Effect of an Internet-based Intervention on Motor Behavior in Patients after Percutaneous Coronary Intervention

Background During the containment of COVID-19，the traditional face-to-face interventions conducted at the rehabilitation center were plagued by many limitations，while internet-based interventions can overcome the limitations of geographic location，working hours and transportation，with less medical costs. Objective To examine the effects of internet-based interventions on knowledge，attitude/belief and practice（KAP） toward rehabilitation exercises，physical activity（PA）level，and exercise compliance inpatients after PCI. Methods The subjects were 76 patients who received their first PCI in Department of Cardiology，Tangshan Gongren Hospital from November 2021 to June 2022. They were randomly and equally divided into two groups to receive either internet-based intervention with routine nursing（experimental group） or routine nursing （control group）. Before and three months after the intervention，the Rehabilitation Exercise Knowledge-Belief-Practice Scale for Patients with Coronary Heart Disease（REKBPCHD），the International Physical Activity Questionnaire-Short Form （IPAQ-SF），and Patients' Exercise Log were used to assess the KAP level，PA level，and exercise adherence，respectively. The impact of network intervention on exercise adherence in patients after PCI by univariate Logistic regression analysis. Results After 3 months of intervention，a significant increase was found in the average total score of REKBPCHD，and the average scores of the knowledge dimension，attitude dimension and practice dimension of the scale in the experimental group（P<0.05），and the increase was more notable than that in the control group（P<0.05）. Moreover，both post-intervention low PA level and total PA level in the experimental group were higher than those in the control group（P<0.05）. Both post-intervention low PA level and total PA level were higher than the baseline levels in the experimental group（P<0.05）. The post-intervention exercise compliance of experimental group were higher than that in the control group（P=0.003）. Univariate Logistic regression analysis showed that the risk of non-adherence to exercise in the experimental group was relatively lower than that in the control group 〔OR=0.143，95%CI（0.034，0.594），P=0.007〕. Conclusion Theinternet-based intervention can effectively improve the KAP level toward rehabilitation，PA level，and exercise adherence in patients after PCI. © 2023 Chinese General Practice. All rights reserved.

Self-reported Medication Adherence in Schizophrenia and Bipolar Disorder Patients during COVID-19 Pandemic in a COVID Care Hospital: A Cross-sectional Study

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic has made it difficult for patients with Schizophrenia and Bipolar Affective Disorder (BPAD) to receive ongoing care, which has led to non adherence to medication and undesirable health outcomes. Lower treatment adherence in severe mental illness might lead to symptom exacerbation and relapses and might cause a strain on the health system during COVID-19 pandemic. Aim: To assess the treatment adherence in Schizophrenia and BPAD patients during prevailing COVID-19 situation in India. Materials and Methods: This cross-sectional study was conducted among 92 patients with Schizophrenia and BPAD through a questionnaire between January to September 2021 in a COVID-19 care hospital Government Medical College Palakkad/District hospital Palakkad, Kerala, India. Demographic and clinical data, adherence to treatment, along with Brief Psychiatric Rating Scale (BPRS), Young Mania Rating Scale (YMRS), Hamilton Rating Scale for Depression (HAM-D). Clinical Global impression (CGI S&I), Work and Social Adjustment Scale (WSAS), Modified COVID Threat Scale (CTS) and Medication Adherence Rating Scale (MARS) were collected. The outcomes included adherence to medication, deterioration of the psychopathology, improvement in severity, social functioning. Descriptive statistics was used to define the sample characteristics and presented as mean and standard deviation and frequency and percentages. Spearman's Correlation coefficient was used to find the correlation between MARS and other variables: CTS, BPRS, YMRS, HAM-D, CGI and WSAS. Results: A total of 92 patients were interviewed which comprised of 43 patients with Schizophrenia and 49 patients with Bipolar disorder. As assessed by MARS rating scale 19 patients (20.65%) had a MARS score less than six suggesting poor adherence and 73 (79.35%) had MARS score 6 and greater suggesting better adherence to the treatment. This was supported by negative correlation with BPRS, YMRS, HAM-D and CGI-S and CGI-I scales which implies that the COVID-19 pandemic did not hinder the patients to take the medication. The mean MARS score was 7.31±2.11. A total of 37 (40.2%) patients had acute exacerbation of the illness during the COVID-19 related lockdown and 37 (40.2%) had exacerbation during the six months prior to COVID-19 lockdown. There was negative correlation between MARS scores and the CTS but was not statistically significant. Conclusion: Despite the COVID-19 pandemic related restriction, patients with Schizophrenia and BPAD were adherent to the medication and the number of relapses during COVID-19 pandemic was similar to the period before the pandemic. COVID-19 related anxiety didn't have an impact on medication adherence and relapse in this study. [ FROM AUTHOR] Copyright of Journal of Clinical & Diagnostic Research is the property of JCDR Research & Publications Private Limited and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Non-adherence and non-persistence to intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy: a systematic review and meta-analysis.

