Grading of Recommendations, Assessment, Development and Evaluation, Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Adherence: comparison of methods to assess medication adherence and classify nonadherence. Determinants of adherence to heart failure medication: a systematic literature review. Aging, antiretrovirals, and adherence: a meta analysis of adherence among older HIV-infected individuals. The challenges of assessing patients' medication beliefs: a qualitative study. HHS Vulnerability Disclosure, Help The impact of medication adherence on coronary artery disease costs and outcomes: a systematic review. We aimed to summarize the evidence for factors that are widely applicable across different conditions, therapies and regions/settings. orange: high (risk of bias), grey: low (risk of bias), blue-grey: unclear (risk of bias). Low health literacy: Implications for managing cardiac patients in practice. 2. 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. Medication adherence: WHO cares? The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Arch Public Health. Full and consistent cooperation of the patient in regimen reduces risk of getting adverse reactions from surgery such as bacterial infections or severe pain on the surgical site. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 2009;13(2):11523. Fifteen SRs met all eligibility criteria and were included in this overview. Mathes T, Antoine S-L, Pieper D. Factors influencing adherence in hepatitis-C infected patients: a systematic review. Association between antiretroviral therapy adherence and employment status: systematic review and meta-analysis. We chose the following factors: age, gender, ethnic status, education, employment, financial status/income, marital status/not living alone, social support, measure of intake complexity (e.g., number of tablets, number of medications, frequency of intake), duration of therapy, duration of disease, comorbidity, co-payments, medication costs and insurance status (insured/not insured). Pieper D, Buechter R, Jerinic P, Eikermann M. Overviews of reviews often have limited rigor: a systematic review. Create a quiet learning environment.Teaching should not be attempted in certain situations. Article TM was an author of two of the included SRs. For instance, most people know anemia that is caused by iron deficiency only but unaware of the other types. Two reviewers independently selected studies according to pre-defined inclusion criteria. We defined a factor as any exposure that is not controlled by the study investigator, Outcome: Implementation adherence (correct dose, timing and/or frequency of intake) [2], Study type: SRs (definition: systematic literature search in at least one electronic database and assessment and documentation of risk of bias of included studies) of quantitative studies. 7. A huge barrier to understanding health-related information is low health literacy. Clipboard, Search History, and several other advanced features are temporarily unavailable. knowledge deficit related to medication compliance 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). Gender seems to have no consistent impact on adherence. The nurse's ongoing assessment and understanding of the patients' reasons for treatment resistance is the key to promoting medication compliance. Of the 21 included SRs, 14 only synthesized the results narratively, and seven performed a meta-analysis. 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. 2012;73(5):691705. Nursing Diagnosis: Deficient Knowledge related to lack of exposure/recall, statement of misconception, or cognitive limitation secondary to surgery as evidenced by inaccurate follow-through of instructions and development of preventable complications. Non-adherence is a crucial point for the success and safety of many therapies [3,4,5]. We performed a systematic literature search in MEDLINE (via PubMed) and Embase (via Embase). Moher D, Liberati A, Tetzlaff J, Altman DG. We performed the search of the electronic databases on June 13, 2018. The common signs and symptoms of knowledge deficit are: Factors that may contribute to the development of deficient knowledge include: Patients might say I do not need your help, I already know this condition before, or I have no idea what the doctor is explaining to me which are perceived as symptoms of deficient knowledge. Nursing diagnoses handbook: An evidence-based guide to planning care. Chen H-Y, Saczynski JS, Lapane KL, Kiefe CI, Goldberg RJ. Anna Curran. Both reviewers agreed to exclude those SRs that reported only the number of statistically significant studies (e.g., 10 studies showed a statistically significant effect of gender) without reporting effect sizes and the total number of studies on a certain comparison (e.g., 12 studies analysed gender). Desired Outcome: The patient will verbalize ones understanding of disease process and possible treatment plan, as well as the familiarity of the drug adverse effects and possible complications. In contrast, 2/3 of all included SRs were at high risk of bias in two or three domains [20, 21, 23, 24, 26, 30, 33, 35, 37,38,39]. Include the patient in their plan.Telling a patient what they should or shouldnt do will not necessarily guarantee adherence. In contrast, the impacts of medication costs and insurance status were uncertain. 2. PLoS Med. knowledge deficit related to medication compliance As an Amazon Associate I earn from qualifying purchases. 