ARTICOLI DALLA LETTERATURA SCIENTIFICA

Women discontinue antihypertensive drug therapymore thanmen. Evidence froman Italian population-based study
Federico Rea, Marta Mella, Matteo Monzio Compagnoni, Anna Cantarutti, Luca Merlino, Giuseppe Mancia, Giovanni Corrao

Objective: Several factors affect adherence to antihypertensive drug treatment, but whether these factors include a sex difference is unclear. Aim of the study was to compare persistence with antihypertensive drug therapy between men and women in a large cohort of patients.
Methods: The 60 526 residents of the Italian Lombardy Region aged 40-80 years newly treated with antihypertensive drugs during 2010 were identified and followed for 1 year after the first prescription. Discontinuation of treatment was defined as lack of prescription renewal for at least 90 days. Log-binomial regression models were fitted to estimate the risk ratio of treatment discontinuation in relation to sex. Other than for the whole population, analyses were stratified according to age, comorbidity status and the initial…Read more

Understanding how young people become motivated to take their human immunodeficiency virus medication (antiretroviral therapy) and how the need for adherence is communicated
Warren Hickson, Pat M Mayers

Background: Antiretroviral therapy (ART), the only effective treatment for human immunodeficiency virus (HIV), requires excellent long-term compliance. Poor levels of adherence to ART, especially amongst adolescents and young adults in South Africa, have been reported.
Aim: This study aimed to explore how young people become motivated to take their HIV medication (ART) and how the need for adherence is communicated.
Setting: The study was conducted in a peri-urban township in the Western Cape, South Africa.
Methods: A qualitative grounded theory approach was employed. Eighty young people were purposively recruited. Participant observation, focus groups and semi-structured interviews were utilised to explore how effective ART adherence messages are in motivating adherence amongst young people and how they would like ART adherence to…Read more
 

Real-world adherence to, and persistence with, once- and twice-daily oral disease-modifying drugs in patients with multiple sclerosis: a systematic review and meta-analysis
Jacqueline A Nicholas, Natalie C Edwards, Roger A Edwards, Anna Dellarole, Megan Grosso, Amy L Phillips

Background: Nonadherence to disease-modifying drugs (DMDs) for multiple sclerosis (MS) is associated with poorer clinical outcomes, including higher rates of relapse and disease progression, and higher medical resource use. A systematic review and quantification of adherence and persistence with oral DMDs would help clarify the extent of nonadherence and nonpersistence in patients with MS to help prescribers make informed treatment plans and optimize patient care. The objectives were to: 1) conduct a systematic literature review to assess the availability and variability of oral DMD adherence and/or persistence rates across ‘real-world’ data sources; and 2) conduct meta-analyses of the rates of adherence and persistence for once- and twice-daily oral DMDs in patients with MS using real-world data…Read more
 

Adherence to beta-blockers and long-term risk of heart failure and mortality after a myocardial infarction
Liyew Desta, Masih Khedri, Tomas Jernberg, Pontus Andell, Moman Aladdin Mohammad, Claes Hofman-Bang, David Erlinge, Jonas Spaak, Hans Persson

Aims: The aim of this study is to investigate the association between adherence to beta-blocker treatment after a first acute myocardial infarction (AMI) and long-term risk of heart failure (HF) and death.
Methods and results: All patients admitted for a first AMI included in the nationwide Swedish web-system for enhancement and development of evidence-based care in heart disease evaluated according to recommended therapies register between 2005 and 2010 were eligible (n = 71 638). After exclusion of patients who died in-hospital, patients with previous HF, patients with unknown left ventricular ejection fraction (EF), and patients who died during the first year after the index event, 38 608 patients remained in the final analysis. Adherence to prescribed beta-blockers was determined for 1 year after the index event using the national registry for prescribed…Read more

Overcoming barriers to engagement and adherence to a home-based physical activity intervention for patients with heart failure: a qualitative focus group studyNduka C Okwose, Nicola O’Brien, Sarah Charman, Sophie Cassidy, David Brodie, Kristian Bailey, Guy A MacGowan, Djordje G Jakovljevic, Leah Avery

Objectives: Clinical guidelines recommend regular physical activity for patients with heart failure to improve functional capacity and symptoms and to reduce hospitalisation. Cardiac rehabilitation programmes have demonstrated success in this regard; however, uptake and adherence are suboptimal. Home-based physical activity programmes have gained popularity to address these issues, although it is acknowledged that their ability to provide personalised support will impact on their effectiveness. This study aimed to identify barriers and facilitators to engagement and adherence to a home-based physical activity programme, and to identify ways in which it could be integrated into the care pathway for patients with heart failure…Read more

Can the adherence to quality of care indicators for early rheumatoid arthritis in clinical practice reduce risk of hospitalisation? Retrospective cohort study based on the Record Linkage of Rheumatic Disease study of the Italian Society for Rheumatology
Anna Zanetti, Carlo Alberto Scirè, Lisa Argnani, Greta Carrara, Antonella Zambon, Italian Society for Rheumatology

Objective: To describe the adherence to quality of care indicators in early rheumatoid arthritis (RA) and to evaluate its impact on the risk of hospitalisation in a real-world setting.

Design: Retrospective cohort study.

Setting: Patients with early-onset RA identified from healthcare regional administrative databases by means of a validated algorithm between 2006 and 2012 in the Lombardy region (Italy).

Participants: The study cohort included 14 203 early-onset RA (71% female, mean age 60 years)…Read more

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