BACKGROUND: Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections play a key role in treating a range of macular diseases. The effectiveness of these therapies is dependent on patients' adherence (the extent to which a patient takes their medicines as per agreed recommendations from the healthcare provider) and persistence (continuation of the treatment for the prescribed duration) to their prescribed treatment regimens. The aim of this systematic review was to demonstrate the need for further investigation into the prevalence of, and factors contributing to, patient-led non-adherence and non-persistence, thus facilitating improved clinical outcomes. METHODS: Systematic searches were conducted in Google Scholar, Web of Science, PubMed, MEDLINE, and the Cochrane Library. Studies in English conducted before February 2023 that reported the level of, and/or barriers to, non-adherence or non-persistence to intravitreal anti-VEGF ocular disease therapy were included. Duplicate papers, literature reviews, expert opinion articles, case studies, and case series were excluded following screening by two independent authors. RESULTS: Data from a total of 409,215 patients across 52 studies were analysed. Treatment regimens included pro re nata, monthly and treat-and-extend protocols; study durations ranged from 4 months to 8 years. Of the 52 studies, 22 included a breakdown of reasons for patient non-adherence/non-persistence. Patient-led non-adherence varied between 17.5 and 35.0% depending on the definition used. Overall pooled prevalence of patient-led treatment non-persistence was 30.0% (P = 0.000). Reasons for non-adherence/non-persistence included dissatisfaction with treatment results (29.9%), financial burden (19%), older age/comorbidities (15.5%), difficulty booking appointments (8.5%), travel distance/social isolation (7.9%), lack of time (5.8%), satisfaction with the perceived improvement in their condition (4.4%), fear of injection (4.0%), loss of motivation (4.0%), apathy towards eyesight (2.5%), dissatisfaction with facilities 2.3%, and discomfort/pain (0.3%). Three studies found non-adherence rates between 51.6 and 68.8% during the COVID-19 pandemic, in part due to fear of exposure to COVID-19 and difficulties travelling during lockdown. DISCUSSION: Results suggest high levels of patient-led non-adherence/non-persistence to anti-VEGF therapy, mostly due to dissatisfaction with treatment results, a combination of comorbidities, loss of motivation and the burden of travel. This study provides key information on prevalence and factors contributing to non-adherence/non-persistence in anti-VEGF treatment for macular diseases, aiding identification of at-risk individuals to improve real-world visual outcomes. Improvements in the literature can be achieved by establishing uniform definitions and standard timescales for what constitutes non-adherence/non-persistence. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020216205.

Unexpected effects of COVID-19 outbreak: adaption of Anti-Retroviral Therapy (ART) delivery policies improved adherence in a population of People Living With HIV (PLWH).

Background: Adherence to Anti-Retroviral Therapy (ART) is crucial for People Living With HIV (PLWH). In Italy, ART is delivered by Hospital Pharmacies, on a renewable prescription from the hospital physician. The measurement of package-refill (the rate of ART packages actually collected out of those to be collected in order to comply with therapy) is an effective tool to evaluate the adherence.During COVID-19 outbreak, at "D. Cotugno" hospital in Naples, Italy, the ART delivery policies have been adapted, in order to reduce the number of patients' access. We analysed the impact of these changes on the pill-refill of ART in January-August 2020, compared with 2018-2019. Methods: "D. Cotugno" hospital is a mono-specialistic Infectious Diseases hospital, caring for about 2500 PLWH. Since February 2020, the hospital was almost entirely dedicated to COVID-19 patients. All out-patient activities were interrupted, except for those dedicated to HIV/AIDS patients.In this preliminary study we included all patients assigned to one of the three Medical Divisions dedicated to HIV, who were already under treatment since at least 2017. Rate of package-refill was obtained by the Hospital Pharmacy registry, demographic and clinical data were derived from clinical database.During COVID-19, many measures were adopted in order to increase safety of PLWH attending to hospital. Among these, medical prescription validity increased from 4 to 6 months, and number of packages to be collected increased from 2 to 4, adopting a multi-month dispensing strategy.Package-refill is adequate if at least 95% of ART have been actually collected; partial and inadequate if 75%-94% or less than 75% of ART, respectively, have been collected. Package-refill was measured during the first year of COVID-19 (March 2020 - February 2021), compared to the same period in the two years before. Results: A total of 594 PLWH were included. PLWH with optimal pill-refill significantly increased in 2020-21 compared to 2018-2020 (62% vs 55%, p 0.013). Discussion: Due to COVID-19, we would have expected a reduction in ART deliveries. Surprisingly, the opposite occurred. The increase of pill-refill rates may be due to different reasons, but we hypothesized that the adaption of delivery policies, with a higher number of packages allowed to be collected, strongly contributed to this result. This study suggests that multi-month dispensing policies may contribute to the improvement of adherence among PLWH.