2014;67(10):107682. Overviews of SRs are always at high risk for discordant or heterogeneous results across the included SRs [42]. Two reviewers independently assessed the risk of bias with the ROBIS tool. Interventions for a client experiecing hallucinations upone admission should occur in a sequence. 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. Value Health. Cultural Competence in Health Care: Is it important for people with chronic conditions? Our overview suggests that there is a social gradient in adherence. 2013;8(5):e64914. In patients taking oral anticancer agents and HIV-infected patients, some evidence was observed, and robust evidence for a negative impact was noted in cardiovascular conditions [28, 30, 32]. Cancer Epidemiol. sharing sensitive information, make sure youre on a federal https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/health-literacy, Impaired Physical Mobility Nursing Diagnosis & Care Plan, Chronic Pain Nursing Diagnosis & Care Plan, Unfamiliarity with subject (new diagnosis or treatment), Inaccurate demonstration or teach-back of instructions, Exhibiting aggression or irritability regarding teaching follow-up, Poor adherence or worsening medical condition, Avoiding eye contact or remaining silent during teaching, Patient will identify risk factors of their disease process and how to prevent worsening of symptoms, Patient will participate in the learning process, Patient will demonstrate the proper execution of, Patient will identify barriers to their learning and how to overcome. Evidence suggests that general mental comorbidity and belonging to an ethnic minority might have a negative impact on adherence and that a higher socioeconomic status might have a positive impact on adherence. Impact of Beliefs about Medicines on the Level of Intentional Non-Adherence to the Recommendations of Elderly Patients with Hypertension. The nurse may need to wait until a more opportune time to teach. The site is secure. For the analysis of the influence of ethnic status on adherence, we considered different comparisons because the grouping in primary studies differed widely. New York: Russell Sage Foundation; 2009. p. 20720. 2014;17(2):28896. The results of each individual included SR are presented in the Additionalfile4. Three SRs were rated to be at high risk of bias in all domains [22, 32, 36]. Knowledge plays a vital role in the patients recovery and may include 3 domains namely: (1) cognitive domain, (2) affective domain, and (3) psychomotor domain. Medication non-adherence is a widespread problem that causes high costs worldwide [5,6,7,8,9,10]. Duration of disease was the only disease-related factor considered in this overview. Medication compliance and persistence: terminology and definitions. Socioeconomic status and nonadherence to antihypertensive drugs: a systematic review and meta-analysis. Some evidence for a negative impact of mental comorbidity on medication adherence was exclusively noted in hepatitis C and cardiovascular conditions [21, 27, 30, 37]. Mann BS, Barnieh L, Tang K, Campbell DJT, Clement F, Hemmelgarn B, et al. We analysed seven potentially socioeconomic adherence-influencing factors. 4. In the final phase 3, the assessor judges whether the whole SRs is at risk of bias. Whiting P, Savovi J, Higgins JPT, Caldwell DM, Reeves BC, Shea B, et al. Among patients with chronic diseases and patients taking oral anticancer agents, there was some evidence that a better financial status has a positive influence on adherence [20, 39]. 2013;18(4):40927. Which interventions are most important for the nurse to include in the client's initial plan of care? In all these domains, more than 50% of the SRs were at high risk of bias. The results for each included SRs are illustrated in Table2. 2013;39(6):61021. Wiesbaden: Springer Fachmedien Wiesbaden; 2017. Factors associated with medication adherence among patients with diabetes in the Middle East and North Africa region: a systematic mixed studies review. Medication adherence influencing factorsan (updated) overview of ROBIS: tool to assess risk of bias in systematic reviews: guidance on how ro use ROBIS; 2016. St. Louis, MO: Elsevier. 0 share; SHARE ON TWITTER 1. Please follow your facilities guidelines, policies, and procedures. J Clin Epidemiol. In contrast, negative effect directions of higher age in chronic diseases, cardiovascular conditions and oral anticancer agents were reported [20, 21, 23, 24, 28, 39]. 2009;15:e2233. 2014;67(4):36875. Grimshaw J. In addition, from the high risk of bias, the main reason for so many uncertain judgements was imprecision. knowledge deficit related to medication compliance The explanation for the inconsistent results of the linear analyses might also be attributed to the fact that the association is indeed non-linear. Educate the patient about enriching the diet with foods rich in iron, folic acid, and vitamin B12 as a remedy for those with nutritional deficiency anemia. knowledge deficit related to medication compliance. A condition-related explanation for heterogeneity might be that many SRs seem to include symptomatic as well as asymptomatic patients. (Select all that apply. The evidence for an impact of education on adherence was uncertain for most diseases/therapies. Educate the patient regarding the anti-GERD medications and their potential side effects, and if such symptoms arise, notify the physician immediately. 2013;126(4):357.e7357.e27.
knowledge deficit related to medication compliance