Therapeutic compliance of first line disease-modifying therapies in patients with multiple sclerosis. COMPLIANCE Study.

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Saiz, A; Mora, S; Blanco, J

2015-05-01

Non-adherence to disease-modifying therapies (DMTs) in multiple sclerosis may be associated with reduced efficacy. We assessed compliance, the reasons for non-compliance, treatment satisfaction, and quality of life (QoL) of patients treated with first-line therapies. A cross-sectional, multicenter study was conducted that included relapsing multiple sclerosis patients. Compliance in the past month was assessed using Morisky-Green test. Seasonal compliance and reasons for non-compliance were assessed by an ad-hoc questionnaire. Treatment satisfaction and QoL were evaluated by means of TSQM and PRIMUS questionnaires. A total of 220 patients were evaluated (91% relapsing-remitting); the mean age was 39.1 years, 70% were female, and the average time under treatment was 5.4 years. Subcutaneous interferon (IFN) β-1b was used in 23% of the patients, intramuscular IFN β-1a in 21%, subcutaneous IFN β-1a in 37%, and with glatiramer acetate in 19%. The overall compliance was 75%, with no significant differences related to the therapy, and 81% did not report any seasonal variation. Compliant patients had significantly lower disability scores and time of diagnosis, and greater satisfaction with treatment and its effectiveness. Discomfort and flu-like symptoms were the most frequent reasons for non-compliance. The satisfaction and QoL were associated with less disability and number of therapeutic switches. The rate of compliance, satisfaction and QoL in multiple sclerosis patients under DMTs is high, especially for those newly diagnosed, less disabled, and with fewer therapeutic switches. Discomfort and flu-like symptoms associated with injected therapies significantly affect adherence. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

'Consumers are patients!' shared decision-making and treatment non-compliance as business opportunity.

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Applbaum, Kalman

2009-03-01

This article describes an aspect of the progressive insertion of commercial interests into the relationship between patients and their clinicians, with particular reference to psychiatry. Treatment noncompliance, a long-standing problem for healthcare professionals, has lately drawn the attention of the pharmaceutical and allied industries as a site at which to improve return on investment (ROI). Newly founded corporate ;compliance departments' and specialized consultancies that regard noncompliance as a form of marketing failure are seeking to rectify it with reinvigorated models and strategies. This intervention stands to impact patients' experience of illness as well as the participation of those formally (physicians, case managers, etc.) and informally (family, friends, etc.) involved in treatment. My analysis draws upon observation at compliance conferences to demonstrate the contrasting models of patient empowerment underlying the marketing vs. medical approaches. I propose a research agenda for measuring the effects of industry compliance programs.

DOTS Compliance by Tuberculosis Patients in District Raipur (Chhattisgarh

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Teeku Sinha

2010-10-01

Full Text Available Background: Compliance to therapy is one of the important factors that affect the outcome. Non-compliance to self administered multi drug tuberculosis treatment regimens is an important cause of failure of initial therapy and relapse as well as acquired drug resistance, requiring more prolonged and expensive therapy. Objective: To know the compliance of DOTS therapy in TB patients in District Raipur and to find out the reasons of non-compliance of DOTS therapy among the patients. Study Design: Cross sectional observational community based study. Study Setting: Microscopic Centers in District Raipur. Participants: 695 patients of Tuberculosis. Result: Study revealed that 65.93% patients had complied with the DOTS therapy and 33.38% were non compliant. Conclusion: Most of the reasons of non-Compliance can be averted by proper counseling of target group. Hence to achieve the goal of RNTCP, proper counseling of target group must be given top priority.

Impact of side-effects of atypical antipsychotics on non-compliance, relapse and cost.

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Mortimer, A; Williams, P; Meddis, D

2003-01-01

Atypical antipsychotics generally have milder side-effects than conventional antipsychotics, but also differ among themselves in this respect. This study aimed to compare the impact of different side-effect profiles of individual atypical antipsychotics on non-compliance, relapse and cost in schizophrenia. A state-transition model was built using literature data supplemented by expert opinion. The model found that quetiapine and ziprasidone were similar in estimated non-compliance and relapse rates. Olanzapine and risperidone had higher estimated non-compliance and relapse rates, and incremental, 1-year, per-patient direct costs, using US-based cost data, of approximately $530 (95% confidence interval [CI] approximately $275, $800), and approximately $485 (95% CI approximately $235, $800), respectively, compared with quetiapine. Incremental costs attributable to different side-effect profiles were highly significant. This study shows that differing side-effect profiles of the newer antipsychotic agents are likely to lead to different compliance rates, and consequent variation in relapse rates. The cost implications of these heterogenous clinical outcomes are substantial.

Compliance or patient empowerment in online communities

DEFF Research Database (Denmark)

Wentzer, Helle; Bygholm, Ann

2010-01-01

New technologies enable a different organization of the public’s admission to health care services. The article discusses whether online support groups in patient treatment are to be understood in the light of patient empowerment or within the tradition of compliance. The back-ground material...... of opening up health care to the critical voice of the public, the quantitative and qualitative studies surprisingly point to a synthesis of the otherwise opposite positions of empowerment and compliance in patient care. Thereby the critical potential of online communities in health care services seems...

Compliance and Subjective Patient Responses to Eyelid Hygiene.

Science.gov (United States)

Alghamdi, Yousef A; Camp, Andrew; Feuer, William; Karp, Carol L; Wellik, Sarah; Galor, Anat

2017-07-01

Lid hygiene is a commonly prescribed first-line therapy in patients with lid margin disease, yet compliance with therapy is not well characterized. The goals of this study were to assess patient compliance with lid hygiene and evaluate which factors predict a favorable symptomatic response to treatment. This was a cross-sectional study of patients seen in the Miami Veterans Affairs eye clinic between August and December 2014. An evaluation was performed to assess dry eye symptoms and lid margin signs. All patients were then instructed to perform warm compresses and lid scrubs. A follow-up phone survey assessed compliance and subjective therapeutic response 6 weeks later. Two hundred seven of 211 (98%) patients (94% male, 60% white) completed the survey. Of the 207 patients, 188 (91%) completed the follow-up survey. Compliance with therapy was reported in 104 patients (55%); 66 reported complete improvement, 30 partial improvement, and 8 no improvement in symptoms. Patients who self-reported dry eye symptoms at first visit (n=86, 74%) were more likely to be compliant with lid hygiene than those who did not report symptoms (n=18, 25%) (Phygiene was longer time of self-reported dry eye symptoms. None of the other signs studied, including the presence of skin rosacea and lid margin telangiectasia, were associated with a differential response to lid hygiene. Patients with dry eye symptoms were moderately compliant with lid hygiene, and patients who performed the routine noted improvement in symptoms.

Influence of social competence of physicians on patient compliance with osteoporosis medications--a study on Polish postmenopausal women.

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Bryl, Nadia; Horst-Sikorska, Wanda; Ignaszak-Szczepaniak, Magdalena; Marcinkowska, Michalina; Michalak, Michał; Sewerynek, Ewa

2012-07-01

The aim of the study was to examine the impact of social competence of physicians on the effectiveness of patient compliance and persistence with therapy. The study included physicians and their patients, previously diagnosed with osteoporosis, and eligible to receive pharmacological treatment. The physicians were evaluated with the social competence questionnaire involving three dimensions: social exposure, intimacy and assertiveness, as well as in the combined scale. All patients in the study group were prescribed the same medication: alendronate once a week. Compliance and persistence of the patients were juxtaposed with social interaction skills of physicians during 7 scheduled appointments at 2-month intervals. Doctor's effectiveness in situations demanding close interpersonal contact was higher in the group with good compliance--group A (p fear and

Compliance of amblyopic patients with occlusion therapy: A pilot study

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Sana Al-Zuhaibi

2009-01-01

Materials and Methods: A total of 31 families with a child (aged 2-12 years, undergoing unilateral amblyopia treatment at the pediatric ophthalmology clinic of Sultan Qaboos University Hospital, Oman, were recruited for this one month study. Parents were interviewed and completed a closed-ended questionnaire. Clinical data including, visual acuity, refraction, diagnosis and treatment, for each patient was collected from the hospital chart and was entered in a data collection sheet. Compliance with occlusion therapy was assessed by self-report accounts of parents and was graded into good, partial, or poor. Association between various factors and degree of compliance was studied using logistic regression modeling. Results: Only 14 (45% patients showed good compliance to occlusion therapy. 17 (55% patients were noncompliant. Improvement in visual acuity strongly correlated with compliance to patching (P = 0.008. Other variables that were studied included, age at onset of therapy; gender; degree of amblyopia; type of amblyopia; use of glasses; and compliance with glasses. These did not emerge as significant predictors of compliance. All but one family with poor compliance stated that the main challenge in following the recommendation to patch for requisite hours was in getting their child to cooperate. Only in one instance, the family cited nonavailability of patches as the main hindrance to compliance. 10/31 (32% families expressed a desire for more information and 18/31 (58% parents did not understand that amblyopia meant decreased vision. Conclusion: Poor compliance is a barrier to successful amblyopia therapy in our practice. Improvement in visual acuity is associated with better compliance with patching. Parents find it difficult to comprehend and retain verbal explanations of various components regarding occlusion therapy for amblyopia. Future study with a larger sample of patients is recommended to investigate the factors affecting compliance with amblyopia

Physician perspectives and compliance with patient advance directives: the role external factors play on physician decision making.

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Burkle, Christopher M; Mueller, Paul S; Swetz, Keith M; Hook, C Christopher; Keegan, Mark T

2012-11-21

Following passage of the Patient Self Determination Act in 1990, health care institutions that receive Medicare and Medicaid funding are required to inform patients of their right to make their health care preferences known through execution of a living will and/or to appoint a surrogate-decision maker. We evaluated the impact of external factors and perceived patient preferences on physicians' decisions to honor or forgo previously established advance directives (ADs). In addition, physician views regarding legal risk, patients' ability to comprehend complexities involved with their care, and impact of medical costs related to end-of-life care decisions were explored. Attendees of two Mayo Clinic continuing medical education courses were surveyed. Three scenarios based in part on previously court-litigated matters assessed impact of external factors and perceived patient preferences on physician compliance with patient-articulated wishes regarding resuscitation. General questions measured respondents' perception of legal risk, concerns over patient knowledge of idiosyncrasies involved with their care, and impact medical costs may have on compliance with patient preferences. Responses indicating strength of agreement or disagreement with statements were treated as ordinal data and analyzed using the Cochran Armitage trend test. Three hundred eighty-eight of 951 surveys were completed (41% response rate). Eighty percent reported they were likely to honor a patient's AD despite its 5 year age. Fewer than half (41%) would honor the AD of a patient in ventricular fibrillation who had expressed a desire to "pass away in peace." Few (17%) would forgo an AD following a family's request for continued resuscitative treatment. A majority (52%) considered risk of liability to be lower when maintaining someone alive against their wishes than mistakenly failing to provide resuscitative efforts. A large percentage (74%) disagreed that patients could not appreciate complexities

Patient compliance with drug therapy for postmenopausal osteoporosis

International Nuclear Information System (INIS)

Ahmad, A.; Khan, M.Y.

2007-01-01

To determine compliance and factors affecting compliance to antiresorptive drugs in osteoporosis, and to compare compliant and non compliant groups in a tertiary care setting. A total of 800 patients with postmenopausal osteoporosis were included in the study. The demographic and reproductive characteristics of all the patients were recorded. Type of antiresorptive drugs prescribed, degree of compliance, time and reasons for discontinuation were studied and analyzed. The mean age of the patients was 64 (+-9) years and their mean duration of follow-up 18 (+-5) months. The prevalence of risk factors for osteoporosis were evenly distributed among treatment groups; 73% patients had a co-morbidity besides osteoporosis while 27% were osteoporotic alone. One or more previous vertebral fractures due to osteoporosis was reported by 14.5% of patients, whereas 35.5% had at least one non-vertebral fracture in their medical history. Out of the total patients 21.5% discontinued the prescribed drug before attending the bone mass re-evaluations, more than half of these within first six months of starting the drugs. The medication that was most frequently discontinued within one year was calcium and vitamin-D (33.7%, p<0.01) while the least discontinued medication was Alendronate (5.9%, p < 0.01) which is taken once a week. In this study the most important determinant of compliance was the type of drug prescribed and its dose frequency, with a definite preference for Alendronate once a week. Treatment compliance was particularly poor for calcium and vitamin-D regimen, thereby emphasizing the need to find new ways of administering supplements, particularly for vitamin-D. (author)

The Impact of Religiosity on Tax Compliance among Turkish Self-Employed Taxpayers

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Serkan Benk

2016-04-01

Full Text Available The aim of this study is to explore the impact between religiosity and voluntary tax compliance and enforced tax compliance for self-employed taxpayers in Turkey, where Islam is the predominant religion. A questionnaire survey was administrated to 375 male and 28 female self-employed taxpayers. In this paper, two dimensions of religiosity, namely interpersonal and intrapersonal religiosity, were studied. Factor analysis and ordinary least squares regression methods were used for data analyses. The results of the study illustrate that general religiosity has a statistically positive impact on both voluntary and enforced tax compliance. When we consider the dimensions of religiosity, only intrapersonal religiosity appears to be a significant contributor only to voluntary tax compliance. Nevertheless, interpersonal religiosity has no significant statistical effect on both voluntary and enforced tax compliance. This is one of the pioneer studies of its kind, and investigates the relationship between religiosity and tax compliance from the perspective of developing countries, particularly, Turkey.

Specific insomnia symptoms and self-efficacy explain CPAP compliance in a sample of OSAS patients.

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Philip, Pierre; Bioulac, Stéphanie; Altena, Elemarije; Morin, Charles M; Ghorayeb, Imad; Coste, Olivier; Monteyrol, Pierre-Jean; Micoulaud-Franchi, Jean-Arthur

2018-01-01

This study explores the association between specific insomnia symptoms (sleep onset, sleep maintenance and early morning awakenings symptoms) and self-efficacy (perceived self-confidence in the ability to use CPAP) with CPAP compliance in French patients with obstructive sleep apnea syndrome (OSAS). We performed a retrospective, cross-sectional analysis of CPAP compliance in a cohort of 404 patients diagnosed with OSAS. Patients completed mailed questionnaires on sleepiness (ESS), insomnia (ISI) and self-efficacy in sleep apnea (SEMSA). Linear regression modeling analyses were performed to explore the impact of measured variables on the number of hours of CPAP use. Of the initial pool of 404 patients, 288 returned the questionnaires (71% response rate). Their mean age was 63.16±12.73 yrs, 31% were females, mean BMI was 30.39±6.31 kg/m2, mean daily CPAP use was 6.19±2.03 h, mean number of years of use was 6.58±6.03 yrs, and mean initial AHI before CPAP use was 34.61±20.71 /h. Age (pCPAP use. We found that specific insomnia symptoms and self-efficacy were associated with CPAP compliance. Our findings underline the need to demonstrate that interventions that reduce insomnia symptoms and improve self-efficacy will increase CPAP compliance.

The Impact of Anesthesia-Influenced Process Measure Compliance on Length of Stay: Results From an Enhanced Recovery After Surgery for Colorectal Surgery Cohort.

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Grant, Michael C; Pio Roda, Claro M; Canner, Joseph K; Sommer, Philip; Galante, Daniel; Hobson, Deborah; Gearhart, Susan; Wu, Christopher L; Wick, Elizabeth

2018-05-17

Process measure compliance has been associated with improved outcomes in enhanced recovery after surgery (ERAS) programs. Herein, we sought to assess the impact of compliance with measures directly influenced by anesthesiology in an ERAS for colorectal surgery cohort. From January 2013 to April 2015, data from 1140 consecutive patients were collected for all patients before (pre-ERAS) and after (ERAS) implementation of an ERAS program. Compliance with 9 specific process measures directly influenced by the anesthesiologist or acute pain service was analyzed to determine the impact on hospital length of stay (LOS). Process measure compliance was associated with a stepwise reduction in LOS. Patients who received >4 process measures (high compliance) had a significantly shorter LOS (incident rate ratio [IRR], 0.77; 95% CI, 0.70-0.85); P process measures) counterparts. Multivariable regression suggests that utilization of multimodal nausea and vomiting prophylaxis (IRR, 0.78; 95% CI, 0.68-0.89; P process measures directly influenced by the anesthesiologists and in concert with a formal anesthesia protocol is associated with reduced LOS. Engaging anesthesiology colleagues throughout the surgical encounter increases the overall value of perioperative care.

Rectal compliance as a routine measurement: extreme volumes have direct clinical impact and normal volumes exclude rectum as a problem.

Science.gov (United States)

Felt-Bersma, R J; Sloots, C E; Poen, A C; Cuesta, M A; Meuwissen, S G

2000-12-01

The clinical impact of rectal compliance and sensitivity measurement is not clear. The aim of this study was to measure the rectal compliance in different patient groups compared with controls and to establish the clinical effect of rectal compliance. Anorectal function tests were performed in 974 consecutive patients (284 men). Normal values were obtained from 24 controls. Rectal compliance measurement was performed by filling a latex rectal balloon with water at a rate of 60 ml per minute. Volume and intraballoon pressure were measured. Volume and pressure at three sensitivity thresholds were recorded for analysis: first sensation, urge, and maximal toleration. At maximal toleration, the rectal compliance (volume/pressure) was calculated. Proctoscopy, anal manometry, anal mucosal sensitivity, and anal endosonography were also performed as part of our anorectal function tests. No effect of age or gender was observed in either controls or patients. Patients with fecal incontinence had a higher volume at first sensation and a higher pressure at maximal toleration (P = 0.03), the presence of a sphincter defect or low or normal anal pressures made no difference. Patients with constipation had a larger volume at first sensation and urge (P 500 ml had complaints of constipation. No correlation between rectal and anal mucosal sensitivity was found. Rectal compliance measurement with a latex balloon is easily feasible. In this series of 974 patients, some patient groups showed an abnormal rectal visceral sensitivity and compliance, but there was an overlap with controls. Rectal compliance measurement gave a good clinical impression about the contribution of the rectum to the anorectal problem. Patients with proctitis and pouchitis had the smallest rectal compliance. A maximal toleration volume 500 ml was only seen in constipated patients, and therapy should be given to prevent further damage to the pelvic floor. Values close to or within the normal range rule out the

Physician perspectives and compliance with patient advance directives: the role external factors play on physician decision making

Directory of Open Access Journals (Sweden)

Burkle Christopher M

2012-11-01

Full Text Available Abstract Background Following passage of the Patient Self Determination Act in 1990, health care institutions that receive Medicare and Medicaid funding are required to inform patients of their right to make their health care preferences known through execution of a living will and/or to appoint a surrogate-decision maker. We evaluated the impact of external factors and perceived patient preferences on physicians’ decisions to honor or forgo previously established advance directives (ADs. In addition, physician views regarding legal risk, patients’ ability to comprehend complexities involved with their care, and impact of medical costs related to end-of-life care decisions were explored. Methods Attendees of two Mayo Clinic continuing medical education courses were surveyed. Three scenarios based in part on previously court-litigated matters assessed impact of external factors and perceived patient preferences on physician compliance with patient-articulated wishes regarding resuscitation. General questions measured respondents’ perception of legal risk, concerns over patient knowledge of idiosyncrasies involved with their care, and impact medical costs may have on compliance with patient preferences. Responses indicating strength of agreement or disagreement with statements were treated as ordinal data and analyzed using the Cochran Armitage trend test. Results Three hundred eighty-eight of 951 surveys were completed (41% response rate. Eighty percent reported they were likely to honor a patient’s AD despite its 5 year age. Fewer than half (41% would honor the AD of a patient in ventricular fibrillation who had expressed a desire to “pass away in peace.” Few (17% would forgo an AD following a family’s request for continued resuscitative treatment. A majority (52% considered risk of liability to be lower when maintaining someone alive against their wishes than mistakenly failing to provide resuscitative efforts. A large percentage

Compliance to medication among hypertensive patients in Murtala ...

African Journals Online (AJOL)

Compliance to medication among hypertensive patients in Murtala Mohammed Specialist Hospital, Kano, Nigeria. M Kabir, Z Iliyasu, LS Abubakar, M Jibril. Abstract. Background: Non-compliance to blood pressure-lowering medication is a major reason for poor control of hypertension worldwide. We assessed the level of ...

[The role of patient compliance in the management of glaucoma].

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Popović Suić, Smiljka; Cerovski, Branimir; Jukić, Tomislav

2008-02-01

The aim of the study was to evaluate patient cooperation in glaucoma treatment. We evaluated data collected by an anonymous questionnare from 98 glaucoma patients who answered 6 questions regarding their compliance and persistence in glaucoma treatment. Study results revealed 50% of patients to fail taking their antiglaucoma therapy regularly. Patients on monotherapy showed better compliance and higher level of satisfaction with treatment than those on combination antiglaucoma therapy consisting of 2 or 3 eyedrops. Discontinuation of persistence was recorded in 31% of patients, whereas 51% of patients did not present for control visits every six months as suggested by their ophthalmologist. Patients are more compliant and persistent with antiglaucoma monotherapy than with combined therapy. Greater compliance and persistence with ocular hypotensive therapy may improve the outcomes in glaucoma.

Subjective and Objective CPAP Compliance in Patients with Obstructive Sleep Apnea Syndrome

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Ji-Ae Choi

2011-08-01

Full Text Available Background and Objective This study aimed to investigate objective and subjective continuous positive airway pressure (CPAP compliance in patients with obstructive sleep apnea syndrome (OSAS. Moreover, we evaluated the factors and benefits associated with good CPAP compliance. Methods Subjects were 153 OSAS patients who underwent polysomnography for CPAP titration. Subjective compliance was defined as reported CPAP use of at least 4 hours a day for five or more days per week, and objective compliance was defined as CPAP use of at least 4 hours a day for more than 70% of the time recorded in the CPAP machine. Results The subjective and objective compliance rates were 34.0% and 20.7%, respectively. Subjectively compliant patients had lower minimum O2 saturation and higher % of time with O2 saturation lower than 90% than did patients declining CPAP treatment. Objectively compliant patients had lower insomnia and depression score and lower minimum O2 saturation than did patients declining CPAP treatment. Daytime sleepiness and subjective sleep quality improved to the same extent in both objectively and subjectively compliant patients. Conclusions Lower insomnia score and more severe OSA correlate with good CPAP compliance. CPAP effect was comparable between subjectively and objectively compliant patients.

Depot-medication compliance for patients with psychotic disorders: the importance of illness insight and treatment motivation.

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Noordraven, Ernst L; Wierdsma, André I; Blanken, Peter; Bloemendaal, Anthony Ft; Mulder, Cornelis L

2016-01-01

Noncompliance is a major problem for patients with a psychotic disorder. Two important risk factors for noncompliance that have a severe negative impact on treatment outcomes are impaired illness insight and lack of motivation. Our cross-sectional study explored how they are related to each other and their compliance with depot medication. Interviews were conducted in 169 outpatients with a psychotic disorder taking depot medication. Four patient groups were defined based on low or high illness insight and on low or high motivation. The associations between depot-medication compliance, motivation, and insight were illustrated using generalized linear models. Generalized linear model showed a significant interaction effect between motivation and insight. Patients with poor insight and high motivation for treatment were more compliant (94%) (95% confidence interval [CI]: 1.821, 3.489) with their depot medication than patients with poor insight and low motivation (61%) (95% CI: 0.288, 0.615). Patients with both insight and high motivation for treatment were less compliant (73%) (95% CI: 0.719, 1.315) than those with poor insight and high motivation. Motivation for treatment was more strongly associated with depot-medication compliance than with illness insight. Being motivated to take medication, whether to get better or for other reasons, may be a more important factor than having illness insight in terms of improving depot-medication compliance. Possible implications for clinical practice are discussed.

Patient Compliance with Surveillance Following Elective Endovascular Aneurysm Repair

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Godfrey, Anthony D., E-mail: deangodfrey@yahoo.co.uk; Morbi, Abigail H. M., E-mail: a.morbi@soton.ac.uk; Nordon, Ian M., E-mail: ian.nordon@uhs.nhs.uk [University Hospital Southampton NHS Foundation Trust, Unit of Cardiac Vascular and Thoracic Surgery - CV& T, Department of Vascular Surgery (United Kingdom)

2015-10-15

PurposeIntegral to maintaining good outcomes post-endovascular aneurysm repair (EVAR) is a robust surveillance protocol. A significant proportion of patients fail to comply with surveillance, exposing themselves to complications. We examine EVAR surveillance in Wessex (UK), exploring factors that may predict poor compliance.MethodsRetrospective analysis of 179 consecutive elective EVAR cases [2008–2013] was performed. 167 patients were male, with the age range of 50–95. Surveillance was conducted centrally (tertiary referral trauma centre) and at four spoke units. Surveillance compliance and predictors of non-compliance including age, gender, co-morbid status, residential location and socioeconomic status were analysed for univariate significance.ResultsFifty patients (27.9 %) were non-compliant with surveillance; 14 (8.1 %) had no imaging post-EVAR. At 1 year, 56.1 % (of 123 patients) were compliant. At years 2 and 3, 41.5 and 41.2 % (of 65 and 34 patients, respectively) were compliant. Four years post-EVAR, only one of eight attended surveillance (12.5 %). There were no statistically significant differences in age (p = 0.77), co-morbid status or gender (p = 0.64). Distance to central unit (p = 0.67) and surveillance site (p = 0.56) was non-significant. While there was a trend towards compliance in upper-middle-class socioeconomic groups (ABC1 vs. C1C2D), correlating with >50 % of non-compliant patients living within <10 mile radius of the central unit, overall predictive value was not significant (p = 0.82).ConclusionsCompliance with surveillance post-EVAR is poor. No independent predictor of non-compliance has been confirmed, but socioeconomic status appears to be relevant. There is a worrying drop-off in attendance beyond the first year. This study highlights a problem that needs to be addressed urgently, if we are to maintain good outcomes post-EVAR.

Patient Compliance with Surveillance Following Elective Endovascular Aneurysm Repair

International Nuclear Information System (INIS)

Godfrey, Anthony D.; Morbi, Abigail H. M.; Nordon, Ian M.

2015-01-01

PurposeIntegral to maintaining good outcomes post-endovascular aneurysm repair (EVAR) is a robust surveillance protocol. A significant proportion of patients fail to comply with surveillance, exposing themselves to complications. We examine EVAR surveillance in Wessex (UK), exploring factors that may predict poor compliance.MethodsRetrospective analysis of 179 consecutive elective EVAR cases [2008–2013] was performed. 167 patients were male, with the age range of 50–95. Surveillance was conducted centrally (tertiary referral trauma centre) and at four spoke units. Surveillance compliance and predictors of non-compliance including age, gender, co-morbid status, residential location and socioeconomic status were analysed for univariate significance.ResultsFifty patients (27.9 %) were non-compliant with surveillance; 14 (8.1 %) had no imaging post-EVAR. At 1 year, 56.1 % (of 123 patients) were compliant. At years 2 and 3, 41.5 and 41.2 % (of 65 and 34 patients, respectively) were compliant. Four years post-EVAR, only one of eight attended surveillance (12.5 %). There were no statistically significant differences in age (p = 0.77), co-morbid status or gender (p = 0.64). Distance to central unit (p = 0.67) and surveillance site (p = 0.56) was non-significant. While there was a trend towards compliance in upper-middle-class socioeconomic groups (ABC1 vs. C1C2D), correlating with >50 % of non-compliant patients living within <10 mile radius of the central unit, overall predictive value was not significant (p = 0.82).ConclusionsCompliance with surveillance post-EVAR is poor. No independent predictor of non-compliance has been confirmed, but socioeconomic status appears to be relevant. There is a worrying drop-off in attendance beyond the first year. This study highlights a problem that needs to be addressed urgently, if we are to maintain good outcomes post-EVAR

Identification of factors involved in medication compliance: incorrect inhaler technique of asthma treatment leads to poor compliance

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Darbà J

2016-02-01

Full Text Available Josep Darbà,1 Gabriela Ramírez,2 Antoni Sicras,3 Laura García-Bujalance,4 Saku Torvinen,5 Rainel Sánchez-de la Rosa6 1Department of Economics, Universitat de Barcelona, 2BCN Health Economics & Outcomes Research S.L., 3Department of Planning, Badalona Serveis Assistencials S.A., Barcelona, 4Market Access Department, Teva Pharmaceutical, Madrid, Spain; 5Market Access Department, Teva Pharmaceuticals Europe BV, Amsterdam, the Netherlands; 6Medical Department, Teva Pharmaceutical, Madrid, Spain Objective: To identify the impact of delivery device of inhaled corticosteroids and long-acting β2-agonist (ICS/LABA on asthma medication compliance, and investigate other factors associated with compliance. Materials and methods: We conducted a retrospective and multicenter study based on a review of medical registries of asthmatic patients treated with ICS/LABA combinations (n=2,213 whose medical devices were either dry powder inhalers (DPIs, such as Accuhaler®, Turbuhaler®, and NEXThaler® or pressurized metered-dose inhalers (pMDI. Medication compliance included persistence outcomes through 18 months and medication possession ratios. Data on potential confounders of treatment compliance such as asthma exacerbations, comorbidities, demographic characteristics, and health care resource utilization were also explored. Results: The probability of asthma medication compliance in case of DPIs was lower compared to pMDIs, which suggests that inhaler devices influence inhalation therapies. There were additional confounding factors that were considered as explanatory variables of compliance. A worse measure of airflow obstruction (forced expiration volume in 1 second, comorbidities and general practitioner (GP consultations more than once per month decreased the probability of compliance. Within comorbidities, alcoholism was positively associated with compliance. Patients of 29–39, 40–50, and 51–61 age groups or suffering from more than two

Patient-Treatment Matching Improves Compliance of Alcoholics in Outpatient Treatment

DEFF Research Database (Denmark)

Nielsen, Anette Søgaard; Nielsen, Bent; Wraae, Olaf

1998-01-01

curves. The consequence of compliance for long-term prognosis was described by means of the Addiction Severity Index. The form of treatment in itself had no importance for compliance. However, correct matching of a patient and a treatment structure resulted in a compliance rate of 63% as opposed to 38...

Patient compliance and supportive periodontal therapy: Study among young adults of Namakkal district

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Subramanium Gokulanathan

2014-01-01

Full Text Available Aims: The aim of this study is to assess the patient compliance to supportive and maintenance periodontal therapy and to determine the reason for noncompliance among young adult patients of Namakkal district, India. Materials and Methods: This was a cross-sectional study conducted on 400 patients who underwent periodontal therapy and subsequently recalled for supportive and maintenance periodontal treatment in the Department of Periodontics, Vivekanandha Dental College for Women, Namakkal. Patients age group 25-35 years and of both gender were equally selected and grouped by occupation and socioeconomic status. According to their compliance with appointments, they are categorized as complete compliance, partially compliance and insufficient or noncompliance. Noncompliance and partially compliance patients were contacted and asked to rate their experience and reason for noncompliance. Results: In this study, 80% of patients showed complete compliance and were regular for supportive periodontal therapy appointments. Women were more regular in maintaining recall appointments than men. Salaried employers showed 84.3% complete compliance, while self-employed personals showed 77% complete compliance and 75% of nonworking personals were regular to the appointment schedule. Noncompliance person has quoted lack of time and forgetting the appointment date as a major reason for missed appointments. Conclusions: This study recommends the need for improvement in communication skills of practitioners and weekend appointment for patient undergoing periodontal maintenance therapy.

[Psychological factors associated to patient's treatment compliance in Chilean diabetic teenagers].