Longitudinal study of the flash glucose monitoring system in type 1 diabetics: An mHealth ally in times of COVID-19.

AIMS AND OBJECTIVES: The aim of this study was to assess the effect of the FreeStyle Libre device implantation in adult type 1 diabetics in a Health Area of Castilla La Mancha (Spain) during the COVID-19 pandemic. BACKGROUND: FreeStyle Libre is a so-called mHealth device that supports health care. During COVID-1 confinement, diabetic patients could have improved their glycaemic monitoring thanks to these devices, although health care in these patients may have been limited due to confinement. METHODS: A 12-month longitudinal study in which a total of 206 type I diabetics participated, belonging to a single health area. Sociodemographic and analytical data and the Self Care Inventory Revised questionnaire (SCI-R) were collected. STROBE checklist was followed. RESULTS: The analysis showed differences related to the use of the sensor. After the study period, patients obtained better levels of basal glucose, glycosylated haemoglobin, creatinine, cholesterol, triglycerides and LDL. In addition, a significant increase in the total score of the SCI-R questionnaire was observed after the use of the monitor (MD -7.77; 95% CI -10.43, -8.29). The same occurred with different SCI-R items such as diet (MD -2.995; 95% CI -3.24, -2.57), glucose determination (MD -3.21; 95% CI -3.52, -2.91), medication administration (MD -2.58; 95% CI -2.53, -1.96) and hypoglycaemic episodes (MD -1.07; 95% CI -1.21, -0.93). In the analysis by groups, worse values of glycosylated haemoglobin and adherence to treatment (p < .05) were observed in overweight/obese subjects versus those with normal weight after one year of study. CONCLUSION: The use of flash monitoring is related to better adherence to most of the recommended habits in diabetes. Nevertheless, there seems to be no relationship with an improvement in physical exercise and preventive aspects of diabetes. A good nursing intervention to support physical exercise and the use of mHealth devices could improve the control of diabetic patients. RELEVANCE TO CLINICAL PRACTICE: The use of this mHealth device has shown positive results and reduced complications. Despite less contact with healthcare facilities due to the pandemic, type 1 diabetic patients have improved their blood results and adherence after using the device for one year. Nursing staff should focus on promoting physical activity and routine disease care in type 1 diabetics.

Impact of Post-Visit Outreach on Inhaled Corticosteroid Refill Persistence in Children and Young Adults With Asthma.

BACKGROUND: Inhaled corticosteroids (ICSs) are a fundamental pillar of most regimens for long-term control of persistent asthma. Poor adherence to ICS medication is a common problem in the asthma population that can lead to poor asthma control. We hypothesized that conducting a follow-up telephone call after general pediatric clinic visits for asthma would improve refill persistence. METHODS: We conducted a prospective cohort analysis of pediatric and young adult subjects followed in our pediatric primary care clinic for asthma on ICS medication found to have poor ICS refill persistence. This cohort received a follow-up telephone outreach call 5-8 weeks after the clinic visit. The primary outcome measure was refill persistence with regard to ICS therapy. RESULTS: There were 289 subjects who met the inclusion criteria and did not meet any exclusion criteria for the study (n = 131 in the primary cohort, n = 158 in the post-COVID cohort). The mean ICS refill persistence increased significantly for subjects in the primary cohort (39.4 ± 30.8% post intervention vs 32.4 ± 19.7% pre intervention) (P = .02) but not in the post-COVID cohort (36.4 ± 25.6% post intervention vs 38.9 ± 21.0% pre intervention) (P = .26). There was not a statistically significant change in hospitalizations after the intervention in either the primary or the post-COVID cohorts (P = .08 and .07, respectively). Systemic corticosteroid courses and emergency department visits decreased significantly post intervention (P = .01 and P = .004, respectively) in the primary group but not in the post-COVID group (P = .75 and P = .16, respectively). CONCLUSIONS: These results suggest that telephone outreach after out-patient clinic visits for asthma may have short-term benefit in ICS refill persistence; however, the effect size was small.

