Medication Adherence and Belief about Medication among Vietnamese Patients with Chronic Cardiovascular Diseases within the Context of Implementing Measures to Prevent COVID-19.

BACKGROUND: Long-term adherence is crucial for optimal treatment outcomes in chronic cardiovascular diseases (CVDs), especially throughout the COVID-19 wide-spreading periods, making patients with chronic CVDs vulnerable subjects. AIM: To investigate the relationship between the characteristics, beliefs about prescribed medication, COVID-19 prevention measures, and medication adherence among patients with chronic CVDs. METHODS: This is a cross-sectional study of outpatients with chronic CVDs in Southern Vietnam. The specific parts regarding the Beliefs about Medicines Questionnaires (BMQ-Specific) and the General Medication Adherence Scale (GMAS) were applied to assess the beliefs about and adherence to medication. The implementation measures to prevent COVID-19 in patients were evaluated according to the 5K message (facemask, disinfection, distance, no gathering, and health declaration) of the Vietnam Ministry of Health. A multivariable logistic regression with the Backward elimination (Wald) method was used to identify the associated factors of medication adherence. RESULTS: A slightly higher score in BMQ-Necessity compared to BMQ-Concerns was observed. A total of 40.7% of patients were recorded as having not adhered to their medications. Patients' behavior was most frequently self-reported by explaining their non-adherence (34.7%). Statistical associations were found between rural living place, unemployment status, no or only one measure(s) of COVID-19 prevention application, and medication adherence. CONCLUSION: During the COVID-19 spreading stage, patients generally showed a positive belief about medication when they rated the importance of taking it higher than its side effects. The data analysis suggested that rather than patients' beliefs, the clinicians should consider the patient factors, including living place, employment, and the number of epidemic preventive measures applied for guiding the target patients for improving medication adherence.

CHINA PH ARMACY Volume 33，Number 9，May 15，2022 Semimonthly Table of Contents Hangzhou expert consensus on comprehensive clinical evaluation of drugs for chronic cardiovascular diseases / 中国药房

There are numerous dr ugs availabl e for the treatment and prevention of cardiovascular diseases. However ，the lack of scientific and standardized clinical comprehensive evaluation system for drugs is the current situation. In order to guide and promote medical institutions to develop the clinical comprehensive evaluation of drugs related to chronic cardiovascular diseases ， with the participation of Hangzhou Pharmacy Management Quality Control Center and 15 medical institutions in Hangzhou ，by widely soliciting the suggestions of clinical and pharmaceutical experts ，Hangzhou First People ’s Hospital Affiliated to the School of Medicine of Zhejiang University has organized the formulation of Hangzhou Expert Consensus on Comprehensive Clinical Evaluation of Drugs for Chronic Cardiovascular Diseases . The pilot evaluation is carried out with antihypertensive drugs and lipid-lowering drugs as examples. The evaluation system of expert consensus adopts a quantitative evaluation system of percentile ， which is systematically evaluated from 7 dimensions including pharmaceutical properties ，safety，effectiveness，economy， innovation，accessibility，and other attributes. The evaluation dimension is more detailed ，which enhances the operability of the drug evaluation system. The purpose of this expert consensus is to provide a decision-making basis for the evaluation and selection of drugs for chronic cardiovascular diseases in medical institutions ，to promote rational drug use and to meet people ’s growing need for better medications.

Factors Differentiating Rural and Urban Population in Determining Anxiety and Depression in Patients with Chronic Cardiovascular Disease: A Pilot Study.

The aim of this cross-sectional study was to analyze selected variables differentiating rural from urban populations, as well as identify potentially increased levels of depression and anxiety in patients with chronic cardiovascular disease. The study was carried out in 193 patients. The study used the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS), the Health Behavior Inventory Questionnaire (HBI), the WHOQOL-BREF Quality of Life Questionnaire, and the Hospital Anxiety and Depression Scale-Modified Version (HADS-M). Spearman's rank correlation coefficient test and logistic regression were used for analyses. In rural patients, we observed a relationship between anxiety and age (1/OR = 1.04; 95% CI: 0.91-0.99), the assessment of satisfied needs (1/OR = 293.86; 95% CI: 0.00001-0.56), and quality of life (QoL) in physical (OR = 1.56; 95% CI: 1.11-2.33), social (1/OR = 1.53; 95% CI: 0.04-0.94), and environmental domains (OR = 1.67; 95% CI: 1.06-3.00), as well as between depression and QoL in physical (1/OR = 1.39; 95% CI: 0.50-0.97) and psychological (OR = 1.37; 95% CI: 1.01-1.93) domains. In city patients, we observed a relationship between the drug and Qol in the physical (1/OR = 1.25; 95% CI: 0.62-0.98) and psychological (OR = 1.49; 95% CI: 1.13) domains. Younger patients living in a rural area with a lower assessment of met needs, a higher level of QoL in physical and environmental domains, and a lower social domain, as well as patients living in a city with a lower QoL in the physical domain and a higher psychological domain, have a greater chance of developing anxiety and depressive disorders.

The Role of Spirituality in Lifestyle Changing Among Patients with Chronic Cardiovascular Diseases: A Literature Review of Qualitative Studies.

