Medication adherence and predictive factors among patients with rheumatoid arthritis: A COM-B model guided structural equation modeling analysis.

OBJECTIVE: To assess medication adherence of patients with rheumatoid arthritis (RA) and explore predictive factors under the guidance of the Capability, Opportunity and Motivation to Behavior (COM-B) model. METHODS: A cross-sectional study was conducted among 221 RA patients conveniently recruited from rheumatology outpatient clinics of a university-affiliated hospital in China. Data about patients' sociodemographic and disease characteristics, medication adherence, functional disability, social support, beliefs about medicines, self-efficacy, and depression were collected via self-administered questionnaires. The influence of factors within the COM-B model on medication adherence were analyzed by the structural equation model. RESULTS: The mean score of medication adherence was 63.19 (SD 8.83), and 214 participants (96.8%) were considered non-adherent to their medication regime. Greater functional disability, higher social support, more positive beliefs about medicines, higher self-efficacy, and lower depression were significantly positively associated directly or indirectly with medication adherence, explaining 66% of the total variance. CONCLUSION: Patients with RA demonstrate poor medication adherence. Essentials in improving medication adherence are delaying the occurrence of disability, promoting social support, shaping beliefs about medicines, enhancing self-efficacy, and relieving depression. PRACTICE IMPLICATIONS: The value of integrated interventions targeting the drivers and barriers to medication adherence identified in this study should be further explored.

Knowledge and Attitudes toward Dementia among Undergraduate Health Professional Students in China: A Cross-Sectional Survey.

PhenomenonDementia is a huge burden to the economic and health care system in China. As the next generation of health care providers, undergraduate health professional students play a pivotal role in caring for dementia patients during their clinical placements and in independent practice. Nevertheless, they may not be adequately prepared to care for patients with dementia by their undergraduate programs. Measuring the knowledge and attitudes of health professional students could be an important step in providing evidence regarding the need to enhance dementia care training in the curriculum. Approach: Responses from 325 Chinese health professional (nursing, medical, and public health) students were included in the analyses. After providing informed consent, students answered questionnaires including a demographic data questionnaire, the Alzheimer's Disease Knowledge Scale (ADKS) and the Dementia Attitudes Scale (DAS). Univariate analyses were performed to test the association between outcomes and potential explanatory variables. Multiple linear regression analysis was used to determine the predictive factors for knowledge and attitudes toward dementia. Findings: Chinese health professional students had a mean ADKS score of 18.92 (SD = 3.20). Better knowledge was associated with advanced education, having family members with medical knowledge, having heard of dementia, and having interest in learning about dementia. Students had a mean DAS score of 89.10 (SD = 8.93), and their attitudes were significantly associated with majoring in public health and having heard of dementia. Students' knowledge was positively, but weakly related with attitudes (r = 0.122, P = 0.028). Insights: Chinese undergraduate health professional students demonstrate insufficient knowledge and less positive attitudes toward dementia than their counterparts in developed countries. Enhanced dementia care-specific curriculum and training are urgently needed in China to meet the growing demand for dementia care services.