Elderly Population Has Higher Prevalence of Polypharmacy Associated with Poor Quality of Life and Low Compliance after Recovery from COVID-19.

Background: Long term effects of COVID are not fully understood yet. The geriatric population has been badly affected. The impact of COVID-19 on the health-related quality of life after recovery and patient compliance is a matter of concern especially in the geriatric population where polypharmacy is often prevalent. Aims and Objectives: This study intended to observe the occurrence of polypharmacy (PP) among COVID-19 recovered older patients with multimorbidity and explore its association with health-related quality of life and compliance in these patients. Materials and Methods: Total 90 patients, above 60 years of age having two or more co-morbidities and recovered from COVID-19 infection were included in this cross-sectional study. Number of pills taken daily by each patient was noted, to determine the occurrence of PP. WHO-QOL-BREF was used to assess the effect of PP on health-related quality of life (HRQOL). Medication adherence was measured using a self-reported questionnaire. Results: PP was found in 94.4% while hyper polypharmacy was found in 45.56% of patients. The overall mean score of HRQOL in patients with PP was 187.91 ± 32.98, indicating poor quality of life with PP (p value 0.0014) whereas the overall mean score of HRQOL in patients with hyper polypharmacy was 177.41 ± 26.11, showing poor quality of life with hyper polypharmacy (p value 0.0005). Increased number of pills corelated with poor quality of life (r =0.49). The medication adherence was found to be poor in patients who received mean number of pills 10.44 ± 2.62 whereas the adherence was good if the mean number of pills was 8.20 ± 2.63, (p value of 0.0001). Conclusion: Polypharmacy is highly prevalent among COVID-19 recovered patients and is associated with poor quality of life as well as poor medication adherence.

Digital Healthy Diet Literacy and Fear of COVID-19 as Associated with Treatment Adherence and Its Subscales among Hemodialysis Patients: A Multi-Hospital Study.

Treatment adherence (TA) is a critical issue and is under-investigated in hemodialysis patients. A multi-center study was conducted from July 2020 to March 2021 on 972 hemodialysis patients in eight hospitals in Vietnam to explore the factors associated with TA during the COVID-19 pandemic. Data were collected, including socio-demographics, an End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ), 12-item short-form health literacy questionnaire (HLS-SF12), 4-item digital healthy diet literacy scale (DDL), 10-item hemodialysis dietary knowledge scale (HDK), 7-item fear of COVID-19 scale (FCoV-19S), and suspected COVID-19 symptoms (S-COVID19-S). Bivariate and multivariate linear regression models were used to explore the associations. Higher DDL scores were associated with higher TA scores (regression coefficient, B, 1.35; 95% confidence interval, 95%CI, 0.59, 2.12; p = 0.001). Higher FCoV-19S scores were associated with lower TA scores (B, -1.78; 95%CI, -3.33, -0.24; p = 0.023). In addition, patients aged 60-85 (B, 24.85; 95%CI, 6.61, 43.11; p = 0.008) with "very or fairly easy" medication payment ability (B, 27.92; 95%CI, 5.89, 44.95; p = 0.013) had higher TA scores. Patients who underwent hemodialysis for ≥5 years had a lower TA score than those who received <5 years of hemodialysis (B, -52.87; 95%CI, -70.46, -35.28; p < 0.001). These findings suggested that DDL and FCoV-19S, among other factors, should be considered in future interventions to improve TA in hemodialysis patients.

Observed Mask Use in Kindergarten Through Grade 12 Schools in Georgia-Fall, 2021.

