The objective of this (updated) overview (systematic review [SR] of systematic reviews) was to identify those factors that influence adherence to oral drugs in patients with physical chronic diseases. It is calculated as follows: \( \mathrm{CCA}=\frac{\left(N-r\right)}{\left(r\times c-r\right)} \); N=number of primary studies (includes multiple counting); r=number of index studies (defined as first-time primary study); and c=number of included systematic reviews. This education promotes competent self-care and gradual independence from the clinicians care. This overview was not registered. Although higher education, employment, higher financial status and marriage/partnership mostly showed a positive effect on adherence, the impact was unclear because of the high uncertainty of the underlying evidence. knowledge deficit related to medication compliance Cite this article. Two reviewers independently assessed the risk of bias with the ROBIS tool. Moreover, the knowledge of influencing factors of adherence can support the development of tailored health technologies to increase adherence by treating the underlying barriers (e.g., depression treatment, reducing co-payments). When general assessment findings suggest patient is not taking oral medications as prescribed, assess further. Sabate E. Adherence to long-therm therapies: evidence for action: Weltgesundheitsorganisation; 2003. Instruct the patient to avoid alcohol, smoking, and caffeinated drinks. Poor health literacy means a patient may lack an understanding of their disease, medications, and when to seek care. We found some evidence for a negative influence of intake of different medications in cardiovascular conditions. In addition, the impact of social support was uncertain in all SRs [23, 28, 30, 37, 38]. St. Louis, MO: Elsevier. High-fat food increases the time for the food to stay in the stomach, as well as hot, spicy, and gas-forming foods which are irritants to the esophagus so it is best to avoid such foods. Her experience spans almost 30 years in nursing, starting as an LVN in 1993. The nurse must first assess if the patient is ready to learn by assessing their interest, emotional status, and mental capacity for learning. Krueger K, Botermann L, Schorr SG, Griese-Mammen N, Laufs U, Schulz M. Age-related medication adherence in patients with chronic heart failure: a systematic literature review. Medical-surgical nursing: Concepts for interprofessional collaborative care. Overviews of SRs are always at high risk for discordant or heterogeneous results across the included SRs [42]. A comparison of the individual SRs shows that only three SRs were at low risk of bias in all four domains [25, 27, 28]. Moreover, none of the included SRs distinguishes intentional (conscious decision not to take medication) and unintentional adherence (forget to take medication); however, it strongly stands to reason that the influencing factors can depend on the underlying reasons for non-adherence [45]. Bitton A, Choudhry NK, Matlin OS, Swanton K, Shrank WH. Nursing Diagnosis: Deficient Knowledge related to lack of exposure/recall secondary to fracture as evidenced by inaccurate follow-through of instructions and development of preventable complications. 176-178, 50935, Cologne, Germany, You can also search for this author in knowledge deficit related to medication compliance Google Scholar. Adherence is a multifactorial phenomenon that can be influenced by various factors. Semin Arthritis Rheum. Article Knowledge Deficit Nursing Diagnosis & Care Plan - RNlessons 2011;64(4):3802. The site is secure. Anemia comes in a lot of types, and a thorough but effective diagnosis is only possible with these procedures depending on the signs or symptoms noted. Determinants of adherence to heart failure medication: a systematic literature review. Medication adherence: understanding the issues and finding - PubMed Impact of Beliefs about Medicines on the Level of Intentional Non-Adherence to the Recommendations of Elderly Patients with Hypertension. how many zombies have been killed in the walking dead. Nonadherence to ACE inhibitors was not significantly associated with blood pressure. In: Cooper H, Hedges L, Valentine J, editors. TM was also an author of two of the included SRs. Knowledge Deficit Nursing Diagnosis & Care Plan | NurseTogether Assess health literacy.Health literacy affects a patients ability to comprehend and process health-related material. If a patient is in pain, worried, upset, or tired then they are not in a state of mind to retain information. Gender seems to have no consistent impact on adherence. This assumption is supported by the fact that especially therapy- and disease-related influencing factors, which are related to the symptomatic patients, were inconsistent. Present small chunks of information over time. Other risk factors for low health literacy include a limited education, low socioeconomic status, and non-native English speakers. Provided by the Springer Nature SharedIt content-sharing initiative. Thus, we believe that positive findings might be caused by spurious findings in primary studies (confounding bias, type one error rate, selective reporting). 200, 51109, Cologne, Germany, Institute for Health Economics and Clinical Epidemiology of the University of Cologne, Gleueler Str. Simplify the regimen. Medication adherence: understanding the issues and finding solutions Medication is the most frequent treatment intervention, and its success depends on patients taking their medicines in line with their prescribed regimen to yield the full benefit of the treatment. For instance, internal fixation devices can ultimately affect the bones strength, while the intramedullary nails, rods, or plates may be removed once the physician recommended it after a long recovery. 2018;93:924. 2011;136(3132):161621. Results of each individual included SR. (DOCX 19kb). Hypertension. 