysis

INTRODUCTION: Coenzyme Q10, also known as Ubiquinone, is a substance now being used as a dietary supplement in many countries including the Philippines. It has also been the focus of several researches as treatment for several diseases including Parkinson's Disease. Several studies have shown that Coenzyme Q10 inhibits mitochondrial dysfunction in Parkinson's Disease, hence delaying its progression.OBJECTIVES: The objective of this study is to assess and summarize the available evidence on the efficacy and safety of Coenzyme Q10 administration in the prevention of the progression of early Parkinson's Disease.METHODS: This is meta-analysis of randomized controlled trials on the use of Coenzyme Q10 in Parkinson's Disease. A literature search in several databases was conducted for relevant studies. Three randomized controlled trials met the inclusion criteria. The efficacy of Coenzyme Q10 were measured using the total and the component scores of the Unified Parkinson Disease Rating Scale on follow-up. On the other hand, safety were measured using the withdrawal rate and the associated adverse reactions during the therapy of CoQ10. The Review Manager Software was utilized for the meta-analysis.RESULTS: Compared to Placebo, treatment of CoQ10 did not show any significant difference in the mean scores of the UPDRS mental and ADL scores. Interestingly, the UPDRS motor score showed a significant difference between Coenzyme Q10 and placebo, but no significant difference when a subgroup analysis between high-dose (-4.03 [-15.07-7.01], p-value 0.47, I2 67%, P for heterogeneity 0.08) and low-dose Coenzyme Q10 (0.53 [-0.89-1.94], p-value 0.47, I2 34%, P for heterogeneity 0.22) was done. Overall, there was no significant difference in the total UPDRS score (0.68 [-0.61-1.97], p-value 0.30, I2 0%, P for heterogeneity 0.70). The anxiety, back pain, headache, sore throat, nausea, dizziness and constipation.CONCLUSION: Contrary to some animal and human studies, this meta-analysis showed that the use of CoQ10 results to non-significant improvement in all components of the UPDRS scores as opposed to placebo. However, the use of CoQ10 is tolerated and seems to be safe but further studies are needed to validate this finding.

Dietary diversity score as an indicator of nutritional adequacy of diets among 16-19 year-old adolescents

Objective. This study was conducted to determine the dietary diversity score and its relation to nutritional adequacy among 16-19 year-old adolescents. Methods. Secondary data analyses were undertaken with a representative sample of 16-19 year-old adolescents (n=521) in a university campus in Manila in 2008. Dietary diversity scores (DDS) were calculated. Nutrient adequacy ratio (NAR) is the ratio of subject's nutrient intake to the 2002 Recommended Energy and Nutrient Intakes (RENI) for Filipinos. The mean adequacy ratio (MAR) was calculated as the sum of NARs for all evaluated nutrients divided by the number of nutrients evaluated, expressed as a ratio (range from 0-1). MAR was used as a measure of adequacy of overall diet. Pearson correlation coefficients between DDS and MAR were calculated and also evaluated for sensitivity and specificity, with MAR taken as the ideal standard of adequate intake. Results. The adolescents had a mean DDS of 3.94 (1.21) and a mean MAR of 0.67 (0.18). There was a strong correlation between MAR and DDS (r=0.543; P < 0.0001). A DDS of 4 was shown to be the best indicators for both MAR equivalent to 0.5 and 0.7 since they provided the best sensitivity and specificity. Conclusion. DDS can be used as a simple and quick indicator of the nutritional adequacy of the diets among these group of adolescents. Further investigation of this tool is needed for other population groups i.e., adults and elderly.

Dietary diversity score as an indicator of nutritional adequacy of diets among 16-19 year-old adolescents

OBJECTIVES: This study was conducted to determine the dietary diversity score and its relation to nutritional adequacy among 16-19 year-old adolescents. METHODS: Secondary data analyses were undertaken with a representative sample of 16-19 year-old adolescents (n=521) in a university campus in Manila in 2008. Dietary diversity scores (DDS) were calculated. Nutrient adequacy ratio (NAR) is the ratio of subject's nutrient intake to the 2002 Recommended Energy and Nutrient Intakes (RENI) for Filipinos. The mean adequacy ratio (MAR) was calculated as the sum of NARs for all evaluated nutrients divided by the number of nutrients evaluated, expressed as a ratio (range from 0-1). MAR was used as a measure of adequacy of overall diet. Pearson correlation coefficients between DDS and MAR were calculated and also evaluated for sensitivity and specificity, with MAR taken as the ideal standard of adequate intake. RESULTS: The adolescents had a mean DDS of 3.94 (1.21) and a mean MAR of 0.67 (0.18). There was a strong correlation between MAR and DDS (r=0.543; P CONCLUSION: DDS can be used as a simple and quick indicator of the nutritional adequacy of the diets among these group of adolescents. Further investigation of this tool is needed for other population groups i.e., adults and elderly.