BACKGROUND: Universal masking, with additional layered prevention strategies, was an essential tool for limiting the transmission of SARS-CoV-2 and ensuring a safe return to in-person learning for kindergarten through 12th grade (K-12) students and staff. Few studies have examined mask adherence in this setting and none have described types of masks worn or locations of mask adherence. This project sought to assess mask adherence, types worn, and location of mask adherence in K-12 settings. METHODS: This study used direct in-person observations to measure the proportion of persons wearing masks correctly; type of masks worn; and location of mask adherence in 19 K-12 schools in Georgia. RESULTS: A total of 16,222 observations were conducted. Among those observed, 85.2% wore masks, with 80.3% wearing the mask correctly. Persons in high school were less likely to wear masks correctly. Correct mask use was most often observed among persons wearing N95-type masks. The prevalence of persons wearing masks correctly in transitional spaces was 5% higher than in congregate spaces. CONCLUSION: In K-12 schools with a universal masking policy, correct mask adherence was high among individuals. Examining adherence to recommended prevention measures can provide K-12 schools feedback to inform targeted messaging and policies during future disease outbreaks.

Mental health and adherence to antiretroviral therapy among Mexican people living with HIV during the COVID-19 pandemic.

BACKGROUND: The mental health and medical follow-up of people living with HIV (PLWH) have been disrupted by the COVID-19 pandemic. The objectives of this study were to assess anxiety, depression and substance use in Mexican PLWH during the pandemic; to explore the association of these symptoms with adherence to antiretroviral therapy (ART), and to compare patients with and without vulnerability factors (low socioeconomic level, previous psychological and/or psychiatric treatment). METHODS: We studied 1259 participants in a cross-sectional study, PLWH receiving care at the HIV clinic in Mexico City were contacted by telephone and invited to participate in the study. We included PLWH were receiving ART; answered a structured interview on sociodemographic data and adherence to ART; and completed the psychological instruments to assess depressive and anxiety symptoms and substance use risk. Data collection was performed from June 2020 to October 2021. RESULTS: 84.7% were men, 8% had inadequate ART adherence, 11% had moderate-severe symptoms of depression, and 13% had moderate-severe symptoms of anxiety. Adherence was related to psychological symptoms (p < 0.001). Vulnerable patients were more likely to be women, with low educational level and unemployed (p < 0.001). CONCLUSIONS: It is important to address mental health of PLWH during the COVID-19 pandemic, with special attention to the most vulnerable individuals. Future studies are needed to understand the relationship between mental health and ART adherence.

The relevance of pacing strategies in managing symptoms of post-COVID-19 syndrome.

BACKGROUND: Post-COVID-19 syndrome (PCS) shares many features with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). PCS represents a major health issue worldwide because it severely impacts patients' work activities and their quality of life. In the absence of treatment for both conditions and given the beneficial effect of pacing strategies in ME/CFS, we conducted this study to assess the effectiveness of pacing in PCS patients. METHODS: We retrospectively included patients meeting the World Health Organization definition of PCS who attended the Internal Medicine Department of Angers University Hospital, France between June 2020 and June 2022, and were followed up until December 2022. Pacing strategies were systematically proposed for all patients. Their medical records were reviewed and data related to baseline and follow-up assessments were collected. This included epidemiological characteristics, COVID-19 symptoms and associated conditions, fatigue features, perceived health status, employment activity, and the degree of pacing adherence assessed by the engagement in pacing subscale (EPS). Recovery was defined as the ability to return to work, and improvement was regarded as the reduction of the number and severity of symptoms. RESULTS: A total of 86 patients were included and followed-up for a median time of 10 [6-13] months. Recovery and improvement rates were 33.7% and 23.3%, respectively. The EPS score was the only variable significantly associated with recovery on multivariate analysis (OR 40.43 [95% CI 6.22-262.6], p < 0.001). Patients who better adhered to pacing (high EPS scores) experienced significantly higher recovery and improvement rates (60-33.3% respectively) than those with low (5.5-5.5% respectively), or moderate (4.3-17.4% respectively) scores. CONCLUSION: Our findings demonstrated that pacing is effective in the management of patients with PCS, and that high levels of adherence to pacing are associated with better outcomes.

A scoping review of non-professional medication practices and medication safety outcomes during public health emergencies.