Science.gov (United States)

Ortiz, Manuel; Ortiz, Eugenia

2005-03-01

Treatment compliance among patients with type 1 diabetes mellitus, is low in 50% of diabetic teenagers, becoming a social and medical problem. To determine psycho-social factors associated to treatment compliance among Chilean diabetic type 1 teenagers. A non experimental study of 61 diabetic teenagers (age 14.9+/-1.9 years, 37 male). The number of blood glucose determinations, socioeconomic level and practice of sports was measured. Psychological tests were applied to analyze self-efficiency, motivation of achievement, self-esteem and knowledge of the illness and its treatment. As a measure of patient compliance, glycosilated hemoglobin (HB1Ac) was measured. Six patients had a good control of diabetes (HB1Ac <7%), 24 had HB1Ac values between 7 and 8.9, and 31 (51%) had values of 9% or more, considered as a poor diabetes control. The intensified insulin treatment scheme, the knowledge of the illness and its treatment and the sense of self-efficiency, were the factors associated with a better compliance with treatment. Teenagers of higher socio-economical levels had a better compliance with treatment. Fifty percent of Chilean diabetic teenagers in this sample had a poor control of the disease and the variable knowledge about the disease is the better predictor of patient compliance.

Evaluating impacts of Clean Air Act compliance strategies

International Nuclear Information System (INIS)

Shirer, D.A.; Evans, R.J.; Harrison, C.D.; Kehoe, D.B.

1993-01-01

The Clean Air Act Amendments of 1990 requires that by the year 2000, US SO 2 emissions must be reduced by 10 million tons. This requirement will have significant impact on coal-fired electric utilities. As a result, most utilities are currently evaluating numerous compliance options, including buying allowances, coal cleaning/blending/switching, and flue gas scrubbing. Moreover, each utility must address its own unique circumstances with regard to competition, efficiency, capital expenditures, reliability, etc. and many utilities may choose a combination of compliance options to simultaneously satisfy their environmental, performance, and financial objectives. The Coal Quality Expert, which is being developed under a clean coal technology project funded by US DOE and EPRI, will predict the economic, operational, and environmental benefits of using higher-quality coals and provides an assessment of the merits of various post-combustion control technologies for specific utility applications. This paper presents background on how utilities evaluate their compliance options, and it describes how the Coal Quality Expert could be used for such evaluations in the future to assure that each utility can select the best combination of coal specifications and emission control technologies to meet its compliance objectives

Impact of a mobile health aplication in the nursing care plan compliance of a home care service in Belo Horizonte, Minas Gerais, Brazil.

Science.gov (United States)

de Britto, Felipe A; Martins, Tatiana B; Landsberg, Gustavo A P

2015-01-01

To assess impact of a mobile health solution in the nursing care plan compliance of a home care service. A retrospective cohort study was performed with 3,036 patients. Compliance rates before and after the implementation were compared. After the implementation of a mobile health aplication, compliance with the nursing care plan increased from 53% to 94%. The system reduced IT spending, increased the nursing team efficiency and prevented planned hiring. The use of a mobile health solution with geolocating feature by a nursing home care team increased compliance to the care plan.

Aortic compliance in patients with aortic regurgitation. Evaluation with magnetic resonance imaging

International Nuclear Information System (INIS)

Murai, Sachiko; Hamada, Seiki; Ueguchi, Takashi

2005-01-01

The purpose of this study was to assess by means of cine magnetic resonance imaging (MRI) aortic compliance before and after aortic valve replacement (AVR with SJM (St. Jude Medical, St paul, MN) valve) in patients with aortic regurgitation (AR). Two groups (healthy controls and patients with severe isolated AR) of 10 subjects each were included in this study. Cine MRI was performed at three locations of the aorta, and aortic compliance was calculated by dividing the maximum change in the aortic area by pulse pressure. Cine MRI is useful to assess abnormalities of aortic compliance in patients with AR. Compared with the control group, aortic compliance in the AR group was significantly less in the ascending aorta (p<0.05), decreasing in order of aortic location. After AVR, aortic compliance improved for all locations. Cine MRI enables assessment of aortic biophysical properties such as a compliance for evaluating the progression of AR and the efficacy of treatment. (author)

Patient's perception, compliance to treatment and health education of antiretroviral therapy among HIV patients at a tertiary healthcare setting

International Nuclear Information System (INIS)

Hussain, A.R.; Abbas, S.M.; Reza, T.E

2013-01-01

Objective: To illustrate perceptions, compliance to treatment and satisfaction levels regarding health education services pertaining to the anti-retrovival therapy among HIV and AIDS patients. Methods: The cross-sectional survey was carried out at the HIV Treatment Centre, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from September 2009 to February 2010 in which patients were interviewed separately regarding their perceptions, compliance to treatment and satisfaction levels regarding health education services pertaining to the anti-retrovival therapy. All data collected was entered into SPSS version 15.0. The data was re-validated and analysed. Results: One hundred and forty patients were interviewed; there were 99 (70.7%) males.. Of the total, 28 (20%) had no knowledge about the beneficial effects of the therapy, and 45 (32 %) ranked health education services extremely beneficial in understanding the anti-retrovival therapy. Conclusion: While a significant proportion of patients considered ART either somewhat beneficial or beneficial in treating their ailment, they were unclear about the impact of health education provided at the treatment centre and different forms of print media. (author)

Patient's perception, compliance to treatment and health education of antiretroviral therapy among HIV patients at a tertiary healthcare setting.

Science.gov (United States)

Hussain, Aleem Raza; Abbas, Syed Muslim; Uzma, Qudsia; Reza, Tahira Ezra

2013-07-01

To illustrate perceptions, compliance to treatment and satisfaction levels regarding health education services pertaining to the anti-retrovival therapy among HIV and AIDS patients. The cross-sectional survey was carried out at the HIV Treatment Centre, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from September 2009 to February 2010 in which patients were interviewed separately regarding their perceptions, compliance to treatment and satisfaction levels regarding health education services pertaining to the anti-retrovival therapy. All data collected was entered into SPSS version 15.0. The data was revalidated and analysed. One hundred and forty patients were interviewed; there were 99 (70.7%) males.. Of the total, 28 (20%) had no knowledge about the beneficial effects of the therapy, and 45 (32 %) ranked health education services extremely beneficial in understanding the anti-retrovival therapy. While a significant proportion of patients considered ART either somewhat beneficial or beneficial in treating their ailment, they were unclear about the impact of health education provided at the treatment centre and different forms of print media.

[Evaluation of compliance with antiretroviral treatment in a cohort of 200 patients in Djibouti, 2005].

Science.gov (United States)

Ahmed, A A; Katlama, C; Ghosn, J; Guiguet, M; Costagliola, D

2007-01-01

We determined the rate of compliance with antiretroviral therapy and investigated the factors that influence it among 86 HIV patients. Compliance ratio (number of tablets taken/number prescribed) was assessed by tablet count. The mean ratio of compliance was 92%. By tablet count, 77% of the patients were compliant (compliance ratio > or =90%). Non-compliance was significantly associated with side-effects, degree of confidentiality of the care centre and travelling. Compliance correlated significantly with viral load. In multivariate analysis, community support and level of education protected against non-compliance. Patients having already missed a dose and those dissatisfied with confidentiality had a 4 times greater risk of non-compliance.

Hand hygiene compliance in transplant and other special patient groups: an observational study.

Science.gov (United States)

Graf, Karolin; Ott, Ella; Wolny, Michael; Tramp, Nadine; Vonberg, Ralf-Peter; Haverich, Axel; Chaberny, Iris Freya

2013-06-01

This study evaluates hand hygiene behavior of health care workers in a German university hospital stratified for treatment of special patient groups (eg, transplant patients). From 2008 to 2010, comprehensive education and training of all health care workers was implemented to improve hand hygiene compliance. Consumption rates of alcohol-based hand rub and gloves were collected and evaluated. Of the 5,647 opportunities of hand disinfection evaluated, 1,607 occurred during care for transplant patients. To our knowledge, this is the largest survey of hand hygiene compliance in special patient groups on intensive care units in a university hospital in Germany. Health care workers on surgical intensive care units showed lower hand hygiene compliance compared with health care workers on other types of intensive care units. Compliance toward hand hygiene was significantly higher on hemato-oncologic and pediatric wards. In general, hand disinfection was performed significantly more frequently after an intervention than before (P hand hygiene compliance when caring for transplant patients or other patients (odds ratio, 1.16; 95% confidence interval: 0.95-1.42). Nurse's and physician's hand hygiene compliance improved because of education. Hand hygiene compliance is not increased in the care for transplant patients (despite their predisposition for nosocomial infections) compared with other patients. Additional studies will be necessary to further investigate these findings. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Patient compliance in hypertension: role of illness perceptions and treatment beliefs.

Science.gov (United States)

Ross, S; Walker, A; MacLeod, M J

2004-09-01

Despite many years of study, questions remain about why patients do or do not take medicines and what can be done to change their behaviour. Hypertension is poorly controlled in the UK and poor compliance is one possible reason for this. Recent questionnaires based on the self-regulatory model have been successfully used to assess illness perceptions and beliefs about medicines. This study was designed to describe hypertensive patients' beliefs about their illness and medication using the self-regulatory model and investigate whether these beliefs influence compliance with antihypertensive medication. We recruited 514 patients from our secondary care population. These patients were asked to complete a questionnaire that included the Beliefs about Medicines and Illness Perception Questionnaires. A case note review was also undertaken. Analysis shows that patients who believe in the necessity of medication are more likely to be compliant (odds ratio (OR)) 3.06 (95% CI 1.74-5.38), Pcompliance influence it indirectly. The self-regulatory model is useful in assessing patients health beliefs. Beliefs about specific medications and about hypertension are predictive of compliance. Information about health beliefs is important in achieving concordance and may be a target for intervention to improve compliance.

Guideline compliance in chronic heart failure patients with multiple comorbid diseases: evaluation of an individualised multidisciplinary model of care.

Directory of Open Access Journals (Sweden)

Tam H Ho

Full Text Available OBJECTIVE: To assess the impact of individualised, reconciled evidence-based recommendations (IRERs and multidisciplinary care in patients with chronic heart failure (CHF on clinical guideline compliance for CHF and common comorbid conditions. DESIGN AND SETTING: A retrospective hospital clinical audit conducted between 1st July 2006 and February 2011. PARTICIPANTS: A total of 255 patients with a diagnosis of CHF who attended the Multidisciplinary Ambulatory Consulting Services (MACS clinics, at the Royal Adelaide Hospital, were included. MAIN OUTCOME MEASURES: Compliance with Australian clinical guideline recommendations for CHF, atrial fibrillation, diabetes mellitus and ischaemic heart disease. RESULTS: Study participants had a median of eight medical conditions (IQR 6-10 and were on an average of 10 (±4 unique medications. Compliance with clinical guideline recommendations for pharmacological therapy for CHF, comorbid atrial fibrillation, diabetes or ischaemic heart disease was high, ranging from 86% for lipid lowering therapy to 98% anti-platelet agents. For all conditions, compliance with lifestyle recommendations was lower than pharmacological therapy, ranging from no podiatry reviews for CHF patients with comorbid diabetes to 75% for heart failure education. Concordance with many guideline recommendations was significantly associated if the patient had IRERs determined, a greater number of recommendations, more clinic visits or if patients participated in a heart failure program. CONCLUSIONS: Despite the high number of comorbid conditions and resulting complexity of the management, high compliance to clinical guideline recommendations was associated with IRER determination in older patients with CHF. Importantly these recommendations need to be communicated to the patient's general practitioner, regularly monitored and adjusted at clinic visits.

Particularly compliance violations in patients with diabetes mellitus of 2nd type

Directory of Open Access Journals (Sweden)

V. V. Chugunov

2017-04-01

Full Text Available Aim: to investigate and establish the specific complains violations in patients with diabetes mellitus (DM of 2nd type. Materials and methods: 543 patients with DM of 2nd type were examined; the disease duration ranged from 2 to 27 years, average – (14.58 ± 1.82 years. Research methods: clinical-anamnestic, clinical-psychopathological, psycho diagnostic, statistical. Research results. We found that compliance to therapy in patients with DM of 2nd type was broken in 90.49 % of cases. We highlighted three options for compliance violations to DM therapy of 2nd type: dismedication (to 68.14 %, disdiet (88.40 % and disexercise (90.49 %. The sub-variants of dismedication compliance violations to DM therapy of 2nd type was hyper-curation type (8.29 %, which was developed according to surplus of appointments execution and hypo-curation type (59.85 %, which was developed according to deficiency of appointments execution. Among them it was possible to distinguish a third – mixed version (7.37 %, which brings together episodes of the surplus and the deficit of medical drugs usage. The sub-options of disdiet option of compliance violations was hyper-curation type (1.66 %, which manifested itself in pathologically excessive rejection of food and hypo-curation type (86.74 %, which manifested itself in a disregard for the restrictions in the diet. Disexercise variant of compliance violations was possible to divide into hyper-curation type (4,24 %, manifested in excessive physical activity and, in its turn, had three subtypes – inceptional (1.66 %, sub-hyper-curation (1.10 % and procurationis (1.47 %, and hypo-curation type of compliance violations (87.48 %, which manifested itself in a disregard of physical exertion. Dominance of disdiet and disexercise compliance violations among patients with DM of 2nd type (χ2 = 117.258, p < 0.01, dismedication option among patients of all hyper-curation types of compliance violations with DM of 2nd type (χ2 = 26

Impact of SO2 emissions cap on Phase I compliance decisions

International Nuclear Information System (INIS)

Bissell, P.E.; Fink, C.E.; Koch, B.J.; Chomka, P.A.

1990-01-01

The SO 2 emissions cap provisions of impending clean air legislation will dramatically affect Phase I and Phase II compliance decisions by electric utilities. Technology-based SO 2 reduction alternatives could become the keystone of most compliance strategies as utilities attempt to achieve lower and lower SO 2 emission rates. Compliance with the Phase II emissions cap will require technological solutions for many utilities which must meet system-wide SO 2 emission rates well below those achievable with low-sulfur eastern coals and, in many instances, western coals. The emissions cap provision, however, will also induce more scrubbing during the Phase I compliance period. The power generation dispatch capability of a hypothetical utility system was simulated to study the impacts of an SO 2 emission cap on compliance strategies in Phase I. The effects of the cap were quantified for generation costs, total SO 2 emissions, and effective emission rates. The results show that achieving compliance by installing state-of-the-art high SO 2 removal scrubbers becomes increasingly attractive as utilities become constrained under the SO 2 cap, even in Phase I

Impact of cognitive function on compliance with treatment in heart failure

Directory of Open Access Journals (Sweden)

Beata Jankowska-Polańska

2017-02-01

Full Text Available In heart failure (HF patients frailty syndrome and cognitive impairment (CI affect outcome by decreasing the capability for performing self-care, adhering to the prescribed treatment regimen, monitoring symptoms. The aim was to investigate whether CI affects the compliance to therapeutic regimens. Methods: 170 with HF were included. We employed the Mini Mental State Examination (MMSE, for dementia and the Revised Heart Failure Compliance Scale to assess compliance. Results: CI patients showed lower compliance in all domains: 2.8±1.0 vs 3.3±1.0 (keeping appointments, 2.8±0.9 vs. 3.4±0.9 (pharmaceutical compliance, 0.4±0.8 vs. 1.4±1.2 (regular body weight monitoring, 2.0±1.3 vs. 2.7±1.0 (reduced salt intake, 1.9±1.2vs. 2.9±1.0 (fluid intake restriction, and 0.5±0.8 vs. 1.7±1.1 (regular exercise. Multiple regression analysis showed cognitive function to be an independent predictor for regular body weight monitoring (β=1.223;p<0.001, fluid intake restriction (β=1.081;p<0.001, and regular exercise (β=1.237;p<0.001. In multivariate analysis, the stimulant variables for compliance with HF treatment were: education (β=1.124, being in a relationship (β=2.231, and lack of cognitive impairment (β=0.320; the number of hospitalizations due to HF was identified as a destimulant (β=-0.495. Conclusion: Non-compliance is a major problem in elderly with HF. The cognitive function is an independent contributor to total compliance and to compliance with non-pharmaceutical recommendations. Being in a relationship and education are independent predictors of better compliance, while the number of rehospitalizations due to HF exacerbations is an independent predictor of worse compliance. Early detection of CI may offer an opportunity for intervention and a key strategy for improving clinical outcomes in older adults with HF.

Personal and social factors regarding medical non-compliance in cardiac failure patients

International Nuclear Information System (INIS)

Mujtaba, S.F.; Masood, T.; Khalid, D.

2011-01-01

Objective: To determine the frequency and association of various personal and social factors with medical non-compliance in cardiac failure patients. Study Design: Cross-sectional, observational study. Place and Duration of Study: National Institute of Cardiovascular Diseases (NICVD), Karachi from January to August 2010. Methodology: Patients admitted in the medical wards of NICVD, who were being treated for cardiac failure, were included. Information regarding basic demographics, education level, self engagement in therapy and status of compliance was obtained by questionnaire. Statistical analysis was carried out by using Fisher's exact test and chi-square. Level of significance was < 0.05. Data was analyzed using SPSS V-15. Out of 267 patients, 73 (27.3%) were compliant while 194 (72.7%) were non-compliant. Educated, self caring patient, and those who knew names of their medications were more compliant than the rest. Conclusion: Medical non-compliance is very common in heart failure patients. Illiteracy and no self engagement in therapy are associated with non-compliance. (author)

[Depression, social support and compliance in patients with chronic heart failure].

Science.gov (United States)

Reutlinger, Julia; Müller-Tasch, Thomas; Schellberg, Dieter; Frankenstein, Lutz; Zugck, Christian; Herzog, Wolfgang; Lossnitzer, Nicole

2010-01-01

Depressive patients with chronic heart failure (CHF) show less social integration and greater physical impairment as well as poorer compliance than non depressive CHF patients. Using multiple regression analyses, this study (n=84) investigated a potential mediating effect of depression on the relationship between compliance and both social support and physical functioning. Results did not support the hypothesized mediating effect of depression. However, the variables age, depression, left ventricular ejection fraction (LVEF) and social support were associated with self-reported compliance. Therefore, a lack of social support and depression should be considered as possible reasons, if patients are noncompliant during the treatment process. © Georg Thieme Verlag KG Stuttgart · New York.

Compliance with recommended care at trauma centers: association with patient outcomes.

Science.gov (United States)

Shafi, Shahid; Barnes, Sunni A; Rayan, Nadine; Kudyakov, Rustam; Foreman, Michael; Cryer, H Gil; Alam, Hasan B; Hoff, William; Holcomb, John

2014-08-01

State health departments and the American College of Surgeons focus on the availability of optimal resources to designate hospitals as trauma centers, with little emphasis on actual delivery of care. There is no systematic information on clinical practices at designated trauma centers. The objective of this study was to measure compliance with 22 commonly recommended clinical practices at trauma centers and its association with in-hospital mortality. This retrospective observational study was conducted at 5 Level I trauma centers across the country. Participants were adult patients with moderate to severe injuries (n = 3,867). The association between compliance with 22 commonly recommended clinical practices and in-hospital mortality was measured after adjusting for patient demographics and injuries and their severity. Compliance with individual clinical practices ranged from as low as 12% to as high as 94%. After adjusting for patient demographics and injury severity, each 10% increase in compliance with recommended care was associated with a 14% reduction in the risk of death. Patients who received all recommended care were 58% less likely to die (odds ratio = 0.42; 95% CI, 0.28-0.62) compared with those who did not. Compliance with commonly recommended clinical practices remains suboptimal at designated trauma centers. Improved adoption of these practices can reduce mortality. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

The impact of cognitive insight, self-stigma, and medication compliance on the quality of life in patients with schizophrenia.

Science.gov (United States)

Lien, Yin-Ju; Chang, Hsin-An; Kao, Yu-Chen; Tzeng, Nian-Sheng; Lu, Chien-Wen; Loh, Ching-Hui

2018-02-01

Impaired quality of life (QoL) is a common and clinically relevant feature of schizophrenia. In the present study, we attempted to formulate a model of QoL in the chronic stage of schizophrenia by including key variables-namely cognitive insight, self-stigma, insight into treatment, and medication compliance-that were proposed as its significant predictors in previous studies. We employed structural equation modeling (SEM) to simultaneously test the associations between these variables. A total of 170 community-dwelling patients with schizophrenia participated in this study. Cognitive insight, self-stigma, insight into treatment, medication compliance, and QoL were assessed through self-reporting. Symptoms were rated by interviewers. The influences of cognitive insight, stigma, insight into treatment, and medication compliance on QoL were supported using SEM. Our findings indicated that cognitive insight had a significant, positive, and direct effect on both self-stigma and insight into treatment; in contrast, it had a negative and direct effect on medication compliance. Notably, no evidence indicated a direct effect of cognitive insight on QoL. Thus, individuals with high cognitive insight reported low QoL because of stigma, low medication compliance, and their increased insight into treatment. In contrast, cognitive insight might indirectly ameliorate QoL mediated by the effect of insight into treatment on medication compliance. The findings provide additional support of the links between cognitive and clinical insight, self-stigma, medication compliance, and QoL in those with schizophrenia and suggest the need for screening and intervention services appropriate for this high-risk population.

Compliance to topical anti-glaucoma medications among patients at a tertiary hospital in North India

Directory of Open Access Journals (Sweden)

Ketaki Rajurkar

2018-06-01

Full Text Available Purpose: The present study aims to estimate the prevalence of non-compliance and improper drop administration technique among glaucoma patients and describe common obstacles to medication compliance. Methods: A hospital-based cross-sectional study, using standardized questionnaire and direct observation by study personnel was conducted among glaucoma patients aged 18 years and above at a tertiary care charitable eye hospital in North India. 151 consecutive glaucoma patients on medical therapy following up at the glaucoma clinics for at least 6 months were recruited. Non-compliance was defined as missing at-least one drop of medication per week and (or the inability to accurately describe the medication regimen. Study personnel also assessed drop administration technique during application of eye drops by patients treating ophthalmologist-provided information, including measures of disease stability. Factors such as socioeconomic status, presence of caregiver, and number of medications with their effect on compliance were studied using chi-square statistics. Results: Among 151 patients interviewed, around 49% of patients reported problems in using glaucoma medications, with 16% of them reporting total non-compliance. 35% of patients demonstrated improper drop administration technique. Forgetfulness was cited as the main reason for being non-compliant and had a significant association with non-compliance (P = 0.00. Paying patients were more compliant as compared to subsidized patients (P = 0.05. Disease was more stable in compliant patients compared to non-compliant patients (P = 0.05. No other factor had significant association with compliance (P > 0.05. Conclusions: Over 50% of the patients surveyed were non-compliant, and 35% demonstrated improper administration technique. Glaucoma patients should be educated on the importance of compliance and aids that minimize forgetfulness, and delivery systems facilitating the delivery of

The role of the psychiatrist in improving patient compliance.

Science.gov (United States)

Hotujac, Ljubomir

2007-02-01

Compliance, usually referring to how well the patient takes the medication as prescribed, is an important issue in clinical practice. However, many patients, especially those with a psychiatric illness, stop taking their medications despite physician advice to continue. This cessation can lead to a deterioration in the condition, a relapse, or a recurrence of the illness. In the literature, many different factors contributing to poor compliance have been described, but the doctor's role and responsibilities are hardly mentioned. These factors will be discussed here with special emphasis on what a doctor should do and what a doctor should avoid.

The impact of a daily smartphone-based feedback system among women with gestational diabetes on compliance, glycemic control, satisfaction, and pregnancy outcome: a randomized controlled trial.

Science.gov (United States)

Miremberg, Hadas; Ben-Ari, Tal; Betzer, Tal; Raphaeli, Hagit; Gasnier, Rose; Barda, Giulia; Bar, Jacob; Weiner, Eran

2018-04-01

Patient compliance and tight glycemic control have been demonstrated to improve outcome in pregnancies complicated by gestational diabetes mellitus. The use of advanced technological tools, including smartphone-based platforms, to improve medical care and outcomes has been demonstrated in various fields of medicine, but only a few small studies were performed with gestational diabetes mellitus patients. We aimed to study the impact of introducing a smartphone-based daily feedback and communication platform between gestational diabetes mellitus patients and their physicians, on patient compliance, glycemic control, pregnancy outcome, and patient satisfaction. This is a prospective, single-center, randomized controlled trial. Newly diagnosed gestational diabetes mellitus patients presenting to our multidisciplinary diabetes-in-pregnancy clinic were randomized to: (1) routine biweekly prenatal clinic care (control group); or (2) additional daily detailed feedback on their compliance and glycemic control from the clinic team via an application installed on their smartphone (smartphone group). The primary outcome was patient compliance defined as the actual blood glucose measurements/instructed measurements ×100. The secondary outcomes included diabetes-control parameters, pregnancy, and neonatal outcomes. The study was adequately powered to detect a 20% difference in patient compliance, based on a preliminary phase that demonstrated 70% baseline compliance to glucose measurements. A total of 120 newly diagnosed gestational diabetes mellitus patients were analyzed. The 2 groups did not differ in terms of age, parity, education, body mass index, family history, maternal comorbidities, oral glucose tolerance test values, and hemoglobin A1C at randomization. The smartphone group demonstrated higher level of compliance (84 ± 0.16% vs 66 ± 0.28%, P diabetes mellitus patients and the multidisciplinary diabetes-in-pregnancy clinic team improved patient compliance and

Hand hygiene compliance in patients under contact precautions and in the general hospital population.

Science.gov (United States)

Almaguer-Leyva, Martín; Mendoza-Flores, Lidia; Medina-Torres, Ana Gabriela; Salinas-Caballero, Ana Gabriela; Vidaña-Amaro, Jose Antonio; Garza-Gonzalez, Elvira; Camacho-Ortiz, Adrián

2013-11-01

Hand hygiene (HH) is the single most important intervention for preventing hospital-acquired infections. Contact precautions are a series of actions that infection control units take to reduce the transmission of nosocomial pathogens. We conducted an observational study of HH compliance. Observations were stratified as opportunities in patients under contact precautions and in the general hospital population. Trained infection control personnel performed all direct evaluations. A total of 3,270 opportunities were recorded. HH compliance was statistically higher in patients on contact precautions than in the overall population (70.3% vs 60.4%; P = .0001). Critical care areas had higher HH compliance when patients were isolated by contact precautions. Medical wards were statistically lower in HH when patients were under contact precautions. Respiratory technicians had the highest HH compliance in both overall performance and in patients under contact precautions. Medical students had a lower HH compliance in both evaluations (P Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Compliance to medication among hypertensive patients in Murtala ...

African Journals Online (AJOL)

%). Patients ... A major factor accounting for inadequate ... counting the remaining pills or pill counting systems). ... Information obtained included socio- .... medication compliance on the control of hypertension. ... Archives of Internal Medicine.

Cognitive defenses and compliance with radiation treatment in cancer patients

International Nuclear Information System (INIS)

Karassik, B.M.

1989-01-01

The present study was undertaken to investigate the relationships between four cognitive defenses and compliance with radiation therapy in cancer patients. The role of accurate self-report of usage of each of the defenses was examined as well. A distinction between direct-action and emotion-focused coping was utilized to conceptualize the possible relationships between compliance and the defenses. Based on the proposals of Heilbrun and Renert (1986) regarding the relative evasiveness of the defenses and available evidence from the compliance literature, it was predicted that noncompliant patients would show more repression, projection, and denial and less rationalization than compliant patients. In addition, based upon the findings of Heilbrun and Pepe (1985) that related self-deception to effectiveness of the defenses in dealing with stress, predictions were also made regarding differences in accuracy of reported defense usage by compliant and noncompliant patients. Noncompliant repressors and projectors and compliant rationalizers were predicted to be less aware of their respective use of these defenses than their compliant counterparts; noncompliant deniers were predicted to be more aware of the use of this defense than compliant deniers

Medication apprehension and compliance among dialysis patients--a comprehensive guidance attitude.

Science.gov (United States)

Katzir, Ze'ev; Boaz, Mona; Backshi, Irena; Cernes, Relu; Barnea, Zvi; Biro, Alexander

2010-01-01

Compliance with treatment regimens is a continuing challenge for chronic dialysis patients and their medical caregivers. Poor patient adherence to prescribed medications can adversely affect treatment outcome. In this pre- versus post-intervention study, 89 chronic dialysis patients [75 hemodialysis (HD), 14 continuous ambulatory peritoneal dialysis (CAPD); mean age 62.7 +/- 12.39 years, 34 females] responded to a written questionnaire designed to assess knowledge about and compliance with 5 groups of prescribed medications: metabolic drugs, antihypertensives, cardiac-supporting agents, peptic disease therapy and hematological replacement therapy. Mode of intake, storage, means of supply and source of information for each class of drug were also assessed. Patients then received both oral and written instructions regarding their prescribed medications (intervention). This information was repeated 3 months later. Six months after the intervention, patients were re-administered the questionnaires. Response to the questionnaires and laboratory data were compared prior to and following the intervention. Overall, compliance with prescribed medications significantly improved following the intervention, from 89 to 95.7%, p = 0.0007. This relative improvement was greater in HD than CAPD patients (27 vs. 2%, p dialysis vintage. Compared to baseline values, post-intervention blood hemoglobin, hematocrit, mean corpuscular volume, ferritin and Ca levels were significantly improved. Dialysis patients appear to benefit from receiving comprehensive guidance about medications, in terms of compliance with medications and blood chemistry and hematology measures. (c) 2009 S. Karger AG, Basel.

Short bowel patients treated for two years with glucagon-like peptide 2 (GLP-2): compliance, safety, and effects on quality of life

DEFF Research Database (Denmark)

Jeppesen, P B; Lund, P; Gottschalck, I B

2009-01-01

BACKGROUND AND AIMS: Glucagon-like peptide 2 (GLP-2) has been shown to improve intestinal absorption in short bowel syndrome (SBS) patients in a short-term study. This study describes safety, compliance, and changes in quality of life in 11 SBS patients at baseline, week 13, 26, and 52 during two...... years of subcutaneous GLP-2 treatment, 400 microgram TID, intermitted by an 8-week washout period. METHODS: Safety and compliance was evaluated during the admissions. The Sickness Impact Profile (SIP), Short Form 36 (SF 36), and Inflammatory Bowel Disease Questionnaire (IBDQ) evaluated quality of life......-ascendo-anastomosis. The investigator excluded a patient due to unreliable feedback. Stoma nipple enlargement was seen in all 9 jejunostomy patients. Reported GLP-2 compliance was excellent (>93%). GLP-2 improved the overall quality of life VAS-score (4.1 +/- 2.8 cm versus 6.0 +/- 2.4 cm, P

Compliance in rheumatoid arthritis and the role of formal patient education

NARCIS (Netherlands)

Brus, H.L.M.; Brus, Herman; van de Laar, Mart A F J; Taal, Erik; Rasker, Johannes J.; Wiegman, O.

1997-01-01

Objective: This study was performed to determine the compliance with the basic treatments for rheumatoid arthritis (RA; medication, physical therapy, and ergonomic measures), to study psychological factors that influence compliance in light of the social learning theory, to learn whether patient

Impact of a structured template and staff training on compliance and quality of clinical handover.