2014;72(1):37. Nursing Diagnosis: Deficient Knowledge related to lack of exposure/recall, misinterpretation of information, or denial of diagnosis secondary to hypertension as evidenced by inaccurate follow-through of instructions and verbalized inaccurate information. Analysis of gender showed inconsistent results. Cutler RL, Fernandez-Llimos F, Frommer M, Benrimoj C, Garcia-Cardenas V. Economic impact of medication non-adherence by disease groups: a systematic review. Nevertheless, the results of our overview were also partly heterogeneous. The majority of healthcare noncompliance challenges include the safety of patients, patient data privacy, and billing procedures. We considered every physical chronic illness. D. Knowledge deficit related to medication compliance. We performed a systematic literature search in MEDLINE (via PubMed) and Embase (via Embase). Co-payments (any or higher) have a negative impact on adherence. There are a variety of aids that may be helpful; however, the interaction with a health professional is very important, both for understanding the reason for non-adherence and for promoting adherence. Medication adherence influencing factorsan (updated) overview of systematic reviews, \( \mathrm{CCA}=\frac{\left(N-r\right)}{\left(r\times c-r\right)} \), https://doi.org/10.1186/s13643-019-1014-8, http://apps.who.int/iris/bitstream/handle/10665/42682/9241545992.pdf;jsessionid=5533CE0804BE2E0722B919623C4C2E05?sequence=1.Assessed, https://www.bristol.ac.uk/media-library/sites/social-community-medicine/robis/robisguidancedocument.pdf.Assessed, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. By using this website, you agree to our Clinical outcomes and adherence to medications measured by claims data Broekmans S, Dobbels F, Milisen K, Morlion B, Vanderschueren S. Medication adherence in patients with chronic non-malignant pain: is there a problem? 2009;15:e2233. Schfer C, editor. In cardiovascular conditions, there was some evidence that patients not paying any co-payments are more adherent than those patients paying (any) co-payments [25, 26]. Bougioukas KI, Liakos A, Tsapas A, Ntzani E, Haidich A-B. 10. Association between drug insurance cost sharing strategies and outcomes in patients with chronic diseases: a systematic review. Insights into the factors that might have a negative influence on adherence are important for several reasons. Therefore, unclear impact ratings indicate that the evidence is insufficient to allow a conclusion not that there is the tendency that these factors have no impact. Future primary studies and SRs should use validated adherence measures, adjust the analysis for relevant confounding factors, avoid using arbitrary cut-offs for influencing factors (e.g., age) and report the effect measures with 95% confidence intervals. Systematic Reviews knowledge deficit related to medication compliance. 2012;73(5):691705. Enhancing the patients competence in detecting anemia by assessing ones current knowledge and perceptions is helpful in planning for individualized teaching. The evidence indicates that socioeconomic status and social support might have a positive impact on adherence and that belonging to an ethnic minority might have a negative impact on adherence. Eur J Pain. Creating a plan that fits the clients lifestyle will ensure the highest chance of adherence and motivation. sharing sensitive information, make sure youre on a federal To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. top mum influencers australia LIVE Mathes T, Jaschinski T, Pieper D. Adherence influencing factors - a systematic review of systematic reviews. 1 The World Health Organization reports adherence at approximately 50 percent among patients taking medications for chronic illnesses. Nursing care plans: Diagnoses, interventions, & outcomes. Most SRs were excluded because a methodological quality assessment of the included primary studies was not performed or factors other than our pre-specified influencing factors were investigated. Identify the support person or caregiver that will benefit the most from teaching. Depression was analysed in patients taking oral anticancer agents, HIV infection or cardiovascular conditions. 2008;11(1):447. CAS Continue with Recommended Cookies. Grimshaw J. (n.d.). Arch Public Health. Medication: reasons and interventions for noncompliance The predictive factors of older patients' knowledge, attitudes, and barriers related to medication . We used the Risk of Bias in Systematic Reviews (ROBIS) tool to assess the included SRs [16]. Marital status was investigated in the SRs on Parkinson disease, inflammatory arthritis, chronic diseases, HIV, patients taking oral anticancer agents and cardiovascular conditions. PMC Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking. Nursing Assessment for Knowledge Deficit 1. Maimaris W, Paty J, Perel P, Legido-Quigley H, Balabanova D, Nieuwlaat R, et al. PubMed Assess the patients ability to comprehend and apply knowledge.The nurse should assess whether a patient is mentally and physically capable of comprehending and implementing instructions provided to them. Her nursing career has led her through many different specialties including inpatient acute care, hospice, home health, case management, travel nursing, and telehealth, but her passion lies in educating through writing for other healthcare professionals and the general public. Moreover, the results for many factors were inconsistent. These factors can be divided into five different dimensions: social and economic factors, therapy-related factors, disease-related factors, patient-related factors and health care system-related factors [10, 11]. Actions to resolve medication discrepancies include: A. Discuss the drug therapy to the patient, including the prescribed OTC drugs and analgesics. Nevertheless, we decided to use modified vote counting because we anticipated that this is the only method to harmonize the results from different types of narrative synthesizes.
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