OBJECTIVES: Public health emergencies (PHE) can disrupt personal medication practices and increase the risk of medication-related harm and other negative medication-related outcomes. Our aim was to examine the extent and nature of published research on this topic to guide future research and practice. STUDY DESIGN: Scoping review. METHODS: Standard electronic databases were searched. PRISMA-ScR guidelines were followed. Extracted data were organised in response to review questions and narrative accounts developed. RESULTS: A total of 129 studies were included, conducted across 32 countries, mostly in the USA (n = 42). Sixty-eight (53%) reported on infectious events, 49 (39%) climatological or ecological events and the remainder a mixture of terrorism, war or other disasters. The studies described several medication safety outcomes (medication-related harm, adherence, supply) and adaptive medication practices (self-altering prescribed medications, sharing medications and changing healthcare providers). Challenges to maintaining routine medication practices during a PHE included transport, finance, quarantine and knowledge-related issues. Twenty-eight studies (22%) examined health inequalities pertaining to adverse medication-related outcomes, with findings suggesting that gender, age, ethnicity, educational and socio-economic status may be related to inequalities. Research gaps identified included carers', children's and minority communities' experiences and intervention studies. CONCLUSIONS: There is considerable evidence of disruptions to routine personal medication practices during PHEs and of medication-related harm and other negative outcomes. Maintaining medication supply for the management of chronic conditions is a universal problem across all emergency types. Research is needed to address these disruptions, particularly amongst people who experience health inequalities who may need additional support.

Effects of older adults' social identification on psychological flourishing and exercise program adherence.

BACKGROUND: With the onset of the COVID-19 pandemic, many exercise programs moved online. The purpose of this study was to examine the extent to which older adults' social identification with other exercise program members contributed to their psychological flourishing and exercise program adherence. METHODS: The study represented a secondary analysis of data derived from the Seniors COVID-19 Pandemic and Exercise (SCOPE) Trial, in which older adults were randomized to a waitlist control condition or one of two online (personal v group) exercise programs. Only data from participants in the trial intervention conditions (N = 162; Mage = 73.52 years; SD = 5.61) were utilized in this secondary analysis. We assessed psychological flourishing and social identification at baseline and every two weeks, as well as program adherence over each 2-week block, for 12 weeks. RESULTS: Based on stepwise multilevel modeling the results revealed that older adults' social identification with others in their respective exercise program had a direct effect on psychological flourishing (ΔR2Unique Marginal = 0.063, p < .001) and program adherence (ΔR2Unique Marginal = 0.014, p = .03). CONCLUSIONS: The results highlight the value of bolstering older adults' social identification with others in an online exercise program to support adherence and well-being.

Drug adherence to anti-tubercular treatment during COVID-19 lockdown in Haldwani block of Nainital district

Background: India saw one of the stringent lockdowns during the COVID-19 pandemic. In the wake of this period, the normal functioning of medical services was affected. People were reluctant to seek medical attention and notification of Tuberculosis dipped. The aim of the study was to estimate the proportion of non-adherence to anti-tubercular treatment and to identify the factors affecting the non-adherence to treatment. Methods: A retrospective community-based study was conducted among 284 tuberculosis patients. They were interviewed using a pre-designed questionnaire consisting of WHO dimensions of non-adherence and lockdown related questions. Results: The proportion of non-adherence to treatment was found to be 5.3%. Factors like chronic diseases, depression, without knowledge on how the disease is transmitted and that medication can be discontinued once the symptoms subsided, alcohol consumption, and trouble accessing medicine were found to be the determining factors in non-adherence to the treatment. Conclusions: Non-adherence to anti-tuberculosis treatment in our study was low but the various dimensions of adherence along with lockdown related factors had significant impact on it. To further minimize non-adherence during emergency like the lockdown due to COVID-19 pandemic, corrective measures must be explored and implemented.

The Impact of Internet health information on adherence to COVID-19 protocols

Introduction: The only way to limit the prevalence of COVID-19 is to adhere strictly to health protocol. In this regard, WHO has provided the information needed to prevent and deal with this disease on its website. To investigate the Impact of Internet Health Information on Adherence to COVID-19 Protocols, in Iran. Material and Methods: This is a cross-sectional survey and structural equation modeling which is done by students of at the Kerman University of Medical Science, Iran. The data collection tool was a questionnaire. SPSS 22.0, and SmartPLS 3software were used to analyze the data. Results: The present study investigated the impact of health information on the WHO website on adherence to COVID-19 protocols among the students of the Kerman University of Medical Sciences. The bootstrapping results indicate relationships between health information seeking constructs and information quality, satisfaction, and reputation. Regarding the other six hypotheses in the present study, it is predicted that they will be rejected in a larger sample. Conclusion: Online information is now available more easily, quickly, and at a lower cost compared to other sources, it should be constantly monitored and constantly improved in quality. Its usefulness, ease of use, accuracy, recency, and simplicity should be constantly investigated. © 2022, Published by Frontiers in Health Informatics.

