Tailored Interventions to Improve Medication Adherence for Cardiovascular Diseases.

Over the past half-century, medical research on cardiovascular disease (CVD) has achieved a great deal; however, medication adherence is unsatisfactory. Nearly 50% of patients do not follow prescriptions when taking medications, which limits the ability to maximize their therapeutic effects and results in adverse clinical outcomes and high healthcare costs. Furthermore, the effects of medication adherence interventions are disappointing, and tailored interventions have been proposed as an appropriate way to improve medication adherence. To rethink and reconstruct methods of improving medication adherence for CVD, the literature on tailored interventions for medication adherence focusing on CVD within the last 5 years is retrieved and reviewed. Focusing on identifying nonadherent patients, detecting barriers to medication adherence, delivering clinical interventions, and constructing theories, this article reviews the present state of tailored interventions for medication adherence in CVD and also rethinks the present difficulties and suggests avenues for future development.

A randomized controlled trial of well-being therapy to promote adaptation and alleviate emotional distress among medical freshmen.

BACKGROUND: Maladjustment and emotional distress are extremely prevalent among first-year medical students in college and are associated with numerous negative consequences for medical freshmen, their families and universities. The current research aimed to detect the efficacy of a well-being therapy in promoting adaptation to college life and alleviating emotional distress among medical freshmen. METHODS: One hundred one participants who met the inclusion criteria were enrolled in a single-blind randomized controlled trial. Well-being therapy was given to the intervention group weekly for 5 weeks (WBT, n = 50). At the same time, students in the placebo control condition (CC, n = 51) were required to record early memory for 5 weeks and at weekly meetings it would be shared voluntarily. Psychological well-being, adaptation, anxiety and depression were recorded at pretest, posttest, and at three-month follow-up. Data from 87 first-year students with complete follow-ups (WBT, n = 39; CC, n = 48) were analyzed over three time periods. RESULTS: Compared with the control group, students undergoing the 5-week well-being therapy reported larger improvements in psychological well-being and adaptation, and greater alleviation in symptoms of anxiety and depression from pretest to posttest to follow-up. CONCLUSIONS: Well-being intervention may provide first-year medical students with skills to efficiently manage maladjustment and emotional distress. It seems that medical freshmen would benefit a lot when such an intervention programme could be incorporated into the general medical education. TRIAL REGISTRATION NUMBER: ChiCTR-ROC-17012636. Registered 11 September 2017 (Retrospectively registered) at Chinese Clinical Trial Registry.

Frontal Alpha EEG Asymmetry Before and After Positive Psychological Interventions for Medical Students.

Subjective well-being (SWB) refers to traits concerned with happiness, fulfillment and enrichment and is a substantial predictor of a flourishing life. Interest in the promotion of well-being has blossomed in recent years, and it is widely reported that positive psychological interventions (PPIs) can effectively improve SWB. However, to date, the neural correlates of PPIs remain elusive. Since previous research has suggested that emotion regulation might be the theoretical foundation for potential working mechanisms, here we used electroencephalography (EEG) techniques to identify whether the intentional increase of subjective well-being through PPIs was associated with greater tonic left frontal activation. Fifty-five students met the inclusion criteria and were allocated to a randomized controlled trial that was single blinded. The intervention group received PPIs once a week for 10 weeks (n = 28). Meanwhile, students in a placebo control group (CG, n = 27) were asked to write down early memories every day for 10 weeks and were invited to share voluntarily at the weekly meeting. Measures of subjective well-being, depression and anxiety were assessed at pre-test and post-test. Forty-eight students completed the post-test, and the collected data were analyzed across time (PPIs, n = 25; CG, n = 23). It was found that students undergoing the 10-week PPIs reported larger improvement in SWB, and greater relief in self-rated depression and anxiety from pre-intervention to post-intervention than did those in the control group. As expected, in conjunction with the promotion of subjective well-being and the amelioration of emotional distress from pre- to post-treatment in the intervention group, a significantly increased coefficient of frontal alpha EEG asymmetry was found. In summary, these findings suggest that adaptive emotion regulation, which is characteristic of greater tonic left frontal activation, reflects the efficiency of PPIs and highlights the frontal alpha EEG asymmetry as a neural substrate linking PPIs and mental health. CLINICAL TRIAL REGISTRATION NUMBER: ChiCTR-ROC-17012636.