Science.gov (United States)

Ahmed, J; Mehmood, S; Rehman, S; Ilyas, C; Khan, L U R

2012-01-01

Change in junior doctors working pattern has brought effective and safe clinical handover into a central role to ensure the patient safety and high quality care. We investigated whether the compliance and quality of clinical handover could be improved through the use of a standardised and structured handover template. A computerised template was developed in accordance with handover guidelines provided by the Royal College of Surgeons of England. Pre- and post-intervention audits against an eleven-point dataset pertaining to the handover of acute surgical admissions were undertaken. The results from the two discrete audits periods were compared to examine the impact of intervention. There were 137 acute surgical admissions during pre-intervention and 155 admissions in post-intervention audit period. A significant improvement in overall handover practice was observed in post-intervention period. The documentation of patient hospital number (84 (61%) vs. 132 (85%) pimportance of safe clinical handover among the junior doctors. Implementation of a standardised guideline-based structured handover template and training of junior doctors are likely to improve compliance to agreed standards, promote quality of care, and protect patient safety. Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Predictors of low compliance with treatment in the patients with gastro-esophageal reflux disease

Directory of Open Access Journals (Sweden)

S. V. Tikhonov

2013-01-01

Full Text Available Gastroesophageal reflux disease is a widespread pathology requiring a long-term initial and maintaining therapy. Identification of the risk factors of low compliance of the patient with the treatment of the gastroesophageal reflux disease may be helpful in optimization of the patient - the doctor contact and thus may improve the compliance. The paper describes the predictors of low compliance that may be disclosed in the period of primary contact with the patients with gastroesophagial reflux pathology.

Medication compliance behavior in psychiatric out‑patients with ...

African Journals Online (AJOL)

2014-10-24

Oct 24, 2014 ... No statistically significant relationship was found between substance use ... Access this article online ... Medication compliance in psychiatric patients in Nigeria. 372 ... had seen their physician until the sample size of 208 was.

Compliance with referrals to medical specialist care: patient and general practice determinants: a cross-sectional study.

Science.gov (United States)

van Dijk, Christel E; de Jong, Judith D; Verheij, Robert A; Jansen, Tessa; Korevaar, Joke C; de Bakker, Dinny H

2016-02-01

In a gatekeeper system, primary care physicians and patients jointly decide whether or not medical specialist care is needed. However, it is the patient who decides to actually use the referral. Referral non-compliance could delay diagnosis and treatment. The objective of this study was to assess patient compliance with a referral to medical specialist care and identify patient and practice characteristics that are associated with it. Observational study using data on 48,784 referrals to medical specialist care derived from electronic medical records of 58 general practices for the period 2008-2010. Referral compliance was based on claims data of medical specialist care. Logistic multilevel regression analyses were conducted to determine associations between patient and general practice characteristics and referral compliance. In 86.6% of the referrals, patients complied. Patient and not practice characteristics were significantly associated with compliance. Patients from deprived urban areas and patients aged 18-44 years were less likely to comply, whereas patients aged 65 years and older were more likely to comply. About 1 in 8 patients do not use their referral. These patients may not receive adequate care. Demographic and socio-economic factors appear to affect compliance. The results of this study may be used to make general practitioners more aware that some patients are more likely to be noncompliant with referrals.

Scoliosis brace design: influence of visual aesthetics on user acceptance and compliance.

Science.gov (United States)

Law, Derry; Cheung, Mei-Chun; Yip, Joanne; Yick, Kit-Lun; Wong, Christina

2017-06-01

Adolescent idiopathic scoliosis is a common condition found in adolescents. A rigid brace is often prescribed as the treatment for this spinal deformity, which negatively affects user compliance due to the discomfort caused by the brace, and the psychological distress resulting from its appearance. However, the latter, which is the impact of visual aesthetics, has not been thoroughly studied for scoliosis braces. Therefore, a qualitative study with in-depth interviews has been carried out with 10 participants who have a Cobb angle of 20°-30° to determine the impact of visual aesthetics on user acceptance and compliance towards the brace. It is found that co-designing with patients on the aesthetic aspects of the surface design of the brace increases the level of user compliance and induces positive user perception. Therefore, aesthetic preferences need to be taken into consideration in the design process of braces. Practitioner Summary: The impact of visual aesthetics on user acceptance and compliance towards a rigid brace for scoliosis is investigated. The findings indicate that an aesthetically pleasing brace and the involvement of patients in the design process of the brace are important for increasing user compliance and addressing psychological issues during treatment.

Patient experiences of partnering with healthcare professionals for hand hygiene compliance: a systematic review.

Science.gov (United States)

Butenko, Samantha; Lockwood, Craig; McArthur, Alexa

2017-06-01

healthcare professionals and patients do not fully support this partnership. Synthesized finding 2: Patients have differing levels of knowledge and balance partnering in hand hygiene against possible detrimental impacts on the caring relationship provided by healthcare professionals, out of concern for their own wellbeing, health outcomes, treatment and/or recovery. The current review highlights the complexity of the patient's experience of partnering with healthcare professionals for hand hygiene compliance. The experiences reported indicated that there is a possible disparity between the healthcare facility and healthcare professionals' promotion and intention of partnering for hand hygiene compliance, and the actual patient's acceptance, participation, partnership, experience and implementation of this initiative. This disconnect between intent and action appears to be influenced by a number of factors including organizational structures as well as drivers such as cultural beliefs and behavior.

Duloxetine compliance and its association with healthcare costs among patients with diabetic peripheral neuropathic pain.

Science.gov (United States)

Wu, N; Chen, S; Boulanger, L; Fraser, K; Bledsoe, S L; Zhao, Y

2009-09-01

Duloxetine is approved to treat diabetic peripheral neuropathic pain (DPNP) in the US. The study objective was to examine the predictors of duloxetine compliance, and its association with healthcare costs among DPNP patients. The study used administrative claims databases to identify non-depressed DPNP patients with a duloxetine prescription dispensed between October 1, 2004 and December 31, 2006. Two cohorts of patients were constructed based on compliance to duloxetine therapy over 1-year follow-up with high compliance defined as a medication possession ratio (MPR) > or =0.80. All-cause, diabetes-, and DPNP-related healthcare costs during 1-year follow-up were estimated. Logistic regressions were performed to examine how average daily dose (ADD) of duloxetine and other factors may influence compliance. Multivariate regressions were estimated to examine the association between compliance and healthcare costs. The study included 1,380 commercially insured (mean age 55 years) and 974 patients with employer-sponsored Medicare supplemental insurance (mean age 75 years). In both populations, patients with an ADD >30 mg were more likely to be compliant with the therapy compared with those with an ADD of compliance patients had greater all-cause ($5,334, pcosts ($3,414, pcompliance patients, with the biggest difference from inpatient costs (all-cause: $7,508; diabetes-related: $3,785, all pcosts were not significant. DPNP patients with a higher ADD of duloxetine over a 1-year follow-up period were more compliant with the therapy. Duloxetine patients with high compliance were also associated with lower healthcare costs. Due to the use of a retrospective cohort design on administrative claims database, limitations of this analysis include a lack of formal diagnostic testing of patients, and inability to infer causality or measure factors such as DPNP severity that are not captured in such database.

Quality of life and compliance in geriatric patients

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Igor Kalugin

2017-09-01

Full Text Available Background. Older adults usually have more than one chronic disease. In most cases, each condition requires constant pharmacotherapy. On average, the clinical examination of patients aged 60 and older reveals at least four or five different chronic pathological states in various phases and stages. Disease interference changes the classical clinical picture, increases the number of complications and their severity, affects the quality of life and prognosis, as a result - complicated medical diagnostic process and reduced compliance. The presence in the elderly both mental and physical illness significantly affects the quality of life. Psychological interventions aimed at a patient's awareness of the disease and methods of its treatment, the creation of therapeutic alliance and the prevention of self-medication, according to our hypothesis, contributes to compliance and quality of life improvement in polymorbid elderly patients suffering from mental disorders. Methods. In the study took part 325 patients who underwent inpatient treatment at the gerontopsychiatric department and signed provided informed consent. The study had a design of a randomized controlled clinical trial. Patients were randomized to experimental and control groups in a ratio of 3 to 1 based on age and gender. The study group of 238 people received standard treatment and psychological interventions. A comparison group of 87 people had only standard treatment. Patients were evaluated for quality of life with SF-36 scale and compliance with Morisky Medication Adherence Scale. Results. We have seen significant intergroup differences on the Morisky Medication Adherence Scale in the baseline period. Consequently, its results were not be taken into account in the final analysis. Before treatment patients’ quality of life between the study groups did not differ statistically (p = 0.317. After the treatment, a statistically significant difference in life quality between experimental

Impact of physician empathy on migraine disability and migraineur compliance

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Hatim S Attar

2012-01-01

Full Text Available Aims: We aim to establish the role that perceived physician empathy plays in determining migraineurs′ outcomes and compliance with migraine management plans. We checked for associations between perceived physician empathy and clinical outcomes as well as compliance with management plans. Materials and Methods: 63 migraineurs were enrolled between July and September 2011. Questionnaire administered at the time of inclusion into the study included self-assessment of disability due to migraine (Migraine Disability Assessment Test followed by migraineurs′ assessment of physician empathy (Consultation and Relational Empathy Measure. Three months later, a telephonic questionnaire ascertained changes in disability due to migraine and compliance with migraine treatment. Statistical Analysis: Data was entered in Microsoft Excel 2010 and analyzed using SPSS 17. Pearson′s correlation was employed to analyze the significance of relationship between variables. P-value of less than 0.05 has been considered statistically significant. Results: Statistically significant positive Pearson′s correlations are seen between perceived empathy and decrease in migraine disability and symptoms over three months (P < 0.05. Significant positive relationships are also seen between perceived empathy and compliance with diet/meal timings, exercising, de-stressing/sleep pattern modification and medications (P < 0.05. Self-reported compliance is significantly correlated with improved patient outcomes (P < 0.05. Conclusions: Substantial positive associations are found between perceived physician empathy and migraineurs′ outcomes and compliance with management plans. This emphasizes the importance of empathy in migraineur-physician communication.

Frequent Evaluation To Improve Compliance In Patients Treated With Occlusion For Amblyopia: A Randomized controlled Trial.

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Iturriaga, Hernan; Zanolli, Mario; Damm, Constanza; Oporto, Jorge; Acuna, Olga; Valenzuela, Felipe

2012-01-01

The benefits of occlusion treatment for amblyopia are well established.True compliance can be difficult to assess and is usually based on patient history. We hypothesize that more visits to the physician provides more chances to improve compliance. We conducted a prospective, comparative, blind trial in which 30 children with amblyopia were randomly assigned to be followed up more frequently (every 4 to 6 weeks) (study group) or as established on our standard regular basis (month intervals based on age in years) (control group). The primary outcome was to study differences in treatment compliance between these groups. The secondary outcome was to report compliance in a group of Chilean children and to compare survey results with adherence, to assess concordance between them. Baseline clinical characteristics were similar in the two groups. 30 patients were recruited. Mean compliance for all patients was 82%. Study group compliance was 83% versus 76% in control group (p = 0.5). Without epidemiology, intention to treat analysis (ITT), study group compliance was 97% compared to 76% in control group (p = 0.049). Pearson correlation between negative responses to a parental survey after treatment, of the percentage of adherence and compliance, was -0.57 and statistically significant (p = 0.013). There were no differences in patient compliance comparing more frequent evaluation versus a follow up evaluation based in an age according scheme. There is a high compliance to occlusion therapy in this group of Chilean children. If parents reported more negative adherence aspects in the survey, the worse the compliance.

Remote mood monitoring for adults with bipolar disorder: An explorative study of compliance and impact on mental health service use and costs.

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Simon, J; Budge, K; Price, J; Goodwin, G M; Geddes, J R

2017-09-01

Remote monitoring of mood disorders may be an effective and low resource option for patient follow-up, but relevant evidence remains very limited. This study explores real-life compliance and health services impacts of mood monitoring among patients with bipolar disorder in the UK. Patients with a diagnosis of bipolar disorder who were registered users of the True Colours monitoring system for at least 12months at study assessment were included in this retrospective cohort study (n=79). Compliance was measured as the proportion of valid depression and mania scale messages received in comparison to their expected numbers over the first 12months of monitoring. Mental health service use data were extracted from case notes, costed using national unit costs, and compared 12months before (pre-TC period) and 12months after (TC period) patients' engagement with monitoring. Associations with relevant patient factors were investigated in a multiple regression model. Average compliance with monitoring was 82%. Significant increases in the annual use and costs of psychiatrist contacts and total mental health services were shown for patients newly referred to the clinic during the pre-TC period but not for long-term patients of the clinic. Psychiatric medication costs increased significantly between the pre-TC and TC periods (£235, P=0.005) unrelated to patients' referral status. Remote mood monitoring has good compliance among consenting patients with bipolar disorder. We found no associations between observed changes in mental health service costs and the introduction of monitoring except for the increase in psychiatric medication costs. Copyright © 2017 The Authors. Published by Elsevier Masson SAS.. All rights reserved.

Predicting the lung compliance of mechanically ventilated patients via statistical modeling

International Nuclear Information System (INIS)

Ganzert, Steven; Kramer, Stefan; Guttmann, Josef

2012-01-01

To avoid ventilator associated lung injury (VALI) during mechanical ventilation, the ventilator is adjusted with reference to the volume distensibility or ‘compliance’ of the lung. For lung-protective ventilation, the lung should be inflated at its maximum compliance, i.e. when during inspiration a maximal intrapulmonary volume change is achieved by a minimal change of pressure. To accomplish this, one of the main parameters is the adjusted positive end-expiratory pressure (PEEP). As changing the ventilator settings usually produces an effect on patient's lung mechanics with a considerable time delay, the prediction of the compliance change associated with a planned change of PEEP could assist the physician at the bedside. This study introduces a machine learning approach to predict the nonlinear lung compliance for the individual patient by Gaussian processes, a probabilistic modeling technique. Experiments are based on time series data obtained from patients suffering from acute respiratory distress syndrome (ARDS). With a high hit ratio of up to 93%, the learned models could predict whether an increase/decrease of PEEP would lead to an increase/decrease of the compliance. However, the prediction of the complete pressure–volume relation for an individual patient has to be improved. We conclude that the approach is well suitable for the given problem domain but that an individualized feature selection should be applied for a precise prediction of individual pressure–volume curves. (paper)

Interventions to promote psychiatric patients' compliance to mental ...

African Journals Online (AJOL)

Method: A systematic review was chosen as a design to identify primary studies that answered the following research question: What is the current evidence on interventions to promote psychiatric patients' compliance to mental health treatment? Selected electronic databases were thoroughly searched. Studies were ...

TREATMENT COMPLIANCE AMONG PATIENTS WITH CHRONIC PANCREATITIS IN THE MOSCOW REGION

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S. V. Beljakova

2014-01-01

Full Text Available Background: In the past decade, incidence of chronic pancreatitis among different age groups has been growing globally and in Russia. Chronic pancreatitis is a progressive disease characterized by development of complications and decrease of exocrine function of pancreas. Treatment should be initiated early, before the complications occur; therapy should account for international experience and established Russian guidelines. Continuous usage of high-dose enzyme preparations preferably in modern dosage forms (microgranules, minimicrospheres or microtablets is one of the key principles in the management of chronic pancreatitis. Patient’s cooperative behavior and good compliance is crucial for achieving treatment targets. Aim: To assess treatment compliance among patients with chronic pancreatitis in the Moscow Region and to identify sources of information on the disease used by the patients. Materials and methods: One hundred patients with chronic pancreatitis in Moscow Region were questionnaired anonymously on their adherence to the medical recommendations for diet, alcohol consumption and medications, particularly enzyme preparations. Patients’ sources of information on the disease were also determined. Results: Poor compliance results were shown: only 28% of patients were fully adherent to medical recommendations; other patients took their medications irregularly, changed drug doses or preparations choosing less expensive and effective drugs. The majority of patients (89% were aware of the main treatment principles, though, 53% didn’t adhere to them. Patients used varied sources of information on the disease including special literature and the web; nevertheless, the information could be incorrectly understood. Only some patients received disease-related information from their physician, and many of the patients described physician-derived information as insufficient. As a result, treatment was often inadequate. Conclusion:  Improved

Does Direct Radiologist-Patient Verbal Communication Affect Follow-Up Compliance of Probably Benign Assessments?

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Bosma, Melissa S; Neal, Colleen H; Klein, Katherine A; Noroozian, Mitra; Patterson, Stephanie K; Helvie, Mark A

2016-03-01

The aim of this study was to determine whether direct verbal communication of results by a radiologist affected follow-up compliance rates for probably benign breast imaging findings. This study was institutional review board approved and HIPAA compliant. A retrospective search identified all patients from January 1, 2010 to December 31, 2010 who had breast findings newly assessed as probably benign (BI-RADS category 3). Patients were categorized by whether the radiologist or the technologist verbally communicated the result and follow-up recommendation. Patient adherence to 6-, 12-, and 24-month follow-up imaging recommendations was recorded. Compliance data were available for 770 of 819 patients in the study. Overall compliance was 83.0% (639 of 770) for 6-month examinations, 68.1% (524 of 770) for 6- and 12-month examinations, and 57.4% (442 of 770) for 6-, 12-, and 24-month examinations. For patients who initially underwent diagnostic mammography alone, there was no significant difference in compliance between those who had and those who did not have radiologist-patient communication (6 months, 81.9% vs 80.8% [P = .83]; 6 and 12 months, 70.8% vs 67.3% [P = .58]; 6, 12, and 24 months, 54.2% vs 58.4% [P = .53]). For patients who initially underwent diagnostic mammography alone versus ultrasound with or without diagnostic mammography, there was no significant difference in compliance (6 months, 81.1% vs 84.3% [P = .24]; 6 and 12 months, 68.1% vs 68.0% [P = .96]; 6, 12, and 24 months, 57.4% vs 57.4% [P = .00]). High initial compliance was achieved by radiologist or technologist verbal communication of findings and recommendations. Direct communication by the radiologist did not increase compliance compared with communication by a technologist. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A Study to Determine the Correlation between Continuity of Care and Patient Medication Compliance

Science.gov (United States)

1984-08-01

U (III FILE ’Y TO DETERMINE THE CORRELATION BETWEEN CONTINUITY OF CARE AND PATIENT MEDICATION COMPLIANCE IA Graduate Research Project Submitted to...43 APPENDIX A. PATIENT MEDICATION COMPLIANCE QUESTIONNAIRE . . . . . 45 B. COMPUTER CODED INPUT FORMAT . . . . . . . ...... 48 C. RESEARCH DATA...and that adhered to by the patient . This failure to comply with medical recommendations results in a waste of health resources, frustration to the

Improving admission medication reconciliation compliance using the electronic tool in admitted medical patients

Science.gov (United States)

Taha, Haytham; abdulhay, dana; Luqman, Neama; Ellahham, Samer

2016-01-01

Sheikh Khalifa Medical City (SKMC) in Abu Dhabi is the main tertiary care referral hospital in the United Arab Emirates (UAE) with 560 bed capacity that is fully occupied most of the time. SKMC senior management has made a commitment to make quality and patient safety a top priority. Our governing body Abu Dhabi Health Services Company has identified medication reconciliation as a critical patient safety measure and key performance indicator (KPI). The medication reconciliation electronic form a computerized decision support tool was introduced to improve medication reconciliation compliance on transition of care at admission, transfer and discharge of patients both in the inpatient and outpatient settings. In order to improve medication reconciliation compliance a multidisciplinary task force team was formed and led this quality improvement project. The purpose of this publication is to indicate the quality improvement interventions implemented to enhance compliance with admission medication reconciliation and the outcomes of those interventions. We chose to conduct the pilot study in general medicine as it is the busiest department in the hospital, with an average of 390 patients admitted per month during the study period. The study period was from April 2014 till October 2015 and a total of 8576 patients were evaluated. The lessons learned were disseminated throughout the hospital. Our aim was to improve admission medication reconciliation compliance using the electronic form in order to ensure patient safety and reduce preventable harm in terms of medication errors. Admission medication reconciliation compliance improved in general medicine from 40% to above 85%, and this improvement was sustained for the last four months of the study period. PMID:27822371

Does compliance to patient safety tasks improve and sustain when radiotherapy treatment processes are standardized?

Science.gov (United States)

Simons, Pascale A M; Houben, Ruud; Benders, Jos; Pijls-Johannesma, Madelon; Vandijck, Dominique; Marneffe, Wim; Backes, Huub; Groothuis, Siebren

2014-10-01

To realize safe radiotherapy treatment, processes must be stabilized. Standard operating procedures (SOP's) were expected to stabilize the treatment process and perceived task importance would increase sustainability in compliance. This paper presents the effects on compliance to safety related tasks of a process redesign based on lean principles. Compliance to patient safety tasks was measured by video recording of actual radiation treatment, before (T0), directly after (T1) and 1.5 years after (T2) a process redesign. Additionally, technologists were surveyed on perceived task importance and reported incidents were collected for three half-year periods between 2007 and 2009. Compliance to four out of eleven tasks increased at T1, of which improvements on three sustained (T2). Perceived importance of tasks strongly correlated (0.82) to compliance rates at T2. The two tasks, perceived as least important, presented low base-line compliance, improved (T1), but relapsed at T2. The reported near misses (patient-level not reached) on accelerators increased (P improvements sustained after 1.5 years, indicating increased stability. Perceived importance of tasks correlated positively to compliance and sustainability. Raising the perception of task importance is thus crucial to increase compliance. The redesign resulted in increased willingness to report incidents, creating opportunities for patient safety improvement in radiotherapy treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.

A logistic regression analysis of factors related to the treatment compliance of infertile patients with polycystic ovary syndrome.

Science.gov (United States)

Li, Saijiao; He, Aiyan; Yang, Jing; Yin, TaiLang; Xu, Wangming

2011-01-01

To investigate factors that can affect compliance with treatment of polycystic ovary syndrome (PCOS) in infertile patients and to provide a basis for clinical treatment, specialist consultation and health education. Patient compliance was assessed via a questionnaire based on the Morisky-Green test and the treatment principles of PCOS. Then interviews were conducted with 99 infertile patients diagnosed with PCOS at Renmin Hospital of Wuhan University in China, from March to September 2009. Finally, these data were analyzed using logistic regression analysis. Logistic regression analysis revealed that a total of 23 (25.6%) of the participants showed good compliance. Factors that significantly (p < 0.05) affected compliance with treatment were the patient's body mass index, convenience of medical treatment and concerns about adverse drug reactions. Patients who are obese, experience inconvenient medical treatment or are concerned about adverse drug reactions are more likely to exhibit noncompliance. Treatment education and intervention aimed at these patients should be strengthened in the clinic to improve treatment compliance. Further research is needed to better elucidate the compliance behavior of patients with PCOS.

[The impact of personality traits on adolescents' adaptation and compliance to clear retainers].

Science.gov (United States)

Xu, Fan; Tang, Guo-Hua

2017-02-01

The aim of this study was to evaluate the adolescents' adaptation and compliance to clear retainers, and to investigate their associations with personality traits. Fifty adolescents at the end of fixed orthodontic treatment were consecutively recruited. After debonding the fixed orthodontic appliances, clear retainers were used. Participants were asked to fill questionnaires 2 months after wearing the clear retainers. A questionnaire was designed to evaluate their adaptation and compliance for clear retianers. Eysenck personality questionnaire was used to assess the personality traits. Spearman rank correlation was used to analyze the associations between personality traits with the adaptation and compliance to clear retainers using SAS8.0 software package. Forty-two of 50 adolescents accomplished the questionnaires. 76% felt no mucous irritation, 95% felt no influence on socializing. However, 75% showed oral constraint, 71% felt impaired speech. Moreover, 40% adolescents wore the retainers less than 18 hours per day. 31% patients had their aligner lost. 83% patients did not brush their teeth after each meal. Neuroticism was positively associated with the effect of impaired chewing (r=0.32). Psychoticism was positively associated with the oral constraint (r=0.31) and facial muscular soreness (r=0.35), but negatively associated with the influence on emotion (r=-0.34). Extraversion was positively associated with the retainers' damage (r=0.31). Adolescents showed good adaptation for clear retainers, but unsatisfactory compliance. There are associations between adolescents' adaptation and compliance for clear retainers and personality traits. These results suggest that clinicians should pay more attention to the compliance of adolescents when using clear retainer. Personality traits could be a useful prediction to assess the compliance for clear aligners.

The impact of health information technology on patient safety.

Science.gov (United States)

Alotaibi, Yasser K; Federico, Frank

2017-12-01

Since the original Institute of Medicine (IOM) report was published there has been an accelerated development and adoption of health information technology with varying degrees of evidence about the impact of health information technology on patient safety.  This article is intended to review the current available scientific evidence on the impact of different health information technologies on improving patient safety outcomes. We conclude that health information technology improves patient's safety by reducing medication errors, reducing adverse drug reactions, and improving compliance to practice guidelines. There should be no doubt that health information technology is an important tool for improving healthcare quality and safety. Healthcare organizations need to be selective in which technology to invest in, as literature shows that some technologies have limited evidence in improving patient safety outcomes.

Physicians′ therapeutic practice and compliance of diabetic patients attending rural primary health care units in Alexandria

Directory of Open Access Journals (Sweden)

Nahla Khamis R Ibrahim

2010-01-01

Full Text Available Objectives: The objectives of the study were to investigate physician′s therapeutic practice and the compliance of diabetic patients attending rural primary health units in Alexandria. Material and Methods: A cross-sectional study was conducted and a multistage stratified random sample method was used for the selection of 600 diabetic patients. Data were collected by means of an interviewing questionnaire, an observation checklist, review of prescriptions and laboratory investigations. A scoring system was made for a diabetic patient′s knowledge and skills, patient′s compliance, doctor-patient relationship, and glycemic control. Results: About 57% always took their medication as prescribed by doctor and on time, only 2.2% always complied with dietary regimen while no one reported regular compliance with exercise regimen. Complications of the regimen was the commonest cause (63.3% of noncompliance. A highly statistically significant difference was found between compliance with all regimens and patient′s knowledge of diabetes. The scores for doctor-patient relationship were all unsatisfactory. Results of glycosylated hemoglobin (HbA1c revealed that metabolic control of four-fifth of the patients was satisfactory, 12% had fair and 8% had poor metabolic control. Conclusions: Patient′s compliance with most of the diabetes regimen was low. Doctor-patient relationship and patient′s compliance should be improved by conducting educational and training programs.

76 FR 28308 - Compliance Policy Guide: Surgeons' Gloves and Patient Examination Gloves; Defects-Criteria for...

Science.gov (United States)

2011-05-17

.... FDA-2011-D-0258] Compliance Policy Guide: Surgeons' Gloves and Patient Examination Gloves; Defects... Compliance Policy Guide Sec. 335.700, Surgeons' Gloves and Patient Examination Gloves; Defects--Criteria for... FDA staff on the submission of seizure recommendations for medical gloves that exceed the defect...

Arterial compliance in patients with cirrhosis: stroke volume-pulse pressure ratio as simplified index

DEFF Research Database (Denmark)

Fuglsang, S; Bendtsen, F; Christensen, E

2001-01-01

Arterial function may be altered in patients with cirrhosis. We determined compliance of the arterial tree (C(1)) in relation to systemic and splanchnic hemodynamic derangement and clinical variables. C(1) and the stroke volume-pulse pressure index (SV/PP) were significantly higher (+62% and +40%...... predictors of SV/PP (P abnormalities in the arterial compliance of these patients....

The Impact of Social Norms, Trust, and Fairness on Voluntary Tax Compliance in Austria

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Maria Kostritsa

2017-12-01

Full Text Available Existing literature stresses the importance of economic factors when aiming to increase voluntary tax compliance. However, emerging voices also point out to relevant social factors, but emphasize that more research needs to be carried out for their verification. Therefore, in this article, research was conducted to provide further evidence to show how social factors have an influence on voluntary tax compliance. The research is the first attempt to replicate the results of the structural model of Jimenez and Iyer (2016 outside of the us, claiming that one’s moral standards (personal norms and perceived fairness directly influence voluntary tax compliance, meanwhile social norms and trust in government have an indirect impact on tax compliance via influencing personal norms and perceived fairness. To achieve a beneficial result, 333 Austrian taxpayers were surveyed in Austria. The data was analysed in spss using frequencies, correlations and regression analysis. The results verify the aforementioned assumptions and emphasize its consideration when aiming to increase voluntary tax compliance.

A study of reasons of non-compliance of psychiatric treatment and patients' attitudes towards illness and treatment in Qatar.

Science.gov (United States)

Bener, Abdulbari; Dafeeah, Elnour E; Salem, Mohamad O

2013-04-01

The aim of this study was to examine the extent of psychiatric patients' compliance and non-compliance with treatment and examine the factors that affect compliance. Patients were recruited who were between 16 and 60 years of age and who were hospitalized with a psychiatric disorder and treated in the outpatient clinics of the psychiatry department. A total of 689 patients were approached and 564 patients agreed to participate in the study, a response rate of 81.8%. Participants were asked to complete a questionnaire that asked about socio-demographic characteristics (e.g., age, gender, nationality, level of education, occupation, marital status, and life style habits); medication(s) prescribed and the participant's response; the degree of social supervision (rated subjectively by the patient as "poor," "good," or "very good"); data also were obtained from clinical records. Data analyses explored significant associations between compliance and non-compliance and a group of relevant variables. Of the 564 patients studied, 328 (58.2%) were compliant with treatment and 236 (41.8%) were non-compliant. There was no significant difference between compliance and non-compliance in terms of gender (p = 0.471). Patients between 21-30 years of age were significantly more compliant with drug treatment than not. Non-compliance was more common among patients diagnosed with schizophrenia (28.4%), followed by depression (14.4%), and bipolar affective disorder (12.7%) (p = 0.001). Only 25% of compliant patients and 26.3% of non-compliant patients used non-psychotropic medication. Social supervision (40%) was very poor in non-compliant patients whereas 49.4% of compliant patients had very good family support. Notable reasons for non-compliance were irregular attendance to clinic (55.5%), ignorance about side effects of medication (61%), free medicine (45.8%), and a lack of education about medication (58.1%). This study revealed that non-compliance rates among psychiatry patients

THE ASSESSMENT OF COMPLIANCE TO THE USE OF NEW ORAL ANTICOAGULANTS IN PATIENTS WITH ATRIAL FIBRILLATION ACCORDING TO THE PROFILE REGISTER

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S. Y. Martsevich

2014-01-01

Full Text Available Aim. To study in the PROFILE register the rate of new oral anticoagulants (NOAC taking in patients with atrial fibrillation (AF and to identify the factors influencing it.Material and methods. Patients with AF who applied to the Cardiology Center in 2013-2014 (n=111 were included into the study. The oral anticoagulants (OAC were recommended to patients at the reference visit (n=97. Inquiry in questionnaire format was performed to assess the compliance to recommended therapy at the follow-up visit. Patients were divided into two groups according to taking/not-taking NOAC. Analysis of the facts that influence the compliance to NOAC therapy was performed.Results. At the reference visit 70 patients desired to receive NOAC. At the follow-up visit 29 (41.4% patients refused to take NOAC. Leading causes of NOAC refusal were satisfactory with warfarin (32.6%, the high price of these drugs (23.9%, the description of adverse reactions in the patient information leaflet for medicines (15.2%, and withdrawal by physician in outpatient clinic/hospital (8.7%. Preferential provision of medicines and warfarin therapy at the time of reference visit had a negative impact on the taking of NOAC. Patients taking NOAC were more aware of the possible outcomes of their illness, the possible side effects of OAC and were more familiar with patient information leaflet for medicines.Conclusion. The study assessed NOAC taking rate and the factors influencing patients' compliance to NOAC therapy.

The effect of positive and negative message framing on short term continuous positive airway pressure compliance in patients with obstructive sleep apnea.