Adherence to treatment and quality of life of patients with hypertension during the COVID-19 pandemic

Introduction: Reduced accessibility to routine follow-up visits in GP surgeries during the COVID-19 pandemic as well as the failure to report to health care facilities for fear of infection may have disrupted doctor-patient cooperation and worsened adherence to therapeutic recommendations. Aim of the research: To examine the quality of life of patients with arterial hypertension and their assessment adherence to therapeutic recommendations during the COVID-19 pandemic. Material(s) and Method(s): A total of 103 hypertensive patients of the Independent Public Healthcare Centre of the Ministry of Interior and Administration in Wroclaw were examined. The World Health Organization Quality of Life Instrument Short Form (WHOQOL-BREF) and the Adherence in Chronic Diseases Scale (ACDS) were used. Result(s): The mean score for perception of quality of life was 3.64 +/-0.73. Quality of life was rated best in the psychological domain (M = 15.05, SD = 2.42) and worst in the physical domain (M = 13.25, SD = 2.67). 57.28% (59/103) of the respondents had medium adherence, 23.30% (24/103) had low adherence, and 19.42% (20/103) had high adherence. The level of adherence was significantly better among patients keeping a self-monitoring diary compared to those who did not keep such a diary (24.19 +/-2.86 vs. 21.86 +/-4.56, p = 0.007). Patient age (r = 0.323, p = 0.001) and systolic blood pressure value (r = -0.193, p = 0.05) significantly correlated with adherence level. The higher the level of adherence, the better the quality of life in the psychological (r = 0.197, p = 0.046) and social (r = 0.198, p = 0.045) domains. Conclusion(s): Adherence to the therapeutic plan and good patient-doctor cooperation are extremely important for the level of quality of life of hypertensive patients.Copyright © 2023 Termedia Publishing House Ltd.. All rights reserved.

Reasons for Non-Adherence to Rheumatology Consultation in Atertiary Care Hospital: Covid-19 Pandemic Consequence?

Objectives: To determine the leading causes for non-adherence to rheumatology consults in a tertiary care hospital. Method(s): Patients who did not show up for their programmed consult were identified using the rheumatology service database, from January 2021 to July 2022, and they were contacted by telephone to determine reasons for their absence. Result(s): During 2021, we identified 2487 patients who did not show for their rheumatology consult. Sixty percent of patients referred that their absence was related to COVID-19 (38% were sick or in contact with a sick relative, and 22% were afraid of getting sick). Meanwhile, 40% mentioned different reasons: 10% have economic problems, and 30% forgot their consult date. On the other hand, during January-July 2022 period, 1529 patients were identified as no shows for their rheumatology consult. Seventy percent of these patients satted that economic problems were the main cause (impossibility to pay for transportation, consultation, requested studies and/or treatment), while 15% said that they forgot about their appointment date, and the other 15% referred to a reason related to the pandemic (mostly, afraid of getting sick with COVID-19). Conclusion(s): The COVID-19 pandemic harmed consult adherence in rheumatology. Initially, this problem was caused by pandemic-related issues, however, reasons for these 'no shows' have changed, being more recently economic troubles the leading cause, which was induced by the pandemic.

Bariatric surgery provision in response to the COVID-19 pandemic: retrospective cohort study of a national registry.

BACKGROUND: When surgery resumed following the outbreak of the COVID-19 pandemic, guidelines recommended the prioritization of patients with greater obesity-related co-morbidities and/or higher body mass index. OBJECTIVE: The aim of this study was to record the effect of the pandemic on total number, patient demographics, and perioperative outcomes of elective bariatric surgery patients in the United Kingdom. SETTING AND METHODS: The United Kingdom National Bariatric Surgical Registry was used to identify patients who underwent elective bariatric surgery during the pandemic (1 yr from April 1, 2020). Characteristics of this group were compared with those of a pre-pandemic cohort. Primary outcomes were case volume, case mix, and providers. National Health Service cases were analyzed for baseline health status and perioperative outcomes. Fisher exact, χ2, and Student t tests were used as appropriate. RESULTS: The total number of cases decreased to one third of pre-pandemic volume (8615 to 2930). The decrease in operating volume varied, with 36 hospitals (45%) experiencing a 75%-100% reduction. Cases performed in the National Health Service fell from 74% to 53% (P < .0001). There was no change in baseline body mass index (45.2 ± 8.3 kg/m2 from 45.5 ± 8.3 kg/m2; P = .23) or prevalence of type 2 diabetes (26% from 26%; P = .99). Length of stay (median 2 d) and surgical complication rate (1.4% from 2.0%; relative risk = .71; 95% CI .45-1.12; P = .13) were unchanged. CONCLUSIONS: In the context of a dramatic reduction in elective bariatric surgery due to the COVID-19 pandemic, patients with more severe co-morbidities were not prioritized for surgery. These findings should inform preparation for future crises.