Chronic cardiovascular diseases (CVD) are diseases with marked morbidity. Patients are often advised to change their lifestyle to prevent complications and impairment of their diseases. Compliance, however, is influenced by multiple factors. Initial studies show that spirituality is an important aspect in health behavior and lifestyle changing, but to health professionals like nurses this is unknown. The aim of this review is to investigate and synthesize evidence about the role of spirituality in lifestyle changing in patients with chronic CVD. A comprehensive search was conducted in electronic databases Academic Search Premier, E-journals, Medline and PubMed, published between the years 2000-2015. After selection based on pre-set inclusion criteria, studies were retrieved and evaluated on quality using the criteria of the QOREC. Twelve studies with a qualitative empirical design and mixed methods were included. This review shows that spirituality, is related to the self-management of patients with chronic diseases. For instance, lifestyle changes are experienced as a continuous inner battle. Religion gives strength, but is also experienced as a struggle. Feelings of guilt and becoming a victim influence patients' experience. For effectively advising patients with CVD on lifestyle changes, nurses cannot ignore this factor but further investigation is required.

The mechanisms of air pollution and particulate matter in cardiovascular diseases.

Clinical and epidemiological studies demonstrate that short- and long-term exposure to air pollution increases mortality due to respiratory and cardiovascular diseases. Given the increased industrialization and the increased sources of pollutants (i.e., cars exhaust emissions, cigarette smoke, industry emissions, burning of fossil fuels, incineration of garbage), air pollution has become a key public health issue to solve. Among pollutants, the particulate matter (PM) is a mixture of solid and liquid particles which differently affects human health depending on their size (i.e., PM10 with a diameter <10 µm reach the lung and PM2.5 with a diameter <2.5 µm penetrate deeper into the lung). In particular, the acute exposure to PM10 and PM2.5 increases the rate of cardiovascular deaths. Thus, appropriate interventions to reduce air pollution may promote great benefits to public health by reducing the risk of cardiovascular diseases. Several biological mechanisms have been identified to date which could be responsible for PM-dependent adverse cardiovascular outcomes. Indeed, the exposure to PM10 and PM2.5 induces sustained oxidative stress and inflammation. PM2.5 is also able to increase autonomic nervous system activation. Some potential therapeutic approaches have been tested both in pre-clinical and clinical studies, based on the intake of antioxidants from dietary or by pharmacological administration. Studies are still in progress to increase the knowledge of PM activation of intracellular pathways and propose new strategies of intervention.

Cuantificación oracional en prospectos de enfermedades cardiovasculares crónicas: implicaciones para la literacidad en salud / Sentence quantification in leaflets of chronic cardiovascular diseases: implications for health literacy

Los prospectos médicos, en cuanto a folletos destinados al paciente, presentan lo que debiese ser información necesaria para el tratamiento del paciente. La información entregada, sin embargo, no siempre se presenta de manera clara y adecuada respecto a la literacidad del destinatario. Esa complejidad puede verse en diversos factores como la gramática, que será el centro de esta investigación, aplicada a folletos de enfermedades cardiovasculares crónicas. OBJETIVO: Observar la complejidad gramatical dentro de un apartado de los prospectos medicamentosos para revisar cuantitativamente las estructuras gramaticales, considerando que una mayor complejidad gramatical implica una mayor dificultad de lectura y comprensión. METODOLOGÍA: Para la investigación se extrae un apartado específico de los prospectos, el cual es común a todos los prospectos analizados. Tras la recolección del corpus y el análisis del mismo, se revisan las oraciones para cada muestra y desde la información recolectada se comienza el trabajo cuantitativo, para, finalmente, extraer resultados y conclusiones. RESULTADOS: Se presenta en los prospectos una alta densidad oracional, lo que implica una gran cantidad de información en una cantidad baja de estructuras, lo que tiene implicancias en la legibilidad y comprensión de los medicamentos. CONCLUSIONES: La alta cantidad de oraciones implica una baja legibilidad y una baja comprensión, lo que significa una baja aprehensión de la información por parte de los destinatarios más aún en casos como el deterioro psicoorgánico, lo que repercute en la literacidad en salud de los destinatarios.

Leaflets, as text destined to medical patients, show the information that should be necessary for the right treatment of the patients. The information given, otherwise, is not always displayed clearly and appropriate respecting the literacy of the receiver. That complexity could be seen in diferent factors as grammar, and this point will be the main objective of this investigation, applied to chronic cardiovascular diseases leaflets. OBJECTIVE: Leaflets, as text destined to medical patients, shows the information that should be necessary for the right treatment of the patients. The information given, otherwise, is not always displayed clearly and appropriate respecting the literacy of the receiver. That complexity could be seen in diferent factors as grammar, and this point will be the main objective of this investigation, applied to chronic cardiovascular diseases leaflets. METHODS: To this investigation, a section of the leaflets is extracted, common to every leaflet analyzed. After recollection of the corpus and his analysis, the sentences from every samples are reviewed and from the collected information the quantitative work starts, to, finally, extract the results and conclusions. RESULTS: Sentence high density is presented in the leaflets, which involves a lot of information in a small amount of structures, which have implications for readability and understanding of medicines. CONCLUSIONS: The high number of sentences implies a low readability and low understanding, which means a low seizure of information by recipients, especially in cases like the psycho-organic deterioration, which affects the health literacy of recipients.