Science.gov (United States)

Pengo, Martino F; Czaban, Marcin; Berry, Marc P; Nirmalan, Prajeshan; Brown, Richard; Birdseye, Adam; Woroszyl, Asia; Chapman, Julia; Kent, Brian D; Hart, Nicholas; Rossi, Gian Paolo; Steier, Joerg

2018-01-01

Continuous positive airway pressure (CPAP), the best available treatment for obstructive sleep apnea (OSA), requires long-term compliance to be effective. Behavioral interventions may be used to improve adherence to CPAP. We aimed to investigate whether positive or negative message framing impacts on CPAP compliance in patients with OSA, when compared to standard care. Consenting patients with confirmed OSA were randomly allocated to receive along with their CPAP either positively or negatively framed messages (Pos; Neg), or standard care (Con). Standardized motivational messages were read out to patients during an initial teaching session and through weekly telephone calls. Patients' compliance data were reviewed 2 and 6 weeks following CPAP initiation. We randomized 112 patients to groups that were matched for age, BMI, and OSA severity. The positively framed group (Pos) showed greater CPAP usage after 2 weeks (total use 53.7±31.4 hours) as compared to the negatively framed and the control group (35.6±27.4 and 40.8±33.5 hours, Pframed groups (Pos n=5; Neg n=8; Con n=11; Pframed messages can improve CPAP adherence in patients with OSA in the short-term; however, strategies for implementing its long-term use need to be developed.

MULTIDISCIPLINARY APPROACH TO SUPPORTING TREATMENT COMPLIANCE IN TUBERCULOSIS PATIENTS

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T. V. Sherstneva

2017-01-01

Full Text Available The article presents the algorithm for working with tuberculosis patients in TB hospital, providing implementation of multidisciplinary patient-centered activities for early diagnostics of psychiatric and social disorders, therapy and rehabilitation of concurrent psychiatric disorders and addictions. Multidisciplinary approach to activities within TB unit is aimed at improvement of treatment compliance of tuberculosis patients. The training programme has been developed in order to improve competency of medical personnel on the issue of treatment interruption prevention and motivating patients to undergo the continuous treatment.

Qualitative examination of compliance in heart failure patients in The Netherlands

NARCIS (Netherlands)

van der Wal, Martje H. L.; Jaarsma, Tiny; Moser, Debra K.; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

2010-01-01

BACKGROUND: Noncompliance with pharmacological and nonpharmacological recommendations is a problem in many heart failure (HF) patients, leading to worse symptoms and readmission. Although knowledge is available regarding factors related to compliance with HF regimens, little is known about patients'

Factors influencing patient compliance with therapeutic regimens in chronic heart failure: A critical incident technique analysis.

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Strömberg, A; Broström, A; Dahlström, U; Fridlund, B

1999-01-01

The aim of this study was to identify factors influencing compliance with prescribed treatment in patients with chronic heart failure. A qualitative design with a critical incident technique was used. Incidents were collected through interviews with 25 patients with heart failure strategically selected from a primary health care clinic, a medical ward, and a specialist clinic. Two hundred sixty critical incidents were identified in the interviews and 2 main areas emerged in the analysis: inward factors and outward factors. The inward factors described how compliance was influenced by the personality of the patient, the disease, and the treatment. The outward factors described how compliance was influenced by social activities, social relationships, and health care professionals. By identifying the inward and outward factors influencing patients with chronic heart failure, health care professionals can assess whether intervention is needed to increase compliance.

Preoperative assessment of lung cancer patients: evaluating guideline compliance (re-audit).

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Jayia, Parminderjit Kaur; Mishra, Pankaj Kumar; Shah, Raajul R; Panayiotou, Andrew; Yiu, Patrick; Luckraz, Heyman

2015-03-01

Guidelines have been issued for the management of lung cancer patients in the United Kingdom. However, compliance with these national guidelines varies in different thoracic units in the country. We set out to evaluate our thoracic surgery practice and compliance with the national guidelines. An initial audit in 2011 showed deficiencies in practice, thus another audit was conducted to check for improvements in guideline compliance. A retrospective study was carried out over a 12-month period from January 2013 to January 2014 and included all patients who underwent radical surgical resection for lung cancer. Data were collected from computerized records. Sixty-eight patients had radical surgery for lung cancer between January 2013 and January 2014. Four patients were excluded from the analysis due to incomplete records. Our results showed improvements in our practice compared to our initial audit. More patients underwent surgery within 4 weeks of computed tomography and positron-emission tomography scanning. An improvement was noticed in carbon monoxide transfer factor measurements. Areas for improvement include measurement of carbon monoxide transfer factor in all patients, a cardiology referral in patients at risk of cardiac complications, and the use of a global risk stratification model such as Thoracoscore. Guideline-directed service delivery provision for lung cancer patients leads to improved outcomes. Our results show improvement in our practice compared to our initial audit. We aim to liaise with other thoracic surgery units to get feedback about their practice and any audits regarding adherence to the British Thoracic Society and National Institute for Health and Care Excellence guidelines. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

The impact of health information technology on patient safety

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Yasser K. Alotaibi

2017-12-01

Full Text Available Since the original Institute of Medicine (IOM report was published there has been an accelerated development and adoption of health information technology with varying degrees of evidence about the impact of health information technology on patient safety. This article is intended to review the current available scientific evidence on the impact of different health information technologies on improving patient safety outcomes. We conclude that health information technology improves patient’s safety by reducing medication errors, reducing adverse drug reactions, and improving compliance to practice guidelines. There should be no doubt that health information technology is an important tool for improving healthcare quality and safety. Healthcare organizations need to be selective in which technology to invest in, as literature shows that some technologies have limited evidence in improving patient safety outcomes.

Impact of Electronic Tax Registers on VAT Compliance: A Study of ...

African Journals Online (AJOL)

The purpose of this study was to assess the impact of use of Electronic Tax Registers (ETRs ) on Value Added Tax (VAT) compliance among private business firms in Kisumu city, Kenya. A sample of 233 private firms was selected from a population of 590 private firms using stratified sampling technique. The data was ...

Radiation treatment compliance in the indigenous population: the pilot of Northern Territory experience and future directions

International Nuclear Information System (INIS)

Le, Hien; Carruthers, Scott; Penniment, Michael; Roos, Daniel; Sullivan, Thomas; Baxi, Siddhartha

2013-01-01

There is a perception that Indigenous patients are less likely to attend radiotherapy treatment. This study sought to determine if a difference in radiotherapy treatment compliance rates exists between Indigenous and non-Indigenous patients. Secondly, we aimed to ascertain which patient, disease and treatment factors affect compliance in Indigenous patients. All patients treated with radiotherapy at the Alan Walker Cancer Care Centre between March and October 2010 were analysed. Data regarding compliance rates (defined as those who chose and completed the recommended course of treatment), patient, disease and treatment factors were collected, and chi-squared and Fisher's exact tests were applied. A total of 41 courses were delivered to Indigenous patients and 224 courses delivered to non-Indigenous patients in this period. There was no difference in compliance between Indigenous and non-Indigenous patients (83% vs. 81%, P=0.75). Of the factors assessed, it was found that there was an association between toxicity grade and compliance (P=0.048). From this cohort, we cannot support the perception that Indigenous patients have overall poorer compliance with recommended radiation treatment courses. In this study, the only factor which correlated significantly with compliance was toxicity grade. It is felt that a number of factors, which negatively impact on compliance, can potentially be counteracted by a culturally sensitive model of care.

Correlation of compliance to statin therapy with lipid profile and serum HMGCoA reductase levels in dyslipidemic patients.

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Grover, Abhinav; Rehan, Harmeet Singh; Gupta, Lalit Kumar; Yadav, Madhur

The efficacy of statin therapy may be lost or vary with reduction in compliance and intensity of statin therapy. To study and correlate the quantitative effect of compliance on lipid profile and 3-hydroxyl-3-methylglutaryl coenzyme A reductase (HMGCoA-R) levels in dyslipidemic patients. Compliance to different intensity of statin therapy assessed by pill count was correlated with serum levels of total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), triglycerides (TG), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB) and HMGCoA-R. Out of 200 patients, 160 received moderate intensity statin therapy whereas 40 were on high intensity statin therapy. The overall mean compliance of patients was 56.7%. The compliance of patients on moderate intensity statin therapy was higher (56.8%) than those on high intensity (56.4%) (p=0.92). There was significant inverse correlation (pstatin therapy was increased above 60%. It is appropriate to improve the compliance to existing statin therapy than switching over to higher intensity statin therapy. Estimation of HMGCoA-R levels may be explored as a surrogate marker to monitor and assess the compliance of patients to statin therapy. Copyright © 2016. Published by Elsevier B.V.

Compliance and treatment satisfaction of post menopausal women treated for osteoporosis. Compliance with osteoporosis treatment

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Huas Dominique

2010-08-01

Full Text Available Abstract Background Adherence to anti-osteoporosis treatments is poor, exposing treated women to increased fracture risk. Determinants of poor adherence are poorly understood. The study aims to determine physician- and patient- rated treatment compliance with osteoporosis treatments and to evaluate factors influencing compliance. Methods This was an observational, cross-sectional pharmacoepidemiological study with a randomly-selected sample of 420 GPs, 154 rheumatologists and 110 gynaecologists practicing in France. Investigators included post-menopausal women with a diagnosis of osteoporosis and a treatment initiated in the previous six months. Investigators completed a questionnaire on clinical features, treatments and medical history, and on patient compliance. Patients completed a questionnaire on sociodemographic features, lifestyle, attitudes and knowledge about osteoporosis, treatment compliance, treatment satisfaction and quality of life. Treatment compliance was evaluated with the Morisky Medication-taking Adherence Scale. Variables collected in the questionnaires were evaluated for association with compliance using multivariate logistic regression analysis. Results 785 women were evaluated. Physicians considered 95.4% of the sample to be compliant, but only 65.5% of women considered themselves compliant. The correlation between patient and physician perceptions of compliance was low (κ: 0.11 [95% CI: 0.06 to 0.16]. Patient-rated compliance was highest for monthly bisphosphonates (79.7% and lowest for hormone substitution therapy (50.0%. Six variables were associated with compliance: treatment administration frequency, perceptions of long-term treatment acceptability, perceptions of health consequences of osteoporosis, perceptions of knowledge about osteoporosis, exercise and mental quality of life. Conclusion Compliance to anti-osteoporosis treatments is poor. Reduction of dosing regimen frequency and patient education may be useful

Impact and management of chemotherapy/radiotherapy-induced nausea and vomiting and the perceptual gap between oncologists/oncology nurses and patients: a cross-sectional multinational survey.

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Vidall, Cheryl; Fernández-Ortega, Paz; Cortinovis, Diego; Jahn, Patrick; Amlani, Bharat; Scotté, Florian

2015-11-01

Chemotherapy/radiotherapy-induced nausea and vomiting (CINV/RINV) can affect half of oncology patients, significantly impacting daily life. Nausea without vomiting has only recently been thought of as a condition in its own right. As such, the incidence of nausea is often underestimated. This survey investigated the incidence and impact of CINV/RINV in patients compared with estimations of physicians/oncology nurses to determine if there is a perceptual gap between healthcare professionals and patients. An online research survey of physicians, oncology nurses and patients was conducted across five European countries. Participants had to have experience prescribing/recommending or have received anti-emetic medication for CINV/RINV treatment. Questionnaires assessed the incidence and impact of CINV/RINV, anti-emetic usage and compliance, and attribute importance of anti-emetic medication. A total of 947 (375 physicians, 186 oncology nurses and 386 patients) participated in this survey. The incidence of nausea was greater than vomiting: 60 % of patients reported nausea alone, whereas 18 % reported vomiting. Physicians and oncology nurses overestimated the incidence of CINV/RINV but underestimated its impact on patients' daily lives. Only 38 % of patients reported full compliance with physicians'/oncology nurses' guidelines when self-administering anti-emetic medication. Leading factors for poor compliance included reluctance to add to a pill burden and fear that swallowing itself would induce nausea/vomiting. There is a perceptual gap between healthcare professionals and patients in terms of the incidence and impact of CINV/RINV. This may lead to sub-optimal prescription of anti-emetics and therefore management of CINV/RINV. Minimising the pill burden and eliminating the requirement to swallow medication could improve poor patient compliance with anti-emetic regimens.

Impact of an educational intervention on hand hygiene compliance and infection rate in a developing country neonatal intensive care unit.

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Chhapola, Viswas; Brar, Rekha

2015-10-01

Nosocomial infections are a significant problem in neonatal intensive care units (NICUs) and hand hygiene (HH) has been stated as an effective mean to prevent spread of infections. The aim of study was to assess the baseline compliance HH practices and to evaluate the impact of hand washing educational programme on infection rate in a NICU. Continuous surveillance of nosocomial infections was done. A total of 15,797 and 12 ,29 opportunities for HH were observed in pre-intervention and postintervention phases, respectively. Compliance of health-care workers for all HH opportunities combined was 46% before intervention and improved significantly to 69% in postintervention (RR 1.49, CI 1.46-1.52, P Nosocomial sepsis rate showed a significant decline from 96 per 1000 patient-days in pre-intervention to 47 per 1000 patient-days in postintervention phase (RR 0.44, CI 0.33-0.58, P nosocomial infection control approach especially important in developing nations. © 2014 Wiley Publishing Asia Pty Ltd.

Increasing compliance with the World Health Organization Surgical Safety Checklist-A regional health system's experience.

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Gitelis, Matthew E; Kaczynski, Adelaide; Shear, Torin; Deshur, Mark; Beig, Mohammad; Sefa, Meredith; Silverstein, Jonathan; Ujiki, Michael

2017-07-01

In 2009, NorthShore University HealthSystem adapted the World Health Organization Surgical Safety Checklist (SSC) at each of its 4 hospitals. Despite evidence that SSC reduces intraoperative mistakes and increase patient safety, compliance was found to be low with the paper form. In November 2013, NorthShore integrated the SSC into the electronic health record (EHR). The aim was to increase communication between operating room (OR) personnel and to encourage best practices during the natural workflow of surgeons, anesthesiologists, and nurses. The purpose of this study was to examine the impact of an electronic SSC on compliance and patient safety. An anonymous OR observer selected cases at random and evaluated the compliance rate before the rollout of the electronic SSC. In June 2014, an electronic audit was performed to assess the compliance rate. Random OR observations were also performed throughout the summer in 2014. Perioperative risk events, such as consent issues, incorrect counts, wrong site, and wrong procedure were compared before and after the electronic SSC rollout. A perception survey was also administered to NorthShore OR personnel. Compliance increased from 48% (n = 167) to 92% (n = 1,037; P World Health Organization SSC is a validated tool to increase patient safety and reduce intraoperative complications. The electronic SSC has demonstrated an increased compliance rate, a reduced number of risk events, and most OR personnel believe it will have a positive impact on patient safety. Copyright © 2016 Elsevier Inc. All rights reserved.

A study at Manchester Dental Hospital, of the compliance of IV sedation patients and their escorts.

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Lightfoot, Kate

2014-01-01

Oral surgery, under intravenous sedation, is carried out on a daily basis at Manchester Dental Hospital. This essay discusses the background of conscious sedation in the dental setting and looks at the compliance of patients (and escorts) when having intravenous sedation. The patient journey, from pre-operative assessment through to treatment is considered. Hospital instructions indicate an obligation for patients to attend with a responsible adult (eighteen or over) who remains with them throughout their treatment, escorts them home,and arranges their care for the next twenty-four hours. By following these instructions the patient should receive optimal care. Two questionnaires were devised and given to patients/escorts to assess their compliance with Manchester Dental Hospital postoperative protocols. 100% compliance was the set standard, with results presented as pie charts. This work began during the undergraduate summer vacation of 2012 and continued over a five-month period. Initial results suggested that compliance was generally good but certain improvements could be made. Suggestions for future development are presented. These aim to give clarity to all patients/escorts and their specific roles in the anticipated treatment.

Home-based zoledronic acid infusion therapy in patients with solid tumours: compliance and patient-nurse satisfaction.

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Lebret, Thierry; Mouysset, Jean-Loup; Lortholary, Alain; El Kouri, Claude; Bastit, Laurent; Ktiouet, Meryem; Slimane, Khemaies; Murraciole, Xavier; Guérif, Stéphane

2013-06-01

This study aimed to explore patient and nurse satisfaction, compliance with best practice, technical feasibility and safety of home infusion of the bisphosphonate zoledronic acid (ZOL). This was a prospective 1-year survey of home ZOL therapy (4 mg Zometa, 15-min i.v., every 3-4 weeks) in patients with bone metastases secondary to a solid malignancy. A physician questionnaire, nurse satisfaction/feasibility questionnaire and patient satisfaction questionnaire were administered at several time-points. Physician participation rate was 56.5% (87/154). Physicians enrolled 818 patients visited by 381 predominantly community nurses. Of the 788 case report forms received, 763 met inclusion criteria. Patient characteristics were as follows: median age, 68 years (30-95); M/F, 40/60; ECOG-PS 0 or 1, 78.6%; and primary tumour site, breast (55.2%), prostate (28.4%), lung (7.2%) or other (9.4%). Nurse satisfaction rates were high: organisation of home ZOL therapy, 90.9%; ease of infusion, 96.7%; patient-nurse relationship, 97.5%; and relationship with hospital staff, 73%. Patient satisfaction was also very high (95.3%). The main reasons were quality of the nurse-patient relationship (57.6%), less travel/waiting (68.8%), home environment (52.9%) and less disruption to daily routine (36.6%). ZOL therapy was well tolerated, the discontinuation rate due to adverse events (including deaths whether related to diseases progression or not) was 33.6%. The incidence of osteonecrosis of the jaw was 0.6% and of fractures, 0.2%. Practitioner compliance with best practice was 76.7-83.7% for recommended and/or tolerated dosage, 73% for dental hygiene checks at inclusion and 48-56% thereafter, 66% for pre-infusion hydration, and often undocumented for calcium/vitamin D supplementation. Home ZOL therapy was well tolerated. Both patient and nurse satisfaction were very high. However, better compliance with best practice should be encouraged.

Relationship of Personal- Social and Therapeutic Factors with Medication Compliance in TB Patients in Ahwaz

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S Jahani

2012-01-01

Full Text Available Introduction: Despite the implementation of DOTS strategy, TB remains one of the ten leading causes of death in developing countries. Compliance with treatment is affected by social, cultural, and economic factors, and patients’ knowledge and attitude as well. The aim of this study was to determine the relationship between compliance with treatment and personal, social and therapeutic factors in TB patients in Ahwaz. Methods: This cross-sectional descriptive study was conducted on 167 TB patients. Subjects were selected based on target. The data were collected using a questionnaire, and by observation, sputum analysis, and Kvzart Ponce urine test. The validity of the questionnaire was tested by the method of content validity, and its internal consistency and reliability was tested by Cronbach's alpha coefficient. Data analyzed by SpSS. Results: Among all subjects, 52.7% of patients showed complete compliance and 35.2% and 12% of them showed partial and poor compliance, respectively. There was a significant relationship between treatment compliance and gender(p=0.009, quality of monthly income(p=0.007, and addiction(p=0.001. The quality of treatment compliance was not significantly related to age, marital status, educational level, ethnicity, and medical complications. Conclusion: The findings showed that Incomplete treatment of TB is much worse than not treating it, because the lack of precision in the administration and consumption of anti-tuberculosis drugs, leads to the emergence of resistant TB. Paying attention to the factors decreasing treatment compliance and trying to eliminate them may lead to better treatment and lower incidence and prevalence of tuberculosis in the community.

Compliance of hospital staff with guidelines for the active surveillance of methicillin-resistant Staphylococcus aureus (MRSA) and its impact on rates of nosocomial MRSA bacteremia.

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Zoabi, Marwan; Keness, Yoram; Titler, Nava; Bisharat, Naiel

2011-12-01

The compliance of hospital staff with guidelines for the active surveillance of methicillin-resistant Staphylococcus aureus (MRSA) in Israel has not been determined. To evaluate the compliance of hospital staff with guidelines for the active surveillance of MRSA and assess its impact on the incidence of nosocomial MRSA bacteremia. We assessed compliance with MRSA surveillance guidelines by assessing adherence to the screening protocol and reviewing medical and nursing charts of patients colonized with MRSA, and observed hand hygiene opportunities among health care workers and colonized patients. Rates of nosocomial MRSA bacteremia and of adherence with hand hygiene among overall hospital staff were obtained from archived data for the period 2001-2010. Only 32.4% of eligible patients were screened for MRSA carriage on admission, and 69.9% of MRSA carriers did not receive any eradication treatment. The mean rate of adherence to glove use among nurses and doctors was 69% and 31% respectively (Phand hygiene 59% and 41% respectively (Phand hygiene increased from 42.3% in 2005 to 68.1% in 2010. Rates of nosocomial MRSA bacteremia decreased by 79.2%, from 0.48 (in 2001) to 0.1 (in 2010) per 1000 admissions (Phand hygiene and concomitant decrease in nosocomial MRSA bacteremia is gratifying. The deficiencies in compliance with MRSA infection control policy warrant an adjusted strategy based on the hospital resources.

Compliance with Supportive Periodontal Treatment in Patients with Dental Implants.

Science.gov (United States)

Hu, Kai-Fang; Lin, Ying-Chu; Ho, Kun-Yen; Chou, Yu-Hsiang

The need for dental implants is increasing, and supportive periodontal treatment can achieve long-term success and prevent peri-implantitis. Contributing factors to noncompliance with long-term scheduled supportive periodontal treatment remain unclear. To investigate whether demographic and clinical characteristics are associated with noncompliance, the authors analyzed data for patients who had received dental implants. The authors recruited patients participating in a supportive periodontal treatment program after receiving permanent prostheses on implants placed from 2005 to 2013. Demographic data and dental treatment histories were collected. Compliance was defined as a record of participation in a standard supportive periodontal treatment program for at least 1 year. The chi-square test, log-rank test, Kaplan-Meier survival curve, and Cox proportional hazards model were used for statistical analysis. The study included 120 patients (259 implants, 60% compliance). The two groups (compliant and noncompliant) differed significantly in frequency distributions for sex (P = .0017), educational level (P = .0325), and histories of substance use (P = .0016), periodontitis (P = .0005), and root planing or flap surgery (P = .0002). The Kaplan-Meier survival curves and log-rank test showed that increases in cumulative continuation rates were significantly associated with male sex (P = .0025); body mass index ≥ 24 kg/m² (P = .0093); and a history of periodontitis (P implant placement, root planing or flap surgery was the crucial factor in determining compliance with supportive periodontal treatment. However, well-designed large-scale studies with a larger sample size are needed to confirm the findings of this study.

Benefits of statin therapy and compliance in high risk cardiovascular patients

Directory of Open Access Journals (Sweden)

Joel A Lardizabal

2010-09-01

Full Text Available Joel A Lardizabal1, Prakash C Deedwania21Division of Cardiology, Department of Medicine, University of California in San Francisco (Fresno-MEP, Fresno, CA, USA; 2University of California in San Francisco, Chief of Cardiology, Veterans Affairs Central California System, Fresno, CA, USAAbstract: Cardiovascular disease (CVD remains the top cause of global mortality. There is considerable evidence that supports the mortality and morbidity benefit of statin therapy in coronary heart disease (CHD and stroke, both in primary and secondary prevention settings. Data also exist pointing to the advantage of statin treatment in other high-risk CVD conditions, such as diabetes, CKD, CHF, and PVD. National and international clinical guidelines in the management of these CVD conditions all advocate for the utilization of statin therapy in appropriate patients. However, overall compliance to statin therapy remains suboptimal. Patient-, physician-, and economic-related factors all play a role. These factors need to be considered in devising approaches to enhance adherence to guideline-based therapies. To fully reap the benefits of statin therapy, interventions which improve long-term treatment compliance in real-world settings should be encouraged.Keywords: cardiovascular disease, statin therapy, coronary heart disease, long-term treatment compliance

Non-compliance in surveillance for patients with previous resection of large (≥1 cm) colorectal adenomas

Institute of Scientific and Technical Information of China (English)

Wolfgang M Brueckl; Berit Fritsche; Brigitte Seifert; Frank Boxberger; Heinz Albrecht; Roland S Croner; Axel Wein; Eckhart G Hahn

2006-01-01

AIM: To assess the extent and reasons of noncompliance in surveillance for patients undergoing polypectomy of large (≥ 1 cm) colorectal adenomas.METHODS: Between 1995 and 2002, colorectal adenomas ≥ 1 cm were diagnosed in 210 patients and subsequently documented at the Erlangen Registry of Colorectal Polyps. One hundred and fifty-eight patients (75.2%) could be contacted by telephone and agreed to be interviewed. Additionally, records were obtained from the treating physicians.RESULTS: Fifty-four out of 158 patients (34.2%)neglected any surveillance. Reasons for non-compliance included lack of knowledge concerning surveillance intervals (45.8%), no symptoms (29.2%), fear of examination (18.8%) or old age/severe illness (6.3%).In a multivariate analysis, the factors including female gender (P = 0.036) and age ≥ 62 years (P = 0.016)proved to be significantly associated with non-compliance in surveillance.CONCLUSION: Efforts to increase compliance in surveillance are of utmost importance, This applies particularly to women's compliance. Effective strategies for avoiding metachronous colorectal adenoma and cancer should focus on both the improvement in awareness and knowledge of patients and information about physicians for surveillance.

Patient compliance with a health care provider referral for an occupational therapy lymphedema consult.

Science.gov (United States)

Dominick, Sally A; Natarajan, Loki; Pierce, John P; Madanat, Hala; Madlensky, Lisa

2014-07-01

Limited information exists on breast cancer patients' compliance to attend outpatient appointments with an occupational therapy (OT) lymphedema specialist. The objectives of this study were (1) to examine patient compliance with a health care provider referral for an OT lymphedema consult and (2) to identify potential barriers to compliance. A retrospective chart review of female breast cancer patients at the UC San Diego Health System was conducted. Electronic medical records were queried for breast cancer patients, who received a health care provider referral for an OT lymphedema consult between June 1, 2010 and December 31, 2011. Descriptive statistics and Fisher's exact chi-square tests were used to examine how specific participant characteristics were associated with attending an OT appointment. A total of 210 female patients received an OT referral from a health care provider related to their breast cancer diagnosis. Forty-three (20.5%) patients did not attend an OT appointment. Non-attenders were more likely to have had fewer lymph nodes removed (Pcancer patients attended recommended OT lymphedema consults, a substantial number of women might benefit from further education about OT for lymphedema prevention following breast cancer treatment. Further research to understand barriers to attendance is recommended, particularly among women with only sentinel nodes removed.

Non-compliance to anti-hypertensive medication and its associated factors among hypertensives

International Nuclear Information System (INIS)

Bilal, A.; Riaz, M.; Shafiq, N.U.; Ahmed, M.; Sheikh, S.; Rasheed, S.

2015-01-01

Non-compliance to anti-hypertensive drugs can have negative impact on cardiovascular outcome. Various studies have been conducted on the issue but the factors are not yet explored properly, particularly in Pakistan. This study was conducted to determine the frequency and factors associated with non-compliance to anti-hypertensive medications in Karachi. Methods: This descriptive cross sectional study was conducted on 113 indoor hypertensive patients included by purposive sampling, aged 30 years and above diagnosed at least 6 months back in public sector tertiary care institutes of Karachi from March to October 2011. Data was collected through a questionnaire in Urdu. Demographic data, hypertension diagnosis, medical co-morbidity, current number of anti-hypertensive medicines, frequency of missing prescribed antihypertensive therapy and other factors affecting compliance pertaining to medicines, patient, physician and health care centre were included in the questionnaire. Results: This study revealed that 68.14% patients were non-compliant. Non-compliance was found to be associated with gender and socioeconomic status. Duration of hypertension, duration between follow up visits to physician, number of drugs, careless attitude, role of physician and limiting access to health care center are found to be important factors in non-compliance. Conclusions: Multiple factors including patients, medicine and health care system related, which can be prevented with simple measures, were found responsible for higher prevalence of non-compliance against anti-hypertensive medicines. (author)

[Insufficient medication compliance in Parkinson's disease].

Science.gov (United States)

Aerts, Marjolein B; van der Eijk, Martijn; Kramers, Kees; Bloem, Bastiaan R

2011-01-01

Medication compliance is generally suboptimal, particularly in patients with complex polypharmacy. This generic treatment problem is described here for Parkinson's disease (PD). We would expect patients with PD to have good medication compliance, since missed doses immediately result in worsening of symptoms. However, recent research has revealed that PD patients demonstrate poor medication compliance. Poor medication compliance is particularly undesirable for patients with PD because regular intake of medication is required for optimal treatment effect. Possible ways of improving medication compliance are pharmacotherapeutic measures and behavioural interventions. Modern methods of communication (text message reminders) and 'smart' pill dispensers may be beneficial, but the advantages of such interventions have not yet been scientifically studied.

[Influence of WeChat platform on the compliance of continuous treatment of scar in adult burn patients].

Science.gov (United States)

Wang, F; Zhang, H L

2018-03-20

Objective: To explore influence of the WeChat platform on the compliance of continuous treatment of scar in adult burn patients. Methods: A total of 124 adult burn patients, conforming to the study criteria, admitted in the Department of Burns of our hospital from January 2015 to January 2016 were divided into WeChat group ( n =63) and control group ( n =61) according to the random number table. Patients in control group only received regular discharging rehabilitation guide, while patients in WeChat group received regular discharging rehabilitation guide and joined WeChat platform after being discharged from hospital. Through pushing rehabilitation plan and rehabilitation related knowledge, organizing support discussion of burn patients, answering the patients' questions, members of WeChat platform intervention group conducted continuous treatment for 6 months on patients of WeChat group. The compliance of functional exercise of patients in two groups in one week before discharge and 3 and 6 months after discharge was evaluated by using the self-made functional exercise compliance log sheet. The compliance of using anti-scar drug and appliance of patients in two groups in 3 and 6 months after discharge was evaluated by using self-made anti-scar drug and appliance usage log sheets. Data were processed with chi-square test, independent sample t test, non-parametric rank sum test of independent sample, and Wilcoxon rank sum test. Results: (1) The compliance ratio of functional exercise of patients in WeChat group (95.24%, 60/63) was close to 93.44% (57/61) in control group in one week before discharge ( χ (2)=0.188, P >0.05). The compliance ratios of functional exercise of patients in WeChat group were respectively 93.65% (59/63) and 87.30% (55/63) in 3 and 6 months after discharge, which were higher than 68.85% (42/61) and 65.57% (40/61) in control group ( χ (2)=12.615, 8.166, P WeChat group was significantly better than that in control group in 3 and 6 months

Compliance and toxicity of adjuvant CMF in elderly breast cancer patients: a single-center experience

International Nuclear Information System (INIS)

De Maio, Ermelinda; Capasso, Immacolata; Rinaldo, Massimo; Morrica, Brunello; Elmo, Massimo; Di Maio, Massimo; Perrone, Francesco; Matteis, Andrea de; Gravina, Adriano; Pacilio, Carmen; Amabile, Gerardo; Labonia, Vincenzo; Landi, Gabriella; Nuzzo, Francesco; Rossi, Emanuela; D'Aiuto, Giuseppe

2005-01-01

Few data are available on compliance and safety of adjuvant chemotherapy when indicated in elderly breast cancer patients; CMF (cyclophosphamide, methotrexate, fluorouracil) can be reasonably considered the most widely accepted standard of treatment. We retrospectively reviewed compliance and safety of adjuvant CMF in patients older than 60. The treatment was indicated if patients had no severe comorbidity, a high-risk of recurrence, and were younger than 75. Toxicity was coded by NCI-CTC. Toxicity and compliance were compared between two age subgroups (<65, ≥ 65) by Fisher exact test and exact Wilcoxon rank-sum test. From March 1991 to March 2002, 180 patients were identified, 100 older than 60 and younger than 65, and 80 aged 65 or older. Febrile neutropenia was more frequent among older patients (p = 0.05). Leukopenia, neutropenia, nausea, cardiac toxicity and thrombophlebitis tended to be more frequent or severe among elderlies, while mucositis tended to be more evident among younger patients, all not significantly. Almost one half (47%) of the older patients receiving concomitant radiotherapy experienced grade 3–4 haematological toxicity. Compliance was similar in the two groups, with 6 cycles administered in 86% and 79%, day-8 chemotherapy omitted at least once in 36% and 39%, dose reduction in 27% and 38%, prolonged treatment duration (≥ 29 weeks) in 10% and 11% and need of G-CSF in 9% and 18%, among younger and older patients, respectively. Our data show that, in a highly selected population of patients 65 or more years old, CMF is as feasible as in patients older than 60 and younger than 65, but with a relevant burden of toxicity. We suggest that prospective trials in elderly patients testing less toxic treatment schemes are mandatory before indicating adjuvant chemotherapy to all elderly patients with significant risk of breast cancer recurrence

Capnography for assessing nocturnal hypoventilation and predicting compliance with subsequent noninvasive ventilation in patients with ALS.