Study design of a phase 4, real-world study (COMPOSUR) to evaluate vibegron in patients with overactive bladder.

BACKGROUND: Overactive bladder (OAB) is defined as urinary urgency accompanied by frequency and nocturia, with or without urge urinary incontinence (UUI). Vibegron, a selective ß3-adrenergic receptor agonist approved in the US in December 2020, demonstrated efficacy in reducing symptoms of OAB and was safe and well tolerated in the 12-week EMPOWUR trial and its 40-week, double-blind extension trial. The goal of the COMPOSUR study is to evaluate vibegron in a real-world setting to assess patient treatment satisfaction, tolerability, safety, duration of treatment, and persistence. METHODS: This is a 12-month, prospective, observational, real-world study, with an optional 12-month extension to 24 months, in the US assessing adults ≥ 18 years old starting a new course of vibegron. Patients must be previously diagnosed with OAB with or without UUI, symptomatic for ≥ 3 months before enrollment, and receive prior treatment with an anticholinergic, with mirabegron, or with a combination of an anticholinergic and mirabegron. Enrollment is performed by the investigator following exclusion and inclusion criteria guided by US product labeling, reinforcing a real-world approach. Patients complete the OAB Satisfaction with Treatment Questionnaire (OAB-SAT-q) monthly and the OAB Questionnaire short form (OAB-q-SF) and Work Productivity and Activity Impairment Questionnaire (WPAI:US) at baseline and monthly for 12 months. Patients are followed up via phone call, in-person visits, or telehealth (ie, virtual) visits. The primary endpoint is patient treatment satisfaction as determined by the OAB-SAT-q satisfaction domain score. Secondary endpoints include percent positive responses to individual OAB-SAT-q questions, additional OAB-SAT-q domain scores, and safety. Exploratory endpoints include adherence and persistence. DISCUSSION: OAB leads to a significant decrease in quality of life, as well as impairment of work activities and productivity. Persistence with OAB treatments can be challenging, often due to lack of efficacy and adverse effects. COMPOSUR is the first study to provide long-term, prospective, pragmatic treatment data for vibegron in the US and the resultant effect on quality of life among patients with OAB in a real-world clinical setting. Trial registration ClinicalTrials.gov identifier: NCT05067478; registered: October 5, 2021.

Impact of the COVID-19 pandemic on positive airway pressure adherence and patients' perspectives in Greece: the role of telemedicine.

STUDY OBJECTIVES: To analyze the impact of national lockdowns in Greece on positive airway pressure (PAP) adherence, patients' perspectives regarding COVID-19 pandemic and the role of telemedicine. METHODS: 872 obstructive sleep apnea (OSA) patients from Southern and 673 from Northern Greece, under PAP treatment, were evaluated with adherence data available 12 months prior to and 3 months after the first and second lockdown. Telemedicine, locally available as part of a research protocol, was used for patient's follow-up in Southern Greece and standard follow up procedures were implemented in Northern Greece. We analyzed the impact of COVID-19 lockdown on PAP adherence, and patients concerns regarding COVID-19 infection. RESULTS: Significant difference was noted in PAP adherence as measured by the hours of use at 12 months prior to and at the 3 months after the first lockdown in Southern (5.6 vs 6.6, p=0.003) and Northern Greece (5.3 vs 6.0, p=0.03). The proportion of patients with optimal adherence (≥6 hours) increased by 18% (p=0.004) in Southern and by 9% (p=0.20) in Northern Greece after the first lockdown and remained steady after the second lockdown in both groups. In Southern Greece, 23% of patients reported that they were concerned about getting COVID-19 due to OSA diagnosis, while only 3% reported decreased sleep duration. Moreover, 9% were concerned that the presence of OSA would make them more susceptible for worse outcome in case of COVID-19 infection. CONCLUSIONS: Our results suggest that maintaining follow-up using telemedicine had a positive influence pointing out the potential role of digital health.