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Sung-Min Kim

Full Text Available BACKGROUND: Patients with amyotrophic lateral sclerosis (ALS suffer from hypoventilation, which can easily worsen during sleep. This study evaluated the efficacy of capnography monitoring in patients with ALS for assessing nocturnal hypoventilation and predicting good compliance with subsequent noninvasive ventilation (NIV treatment. METHODS: Nocturnal monitoring and brief wake screening by capnography/pulse oximetry, functional scores, and other respiratory signs were assessed in 26 patients with ALS. Twenty-one of these patients were treated with NIV and had their treatment compliance evaluated. RESULTS: Nocturnal capnography values were reliable and strongly correlated with the patients' respiratory symptoms (R(2 = 0.211-0.305, p = 0.004-0.021. The duration of nocturnal hypercapnea obtained by capnography exhibited a significant predictive power for good compliance with subsequent NIV treatment, with an area-under-the-curve value of 0.846 (p = 0.018. In contrast, no significant predictive values for nocturnal pulse oximetry or functional scores for nocturnal hypoventilation were found. Brief waking supine capnography was also useful as a screening tool before routine nocturnal capnography monitoring. CONCLUSION: Capnography is an efficient tool for assessing nocturnal hypoventilation and predicting good compliance with subsequent NIV treatment of ALS patients, and may prove useful as an adjunctive tool for assessing the need for NIV treatment in these patients.

The theory of reasoned action and patient compliance during orthodontic treatment.

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Bos, Annemieke; Hoogstraten, Johan; Prahl-Andersen, Birte

2005-12-01

The aim of the present study was to investigate the potential of the theory of reasoned action (TRA) for the prediction and understanding of patients' intention to comply during orthodontic treatment and to analyze the effect of two additional variables in the model, namely perceived behavioral control and anticipated regret. Moreover, (the determinants of) intentions of orthodontic patients to comply during treatment were compared with (the determinants of) intentions of parents to stimulate this cooperation. A questionnaire was handed out to patients and parents visiting the Department of Orthodontics of the Academic Centre of Dentistry in Amsterdam. In both the patient and parent sample, independent-sample t-tests, correlation analyses and stepwise regression analyses were conducted. Variables in both samples were compared and tested. The extended version of the TRA explained 20% of the variance in the patients' intention to comply. The patients' anticipated regret, attitude and motivation to comply were significant determinants of the patients' intention to comply. In addition, the parents' attitude toward compliance was a significant predictor. The role of parents in enhancing patients' intentions to comply cannot be neglected. Our findings suggest that patients' intentions to comply during orthodontic treatment are influenced by factors outside of the TRA. Therefore, it is recommended to develop a new model, in which factors of the TRA are included, which can be used specifically for the study of compliance in orthodontics.

Diastolic compliance and exercise-induced left ventricular diastolic volume changes in patients with coronary artery disease

International Nuclear Information System (INIS)

Choi, W.; Varma, V.; Wasserman, A.; Katz, R.; Reba, R.; Ross, A.

1983-01-01

This study consists of 46 consecutive patients who had supine resting and exercise multigated (MUGA) blood pool studies. All patients had angio-graphically important coronary stenosis in at least one major vessel. Thirty-five out of 46 patients with coronary artery disease increased left ventricular end diastolic volume with a supine exercise. The remaining eleven patients dit not dilate the left ventricle. Those patients, who were able to increase their end diastolic volume during exercise, had better compliance of the left ventricle manifested by lower end diastolic pressures, whereas, patients with poor left ventricular compliance were unable to volume expand during supine exercise

On the regularization of impact without collision: the Painlevé paradox and compliance

DEFF Research Database (Denmark)

Hogan, S. J.; Kristiansen, K. Uldall

2017-01-01

approach, we recover impact without collision (IWC) in both the inconsistent and the indeterminate Painlevéé paradoxes, in the latter case giving an exact formula for conditions that separate IWC and lift-off. We solve the problem for arbitrary values of the compliance damping and give explicit...

Evaluation of Blood Pressure Control Levels and Treatment Compliances of Hypertensive Patients

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Cenk Aypak

2013-04-01

Full Text Available Purpose: The aim of the study is to evaluate the knowledge of patients about hypertension (HT, compliance with lifestyle changes and to determine their blood pressure levels under antihypertensive therapy. Method: Hypertensive patients that applied to Family medicine outpatient clinics of Diskapi Yildirim Beyazit Education and Research Hospital for the first time, in 2012 (between February 1 to April 30, were included in our cross-sectional study. Patients are evaluated primarily for the control and the factors that can affect high blood pressure and the rate on achieving treatment goals. Results: Three hundred and forty patients were included in the study. The mean age of the patients was 60.5±10.7 years and 222 of them (65.3% were female. The blood pressure was not under control in 108 (31.8% patients. The mean body weight of male patients was statistically higher than females (p=0.015. The number of the patients that knew the normal blood pressure value was 249 (73.2%. Among those 155 (62.2% were women and 179 (71.9% were younger than 65 years of age (p=0.0001. Forty one patients (12.1% were still smoking, 46 (13.5% patients were exercising regularly and 32 (9.4% were consuming regular diet. Blood pressure was better controlled in the group that was exercising regularly (p=0.001. The rate of male patients that were on regular exercise and diet, were higher than females (p=0.09. Only 86 patients (25.3% knew the name of their antihypertensive medication and 65 of patients (19.1% knew the dose of their medication. Female patients knew the name of their medication better than males (p=0.002. 156 patients (45.9% were using two kinds of antihypertensive medication. 58 patients (17.1% were skipping doses a few times a week. Conclusion: The knowledge of hypertensive patients on their illness and their compliance on non-drug treatments were inadequate. The compliance of patients should be improved by development of patient-doctor should be improved

A Summation Analysis of Compliance and Complications of Compression Hosiery for Patients with Chronic Venous Disease or Post-thrombotic Syndrome.

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Kankam, Hadyn K N; Lim, Chung S; Fiorentino, Francesca; Davies, Alun H; Gohel, Manj S

2018-03-01

Compression stockings are commonly prescribed for patients with a range of venous disorders, but are difficult to don and uncomfortable to wear. This study aimed to investigate compliance and complications of compression stockings in patients with chronic venous disease (CVD) and post-thrombotic syndrome (PTS). A literature search of the following databases was carried out: MEDLINE (via PubMed), EMBASE (via OvidSP, 1974 to present), and CINAHL (via EBSCOhost). Studies evaluating the use of compression stockings in patients with CVD (CEAP C2-C5) or for the prevention or treatment of PTS were included. After scrutinising full text articles, compliance with compression and associated complications were assessed. Compliance rates were compared based on study type and degree of compression. Good compliance was defined as patients wearing compression stockings for >50% of the time. From an initial search result of 4303 articles, 58 clinical studies (37 randomised trials and 21 prospective studies) were selected. A total of 10,245 limbs were included, with compression ranging from 15 to 40 mmHg (not stated in 12 studies) and a median follow-up of 12 months (range 1-60 months). In 19 cohorts, compliance was not assessed and in a further nine, compliance was poorly specified. Overall, good compliance with compression was reported for 5371 out of 8104 (66.2%) patients. The mean compliance, weighted by study size, appeared to be greater for compression ≤25 mmHg (77%) versus > 25 mmHg (65%) and greater in the randomised studies (74%) than in prospective observational studies (64%). Complications of stockings were not mentioned in 43 out of 62 cohorts reviewed. Where complications were considered, skin irritation was a common event. In published trials, good compliance with compression is reported in around two thirds of patients, with inferior compliance in those given higher degrees of compression. Further studies are required to identify predictors of non-compliance

The Critical Role of Pulmonary Arterial Compliance in Pulmonary Hypertension

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Prins, Kurt W.; Pritzker, Marc R.; Scandurra, John; Volmers, Karl; Weir, E. Kenneth

2016-01-01

The normal pulmonary circulation is a low-pressure, high-compliance system. Pulmonary arterial compliance decreases in the presence of pulmonary hypertension because of increased extracellular matrix/collagen deposition in the pulmonary arteries. Loss of pulmonary arterial compliance has been consistently shown to be a predictor of increased mortality in patients with pulmonary hypertension, even more so than pulmonary vascular resistance in some studies. Decreased pulmonary arterial compliance causes premature reflection of waves from the distal pulmonary vasculature, leading to increased pulsatile right ventricular afterload and eventually right ventricular failure. Evidence suggests that decreased pulmonary arterial compliance is a cause rather than a consequence of distal small vessel proliferative vasculopathy. Pulmonary arterial compliance decreases early in the disease process even when pulmonary artery pressure and pulmonary vascular resistance are normal, potentially enabling early diagnosis of pulmonary vascular disease, especially in high-risk populations. With the recognition of the prognostic importance of pulmonary arterial compliance, its impact on right ventricular function, and its contributory role in the development and progression of distal small-vessel proliferative vasculopathy, pulmonary arterial compliance is an attractive target for the treatment of pulmonary hypertension. PMID:26848601

Comprehension and compliance with the discharge advice and quality of life at home among the postoperative neurosurgery patients discharged from PGIMER, Chandigarh, India

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Kumar, Vishal; Singh, Amarjeet; Tewari, Manoj K.; Kaur, Sukhpal

2016-01-01

Problem Statement: Neurosurgical patients require special care not only in the hospital but also after their discharge from the hospital. Comprehension and compliance to the instructions given by the doctors/nurses at the time of discharge is important in home care of these patients. Many such patients suffer from various co-morbidities. Variable periods of convalescence affect health-related quality of life in these patients. Purpose of the Study: To determine the degree of compliance of neurosurgery patients and their family caregivers with the discharge advice given by the consultantsTo evaluate the quality of life of these patientsTo know the problems faced by these patients at home. Materials and Methods: This cross-sectional interview-based descriptive study was conducted in 2010 in Chandigarh. These patients were visited at their home. A scale was evolved to evaluate comprehension and compliance to the advice given at the time of discharge, according to the criteria developed by Clark et al. Lawton Brody instrumental activity of daily life and Spitzer quality of life index were used to assess patients' quality of life after the operation. Verbatim responses were recorded for the purpose of qualitative research. Results: Overall, 58 patients and their caregivers were interviewed at home. Mean age of the patients was 38.9 years. Out of 37 patients, 35 showed good comprehension and 33 patients had a good compliance with the instructions given for medication. The condition of 74.1% patients improved after the operation. Depression was reported in 31% of the patients. Many (36.2%) patients had to quit their job due to the disease. Almost half (47.4%) of the patients were independent in daily activities of their life while being evaluated on Barthel activity of daily life index. Conclusion and Recommendations: It is in the long term that the true complexity and impact of operations become apparent. After operation, such patients are likely to have a range of

Evaluating compliance with institutional preoperative testing guidelines for minimal-risk patients undergoing elective surgery.

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Siriussawakul, Arunotai; Nimmannit, Akarin; Rattana-arpa, Sirirat; Chatrattanakulchai, Siritda; Saengtawan, Puttachard; Wangdee, Aungsumat

2013-01-01

Few investigations preoperatively are important for low-risk patients. This study was designed to determine the level of compliance with preoperative investigation guidelines for ASA I patients undergoing elective surgery. Secondary objectives included the following: to identify common inappropriate investigations, to evaluate the impact of abnormal testing on patient management, to determine factors affecting noncompliant tests, and to estimate unnecessary expenditure. This retrospective study was conducted on adult patients over a one-year period. The institute's guidelines recommend tests according to the patients' age groups: a complete blood count (CBC) for those patients aged 18-45; CBC, chest radiograph (CXR) and electrocardiography (ECG) for those aged 46-60; and CBC, CXR, ECG, electrolytes, blood glucose, blood urea nitrogen (BUN), and creatinine (Cr) for patients aged 61-65. The medical records of 1,496 patients were reviewed. Compliant testing was found in only 12.1% (95% CI, 10.5-13.9). BUN and Cr testings were the most frequently overprescribed tests. Overinvestigations tended to be performed on major surgery and younger patients. Overall, overinvestigation incurred an estimated cost of US 200,000 dollars during the study period. The need to utilize the institution's preoperative guidelines should be emphasized in order to decrease unnecessary testing and the consequential financial burden.

Costs, quality of life and treatment compliance associated with antibiotic therapies in patients with cystic fibrosis: a review of the literature.

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Weiner, Jennifer R; Toy, Edmond L; Sacco, Patricia; Duh, Mei Sheng

2008-04-01

Cystic fibrosis is the most common incurable hereditary disease in the US. Persistent respiratory infection is the leading cause of morbidity and mortality in cystic fibrosis patients. This study aimed to review the literature on economic and quality of life outcomes and treatment compliance associated with antibiotic therapies for cystic fibrosis patients. A systematic literature review was conducted using keyword searches of the MEDLINE database and selected conference abstracts. The review covered studies published between January 1990 and May 2007. Evidence suggests that inhaled tobramycin, a key chronic suppressive therapy, can reduce other healthcare costs. The main determinants of the cost of care include disease severity and respiratory infection. Costs vary widely by country. There is evidence that inhaled tobramycin and oral azithromycin improve quality of life and that treatment setting and patient convenience may also impact on quality of life. Antibiotic treatment compliance varied significantly and depended on the method of measurement, with more subjective measures tending to be higher. This review concludes by offering directions for future research.

Patient compliance and disease management in the treatment of psoriasis in the Netherlands

NARCIS (Netherlands)

van de Kerkhof, P. C.; de Hoop, D.; de Korte, J.; Cobelens, S. A.; Kuipers, M. V.

2000-01-01

Compliance behaviour and disease management are important issues in chronic skin diseases. Psoriasis patients are 'experts by experience' because of many years of treatment. Therefore, it is relevant to gather data from patients on the actual use of antipsoriatic treatments. The following questions

Effect of hand sanitizer location on hand hygiene compliance.

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Cure, Laila; Van Enk, Richard

2015-09-01

Hand hygiene is the most important intervention to prevent infection in hospitals. Health care workers should clean their hands at least before and after contact with patients. Hand sanitizer dispensers are important to support hand hygiene because they can be made available throughout hospital units. The aim of this study was to determine whether the usability of sanitizer dispensers correlates with compliance of staff in using the sanitizer in a hospital. This study took place in a Midwest, 404-bed, private, nonprofit community hospital with 15 inpatient care units in addition to several ambulatory units. The usability and standardization of sanitizers in 12 participating inpatient units were evaluated. The hospital measured compliance of staff with hand hygiene as part of their quality improvement program. Data from 2010-2012 were analyzed to measure the relationship between compliance and usability using mixed-effects logistic regression models. The total usability score (P = .0046), visibility (P = .003), and accessibility of the sanitizer on entrance to the patient room (P = .00055) were statistically associated with higher observed compliance rates. Standardization alone showed no significant impact on observed compliance (P = .37). Hand hygiene compliance can be influenced by visibility and accessibility of dispensers. The sanitizer location should be part of multifaceted interventions to improve hand hygiene. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Role of illness perceptions and medication beliefs on medication compliance of elderly hypertensive cohorts.

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Rajpura, Jigar R; Nayak, Rajesh

2014-02-01

Poor compliance with antihypertensive medications is one possible reason why its success in clinical trials has not been translated into everyday practice. In addition, medication noncompliance in elderly leads to increased hospitalizations, physician visits, and higher health care costs. The study assessed influence of illness perceptions and medications beliefs on medication compliance of elderly hypertensive cohorts. A cross-sectional survey research design, utilizing self-administered health surveys, was adapted to address key study objectives. Conceptualized associations among the study variables were explored to assess their individual as well as their collective impact on the medication compliance. A total of 78 (66%) study samples were found to be noncompliant with their medications. Analysis revealed that perceptions about illness and beliefs about medication jointly played a significant role in the prediction of medication compliance (F = 5.966, P compliance building in elderly populations having hypertension by incorporating the value and importance of patient perceptions of illness and medications in order to achieve desired patient outcomes.

Gender and ethnic differences in arterial compliance in patients with intermittent claudication.

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Gardner, Andrew W; Montgomery, Polly S; Blevins, Steve M; Parker, Donald E

2010-03-01

To assess the gender and ethnic differences in arterial compliance in patients with intermittent claudication. A total of 114 patients participated, including 38 Caucasian men, 32 Caucasian women, 16 African American men, and 28 African American women. Patients were assessed on large artery elasticity index (LAEI), small artery elasticity index (SAEI), age, weight, body mass index, ankle-brachial index (ABI), smoking status, and metabolic syndrome components. Group differences were found for LAEI (P = .042), SAEI (P = .019), body mass index (P = .020), prevalence of elevated fasting glucose (P = .001), and prevalence of abdominal obesity (P = .025). Significant covariates for LAEI included age (P = .0002) and elevated triglycerides (P = .0719). LAEI (units = 10 mL x mm Hg) adjusted for age and triglycerides was 39% lower (P = .0005) in African Americans (11.4 +/- .90; mean +/- SE) than in Caucasians (15.8 +/- 0.72), whereas no significant difference (P = .7904) existed between men (13.8 +/- 0.81) and women (13.5 +/- 0.79). Significant covariates for SAEI included age (P = .0001), abdominal obesity (P = .0030), and elevated blood pressure (P = .0067). SAEI (units = 100 mL x mm Hg) adjusted for age, abdominal obesity, and elevated blood pressure was 32% lower (P = .0007) in African-Americans (2.8 +/- 0.3) than in Caucasians 4.1 +/- 0.2), and was 18% lower (P = .0442) in women (3.1 +/- 0.2) than in men (3.8 +/- 0.2). African American patients with intermittent claudication have more impaired macrovascular and microvascular function than Caucasian patients, and women have more impaired microvascular function than men. These ethnic and gender differences in arterial compliance are evident even though ABI was similar among groups, suggesting that arterial compliance provides unique information to quantify vascular impairment in patients with intermittent claudication.

Prognostic value of physicians' assessment of compliance regarding all-cause mortality in patients with type 2 diabetes: primary care follow-up study

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Rüter Gernot

2006-07-01

Full Text Available Abstract Background Whether the primary care physician's assessment of patient compliance is a valuable prognostic marker to identify patients who are at increased risk of death, or merely reflects measurement of various treatment parameters such as HbA1C or other laboratory markers is unclear. The objective of this prospective cohort study was to investigate the prognostic value of the physicians' assessment of patient compliance and other factors with respect to all-cause mortality during a one year follow-up period. Methods A prospective cohort study was conducted among 1014 patients with type 2 diabetes aged 40 and over (mean age 69 years, SD 10.4, 45% male who were under medical treatment in 11 participating practices of family physicians and internists working in primary care in a defined region in South Germany between April and June 2000. Baseline data were gathered from patients and physicians by standardized questionnaire. The physician's assessment of patient compliance was assessed by means of a 4-point Likert scale (very good, rather good, rather bad, very bad. In addition, we carried out a survey among physicians by means of a questionnaire to find out which aspects for the assessment of patient compliance were of importance to make this assessment. Active follow-up of patients was conducted after one year to determine mortality. Results During the one year follow-up 48 (4.7% of the 1014 patients died. Among other factors such as patient type (patients presenting at office, nursing home or visited patients, gender, age and a history of macrovascular disease, the physician's assessment of patient compliance was an important predictor of all-cause mortality. Patients whose compliance was assessed by the physician as "very bad" (6% were significantly more likely to die during follow-up (OR = 2.67, 95% CI 1.02–6.97 after multivariable adjustment compared to patients whose compliance was assessed as "rather good" (45% or "very good

Biomarkers to Monitor Gluten-Free Diet Compliance in Celiac Patients

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María de Lourdes Moreno

2017-01-01

Full Text Available Gluten-free diet (GFD is the only treatment for celiac disease (CD. There is a general consensus that strict GFD adherence in CD patients leads to full clinical and histological remission accompanied by improvement in quality of life and reduced long-term complications. Despite the importance of monitoring the GFD, there are no clear guidelines for assessing the outcome or for exploring its adherence. Available methods are insufficiently accurate to identify occasional gluten exposure that may cause intestinal mucosal damage. Serological tests are highly sensitive and specific for diagnosis, but do not predict recovery and are not useful for follow-up. The use of serial endoscopies, it is invasive and impractical for frequent monitoring, and dietary interview can be subjective. Therefore, the detection of gluten immunogenic peptides (GIP in feces and urine have been proposed as new non-invasive biomarkers to detect gluten intake and verify GFD compliance in CD patients. These simple immunoassays in human samples could overcome some key unresolved scientific and clinical problems in CD management. It is a significant advance that opens up new possibilities for the clinicians to evaluate the CD treatment, GFD compliance, and improvement in the quality of life of CD patients.

Quality of life with rivaroxaban in patients with non-valvular atrial fibrilation by therapeutic compliance.

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Márquez-Contreras, Emilio; Martell-Claros, Nieves; Gil-Guillén, Vicente; De la Figuera-Von Wichmann, Mariano; Sánchez-López, Eugenio; Gil-Gil, Ines; Márquez-Rivero, Sara

2017-03-01

To assess the quality of life (QOL) with rivaroxaban in patients with non-valvular atrial fibrilation (NVAF) related to therapeutic compliance. Prospective, longitudinal, multicenter study was developed in 160 Spanish primary or specialized care centers. We included 412 patients treated with rivaroxaban, prescribed for stroke prevention. Three visits were conducted: baseline, 6 and 12 months. Compliance was measured by electronic monitoring systems. QOL was measured by a specific questionnaire. We calculated the percentage of compliance means, the percentage of daily compliers and the score of QOL. Three hundred and seventy patients finished the study (mean age 75.19 SD: 7.5 years). Daily compliance was 83.5% (CI 78.53-88.57%) (n = 309) and 80% (CI 74.65-85.35%) at 6 and 12 months, respectively. Average QOL rating was 112.85 (SD 29.31) in non-compliant and 111.80 (SD 29.31) in the compliant group (p = Not significant), and after 12 months of 124.67 (SD 30.78) and 83.47 (SD 26.44), respectively (p < 0.0001), with a decrease in the score compliers (p < 0.01) and an increase in non-compliant group (p < 0.05). A higher number of drugs consumed, as well as the number of diseases/conditions suffered, the older age of the patients and having been previously treated with VKA were associated with a higher overall score (worse QOL). QOL in NVAF patients treated with rivaroxaban improved significantly over the study group at the expense of compliers. A worse QOL was associated with pluripathology, polymedication, older patients and previous treatment with VKA.

Mechanisms and patient compliance of dust-mite avoidance regimens in dwellings of mite-allergic rhinitic patients

NARCIS (Netherlands)

Kniest, F.M.; Wolfs, B.G.; Vos, H.; Ducheine, B.O.I.; Schayk-Bakker, M.J.; de Lange, P.J.P.; Vos, E.M.P.; Bronswijk, van J.E.M.H.

1992-01-01

We report on the mechanisms, the environmental changes and patient compliance with regard to conventional and new dust and mite avoidance measures to prevent allergic symptoms caused by mite allergens, taking into account both allergen contamination and the developmental success of pyroglyphid

THE EVALUATION OF COMPLIANCE TO ANTIHYPERTENSIVE THERAPY IN PATIENTS AFTER STROKE AND POSTSTROKE DEPRESSION DURING ANTIDEPRESSANT THERAPY

Directory of Open Access Journals (Sweden)

B. B. Fishman

2010-01-01

Full Text Available Aim. To study the effect of the antidepressant paroxetine on the compliance to antihypertensive therapy in patients with arterial hypertension (HT and post-stroke depression.Material and methods. Patients (n=24 aged 55-73 with controlled HT (blood pressure, BP<140/90 mm Hg and with subclinical poststroke depression after rehabilitation course were included into the study. Patients were split into two groups. Patients of group 1 (n=12 received adequate antihypertensive therapy and selective serotonin reuptake inhibitor paroxetine. Patients of group 2 (n=12 received antihypertensive therapy only. The study duration was 16 weeks. Patient compliance to antihypertensive therapy, BP and severity of depressive disorders, motor and intellectual functions was evaluated initially and after 16 weeks.Results. BP>140/80 mmHg after 16 weeks was found in 10 (41.6% patients. Clinical post-stroke depression was found in 7 (30.4% patients, 5 (41.6% of them were from group 2 (OR=0.35, 95% CI 0.12-0.78. High treatment compliance was in 15 (65.2% patients, and 9 (81.8% of them were from group 1. Nine (39.1% patients did not receive an adequate antihypertensive therapy, 5 (41.6% of them were from group 2 and could not explain their refusal from medication. General index of intellectual function was higher in patients of group 1 (p=0.034 than this in group 2; index of motor function did not change significantly (p>0.05.Conclusion. Reduction of compliance to antihypertensive therapy and rehabilitation in hypertensive patients after stroke is associated with unmotivated refusal from treatment because of clinical post-stroke depression.

Elevated arterial compliance in patients with cirrhosis is not related to arterial endothelin-1

DEFF Research Database (Denmark)

Møller, Søren; Gülberg, V; Becker, U

2002-01-01

study was to investigate a potential relation between altered arterial compliance and arterial ET-1 in patients with cirrhosis. As ET-1 may be manipulated by somastostatin, the study includes infusion of octreotide in a subset of patients. METHODS: A total of 67 patients with cirrhosis and 27 controls...

Fuel price impacts and compliance costs associated with the Renewable Fuel Standard (RFS)

International Nuclear Information System (INIS)

Christensen, Adam; Siddiqui, Sauleh

2015-01-01

US policy instruments concerning vehicle biofuels are currently being revisited. For example, as part of an on-going annual Renewable Fuel Standard (RFS) implementation, the Environmental Protection Agency (EPA) requests stakeholder feedback/analysis of programmatic effects, including impacts on gasoline/diesel prices and compliance costs. Motivated by the need for regulatory-specific feedback, a novel regional market model is developed that quantifies price impacts across different regional markets for a number of market variables, including several types of compliance certificates known as Renewable Identification Numbers (RINs). An analysis of the most recent EPA proposal suggests that the D4 (biodiesel) RIN price could rise to >$1.00/RIN. Sensitivity results show that the D4 RIN price is highly sensitive to soybean oil prices, while D5/D6 RIN prices are most sensitive to the volume of E85 consumed. It was found that the projected costs associated with the RFS in 2017 could be reduced by approximately 50% if an additional 600 million gallons of E85 were consumed. The analysis also suggests that the RFS does not dramatically affect the retail price of either gasoline and diesel fuels paid by consumers. - Highlights: • The most recent EPA could cause the biodiesel RIN price to rise to >$1.00/RIN. • D5/D6 RIN prices are most sensitive to the volume of E85 consumed. • Retail prices for fuel do not change dramatically. • 2017 compliance costs could fall by 50% if more E85 were consumed.

A care study exploring a patient's non-compliance to haemodialysis.

Science.gov (United States)

Murphy, Fiona

This care study is based on the nursing assessment of a 26-year-old man (MT) who attends a local haemodialysis unit for treatment using Gordon's (1994) functional health patterns. There will be a discussion of this framework and the methods used to assess this patient including an exploration of one of the problem areas identified--that of non-compliance.

Patient compliance with exercise: different theoretical approaches to short-term and long-term compliance.

NARCIS (Netherlands)

Sluijs, E.M.; Knibbe, J.J.

1991-01-01

Compliance with exercise regimens is difficult to obtain as is compliance with other medical regimens. In analyzing noncompliance, two problems exist: (I) current theories only partly explain patients’ noncompliance; (2) health care providers seldom act according to the recommendations derived from

Compliance with dental treatment recommendations by rural paediatric patients after a live-video teledentistry consultation: A preliminary report.

Science.gov (United States)

McLaren, Sean W; Kopycka-Kedzierawski, Dorota T

2016-04-01

The purpose of this research was to assess the compliance rate with recommended dental treatment by rural paediatric dental patients after a live-video teledentistry consultation. A retrospective dental chart review was completed for 251 rural paediatric patients from the Finger Lakes region of New York State who had an initial teledentistry appointment with a paediatric dentist located remotely at the Eastman Institute for Oral Health in Rochester, NY. The recommended treatment modalities were tabulated and comprehensive dental treatment completion rates were obtained. The recommended treatment modality options of: treatment in the paediatric dental clinic; treatment using nitrous oxide anxiolysis; treatment with oral sedation; treatment in the operating room with general anaesthesia; or teleconsultation were identified for the 251 patients. Compliance rates for completed dental treatment based on initial teleconsultation recommendations were: 100% for treatment in the paediatric dental clinic; 56% for nitrous oxide patients; 87% for oral sedation; 93% for operating room; and 90% for teleconsultations. The differences in the compliance rates for all treatment modalities were not statistically significant (Fisher's exact test, p > 0.05). Compliance rates for completed comprehensive dental treatment for this rural population of paediatric dental patients were quite high, ranging from 56% to 100%, and tended to be higher when treatment was completed in fewer visits. Live-video teledentistry consultations conducted among rural paediatric patients and a paediatric dentist in the specialty clinic were feasible options for increasing dental treatment compliance rates when treating complex paediatric dental cases. © The Author(s) 2015.

Patient compliance with extended low molecular weight heparin injections following hip and knee arthroplasty.

Science.gov (United States)

Deakin, Dan E; Mishreki, Andrew; Aslam, Nadim; Docker, Charles

2010-01-01

The use of extended duration thromboprophylaxis following hip and knee arthroplasty is becoming widespread. The aim of our study was to determine patient compliance with extended duration thromboprophylaxis using low molecular weight (LMWH) injections following hip and knee arthroplasty. 42 consecutive patients undergoing hip and knee arthroplasty were prospectively contacted during their fifth post operative week. A fully anonymised questionnaire was completed by each patient. All patients responded. One was excluded having been prescribed warfarin for pre existing atrial fibrillation. Twenty nine (71%) patients were discharged with the intention of self administering LMWH injections. Eight (20%) and four (9%) patients were discharged with the intention of administration by a relative or district nurse respectively. No patient required the person administering the injections to be changed after discharge from hospital. 90% (n=37) of patients reported not missing any doses. 10% (n=2) of patients missed one dose and 10% (n=2) missed two doses. Patient compliance with extended duration thromboprophylaxis using LMWH injections is extremely high. Oral thromboprophylaxis may be useful in the minority of patients requiring daily visits by a nurse to administer injections.

Preoperative chemotherapy for operable breast cancer is associated with better compliance with adjuvant therapy in matched stage II and IIIA patients.

Science.gov (United States)

Komenaka, Ian K; Hsu, Chiu-Hsieh; Martinez, Maria Elena; Bouton, Marcia E; Low, Boo Ghee; Salganick, Jason A; Nodora, Jesse; Hibbard, Michael L; Jha, Chandra

2011-01-01

Preoperative chemotherapy (PC) for operable breast cancer has shown significant benefits in prospective trials. Many patients are treated in the community setting and some may question the applicability of PC outside the university setting. Retrospective review was performed of stage II and IIIA breast cancer patients treated from January 2002 to July 2009. Fifty-three of 57 patients who underwent PC were matched based on age, tumor size, and hormone receptor status with 53 patients who did not undergo PC. Differences in patient compliance with physician recommendations for all types of adjuvant therapy were evaluated. Crude odds ratios and adjusted odds ratios derived from conditional logistic regression models were calculated. There were 106 patients included. Patient compliance with chemotherapy was better in the PC group than in the adjuvant chemotherapy (AC) group (100% versus 70%; p = .0001). Similarly, more patients in the PC group completed radiation therapy (96% versus 65%; p = .0003) and initiated hormonal therapy (100% versus 62%; p = .0001). Conditional logistic regression revealed that higher pathologic stage and current cigarette smoking were associated with poorer compliance with chemotherapy. For radiation therapy, the univariate model revealed that compliance with chemotherapy and being employed were associated with completion of radiation, whereas current cigarette smoking and larger pathologic size were associated with poorer compliance with radiation. For hormonal therapy, current cigarette smokers were more likely to be noncompliant with initiation of hormonal therapy. PC for operable breast cancer can improve patient compliance with chemotherapy. Current cigarette smokers were more likely to be noncompliant with all types of adjuvant therapy.

Vitamin D supplementation in inflammatory bowel disease: the role of dosage and patient compliance.

Science.gov (United States)

Kojecky, V; Adamikova, A; Klimek, P

2016-01-01

Vitamin D substitution is recommended in patients with inflammatory bowel disease. Specific guidelines are lacking. The aim of this study was to assess the effect of vitamin D supplementation with respect to dosage and patient compliance. A prospective cohort study of 167 Crohn disease/ulcerative colitis outpatients. Patients were screened for serum vitamin D (25OHD2+3) at the end of summer and in late winter. Demographic data, history of vitamin D supplementation were recorded and matched with prescription records. A total of 57 subjects used vitamin D supplementation (mean dose 1104 IU/day). 25OHD2+3 levels were lower (p compliance with vitamin D supplementation was low, however this fact did not significantly contribute to the degree of vitamin D deficiency in this dosage (Tab. 3, Fig. 1, Ref. 21).

Evaluating Compliance with Institutional Preoperative Testing Guidelines for Minimal-Risk Patients Undergoing Elective Surgery

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Arunotai Siriussawakul

2013-01-01

Full Text Available Background. Few investigations preoperatively are important for low-risk patients. This study was designed to determine the level of compliance with preoperative investigation guidelines for ASA I patients undergoing elective surgery. Secondary objectives included the following: to identify common inappropriate investigations, to evaluate the impact of abnormal testing on patient management, to determine factors affecting noncompliant tests, and to estimate unnecessary expenditure. Methods. This retrospective study was conducted on adult patients over a one-year period. The institute’s guidelines recommend tests according to the patients’ age groups: a complete blood count (CBC for those patients aged 18–45; CBC, chest radiograph (CXR and electrocardiography (ECG for those aged 46–60; and CBC, CXR, ECG, electrolytes, blood glucose, blood urea nitrogen (BUN, and creatinine (Cr for patients aged 61–65. Results. The medical records of 1,496 patients were reviewed. Compliant testing was found in only 12.1% (95% CI, 10.5–13.9. BUN and Cr testings were the most frequently overprescribed tests. Overinvestigations tended to be performed on major surgery and younger patients. Overall, overinvestigation incurred an estimated cost of US 200,000 dollars during the study period. Conclusions. The need to utilize the institution’s preoperative guidelines should be emphasized in order to decrease unnecessary testing and the consequential financial burden.

Extrinsic incentives and tax compliance

OpenAIRE

Sour, Laura; Gutiérrez Andrade, Miguel Ángel

2011-01-01

This paper models the impact of extrinsic incentives in a tax compliance model. It also provides experimental evidence that confirms the existence of a positive relationship between rewards and tax compliance. If individuals are audited, rewards for honest taxpayers are effective in increasing the level of tax compliance. These results are particularly relevant in countries where there is little respect for tax law since rewards can contribute to crowding in the intrinsic motivation to comply.

Compliance and persistence of antidepressants versus anticonvulsants in patients with neuropathic pain during the first year of therapy.

Science.gov (United States)

Gharibian, Derenik; Polzin, Jennifer K; Rho, Jay P

2013-05-01

Neuropathic pain (NP) is a chronic condition that has human, social, and economic consequences. A variety of agents can be used for treatment; however, antidepressants and anticonvulsants are the 2 classes most widely studied and represent first-line agents in the management of NP. Little information is known about the adherence patterns of these medications during the first year of therapy in patients with NP. To examine the compliance and persistence of antidepressants versus anticonvulsants in patients with NP during the first year of therapy. Using electronic medical and pharmacy data for the Kaiser Permanente Southern California region, the adherence patterns for patients with a NP diagnosis prescribed an antidepressant or an anticonvulsant were studied. Compliance and persistence were measured using the medication possession ratio and the Refill-Sequence model, respectively. The study included 1817 patients with NP diagnosis taking either an antidepressant or an anticonvulsant. Within the antidepressant group, 42.9% were considered compliant, compared with 43.7% in the anticonvulsant group. Subanalysis of the 2 cohorts revealed that patients on venlafaxine were the most compliant (69.4%) compared with patients taking gabapentin (44.4%) and tricyclic antidepressants (41.8%) (Panticonvulsant group were considered persistent with their medication refills. Compliance and persistence rates were similar for patients with NP diagnosis taking antidepressants and anticonvulsants. Higher compliance was observed among patients taking venlafaxine; however, this population did have a small sample size.

Pilot study: Assessing the effect of continual position monitoring technology on compliance with patient turning protocols.

Science.gov (United States)

Schutt, Suann Cirigliano; Tarver, Christine; Pezzani, Michelle

2018-01-01

The study aim was to evaluate if continual patient position monitoring, taking into account self-turns and clinician-assisted turns, would increase the percentage of time a patient's position changed at least every 2 hr. While patient turning has clinical benefits, current models to help staff remember to turn patients, such as "turn clocks" and timers, have not resulted in high compliance with turning protocols. In addition, reminders are based on arbitrary 2-hr windows (such as turning on "even" hours) rather than on individual patient activity, including self-turns. This is a first inpatient, non-randomized, pre-/postintervention study. Data collection occurred from May 2013-February 2014 on a 39-bed medical unit in a community hospital. Baseline patient turning data were recorded by a sensor; however, the patient data were not displayed at the nurses' station to establish compliance with the hospital's turning protocol. Postintervention, patient position information was wirelessly displayed on nurses' station computer monitors in real time. A Student t test was used to compare baseline to postintervention "mean time in compliance." Data from 138 patients ( N  =   7,854 hr of monitoring) were collected. The baseline phase yielded 4,322 hr of position monitoring data and the postintervention phase yielded 3,532 hr of data. Statistically significant improvement was demonstrated in the percentage of time a patient's position changed at least every 2 hr from baseline to postintervention.

Treatment Efficacy and Compliance in Patients with Diabetic Macular Edema Treated with Ranibizumab in a Real-Life Setting

Directory of Open Access Journals (Sweden)

Anne-Laurence Best

2018-01-01

Full Text Available Purpose. To assess real-life efficacy of ranibizumab and treatment compliance of patients with vision loss secondary to diabetic macular edema (DME. Methods. A retrospective study was conducted in DME patients treated with ranibizumab. Patients were monitored every 4 weeks for visual acuity (VA and central retinal thickness (CRT by SD-OCT. All patients received a loading dose of 3 monthly injections followed by retreatments on an as-needed basis. The primary endpoint was the change in VA at M12. Patient compliance to the follow-up and the correlation between the injection number and VA were also investigated. Compliance was compared to that of neovascular age-related macular degeneration (nAMD patients. Results. Seventy-two eyes of 55 consecutive DME patients were included. At baseline, the mean VA was 56.5 letters and CRT was 470 μm. At M12, the mean VA was 63.4 letters (p 70 letters, the mean VA change was +6.9 letters, and the mean CRT was 361.9 μm (p=0.0001 after a mean number of 5.33 intravitreal injections. In patients who received ≥7 injections, the VA gain and final VA were significantly higher than in patients who received <7 injections. At M12, 25.45% of DME patients were lost to follow-up versus 16.8% of nAMD patients (n=55. Discussion/Conclusion. Our study confirms the real-life efficacy of ranibizumab in DME at M12 and the need for a large number of injections to achieve better visual outcomes. We also showed a trend to a lower compliance in diabetic versus nAMD patients.

[Insufficient medication compliance in Parkinson's disease

NARCIS (Netherlands)

Aerts, M.B.; Eijk, M. van der; Kramers, C.; Bloem, B.R.

2011-01-01

Medication compliance is generally suboptimal, particularly in patients with complex polypharmacy. This generic treatment problem is described here for Parkinson's disease (PD). We would expect patients with PD to have good medication compliance, since missed doses immediately result in worsening of

Sustained Reduction of Ventilator-Associated Pneumonia Rates Using Real-Time Course Correction With a Ventilator Bundle Compliance Dashboard.

Science.gov (United States)

Talbot, Thomas R; Carr, Devin; Parmley, C Lee; Martin, Barbara J; Gray, Barbara; Ambrose, Anna; Starmer, Jack

2015-11-01

The effectiveness of practice bundles on reducing ventilator-associated pneumonia (VAP) has been questioned. To implement a comprehensive program that included a real-time bundle compliance dashboard to improve compliance and reduce ventilator-associated complications. DESIGN Before-and-after quasi-experimental study with interrupted time-series analysis. SETTING Academic medical center. In 2007 a comprehensive institutional ventilator bundle program was developed. To assess bundle compliance and stimulate instant course correction of noncompliant parameters, a real-time computerized dashboard was developed. Program impact in 6 adult intensive care units (ICUs) was assessed. Bundle compliance was noted as an overall cumulative bundle adherence assessment, reflecting the percentage of time all elements were concurrently in compliance for all patients. The VAP rate in all ICUs combined decreased from 19.5 to 9.2 VAPs per 1,000 ventilator-days following program implementation (Pdashboard was associated with significant sustained decreases in VAP rates and an increase in bundle compliance among adult ICU patients.

Compliance with therapy in patients with chronic hepatitis C: associations with psychiatric symptoms, interpersonal problems, and mode of acquisition.

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Kraus, M R; Schäfer, A; Csef, H; Faller, H; Mörk, H; Scheurlen, M

2001-10-01

Tolerance of interferon-a therapy for hepatitis C is often poor and medication is expensive. Compliance with diagnostic procedures and, even more important, with medical treatment is obviously critical to minimize the rate of dropouts and to maximize cost efficiency. Moreover, a good concordance with scheduled follow-ups is important for early recognition and treatment of interferon-associated side effects. Therefore, we investigated psychiatric symptoms, interpersonal problems, different modes of acquisition, and sociodemographic factors in HCV-infected patients as possible predictor variables of good versus poor compliance. In a longitudinal study, 74 patients with chronic hepatitis C (CHC) who fulfilled the criteria for treatment with interferon (IFN)-alpha-2b with or without ribavirin were investigated prospectively to identify those at risk for poor compliance during IFN medication. To assess predictive factors, we used both IIP-C (Inventory of Interpersonal Problems) and SCL-90-R (Symptom Check List 90 Items Revised) as psychometric instruments. Sociodemographic and somatic variables as well as compliance during IFN therapy were also evaluated. Poor compliance before or during medication was demonstrated by 23% (N = 17) of HCV patients. Sociodemographic factors and mode of acquisition, particularly former intravenous drug (IVD) abuse were not significantly linked with compliance. Logistic regression analysis demonstrated that the subgroup of patients with compliance problems was best identified by both pretherapeutic psychiatric symptoms and interpersonal problems. Predictive value was best and significant for anger-hostility (P = 0.009), intrusive (P = 0.014), depression (P = 0.015), and phobic anxiety (P = 0.049). Adopting this statistical prediction model, sensitivity was 47.1%, but specificity reached 98.3%. In total, 86.5% of cases were classified correctly. In situations of unclear indication for IFN therapy, psychological variables assessment of before

Long term telemedicine study of compliance in paranoid schizophrenia.

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Krzystanek, Marek; Krzeszowski, Dariusz; Jagoda, Karolina; Krysta, Krzysztof

2015-09-01

Low compliance is one of the crucial problems of contemporary psychiatry. Relapses, deterioration of cognitive functioning, negative symptoms, neuroleptic resistance are the examples of many consequences of noncompliance in schizophrenia The study was designed to assess the compliance in the 200 patients diagnosed with paranoid schizophrenia, all in the state of symptomatic remission and on the stable neuroleptic treatment. The compliance was assessed using a telepsychiatric system, sending reminders: 1 hour before the planned dose to remind them that drug intake is approaching, and at the moment of intake to check if they took the drug. The confirmed drug intakes were counted by the telepsychiatric system. 158 patients completed the study period. The compliance in the first month of the treatment was 44.6% and decreased over the rest of the period to the level of 33.4%. 50% of the schizophrenic patients were compliant at a level lower than 37%. This group was considered the low compliance group, and in this group the compliance increased after 6 months from 9.3% to 10.3% (p<0.0001). The compliance in the group of schizophrenic patients in remission is very low. The telemedicine system improves the compliance in the patients with the worst compliance.

Role of health education and self-action plan in improving the drug compliance in bronchial asthma.

Science.gov (United States)

Gaude, Gajanan S; Hattiholi, Jyothi; Chaudhury, Alisha

2014-01-01

Considering the prevalence and associated burden of disease due to bronchial asthma, it is mandatory to obtain an optimal control of the disease and to improve outcomes for these patients. But it has been observed that there is very poor adherence to the inhalational therapy which leads to the suboptimal control of the disease. To study the adherence for aerosol therapy in bronchial asthma patients and to assess the impact of health education and self-action plan in improving the compliance to the therapy. A prospective study was done in a total of 500 bronchial asthma patients over a period of 2 years. Once included in the study, the patients were followed-up for a total of 12 weeks for calculation of nonadherence to the aerosol therapy. In nonadherent patients, we employed various health education strategies to improve the compliance in these cases. A total of 500 patients of bronchial asthma who were started on aerosol therapy over duration of 2 years were included in the study. At the end of 12 weeks, it was observed that, only 193 patients (38.6%) had regular compliance and 307 patients (61.4%) were noncompliant to aerosol therapy as prescribed for bronchial asthma. Factors that were associated with poor compliance were: Lower educational level status, poor socioeconomic status, cumbersome regimens, dislike of medication, and distant pharmacies. Nondrug factors that reduced the compliance were: Fears about side effects, anger about condition or its treatment, forgetfulness or complacency, and patient's ill attitudes toward health. After employing the various strategies for improving the compliance in these patients, the compliance increased in 176 patients (57.3%) among the earlier defaulted patients, while the remaining 131 patients (42.7%) were found to be noncompliant even after various educational techniques. Noncompliance in asthma management is a fact of life and no single compliance improving strategy probably will be as effective as a good physician-patient

Compliance with preoperative oral nutritional supplements in patients at nutritional risk--only a question of will?

Science.gov (United States)

Grass, F; Bertrand, P C; Schäfer, M; Ballabeni, P; Cerantola, Y; Demartines, N; Hübner, M

2015-04-01

Preoperative nutrition has been shown to reduce morbidity after major gastrointestinal (GI) surgery in selected patients at risk. In a randomized trial performed recently (NCT00512213), almost half of the patients, however, did not consume the recommended dose of nutritional intervention. The present study aimed to identify the risk factors for noncompliance. Demographic (n = 5) and nutritional (n = 21) parameters for this retrospective analysis were obtained from a prospectively maintained database. The outcome of interest was compliance with the allocated intervention (ingestion of ⩾ 11/15 preoperative oral nutritional supplement units). Uni- and multivariate analyses of potential risk factors for noncompliance were performed. The final analysis included 141 patients with complete data sets for the purpose of the study. Fifty-nine patients (42%) were considered noncompliant. Univariate analysis identified low C-reactive protein levels (P = 0.015), decreased recent food intake (P = 0.032) and, as a trend, low hemoglobin (P = 0.065) and low pre-albumin (P = 0.056) levels as risk factors for decreased compliance. However, none of them was retained as an independent risk factor after multivariate analysis. Interestingly, 17 potential explanatory parameters, such as upper GI cancer, weight loss, reduced appetite or co-morbidities, did not show any significant correlation with reduced intake of nutritional supplements. Reduced compliance with preoperative nutritional interventions remains a major issue because the expected benefit depends on the actual intake. Seemingly, obvious reasons could not be retained as valid explanations. Compliance seems thus to be primarily a question of will and information; the importance of nutritional supplementation needs to be emphasized by specific patients' education.

Electronic compliance monitoring of topical treatment after ophthalmic surgery.

Science.gov (United States)

Hermann, Manuel Marcel; Ustündag, Can; Diestelhorst, Michael

2010-08-01

The success of many medical treatments is built on compliance. Electronic monitoring is the most accurate tool to quantify compliance by measuring adherence. In order to assess the efficiency of a recently introduced miniature monitoring device for eye drop application, we evaluated adherence in ophthalmic patients undergoing post-operative short-term topical treatment. This pilot study enrolled 30 outpatients (mean age 61.8 +/- 18.5 years) after cataract (n = 24) and glaucoma filtration surgery (n = 6) applying fixed-combination eye drops containing prednisolone and gentamicin five times daily for 2 weeks. Patients received eye drops in conventional bottles each equipped with a miniature monitoring device recording events of application. Two patients failed to bring back the monitoring device; therefore data collected from only 28 patients could be examined. Data showed highly variable results with a mean dose compliance of 50.2%. Dose compliance was below 25% in approximately one out of five patients. Four cataract patients, but no glaucoma patient, discontinued therapy prematurely. The observed mean dosage interval was calculated for each patient and ranged 4.6-19.7 h. Thirty percent of analysed dosage intervals exceeded 12.0 h. Different patterns of compliance behaviour-like early non-persistence, drug holiday and low treatment frequency could be identified and illustrated using electronic data. Age or gender did not significantly influence compliance rates. Our pilot study demonstrates successful electronic compliance monitoring using a technology capable of continuous data recording over weeks of treatment. The low compliance rate for a relevant part of the patients demonstrates the necessity to study and improve compliance in ophthalmology. In future, new application methods and electronic application devices may improve treatment response in eye care.

Low compliance with alcohol gel compared with chlorhexidine for hand hygiene in ICU patients: results of an alcohol gel implementation program

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Luis Fernando Aranha Camargo

Full Text Available Although the introduction of alcohol based products have increased compliance with hand hygiene in intensive care units (ICU, no comparative studies with other products in the same unit and in the same period have been conducted. We performed a two-month-observational prospective study comparing three units in an adult ICU, according to hand hygiene practices (chlorhexidine alone-unit A, both chlorhexidine and alcohol gel-unit B, and alcohol gel alone-unit C, respectively. Opportunities for hand hygiene were considered according to an institutional guideline. Patients were randomly allocated in the 3 units and data on hand hygiene compliance was collected without the knowledge of the health care staff. TISS score (used for measuring patient complexity was similar between the three different units. Overall compliance with hand hygiene was 46.7% (659/1410. Compliance was significantly higher after patient care in unit A when compared to units B and C. On the other hand, compliance was significantly higher only between units A (32.1% and C (23.1% before patient care (p=0.02. Higher compliance rates were observed for general opportunities for hand hygiene (patient bathing, vital sign controls, etc, while very low compliance rates were observed for opportunities related to skin and gastroenteral care. One of the reasons for not using alcohol gel according to health care workers was the necessity for water contact (35.3%, 12/20. Although the use of alcohol based products is now the standard practice for hand hygiene the abrupt abolition of hand hygiene with traditional products may not be recommended for specific services.

Role of Spiritual Sentiments in Improving the Compliance of Water Intake in Patients with Urolithiasis.

Science.gov (United States)

Ali, Liaqat; Ali, Saima; Hussain, Syed Awlad; Haider, Fayyaz; Ali, Shehla

2018-02-01

The aim of this study was to compare the compliance for water intake and rate of recurrence between spiritually motivated and non-motivated patients of renal tract stone disease. It is a multi centric prospective cohort study, conducted in Department of Urology, Institute of Kidney Diseases and Peshawar Medical College, from January 10, 2009 to December 2012. A total of 180 patients with comparable demographic, IQ, EQ and BMI after achieving complete stone clearance were divided into two equal groups. Both groups were instructed to increase the water intake timetable according to AUA guidelines. Group 'A' comprising of 90 patients who were identified as spiritually motivated patients based on questioner of FICA 12 is also instructed that increasing the water intake is mentioned in contemporary Islamic medicine. No spiritual instruction was given to Group B. The instructed guidelines and practice for amount and timing of water intake were recalled from participants at the end of 6 and 12 months. The data were recorded on structured proforma and was analyzed using SPSS version 17. The mean age of the patient in Group A was 37.5 years (18-70 years), while in Group B it was 34 years (18-65 years). Urolithiasis affected predominantly male gender in both groups. Sixty-five patients (72.2 %) in Group A have significant compliance (p < 0.001) for water intake over Group B (46 %). The spiritually motivated Group A has significantly reduced rate of recurrence of stones in 23 patients versus 37 in Group B. The spiritually motivated patients had significantly better compliance for water intake and reduced rate of recurrence versus non-motivated individuals in urolithiasis.

The elderly on dialysis: some considerations in compliance.

Science.gov (United States)

McKevitt, P M; Jones, J F; Lane, D A; Marion, R R

1990-10-01

Compliance with scheduled treatments, dietary and fluid restrictions, and multiple medications is an important component in the care and well-being of end-stage renal disease (ESRD) patients. Given the rigorus and complex demands of dialysis, it is important to examine the issue of compliance, focusing on a large and ever-increasing segment of our patient population, the elderly. The ESRD literature reflects efforts to define and measure levels of compliance, identify factors that influence and predict compliance, and develop intervention strategies to improve adherence to treatment regimens. While limited attention has been focused specifically on the elderly, there are studies suggesting that age may be a factor associated with improved adherence and that social support may be a significant contributor to compliance in this patient group. In an effort to examine the current status and needs of the dialysis elderly, research is in progress at Chromalloy American Kidney Center, Washington University, which replicates a study of 5 years ago. Eighty-four patients age 60 and over, on dialysis for a minimum of 6 months, were identified. Sociodemographic, treatment, compliance, and functional capacity data were collected; additional mental and psychological testing was completed on patients willing and able to participate. Preliminary data suggest the current elderly population is larger and significantly older than that of 5 years ago. Other sociodemographic data indicate the population is increasingly female, black, and more socioeconomically disadvantaged. In regard to compliance, the vast majority of elderly demonstrate good compliance as measured by serum potassium, fair to good compliance with phosphorus, and fair to poor compliance with fluid restrictions.(ABSTRACT TRUNCATED AT 250 WORDS)

Compliance with removable orthodontic appliances.

Science.gov (United States)

Shah, Nirmal

2017-12-22

Data sourcesMedline via OVID, PubMed, Cochrane Central Register of Controlled Trials, Web of Science Core Collection, LILACS and BBO databases. Unpublished clinical trials accessed using ClinicalTrials.gov, National Research Register, ProQuest Dissertation and Thesis database.Study selectionTwo authors searched studies from inception until May 2016 without language restrictions. Quantitative and qualitative studies incorporating objective data on compliance with removable appliances, barriers to appliance wear compliance, and interventions to improve compliance were included.Data extraction and synthesisQuality of research was assessed using the Cochrane Collaboration's risk of bias tool, the risk of bias in non-randomised studies of interventions (ROBINS-I), and the mixed methods appraisal tool. Statistical heterogeneity was investigated by examining a graphic display of the estimated compliance levels in conjunction with 95% confidence intervals and quantified using the I-squared statistic. A weighted estimate of objective compliance levels for different appliances in relation to stipulated wear and self-reported levels was also calculated. Risk of publication bias was assessed using funnel plots. Meta-regression was undertaken to assess the relative effects of appliance type on compliance levels.ResultsTwenty-four studies met the inclusion criteria. Of these, 11 were included in the quantitative synthesis. The mean duration of objectively measured wear was considerably lower than stipulated wear time amongst all appliances. Headgear had the greatest discrepancy (5.81 hours, 95% confidence interval, 4.98, 6.64). Self-reported wear time was consistently higher than objectively measured wear time amongst all appliances. Headgear had the greatest discrepancy (5.02 hours, 95% confidence interval, 3.64, 6.40). Two studies found an increase in compliance with headgear and Hawley retainers when patients were aware of monitoring. Five studies found younger age groups to

Investigating compliance with SME-friendly procurement policy

OpenAIRE

Flynn, Anthony

2016-01-01

This study investigates compliance with SME-friendly policy in public procurement. Two research questions guide the investigation. The first is the extent to which policy is being complied with. The results, which are based on 349 public buyer survey responses, reveal compliance to be moderate; indicated by a mean score of 14.54 out of 22 on the compliance index. The second question concerns the impact of institutional forces on policy compliance. A predictive model informed by institutional ...

Impact, compliance and control of legislation

DEFF Research Database (Denmark)

Panek, Aleksander; Thomsen, Kirsten Engelund; Rose, Jørgen

on the requirements and how MS deal with the respect of requirements. Compliance and control are essential parts of successfully implementing the EPBD. The main recommendations and findings from reports collected vary significantly regarding EPBD implementation, the large potential for further savings, the needs...

Evaluation of the relationship between compliance with the follow-up and treatment protocol and health literacy in bladder tumor patients.

Science.gov (United States)

Turkoglu, Ali Riza; Demirci, Hakan; Coban, Soner; Guzelsoy, Muhammet; Toprak, Erdem; Aydos, Mustafa Murat; Ture, Deniz Azkan; Ustundag, Yasemin

2018-03-07

To investigate the relationship between the compliance of bladder cancer patients with cystoscopic follow-up and the treatment protocol, and their health literacy. Patients who underwent transurethral resection surgery for bladder tumor were found to have non-muscular invasive bladder carcinoma on pathology examination and then underwent cystoscopic follow-up for 1 year or more were included in the study. Cystoscopic follow-up was recommended to the low- and high-risk groups in terms of progression and recurrence. The patients were evaluated with the Health Literacy Survey-European Union scale. The mean age of the patients was 67.13 ± 10.77 years. The treatment continuity rate was 80.50% (n = 33) in the adequate health literacy group (n = 41) and significantly higher than the 56.50% (n = 48) rate in the inadequate health literacy group (n = 85) (p = .008). The health literacy results revealed that the health promotion and general index score was higher in the group of patients under the age of 65. Adequate health literacy in bladder cancer patients is associated with better compliance with the treatment protocol. Young patients show better compliance with the follow-up protocol recommended by the physician. Increasing the follow-up protocol compliance of elderly patients with inadequate health literacy is necessary.

Study of non-compliance among chronic hemodialysis patients and its impact on patients′ outcomes

Directory of Open Access Journals (Sweden)

Salwa Ibrahim

2015-01-01

Full Text Available Non-adherence to prescription is common among hemodialysis (HD patients and has been associated with significant morbidity. At least 50% of HD patients are believed to be non-adherent to some part of their treatment. We aimed to assess the prevalence of non-adherence to dialysis prescription among 100 chronic HD patients. We explored the relationship between non-adherence on one hand and socioeconomic profile, depression scores and cognitive function on the other hand. The impact of patients′ non-adherence on nutritional status, quality of life and dialysis adequacy was also assessed. The mean age of the study group was 50.51 ± 12.0 years. There were 62 females and 38 males in the study. Thirty-six patients (36% were non-compliant to their dialysis prescription. No significant differences were detected between compliant and non-compliant patients in their education level and employment status. Inter-dialytic weight gain, serum phosphorus and depression scores were significantly higher in non-compliant patients compared with compliant patients, whereas body weight, serum albumin, serum calcium, quality of life scores and nutrition scores were significantly higher in compliant patients (P <0.05. In conclusion, non-adherence is highly prevalent among chronic HD patients and is associated with poor quality of life, depression and malnutrition.

COMPLIANCE TO LONG-TERM TREATMENT OF CARDIOLOGIC PATIENTS WITH MILD TO MODERATE DEPRESSION: INEFFECTIVENESS OF ANTIDEPRESSIVE THERAPY WITH PIRLINDOL IN RANDOMIZED STUDY

Directory of Open Access Journals (Sweden)

E. V. Strokova

2015-12-01

Full Text Available Aim. To evaluate the influence of antidepressant therapy with pirlindol on compliance to the long-term treatment and quality of life in patients with cardiovascular diseases and mild to moderate depression. Material and methods. 61 patients with cardiovascular diseases and mild to moderate depression (according to Beck depression scale were randomized into two groups. Patients of intervention group received pirlindol, while patients of control group did not receive this drug. Compliance to cardiovascular and antidepressant treatment were estimated in 3 and 6 months. Adverse reactions and patients self-assessment of their well-being and global satisfaction in treatmen were also registered.  Results. 24 (75%, 2 (6% and 0 patients of intervention group continue pirlindol treatment in 1, 3 and 6 months, respectively. In 3 months of observation patients of intervention group took drugs for cardiovascular diseases more often than these in control group (81% vs 72%, respectively , р<0.05, they also less frequently showed adverse reactions (56% vs 72%, respectively ,p=0.01 and more often — improvement of their well-being (65% vs 50%, respectively , р=0.03. Compliance to cardiovascular therapy did not differ significantly in patients of both groups by the end the study.  Conclusion. Antidepressant therapy with pirlindol did not influence compliance to long-term cardiovascular treatment in patients with cardiovascular diseases and mild to moderate depression, apparently because of low compliance to pirlindol therapy.

Assessing the impact of Cross Compliance measures on nitrogen fluxes from European farmlands with DNDC-EUROPE

Energy Technology Data Exchange (ETDEWEB)

Follador, Marco, E-mail: marco.follador@jrc.ec.europa.eu [European Commission, DG Joint Research Centre, Institute for Environment and Sustainability, Climate Change Unit, Via E. Fermi 2749, I-21027 Ispra, Varese (Italy); Leip, Adrian [European Commission, DG Joint Research Centre, Institute for Environment and Sustainability, Climate Change Unit, Via E. Fermi 2749, I-21027 Ispra, Varese (Italy); Orlandini, Lorenzo [European Commission, DG Agriculture and Rural Development, L2 Economic Analysis of EU Agriculture, B-1049 Brussels (Belgium)

2011-11-15

We investigated the effects of the agricultural Cross Compliance measures for European cultivated lands, focusing on nitrogen (N) fluxes from corn fields. Four scenarios have been designed according to some conservation farming practices, namely no-till, max manure, catch crop and N splitting. Results indicated that (1) in the no-till scenario the N{sub 2}O fluxes are decreased during the first simulated years, with a return to default fluxes in following years; no-till particularly decreased N{sub 2}O emission in the dryer and colder simulation spatial units (HSMUs); (2) the no-till and the N splitting scenarios slightly increased the N surplus because of a decrease in plant uptake; (3) introducing a rotation with alfalfa decreased the N leaching in the corn crops following the catch crops; and (4) the application of fertilizer and manure during the cold and wet seasons led to an increase of N leaching. - Highlights: > Cross Compliance measures reduced the environmental impact of farming activities. > No-tillage decreased N{sub 2}O emissions especially in the dryer and colder regions. > The manure limit amendment decreased the N{sub 2}O emission, N leaching and surplus. > The rotation yield-catch crops decreased the N leaching. > The N input during cold and wet periods significantly augmented the N leaching. - Model simulations suggested that Cross Compliance measures can help reducing the environmental impact of corn cultivation.

Evaluation of Therapy Management and Patient Compliance in Postmenopausal Patients with Hormone Receptor-positive Breast Cancer Receiving Letrozole Treatment: The EvaluateTM Study

Science.gov (United States)

Fasching, P. A.; Fehm, T.; Kellner, S.; de Waal, J.; Rezai, M.; Baier, B.; Baake, G.; Kolberg, H.-C.; Guggenberger, M.; Warm, M.; Harbeck, N.; Würstlein, R.; Deuker, J.-U.; Dall, P.; Richter, B.; Wachsmann, G.; Brucker, C.; Siebers, J. W.; Fersis, N.; Kuhn, T.; Wolf, C.; Vollert, H.-W.; Breitbach, G.-P.; Janni, W.; Landthaler, R.; Kohls, A.; Rezek, D.; Noesslet, T.; Fischer, G.; Henschen, S.; Praetz, T.; Heyl, V.; Kühn, T.; Krauß, T.; Thomssen, C.; Kümmel, S.; Hohn, A.; Tesch, H.; Mundhenke, C.; Hein, A.; Rauh, C.; Bayer, C. M.; Jacob, A.; Schmidt, K.; Belleville, E.; Hadji, P.; Wallwiener, D.; Grischke, E.-M.; Beckmann, M. W.; Brucker, S. Y.

2014-01-01

Introduction: The EvaluateTM study (Evaluation of therapy management and patient compliance in postmenopausal hormone receptor-positive breast cancer patients receiving letrozole treatment) is a prospective, non-interventional study for the assessment of therapy management and compliance in the routine care of postmenopausal women with invasive hormone receptor-positive breast cancer receiving letrozole. The parameters for inclusion in the study are presented and discussed here. Material and Methods: Between January 2008 and December 2009 a total of 5045 patients in 310 study centers were recruited to the EvaluateTM study. Inclusion criteria were hormone receptor-positive breast cancer and adjuvant treatment or metastasis. 373 patients were excluded from the analysis for various reasons. Results: A total of 4420 patients receiving adjuvant treatment and 252 patients with metastasis receiving palliative treatment were included in the study. For 4181 patients receiving adjuvant treatment, treatment with the aromatase inhibitor letrozole commenced immediately after surgery (upfront). Two hundred patients had initially received tamoxifen and started aromatase inhibitor treatment with letrozole at 1–5 years after diagnosis (switch), und 39 patients only commenced letrozole treatment 5–10 years after diagnosis (extended endocrine therapy). Patient and tumor characteristics were within expected ranges, as were comorbidities and concurrent medication. Conclusion: The data from the EvaluateTM study will offer a good overview of therapy management in the routine care of postmenopausal women with hormone receptor-positive breast cancer. Planned analyses will look at therapy compliance and patient satisfaction with how information is conveyed and the contents of the conveyed information. PMID:25568468

Compliance Framing - Framing Compliance

OpenAIRE

Lutz-Ulrich Haack; Martin C. Reimann

2012-01-01

Corporations have to install various organizational measures to comply with legal as well as internal guidelines systematically. Compliance management systems have the challenging task to make use of an internal compliance-marketing approach in order to ensure not only an adequate but also effective compliance-culture. Compliance-literature and findings of persuasive goal-framing-theory give opposite implications for establishing a rather values- versus rule-based compliance-culture respectiv...

[Assessment of compliance for oral medicines with MMSE, Mini-Mental State Examination, in hospitalized elderly patients].

Science.gov (United States)

Miura, Masatomo; Kakei, Masafumi; Iwasawa, Saaya; Morii, Tsukasa; Miura, Takeshi; Sasaki, Hiroshi; Satoh, Takehiro; Fujita, Hiroki; Narita, Takuma; Shirakawa, Hideko; Yamada, Yuichiro; Suzuki, Toshio

2007-10-01

The minimental state examination (MMSE) is a widely used, standardized method to assess cognitive function including movement-related disorders with high reliability. We studied the relationship between MMSE scores and the ability to take oral medications correctly (ingestion compliance) in 70 elderly inpatients (mean age 71.3+/-7.0 years). Patients with abnormal glucose tolerance as determined by an HbA(1c) level of 5.8% or greater including diabetes showed a trend of lower MMSE scores compared with patients with normal glucose tolerance, and the scores were negatively correlated with HbA1c, age, and systolic blood pressure (P<0.05). Self-management in taking oral medications was very difficult in 4 patients whose MMSE scores were 21 points or less. Thus ingestion supervisions by nurses were required in these patients. Furthermore, 9 of 12 noncompliant patients had MMSE scores ranging from 22 to 26 points. We instructed these patients to take medications in a one-dose package as a useful tool to improve compliance. The MMSE score was 27 or higher in 44 of 54 compliant patients, and 10 patients had scores ranging from 21 to 26. The sensitivity and specificity for noncompliance at an MMSE score cut-off point of 26 were 75.0% and 81.5%, respectively. In conclusion, it is necessary to coordinate ingestion methods matched to each patient according to their abilities to comply with medication schedules. They should be preevaluated with the MMSE to improve ingestion compliance. The MMSE is a recommended test in hospitalized elderly patients for the assessment of the ability to take medications safely.

Beneficial Effect of Educational and Nutritional Intervention on the Nutritional Status and Compliance of Gastric Cancer Patients Undergoing Chemotherapy: A Randomized Trial.

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Xie, Feng-Lan; Wang, Yong-Qian; Peng, Li-Fen; Lin, Fang-Yu; He, Yu-Long; Jiang, Zhuo-Qin

2017-07-01

Surgery combined with chemotherapy is the standard treatment for gastric cancer (GC); however, chemotherapy-relative adverse effects are common and result in malnutrition and a poor prognosis. In addition, compliance to postoperative chemotherapy remains a problem. This study aimed to prospectively investigate the effect of educational and nutritional interventions on the nutritional status and compliance of GC patients undergoing postoperative chemotherapy. A total of 144 GC patients were randomized into an intervention group that received intensive individualized nutritional and educational interventions during the entire course of chemotherapy and control group that received basic nutrition care and health education during hospitalization. The nutritional status and compliance between the two groups were compared. The interventions significantly improved calorie and iron intake within 24 h after the first chemotherapy session, and improved patients' weight, hemoglobin, total serum protein, and albumin levels during the entire course of chemotherapy. The compliance rate with chemotherapy was significantly higher in the intervention group than in the control group (73.61% vs. 55.56%, P = 0.024). A combination of nutritional and educational interventions provided beneficial effect on the nutrition status and compliance of gastric patients undergoing postoperative chemotherapy, which is worthy of clinical application.

What role does measuring medication compliance play in evaluating the efficacy of naltrexone?

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Baros, Alicia M; Latham, Patricia K; Moak, Darlene H; Voronin, Konstantin; Anton, Raymond F

2007-04-01

Compliance with medication in pharmacotherapy trials of alcoholism has been shown to be equal to, or more, important than in other areas of medicine. Research has suggested that naltrexone's effectiveness can be greatly influenced by the compliance of participants in clinical trials. Presently, we compare 2 compliance measurement methods [urine riboflavin and medication event monitoring system (MEMS)] used simultaneously to evaluate naltrexone's efficacy and the impact of compliance on the size of observable treatment effects. One hundred and thirty-seven of 160 randomized alcoholic patients completed 12-weeks (84 days) of naltrexone or placebo and cognitive behavioral therapy (CBT) or motivational enhancement therapy (MET). Urine riboflavin was determined during study weeks 2, 6, and 12. The MEMS provided a detailed computerized record of when a participant opened their medication bottle throughout the trial. Baseline predictors of MEMS (80% openings) and urine riboflavin (>or=1,500 ng/mL by fluorimetry) compliance were examined. The effects of the treatments in the compliant participants defined by one, the other, or both methods were compared and contrasted with a previously reported intent-to-treat analysis where compliance was not taken into account. Age was predictive of compliance. 105 participants were deemed compliant via urine riboflavin criteria, 87 via MEMS, and 77 when both criteria were met, with no significant differences between treatment groups. The most compliant participants showed a significant medication by therapy interaction. Those treated with naltrexone/CBT showed more abstinence days (pcompliance measurement methods. Compliance measurement does appear to influence the evaluation of the efficacy of naltrexone within the context of CBT. Treatment effect sizes approximately doubled in the most compliant individuals. Measuring compliance by either of 2 distinct methods provides approximately similar results. As compliance with naltrexone

Unilateral Muscle Artifacts due to Non-compliance During Uptake Phase of 18F-FDG PET/CT in an Oncologic Patient

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William Makis

2018-02-01

Full Text Available A 49-year-old male patient with a prior history of poor compliance with medical appointments was referred for an 18F-fluoro-2-deoxy-D-glucose (18F-FDG positron emission tomography/computed tomography (PET/CT for the staging of a rectal squamous cell carcinoma. The PET/CT showed unilateral diffuse skeletal muscle 18F-FDG uptake as well as bilateral salivary gland uptake artifacts, suggestive of non-compliance with patient preparation instructions. The PET/CT nurse noted that during the 18F-FDG uptake phase, the patient appeared intoxicated, and she found two beer cans hidden in the waste disposal beside his chair just prior to imaging. The patient only admitted to eating a cookie approximately 30 minutes after the injection of 18F-FDG PET/CT and denied consuming alcohol during the uptake phase. We present the imaging findings of non-compliance with patient instructions during the uptake phase of 18F-FDG.

Direct medical costs and medication compliance among fibromyalgia patients: duloxetine initiators vs. pregabalin initiators.

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Sun, Peter; Peng, Xiaomei; Sun, Steve; Novick, Diego; Faries, Douglas E; Andrews, Jeffrey S; Wohlreich, Madelaine M; Wu, Andrew

2014-01-01

To assess and compare direct medical costs and medication compliance between patients with fibromyalgia who initiated duloxetine and patients with fibromyalgia who initiated pregabalin in 2008. A retrospective cohort study design was used based on a large US national commercial claims database (2006 to 2009). Patients with fibromyalgia aged 18 to 64 who initiated duloxetine or pregabalin in 2008 and who had continuous health insurance 1 year preceding and 1 year following the initiation were selected into duloxetine cohort or pregabalin cohort based on their initiated agent. Medication compliance was measured by total supply days, medication possession ratio (MPR), and proportion of patients with MPR ≥ 0.8. Direct medical costs were measured by annual costs per patient and compared between the cohorts in the year following the initiation. Propensity score stratification and bootstrapping methods were used to adjust for distribution bias, as well as cross-cohort differences in demographic, clinical and economic characteristics, and medication history prior to the initiation. Both the duloxetine (n = 3,033) and pregabalin (n = 4,838) cohorts had a mean initiation age around 49 years, 89% were women. During the postindex year, compared to the pregabalin cohort, the duloxetine cohort had higher totally annual supply days (273.5 vs. 176.6, P costs ($2,994.9 vs. $4,949.6, P costs ($8,259.6 vs. $10,312.2, P costs ($5,214.6 vs. $5,290.8, P > 0.05), and lower total medical costs ($16,469.1 vs. $20,552.6, P compliance and consumed less inpatient, outpatient, and total medical costs than those who initiated pregabalin. © 2013 The Authors Pain Practice © 2013 World Institute of Pain.

Assessing the impact of Cross Compliance measures on nitrogen fluxes from European farmlands with DNDC-EUROPE

International Nuclear Information System (INIS)

Follador, Marco; Leip, Adrian; Orlandini, Lorenzo

2011-01-01

We investigated the effects of the agricultural Cross Compliance measures for European cultivated lands, focusing on nitrogen (N) fluxes from corn fields. Four scenarios have been designed according to some conservation farming practices, namely no-till, max manure, catch crop and N splitting. Results indicated that (1) in the no-till scenario the N 2 O fluxes are decreased during the first simulated years, with a return to default fluxes in following years; no-till particularly decreased N 2 O emission in the dryer and colder simulation spatial units (HSMUs); (2) the no-till and the N splitting scenarios slightly increased the N surplus because of a decrease in plant uptake; (3) introducing a rotation with alfalfa decreased the N leaching in the corn crops following the catch crops; and (4) the application of fertilizer and manure during the cold and wet seasons led to an increase of N leaching. - Highlights: → Cross Compliance measures reduced the environmental impact of farming activities. → No-tillage decreased N 2 O emissions especially in the dryer and colder regions. → The manure limit amendment decreased the N 2 O emission, N leaching and surplus. → The rotation yield-catch crops decreased the N leaching. → The N input during cold and wet periods significantly augmented the N leaching. - Model simulations suggested that Cross Compliance measures can help reducing the environmental impact of corn cultivation.

Compliance with barrier precautions during paediatric trauma resuscitations.

Science.gov (United States)

Kelleher, Deirdre C; Carter, Elizabeth A; Waterhouse, Lauren J; Burd, Randall S

2013-03-01

Barrier precautions protect patients and providers from blood-borne pathogens. Although barrier precaution compliance has been shown to be low among adult trauma teams, it has not been evaluated during paediatric resuscitations in which perceived risk of disease transmission may be low. The purpose of this study was to identify factors associated with compliance with barrier precautions during paediatric trauma resuscitations. Video recordings of resuscitations performed on injured children (compliance with an established policy requiring gowns and gloves. Depending on activation level, trauma team members included up to six physicians, four nurses, and a respiratory therapist. Multivariate logistic regression was used to determine the effect of team role, resuscitation factors, and injury mechanism on barrier precaution compliance. Over twelve weeks, 1138 trauma team members participated in 128 resuscitations (4.7% penetrating injuries, 9.4% highest level activations). Compliance with barrier precautions was 81.3%, with higher compliance seen among roles primarily at the bedside compared to positions not primarily at the bedside (90.7% vs. 65.1%, pcompliance, while surgical attendings (20.8%) had the lowest (prole, increased compliance was observed during resuscitations of patients with penetrating injuries (OR=3.97 [95% CI: 1.35-11.70], p=0.01), during resuscitations triaged to the highest activation level (OR=2.61 [95% CI: 1.34-5.10], p=0.005), and among team members present before patient arrival (OR=4.14 [95% CI: 2.29-7.39], pCompliance with barrier precautions varies by trauma team role. Team members have higher compliance when treating children with penetrating and high acuity injuries and when arriving before the patient. Interventions integrating barrier precautions into the workflow of team members are needed to reduce this variability and improve compliance with universal precautions during paediatric trauma resuscitations. Copyright © 2012 Elsevier

Dietary compliance in Iranian children and adolescents with celiac disease

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Taghdir M

2016-08-01

Full Text Available Maryam Taghdir,1 Naser Honar,2 Seyed Mohammad Mazloomi,3 Mojtaba Sepandi,4 Mahkameh Ashourpour,1 Musa Salehi5 1Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; 2Department of Pediatric Gastroenterology and Hepatology, Shiraz University of Medical Sciences, Shiraz, Iran; 3Nutrition Research Center, Department of Food Hygiene and Quality Control, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; 4Department of Epidemiology and Biostatistics, Baqyiatallah University of Medical Sciences, Tehran, Iran; 5Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Introduction: Celiac disease (CD is caused due to intake of gluten, a protein component in wheat, barley, and rye. The only treatment currently available for CD is strict lifetime adherence to a gluten-free diet (GFD which is a diet that excludes wheat, barley, and rye. There is limited information on barriers to following a GFD. The present study aimed to investigate the compliance with a GFD, barriers to compliance, and the impact of compliance on the quality of life (QOL in Iranian children and adolescents suffering from CD.Methods: In this cross-sectional study, a total of 65 known cases of CD (both males and females, diagnosed in Namazi Hospital, a large referral center in south of Iran, selected by census were studied in 2014. Dietary compliance was assessed using a questionnaire. A disease-specific QOL questionnaire for children with CD (the celiac disease DUX [CDDUX] was used. Comparisons between categorical variables were performed using chi-square test.Results: Sixty-five patients, 38 females (58.5% and 27 (41.5% males, were surveyed. Mean (± standard deviation [SD] age of the respondents was 11.3 (±3.8 years. Dietary compliance was reported by

Negative impact of asthma on patients in different age groups.

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Alith, Marcela Batan; Gazzotti, Mariana Rodrigues; Montealegre, Federico; Fish, James; Nascimento, Oliver Augusto; Jardim, José Roberto

2015-01-01

To evaluate the impact of asthma on patients in Brazil, by age group (12-17 years, 18-40 years, and ≥ 41 years). From a survey conducted in Latin America in 2011, we obtained data on 400 patients diagnosed with asthma and residing in one of four Brazilian state capitals (São Paulo, Rio de Janeiro, Curitiba, and Salvador). The data had been collected using a standardized questionnaire in face-to-face interviews. For the patients who were minors, the parents/guardians had completed the questionnaire. The questions addressed asthma control, number of hospitalizations, number of emergency room visits, and school/work absenteeism, as well as the impact of asthma on the quality of life, sleep, and leisure. We stratified the data by the selected age groups. The proportions of patients who responded in the affirmative to the following questions were significantly higher in the 12- to 17-year age group than in the other two groups: "Have you had at least one episode of severe asthma that prevented you from playing/exercising in the last 12 months?" (p = 0.012); "Have you been absent from school/work in the last 12 months?" (p age group reported that normal physical exertion was very limiting (p = 0.010 vs. the other groups), whereas 14% of the patients in the ≥ 41-year age group described social activities as very limiting (p = 0.011 vs. the other groups). In this sample, asthma had a greater impact on the patients between 12 and 17 years of age, which might be attributable to poor treatment compliance.

Education as prescription for patients with type 2 diabetes mellitus: compliance and efficacy in clinical practice.

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Kim, Mi Yeon; Suh, Sunghwan; Jin, Sang-Man; Kim, Se Won; Bae, Ji Cheol; Hur, Kyu Yeon; Kim, Sung Hye; Rha, Mi Yong; Cho, Young Yun; Lee, Myung-Shik; Lee, Moon Kyu; Kim, Kwang-Won; Kim, Jae Hyeon

2012-12-01

Diabetes self-management education has an important role in diabetes management. The efficacy of education has been proven in several randomized trials. However, the status of diabetes education programs in real Korean clinical practice has not yet been evaluated in terms of patient compliance with the education prescription. We retrospectively analyzed clinical and laboratory data from all patients who were ordered to undergo diabetes education during 2009 at Samsung Medical Center, Seoul, Korea (n=2,291). After excluding ineligible subjects, 588 patients were included in the analysis. Among the 588 patients, 433 received education. The overall compliance rate was 73.6%, which was significantly higher in the subjects with a short duration or living in a rural area compared to those with a long duration (85.0% vs. 65.1%, respectively; Ppatients refuse to get education despite having a prescription from their physician. This refusal rate was higher in the patients with long-standing diabetes or in urban residence. Furthermore, education was more effective in patients with a short duration of diabetes in clinical practice.

The everyday elasticity of compliance in a symptomless disease

DEFF Research Database (Denmark)

Felde, Lina Hoel

2011-01-01

Medically, compliance refers to the extent to which a patient's response to medical advice coincides with doctors' orders. Rather than this absolute standard, this article treats compliance as an institutionally available discourse continually figured in practice. The aim of this article is to de......Medically, compliance refers to the extent to which a patient's response to medical advice coincides with doctors' orders. Rather than this absolute standard, this article treats compliance as an institutionally available discourse continually figured in practice. The aim of this article...... give-and-take. This elasticity of compliance reveals a reflexive critique of medical compliance as a moral standard and leads us to discuss how people are adequately compliant in everyday moral contexts....

Efficacy of and patient compliance with a ketogenic diet in adults with intractable epilepsy: a meta-analysis.

Science.gov (United States)

Ye, Fang; Li, Xiao-Jia; Jiang, Wan-Lin; Sun, Hong-Bin; Liu, Jie

2015-01-01

Despite the successful use of a ketogenic diet in pediatric epilepsy, its application in adults has been limited. The aim of this meta-analysis was to summarize the findings of relevant published studies in order to identify the efficacy of and compliance with a ketogenic diet and its main subtypes (i.e., classic ketogenic diet and modified Atkins diet) in adults with intractable epilepsy, and to provide useful information for clinical practice. Electronic searches of PubMed, EMBASE, Google Scholar, and the ISI Web of Science were conducted to identify studies of the efficacy of and patient compliance with a ketogenic diet in adults with intractable epilepsy; the included studies were reviewed. Meta-analyses were performed using STATA to determine combined efficacy rates and combined rates of compliance with the ketogenic diet and its main subtypes. In total, 12 studies qualified for inclusion, and data from 270 patients were evaluated.The results of the meta-analysis revealed combined efficacy rates of all types of ketogenic diet, a classical ketogenic diet, and a modified Atkins diet were 42%, 52%, and 34%, respectively; the corresponding combined compliance rates were 45%, 38%, and 56%. The results indicate that a ketogenic diet is a promising complementary therapy in adult intractable epilepsy, and that while a classical ketogenic diet may be more effective, adult patients are likely to be less compliant with it than with a modified Atkins diet.

Effect of Contract Compliance Rate to a Fourth-Generation Telehealth Program on the Risk of Hospitalization in Patients With Chronic Kidney Disease: Retrospective Cohort Study.

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Hung, Chi-Sheng; Lee, Jenkuang; Chen, Ying-Hsien; Huang, Ching-Chang; Wu, Vin-Cent; Wu, Hui-Wen; Chuang, Pao-Yu; Ho, Yi-Lwun

2018-01-24

Chronic kidney disease (CKD) is prevalent in Taiwan and it is associated with high all-cause mortality. We have shown in a previous paper that a fourth-generation telehealth program is associated with lower all-cause mortality compared to usual care with a hazard ratio of 0.866 (95% CI 0.837-0.896). This study aimed to evaluate the effect of renal function status on hospitalization among patients receiving this program and to evaluate the relationship between contract compliance rate to the program and risk of hospitalization in patients with CKD. We retrospectively analyzed 715 patients receiving the telehealth care program. Contract compliance rate was defined as the percentage of days covered by the telehealth service before hospitalization. Patients were stratified into three groups according to renal function status: (1) normal renal function, (2) CKD, or (3) end-stage renal disease (ESRD) and on maintenance dialysis. The outcome measurements were first cardiovascular and all-cause hospitalizations. The association between contract compliance rate, renal function status, and hospitalization risk was analyzed with a Cox proportional hazards model with time-dependent covariates. The median follow-up duration was 694 days (IQR 338-1163). Contract compliance rate had a triphasic relationship with cardiovascular and all-cause hospitalizations. Patients with low or very high contract compliance rates were associated with a higher risk of hospitalization. Patients with CKD or ESRD were also associated with a higher risk of hospitalization. Moreover, we observed a significant interaction between the effects of renal function status and contract compliance rate on the risk of hospitalization: patients with ESRD, who were on dialysis, had an increased risk of hospitalization at a lower contract compliance rate, compared with patients with normal renal function or CKD. Our study showed that there was a triphasic relationship between contract compliance rate to the

Oral hygiene compliance in orthodontic patients: a randomized controlled study on the effects of a post-treatment communication.

Science.gov (United States)

Cozzani, Mauro; Ragazzini, Giulia; Delucchi, Alessia; Mutinelli, Sabrina; Barreca, Carlo; Rinchuse, Daniel J; Servetto, Roberto; Piras, Vincenzo

2016-12-01

Several studies have recently demonstrated that a post-treatment communication to explain the importance of an oral hygiene can improve the orthodontic patients' compliance over a period of 66 days. The main goal of this study is to evaluate the effects of a structured follow-up communication after orthodontic appliance application on oral hygiene compliance after 30-40 days. Eighty-four orthodontic participants enrolled from patients who were beginning fixed orthodontic treatment at the Orthodontic Department, Gaslini Hospital, Genova, between July and October 2014 were randomly assigned to one of three trial arms. Before the bonding, all patients underwent a session of oral hygiene aimed at obtaining an plaque index of "zero." At the following orthodontic appointment, the plaque index was calculated for each patient in order to assess oral hygiene compliance. The first group served as control and did not receive any post-procedure communication, the second group received a structured text message giving reassurance, and the third group received a structured telephone call. Participants were blinded to group assignment and were not made aware that the text message or the telephone call was part of the study. (The research protocol was approved by the Italian Comitato Etico Regionale della Liguria-sezione 3^ c/o IRCCS-Istituto G. Gaslini 845/2014, and it is not registered in the trial's register.) RESULTS: Thirty patients were randomly assigned to the control group, 28 participants to the text message group, and 26 to the telephone group. Participants who received a post-treatment communication reported higher level of oral hygiene compliance than participants in the control group. The plaque index was 0.3 (interquartile range (Iqr), 0.60) and 0.75 (Iqr, 1.30), respectively, with a significant difference (P = 0.0205). A follow-up procedure after orthodontic treatment may be an effective tool to increase oral hygiene compliance also over a short period.

Analysis of variables affecting drug compliance in schizophrenia

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Shakeel Ansari

2014-01-01

Full Text Available Context: As compliance of the patient during management of schizophrenia is crucial, the current study was conducted to find out the factors that affected compliance. Aims: The aim of the study was to analyze the prevalence of noncompliance and to find out different factors affecting compliance in schizophrenic patients. Materials and Methods: Observational cross-sectional study was conducted on 100 adult schizophrenic patients. Noncompliance was assessed using the rating of medication influence (ROMI scale. Severity of illness was measured using positive and negative syndrome scale (PANSS. Results: Prevalence of noncompliance was 37%. Using ROMI scale; positive relationship with psychiatrist, family pressure for taking medications, stigma, and substance abuse were found to be significant factors. Severity of illness was also found as determining factor. Conclusion: To improve the compliance in schizophrenia patients, roles of both psychiatrists and family members are crucial.

Motivation and compliance with intraoral elastics.

Science.gov (United States)

Veeroo, Helen J; Cunningham, Susan J; Newton, Jonathon Timothy; Travess, Helen C

2014-07-01

Intraoral elastics are commonly used in orthodontics and require regular changing to be effective. Unfortunately, poor compliance with elastics is often encountered, especially in adolescents. Intention for an action and its implementation can be improved using "if-then" plans that spell out when, where, and how a set goal, such as elastic wear, can be put into action. Our aim was to determine the effect of if-then plans on compliance with elastics. To identify common barriers to compliance with recommendations concerning elastic wear, semistructured interviews were carried out with 14 adolescent orthodontic patients wearing intraoral elastics full time. Emerging themes were used to develop if-then plans to improve compliance with elastic wear. A prospective pilot study assessed the effectiveness of if-then planning aimed at overcoming the identified barriers on compliance with elastic wear. Twelve participants were randomized equally into study and control groups; the study group received information about if-then planning. The participants were asked to collect used elastics, and counts of these were used to assess compliance. A wide range of motivational and volitional factors were described by the interviewed participants, including the perceived benefits of elastics, cues to remember, pain, eating, social situations, sports, loss of elastics, and breakages. Compliance with elastic wear was highly variable among patients. The study group returned more used elastics, suggesting increased compliance, but the difference was not significant. The use of if-then plans might improve compliance with elastic wear when compared with routine clinical instructions. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Interventions to improve hand hygiene compliance in patient care.

Science.gov (United States)

Gould, Dinah J; Moralejo, Donna; Drey, Nicholas; Chudleigh, Jane H; Taljaard, Monica

2017-09-01

Health care-associated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an effective preventive measure. This is an update of a previously published review. To assess the short- and long-term success of strategies to improve compliance to recommendations for hand hygiene, and to determine whether an increase in hand hygiene compliance can reduce rates of health care-associated infection. We conducted electronic searches of the Cochrane Register of Controlled Trials, PubMed, Embase, and CINAHL. We conducted the searches from November 2009 to October 2016. We included randomised trials, non-randomised trials, controlled before-after studies, and interrupted time series analyses (ITS) that evaluated any intervention to improve compliance with hand hygiene using soap and water or alcohol-based hand rub (ABHR), or both. Two review authors independently screened citations for inclusion, extracted data, and assessed risks of bias for each included study. Meta-analysis was not possible, as there was substantial heterogeneity across studies. We assessed the certainty of evidence using the GRADE approach and present the results narratively in a 'Summary of findings' table. This review includes 26 studies: 14 randomised trials, two non-randomised trials and 10 ITS studies. Most studies were conducted in hospitals or long-term care facilities in different countries, and collected data from a variety of healthcare workers. Fourteen studies assessed the success of different combinations of strategies recommended by the World Health Organization (WHO) to improve hand hygiene compliance. Strategies consisted of the following: increasing the availability of ABHR, different types of education for staff, reminders (written and verbal), different types of performance feedback, administrative support, and staff involvement. Six studies assessed different types of performance feedback, two studies evaluated education, three studies evaluated cues such

Compliance among soft contact lens wearers.

Science.gov (United States)

Kuzman, Tomislav; Kutija, Marija Barisić; Masnec, Sanja; Jandroković, Sonja; Mrazovac, Danijela; Jurisić, Darija; Skegro, Ivan; Kalauz, Miro; Kordić, Rajko

2014-12-01

Contact lens compliance is proven to be crucial for preventing lens wear-related complications because of the interdependence of the steps in lens care regime and their influence on lens system microbial contamination. Awareness of the patients' lens handling compliance as well as correct recognition of non-compliant behaviours is the basis for creating more targeted strategies for patient education. The aim of this study was to investigate compliance among soft contact lens (SCL) wearers in different aspects of lens care handling and wearing habits. In our research 50 asymptomatic lens wearers filled out a questionnaire containing demographic data, lens type, hygiene and wearing habits, lenses and lens care system replacement schedule and self-evaluation of contact lens handling hygiene. We established criteria of compliance according to available manufacturer's recommendations, prior literature and our clinical experience. Only 2 (4%) of patients were fully compliant SCL wearers. The most common non-compliant behaviours were insufficient lens solution soaking time (62%), followed by failure to daily exchange lens case solution and showering while wearing lenses. 44% of patients reported storing lenses in saline solution. Mean lens storage case replacement was 3.6 months, with up to 78% patients replacing lens case at least once in 3 months. Average grade in self evaluating level of compliance was very good (4 +/- 0.78) (from 1-poor level of hygiene to 5-great level of hygiene). Lens wearers who reported excessive daily lens wear and more than 10 years of lens wearing experience were also found to be less compliant with other lens system care procedures. (t = -2.99, df=47, p rate, self grading was relatively high. Therefore, these results indicate the need for patient education and encouragement of better lens wearing habits and all of the lens maintenance steps at each patient visit.

Differences in compliance with Surviving Sepsis Campaign recommendations according to hospital entrance time: day versus night.

Science.gov (United States)

Almeida, Mónica; Ribeiro, Orquídea; Aragão, Irene; Costa-Pereira, Altamiro; Cardoso, Teresa

2013-04-23

Higher compliance with Surviving Sepsis Campaign (SSC) recommendations has been associated with lower mortality. The authors evaluate differences in compliance with SSC 6-hour bundle according to hospital entrance time (day versus night) and its impact on hospital mortality. Prospective cohort study of all patients with community-acquired severe sepsis admitted to the intensive care unit of a large university tertiary care hospital, over 3.5 years with a follow-up until hospital discharge. Time to compliance with each recommendation of the SSC 6-hour bundle was calculated according to hospital entrance period: day (08:30 to 20:30) versus night (20:30 to 08:30). For the same periods, clinical staff composition and the number of patients attending the emergency department (ED) was also recorded. In this period 300 consecutive patients were included. Compliance rate was (night vs. day): serum lactate measurement 57% vs. 49% (P = 0.171), blood cultures drawn 59% vs. 37% (P 8 mmHg 45% vs. 29% (P = 0.021), and central venous oxygen saturation (SvcO₂) >70%, 7% vs. 2% (P = 0.082); fluids were administered in all patients with hypotension in both periods and vasopressors were administered in patients with hypotension not responsive to fluids in 100% vs. 99%. Time to get specific actions done was also different (night vs. day): serum lactate measurement (4.5 vs. 7 h, P = 0.018), blood cultures drawn (4 vs. 8 h, P night with a higher proportion of less differentiated doctors. The number of patients attending the Emergency Department was lower overnight. Hospital mortality rate was 34% in patients entering in the night period vs. 40% in those entering during the day (P = 0.281). Compliance with SSC recommendations was higher at night. A possible explanation might be the increased nurse to patient ratio in that period. Adjustment of the clinical team composition to the patients' demand is needed to increase compliance and improve prognosis.

A randomized trial to determine the impact on compliance of a psychophysical peripheral cue based on the Elaboration Likelihood Model.

Science.gov (United States)

Horton, Rachael Jane; Minniti, Antoinette; Mireylees, Stewart; McEntegart, Damian

2008-11-01

Non-compliance in clinical studies is a significant issue, but causes remain unclear. Utilizing the Elaboration Likelihood Model of persuasion, this study assessed the psychophysical peripheral cue 'Interactive Voice Response System (IVRS) call frequency' on compliance. 71 participants were randomized to once daily (OD), twice daily (BID) or three times daily (TID) call schedules over two weeks. Participants completed 30-item cognitive function tests at each call. Compliance was defined as proportion of expected calls within a narrow window (+/- 30 min around scheduled time), and within a relaxed window (-30 min to +4 h). Data were analyzed by ANOVA and pairwise comparisons adjusted by the Bonferroni correction. There was a relationship between call frequency and compliance. Bonferroni adjusted pairwise comparisons showed significantly higher compliance (p=0.03) for the BID (51.0%) than TID (30.3%) for the narrow window; for the extended window, compliance was higher (p=0.04) with OD (59.5%), than TID (38.4%). The IVRS psychophysical peripheral cue call frequency supported the ELM as a route to persuasion. The results also support OD strategy for optimal compliance. Models suggest specific indicators to enhance compliance with medication dosing and electronic patient diaries to improve health outcomes and data integrity respectively.

The hand hygiene compliance of student nurses during clinical placements.

Science.gov (United States)

Sundal, Jorun Saetre; Aune, Anne Grethe; Storvig, Eline; Aasland, Jenny Kristin; Fjeldsaeter, Kaja Linn; Torjuul, Kirsti

2017-12-01

To observe student nurses' overall and moment-specific hand hygiene compliance during clinical placement. Hand hygiene is the single most important measure to prevent healthcare-associated infections. However, research has shown low compliance among healthcare workers. During clinical placements, student nurses perform various nursing tasks and procedures to a large number of patients, requiring extensive patient contact. It is crucial that they practice correct hand hygiene to prevent healthcare-associated infections. Open, standardised and nonparticipating observations. Twenty-nine student nurses were observed three times for 20 ± 10 min during clinical placement in a Norwegian university hospital. To measure compliance, we used WHO's Hand Hygiene Observation tool, based on the model "My five moments for hand hygiene". Overall hand hygiene compliance in the student group was 83.5%. Highest moment-specific compliance was after touching patient surroundings, after touching patients and after body fluid exposure risk. Lowest moment-specific compliance was recorded before touching patients or patient surroundings, and before clean/aseptic procedures. Nurse education needs to be improved both theoretically and during clinical placements in order to advance and sustain compliance among student nurses. Increasing healthcare workers' compliance with hand hygiene guidelines remains a challenge to the clinical community. In order to reduce healthcare-associated infections, it is important to educate student nurses to comply with the guidelines during clinical placements. Identifying student nurses' hand hygiene performance is the first step towards developing teaching methods to improve and sustain their overall and moment-specific compliance. As a measure to ensure student compliance during clinical placements, mentors should be aware of their influence on students' performance, act as hand hygiene ambassadors, encourage students to comply with established guidelines

Relation of epicardial adipose tissue with arterial compliance and stiffness in patients with hypertension.

Science.gov (United States)

Korkmaz, Levent; Cirakoglu, Omer Faruk; Ağaç, Mustafa Tarik; Erkan, Hakan; Korkmaz, Ayca Ata; Acar, Zeydin; Kul, Selim; Hatem, Engin; Çelik, Şükrü

2014-09-01

The main aim of the present study was to investigate the association between epicardial adipose tissue (EAT) and arterial function in patients with asymptomatic hypertension. Patients with hypertension (n = 155) were enrolled consecutively. Patients with decreased arterial compliance (AC) and increased cardioankle vascular index (CAVI) had higher EAT values compared with those with normal AC and CAVI (6.23 ± 1.67 vs 4.91 ± 1.40, P arterial function in patients with asymptomatic hypertension. The link between EAT and arterial stiffness deserves further investigation. © The Author(s) 2013.

[Impact of glutamine, eicosapntemacnioc acid, branched-chain amino acid supplements on nutritional status and treatment compliance of esophageal cancer patients on concurrent chemoradiotherapy and gastric cancer patients on chemotherapy].

Science.gov (United States)

Cong, Minghua; Song, Chenxin; Zou, Baohua; Deng, Yingbing; Li, Shuluan; Liu, Xuehui; Liu, Weiwei; Liu, Jinying; Yu, Lei; Xu, Binghe

2015-03-17

To explore the effects of glutamine, eicosapntemacnioc acid (EPA) and branched-chain amino acids supplements in esophageal cancer patients on concurrent chemoradiotherapy and gastric cancer patients on chemotherapy. From April 2013 to April 2014, a total of 104 esophageal and gastric carcinoma patients on chemotherapy or concurrent chemoradiotherapy were recruited and randomly divided into experimental and control groups. Both groups received dietary counseling and routine nutritional supports while only experimental group received supplements of glutamine (20 g/d), EPA (3.3 g/d) and branched-chain amino acids (8 g/d). And body compositions, blood indicators, incidence of complications and completion rates of therapy were compared between two groups. After treatment, free fat mass and muscle weight increased significantly in experiment group while decreased in control group (P nutrition status, decrease the complications and improve compliance for esophageal cancer patients on concurrent chemo-radiotherapy and gastric cancer patients on postoperative adjuvant chemotherapy.

Interventions to improve hand hygiene compliance in patient care.

Science.gov (United States)

Gould, Dinah J; Moralejo, Donna; Drey, Nicholas; Chudleigh, Jane H

2010-09-08

Health care-associated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an effective preventive measure. To update the review done in 2007, to assess the short and longer-term success of strategies to improve hand hygiene compliance and to determine whether a sustained increase in hand hygiene compliance can reduce rates of health care-associated infection. We conducted electronic searches of: the Cochrane Central Register of Controlled Trials; the Cochrane Effective Practice and Organisation of Care Group specialised register of trials; MEDLINE; PubMed; EMBASE; CINAHL; and the BNI. Originally searched to July 2006, for the update databases were searched from August 2006 until November 2009. Randomised controlled trials, controlled clinical trials, controlled before and after studies, and interrupted time series analyses meeting explicit entry and quality criteria used by the Cochrane Effective Practice and Organisation of Care Group were eligible for inclusion. Studies reporting indicators of hand hygiene compliance and proxy indicators such as product use were considered. Self-reported data were not considered a valid measure of compliance. Studies to promote hand hygiene compliance as part of a care bundle approach were included, providing data relating specifically to hand hygiene were presented separately. Studies were excluded if hand hygiene was assessed in simulations, non-clinical settings or the operating theatre setting. Two reviewers independently extracted data and assessed data quality. Four studies met the criteria for the review: two from the original review and two from the update. Two studies evaluated simple education initiatives, one using a randomized clinical trial design and the other a controlled before and after design. Both measured hand hygiene compliance by direct observation. The other two studies were both interrupted times series studies. One study presented three separate interventions within the

Low Left Atrial Compliance Contributes to the Clinical Recurrence of Atrial Fibrillation after Catheter Ablation in Patients with Structurally and Functionally Normal Heart.

Science.gov (United States)

Park, Junbeom; Yang, Pil-sung; Kim, Tae-Hoon; Uhm, Jae-Sun; Kim, Joung-Youn; Joung, Boyoung; Lee, Moon-Hyoung; Hwang, Chun; Pak, Hui-Nam

2015-01-01

Stiff left atrial (LA) syndrome was initially reported in post-cardiac surgery patients and known to be associated with low LA compliance. We investigated the physiological and clinical implications of LA compliance by estimating LA pulse pressure (LApp) among patients with atrial fibrillation (AF) and structurally and functionally normal heart. Among 1038 consecutive patients with LA pressure measurements before AF ablation, we included 334 patients with structurally and functionally normal heart (81.7% male, 54.1±10.6 years, 77.0% paroxysmal AF) after excluding those with hypertension, diabetes, and previous ablation or cardiac surgery. We measured LApp (peak-nadir LA pressure) at the beginning of the ablation procedure and compared the values with clinical parameters and the AF recurrence rate. AF patients with normal heart were younger and more frequently male and had paroxysmal AF, a lower body mass index, and a lower LApp compared to others (all p<0.05). Based on the median value, the low LA compliance group (LApp≥13 mmHg) had a smaller LA volume index and lower LA voltage (all p<0.05) compared to the high LA compliance group. During a mean follow-up of 16.7±11.8 months, low LA compliance was independently associated with two fold-higher risk of clinical AF recurrence (HR:2.202; 95%CI:1.077-4.503; p = 0.031). Low LA compliance, as determined by an elevated LApp, was associated with a smaller LA volume index and lower LA voltage and independently associated with higher clinical recurrence after catheter ablation in AF patients with structurally and functionally normal heart.

Finding the Stronger Impact among Bribery, Financial Reward, and Religious Attitude: The Insights of Experiment on Environmental Tax Compliance in Indonesia

OpenAIRE

Iskandar, Deden Dinar; Wuenscher, Tobias

2012-01-01

The degradation of environmental quality has been one of the main concerns in Indonesia. The government has mentioned the environmental tax as the instrument of environmental management; however, the primary potential problem will be the issue of compliance. Inspired by the situation in Indonesia, this study is expected to contribute on environmental regulation and tax compliance literatures by examining and comparing the impact of bribery, financial reward, and religious attitude on complian...

Related factors to semi-recumbent position compliance and pressure ulcers in patients with invasive mechanical ventilation: An observational study (CAPCRI study).

Science.gov (United States)

Llaurado-Serra, Mireia; Ulldemolins, Marta; Fernandez-Ballart, Joan; Guell-Baro, Rosa; Valentí-Trulls, Teresa; Calpe-Damians, Neus; Piñol-Tena, Angels; Pi-Guerrero, Mercedes; Paños-Espinosa, Cristina; Sandiumenge, Alberto; Jimenez-Herrera, María F

2016-09-01

Semi-recumbent position is recommended to prevent ventilator-associated pneumonia. Its implementation, however, is below optimal. We aimed to assess real semi-recumbent position compliance and the degree of head-of-bed elevation in Spanish intensive care units, along with factors determining compliance and head-of-bed elevation and their relationship with the development of pressure ulcers. Finally, we investigated the impact that might have the diagnosis of pressure ulcers in the attitude toward head-of-bed elevation. We performed a prospective, multicenter, observational study in 6 intensive care units. Inclusion criteria were patients ≥18 years old and expected to remain under mechanical ventilator for ≥48h. Exclusion criteria were patients with contraindications for semi-recumbent position from admission, mechanical ventilation during the previous 7 days and prehospital intubation. Head-of-bed elevation was measured 3 times/day for a maximum of 28 days using the BOSCH GLM80(®) device. The variables collected related to patient admission, risk of pressure ulcers and the measurements themselves. Bivariate and multivariate analyses were carried out using multiple binary logistic regression and linear regression as appropriate. Statistical significance was set at preplacement therapy, nursing shift, open abdomen, abdominal vacuum therapy and agitation. Twenty-five patients (9.1%) developed a total of 34 pressure ulcers. The diagnosis of pressure ulcers did not affect the head-of-bed elevation. In the multivariate analysis, head-of-bed elevation was not identified as an independent risk factor for pressure ulcers. Semi-recumbent position compliance is below optimal despite the fact that it seems achievable most of the time. Factors that affect semi-recumbent position include the particular intensive care unit, abdominal conditions, renal replacement therapy, agitation and bed type. Head-of-bed elevation was not related to the risk of pressure ulcers. Efforts

Compliance with Private Food Safety Standards among ...

International Development Research Centre (IDRC) Digital Library (Canada)

... and the livelihood impact of compliance. In addition, the project aims to build the capacity of farmers and other locally based actors to enhance compliance and thereby contribute to increased welfare in the project area. Expected outputs include one PhD thesis, five master's theses, and various journal publications and ...

The effect of palatability of oral contrast media on compliance with drinking protocols, and on bowel opacification, in abdominal CT

International Nuclear Information System (INIS)

Morgan, Bruno; Basu, Avi; Kithoray, Surjinder; Tyagi, Raman; Campbell, Shona; Liddicoat, Amanda

2009-01-01

Purpose: To assess whether palatability of oral contrast in CT has an impact on adherence to oral contrast media drinking protocols; and whether such variation has an impact on bowel opacification. Three different types of contrast media were compared; ionic and non-ionic iodinated oral contrast (Gastrografin, Diatrizoate, Schering AG), Gastromiro (Iopamidol, Bracco SpA) and the barium based contrast E-Z-Cat (E-Z-EM). Materials and methods: In the first stage of the study 101 prospective patients were randomly given 1 L of a ∼2% solution of Gastrografin or Gastromiro prior to a body CT scan. Data was recorded concerning the palatability of the oral contrast, drinking protocol compliance and bowel opacification. The second stage involved 66 prospective patients given Gastromiro or E-Z-Cat (again 1 L of ∼2% solution). Results: Gastromiro had better palatability than Gastrografin (p = 0.001) and improved protocol compliance. E-Z-Cat had similar palatability to Gastromiro . Patients who found the oral contrast more palatable had improved drinking protocol compliance (p = 0.007) and improved small bowel opacification (p = 0.03). E-Z-Cat had similar palatability and protocol compliance to Gastromiro but better overall small bowel opacification (p = 0.001). Conclusion: In conclusion we suggest that the palatability of oral contrast is not only important to the patients overall experience of body CT, but that it is also linked to adherence with oral contrast drinking protocols leading to better bowel opacification.

Compliance in black patients with non-insulin- dependent diabetes ...

African Journals Online (AJOL)

1991-05-04

May 4, 1991 ... Poor compliance with drug therapy is an important cause of therapeutic failure. ... agents were interviewed and various factors, such as age, sex, degree of .... were made. It was found that compliance had no influence on .... and phenformin in human plasma and urine by reversed-phase high-performance.

Narratives of empowerment and compliance: studies of communication in online patient support groups.

Science.gov (United States)

Wentzer, Helle S; Bygholm, Ann

2013-12-01

New technologies enable new forms of patient participation in health care. The article discusses whether communication in online patient support groups is a source of individual as well as collective empowerment or to be understood within the tradition of compliance. The discussion is based on a qualitative analysis of patient communication in two online groups on the Danish portal sundhed.dk, one for lung patients and one for women with fertility problems. The object of study is the total sum of postings during a specific period of time - a total of 4301 posts are included. The textmaterial was analyzed according to the textual paradigm of Paul Ricoeur, and the three steps of critical interpretation. Thus, the analysis moves from describing communicative characteristics of the site to a thorough semantic analysis of its narrative structure of construing meaning, interaction and collective identity, and finally as a source of collective action. The meta-narratives of the two groups confirm online patient support groups for individual empowerment, for collective group identity, but not for collective empowerment. The collective identities of patienthood on the two sites are created by the users (patients) through specific styles of communication and interaction, referred to as 'multi-logical narratives'. In spite of the potential of online communities of opening up health care to the critical voice of the public, the analysis points to a synthesis of the otherwise opposite positions of empowerment and compliance in patient care. On a collective level, the site is empowering the individual users to comply with 'doctor's recommendations' as a group. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Effect of intervention using a messaging app on compliance and duration of treatment in orthodontic patients.

Science.gov (United States)

Li, Xue; Xu, Zhen-Rui; Tang, Na; Ye, Cui; Zhu, Xiao-Ling; Zhou, Ting; Zhao, Zhi-He

2016-11-01

This study aims to determine the effectiveness of a messaging app (WeChat) in improving patients' compliance and reducing the duration of orthodontic treatment (DOT). A randomized controlled trial was performed in a dental hospital and a clinic from August 2012 to May 2015. Orthodontic patients were included at the beginning of treatment. Patients with multiphase treatment or braceless technique were excluded. Participants were randomized to WeChat group (received regular reminders and educational messages) or control group (received conventional management) and were followed up until the treatment was completed. Primary outcome measure was DOT. Others were late and failed attendance, bracket bond failure, and oral hygiene condition. One hundred twelve patients in each group participated and completed the trial. DOT in WeChat group were 7.3 weeks shorter (P = 0.007). There were less failed attendance (3.1 vs. 10.9 %, P bond failure (11.8 vs. 16.1 %, P duration and bracket bond failure, and improving the attendance in orthodontic patients. DOT can be reduced by improving patient's compliance. The messaging app is useful for outpatient education and management.

Perceived service quality's effect on patient satisfaction and behavioural compliance.

Science.gov (United States)

Mohamed, Bahari; Azizan, Noor Azlinna

2015-01-01

The purpose of this paper is to advance healthcare service quality research using hierarchical component models. This study used a quantitative approach with cross-sectional design as a survey method, combining cluster and convenience sampling and partial least square structural equation modelling (PLS-SEM) to validate the research model and test the hypotheses. The study extends health service quality literature by showing that: patient satisfaction (PS) is dominant, significant and indirect determinant of behavioural compliance (BC); perceived service quality has the strongest effect on BC via PS. Only one hospital was evaluated. The study provides managers with a service quality model for conducting integrated service delivery systems analysis and design. Overall, the study makes a significant contribution to healthcare organizations, better health outcomes for patients and better quality of life for the community.

Oral hygiene compliance in orthodontic patients: a randomized controlled study on the effects of a post-treatment communication

Directory of Open Access Journals (Sweden)

Mauro Cozzani

2016-12-01

Full Text Available Abstract Background Several studies have recently demonstrated that a post-treatment communication to explain the importance of an oral hygiene can improve the orthodontic patients’ compliance over a period of 66 days. The main goal of this study is to evaluate the effects of a structured follow-up communication after orthodontic appliance application on oral hygiene compliance after 30–40 days. Methods Eighty-four orthodontic participants enrolled from patients who were beginning fixed orthodontic treatment at the Orthodontic Department, Gaslini Hospital, Genova, between July and October 2014 were randomly assigned to one of three trial arms. Before the bonding, all patients underwent a session of oral hygiene aimed at obtaining an plaque index of “zero.” At the following orthodontic appointment, the plaque index was calculated for each patient in order to assess oral hygiene compliance. The first group served as control and did not receive any post-procedure communication, the second group received a structured text message giving reassurance, and the third group received a structured telephone call. Participants were blinded to group assignment and were not made aware that the text message or the telephone call was part of the study. (The research protocol was approved by the Italian Comitato Etico Regionale della Liguria-sezione 3^ c/o IRCCS-Istituto G. Gaslini 845/2014, and it is not registered in the trial’s register. Results Thirty patients were randomly assigned to the control group, 28 participants to the text message group, and 26 to the telephone group. Participants who received a post-treatment communication reported higher level of oral hygiene compliance than participants in the control group. The plaque index was 0.3 (interquartile range (Iqr, 0.60 and 0.75 (Iqr, 1.30, respectively, with a significant difference (P = 0.0205. Conclusions A follow-up procedure after orthodontic treatment may be an effective tool to

Effects of Messages Delivered by Mobile Phone on Increasing Compliance With Shoulder Exercises Among Patients With a Frozen Shoulder.

Science.gov (United States)

Chen, Hui-Chun; Chuang, Tai-Yuan; Lin, Pi-Chu; Lin, Yen-Kuang; Chuang, Yeu-Hui

2017-07-01

The aim of this study was to examine the effects of reminders, encouragement, and educational messages delivered by mobile phone on shoulder exercise compliance and improvements in shoulder function among patients with a frozen shoulder. A randomized controlled trial design was used. A convenience sample of patients with a frozen shoulder in an orthopedic outpatient clinic was recruited. All participants were instructed on how to do shoulder exercises and were provided with a printed pamphlet about shoulder exercises. Then, the intervention group received reminders, encouragement, and educational messages by mobile phone daily for the next 2 weeks, while the comparison group did not. The intervention group had higher compliance with shoulder exercises than did the comparison group (t = 2.263, p = .03) and had significant improvements in shoulder forward flexion (F = 12.067, p = .001), external rotation (F = 13.61, p = .001), and internal rotation (F = 5.903, p = .018) compared to those in the comparison group after the 2-week intervention. The text messages significantly increased patient compliance with shoulder exercises and thus improved patients' shoulder range of motion. Hospital or clinics can send appropriate messages to patients via text message platforms in order to remind and encourage them to do shoulder exercises. © 2017 Sigma Theta Tau International.

Effect of a system-oriented intervention on compliance problems in schizophrenia

DEFF Research Database (Denmark)

Skarsholm, Hanne; Støvring, Henrik; Nielsen, Bent

2014-01-01

Background. Numerous studies have been conducted with a view to developing strategies for improvement of medical compliance in patients with schizophrenia. All of the studies conducted so far have had an individual approach to compliance based on the assumption that noncompliance is determined...... individually due to inappropriate behavior in the patient. We conducted a pragmatic controlled trial with a system-oriented approach, to provide a new perspective on compliance and test the efficacy of a multifactorial intervention at the system level in a routine clinical setting, an approach that has...... not previously been used for the improvement of compliance. Methods. 30 patients were allocated to the system-oriented therapy and 40 patients were allocated to the reference intervention, which consisted of individually based compliance therapy. The follow-up period was six months. Primary endpoint...

Evaluation of pharyngeal volume and compliance of OSAHS patients using 3D CT and volume measurement

International Nuclear Information System (INIS)

Lan, Zhijie

2004-01-01

The intrinsic properties such as baseline caliber and compliance of the upper airway are thought to be important in the pathogenesis of obstructive sleep apnea hypopnea syndrome (OSAHS).The author attempted using imaging methods to evaluate both baseline caliber and compliance in normal individuals and OSAHS patients, and to localize the obstructive sites in OSAHS patients. Critical closing pressure (P crit ) and minimally effective therapeutical pressure (P eff ) were measured and computed tomography (CT) scan of pharynx was performed during wakefulness and drug-induced sleep with P crit , 0 cm H 2 O and P eff being given through a nose mask system. 7 normal individuals (age, 32.2±6.5 y's and body mass index, 23.6±5.4 kg/m 2 ) and 13 OSAHS patients (age, 33.3±6.4 y's and body mass index, 25.9±6.0 kg/m 2 ) were studied. 3D images of pharyngeal airway were reconstructed, and volume of each subdivision of pharynx was measured. Volume, average area and compliance of each subdivision were compared between the two groups. On an air-mode view of 3D image, the outline of pharynx was shown as transparent tubal structure, on which the narrowing collapse of airway at any level or any direction can be easily identified. Anatomy of pharynx could be easily understood on the virtual endoscopic mode. During wakefulness, the average area of the upper (1.20±0.26 cm 2 vs. 1.57±0.17 cm 2 , P 2 vs. 2.58±0.27 cm 2 , P 2 vs. 1.45±0.18 cm 2 , P 2 vs. 2.44±0.26 cm 2 ). The compliance of the middle part (0.28±0.15/cmH 2 O vs. 0.13±0.07/cmH 2 O, P<0.05) of pharynx was significantly higher in OSAHS patients than in normal individuals. The data suggested that OSAHS patients have a narrower and more collapsible pharynx compared to the normal subjects. The method of the present study is valid to evaluate both morphology and function of the upper airway. (author)

Impact of daily chlorhexidine baths and hand hygiene compliance on nosocomial infection rates in critically ill patients.

Science.gov (United States)

Martínez-Reséndez, Michel Fernando; Garza-González, Elvira; Mendoza-Olazaran, Soraya; Herrera-Guerra, Alexis; Rodríguez-López, Juan Manuel; Pérez-Rodriguez, Edelmiro; Mercado-Longoria, Roberto; Camacho-Ortiz, Adrián

2014-07-01

Up to 25% of all nosocomial infections (NIs) develop in critically ill patients. Our objective was to evaluate chlorhexidine (CHX) bathing and hand hygiene (HH) compliance in the reduction of NIs in the intensive care unit. The study comprised three 6-month periods: preintervention (PIP; soap/water bathing), intervention (IP; bathing with CHX-impregnated wipes), and postintervention (PoIP; soap/water bathing). An HH program was implemented during the IP and PoIP. Primary outcomes were global and specific NI rates. A total of 1007 patients were included. Infection rates per 100 discharges were higher in the PIP compared with the IP and also higher in the PoIP compared with the IP (P = .0004 and .0109, respectively). Global infection rates per 1000 hospital-days were higher in the PIP than in the IP (P = .0268). The rates of ventilator-associated pneumonia (VAP) and catheter-associated urinary tract infection (CAUTI) were higher in the PIP than in the IP (P = .036 and .0001, respectively). Isolation of Acinetobacter baumannii from VAP specimens (P = .0204) and isolation of Candida spp from CAUTI specimens (P = .0005) decreased as well. The combined intervention reduced global and specific infection rates, including rates of VAP associated with A baumannii and CAUTI associated with Candida spp. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Cross compliance and competitiveness of the European beef and pig sector

NARCIS (Netherlands)

Roest, de K.; Jongeneel, R.; Dillen, K.; Winsten, J.

2008-01-01

Beef and pig production are important sectors affected by the cross-compliance policy. Full compliance with SMRs and GAECs generates costs and benefits which may have an impact on the competitiveness of these sectors on the world market. Compliance with the Nitrate Directive, animal identification

Patient compliance with drug therapy in schizophrenia. Economic and clinical issues.

Science.gov (United States)

Lindström, E; Bingefors, K

2000-08-01

The effectiveness of drug treatment in clinical practice is considerably lower than the efficacy shown in controlled studies. The lower effectiveness in practice presumably leads to lower cost effectiveness of drug treatment in real-life situations compared with that demonstrated by studies based on results from controlled trials. Improved cost effectiveness in routine clinical practice would be a significant advantage in the treatment of schizophrenia, one of the most costly diseases in society. The aetiology of schizophrenia is unknown, and there is no cure. The main aims of therapy with antipsychotic medication include the effective relief of symptoms without the introduction of adverse effects or serious adverse events, improved quality of life, cost effectiveness and a positive long term outcome. The older classical antipsychotic drugs do not always meet these requirements because of their well-known limitations, such as a lack of response in a subgroup of individuals with schizophrenia and intolerable adverse effects. There has long been a need for new antipsychotics that can ameliorate more symptoms and have no or few adverse effects. Some of the recently introduced antipsychotics have been shown to be more effective in certain clinical situations and to have a more favourable adverse effect profile than the classical antipsychotics. A major factor contributing to the lower effectiveness of drug treatment is noncompliance, which may be very high in schizophrenia. There are several factors influencing compliance, including drug type and formulation, patient, disease status, physician, health care system, community care and family. There have been very few studies of compliance improvement strategies in schizophrenia or, indeed, in medicine in general. Current methods are relatively complex and there are differing opinions on their effectiveness. There are several ways to increase compliance in schizophrenia--the evidence is strongest for psychoeducative

A Review of Factors for Tax Compliance

Directory of Open Access Journals (Sweden)

Nicoleta BARBUTA-MISU

2011-03-01

Full Text Available The aim of this paper is to identify the variables of tax compliance analysed by researchers from various countries and adapting them to the Romanian conditions to create a model to include factors that influence decision of tax compliance. Tax compliance has been studied in economics by analysing the individual decision of a representative person between paying taxes and evading taxes. In the research of tax compliance have been done many empirical studies that emphasized the impact of a wide variety of potential determinants of voluntary compliance with individual income/profit tax filing and reporting obligations. The most important determinants identified are: economic factors as the level of income, audit probabilities, tax audit, tax rate, tax benefits, penalties, fines and other non-economic factors as attitudes toward taxes, personal, social and national norms, perceived fairness etc.

Chemical exposure reduction: Factors impacting on South African herbicide sprayers' personal protective equipment compliance and high risk work practices.

Science.gov (United States)

Andrade-Rivas, Federico; Rother, Hanna-Andrea

2015-10-01

The high exposure risks of workers to herbicides in low- and middle-income countries is an important public health concern because of the potential resulting negative impacts on workers' health. This study investigated workers' personal protective equipment (PPE) compliance as a risk mitigation measure; particularly workers who apply herbicides for Working for Water (WfW) - a South African invasive alien vegetation control programme. The study aim was to understand workers' low PPE compliance by analysing their risk perceptions of herbicide use, working conditions and socio-cultural context. Research methods included ethnographic observations, informal interviews, visual media, questionnaires and a focus group. Study results indicated that low PPE compliance persists despite workers' awareness of herbicide exposure risks and as a result of the influence from workers' socio-cultural context (i.e. gender dynamics and social status), herbicide risk perceptions and working conditions (i.e. environmental and logistical). Interestingly, teams comprised of mostly women had the highest compliance rate. These findings highlighted that given the complexity of PPE compliance, especially in countries with several economic and social constraints, exposure reduction interventions should not rely solely on PPE use promotion. Instead, other control strategies requiring less worker input for effectiveness should be implemented, such as elimination and substitution of highly hazardous pesticides, and altering application methods. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Reduction in exhaled nitric oxide tracks improved patient inhaler compliance in difficult asthma-a case study.

Science.gov (United States)

Hunt, Eoin; Flynn, Deirdre; MacHale, Elaine; Costello, Richard W; Murphy, Desmond M

2017-12-26

Exhaled nitric oxide is believed be a useful surrogate for airways inflammation while non-adherence with therapy is known to be associated with worsening of asthma control. We present the case of a 49-year-old female with steroid-dependent asthma and an exacerbation rate of >20/year. She was enrolled in a 3-month-long prospective study using a validated diagnostic inhaler device that provided objective evidence of inhaler compliance. Fractional exhaled nitric oxide (FeNO), peak expiratory flow rates, asthma control questionnaires were measured throughout the study period. Peripheral eosinophil count was obtained prior to the study, during the study, and immediately afterwards. Improvement in compliance at the end of the study led to significant improvements in lung function peak expiratory flow rate (PEFR), and objective scores of asthma. There was an observed improvement in PEFR after 4 weeks, with an associated decrease in FeNO from 92 to 9 ppb that plateaued over the remainder of the study. Her eosinophil count was 0.79 × 10 9 /litre prior to starting in the study, 0.37 × 10 9 /litre after 2 months, and 0.1 × 10 9 /litre at the end of the study. We believe that this is the first case study to objectively prove that improvements in compliance can lead to dramatic reductions in the overall inflammatory airway response and in particular that improvements in patient compliance are mirrored by marked reduction in FeNO levels. These changes occurred in tandem with an observed clinical improvement in our patient.

Compliance of patients concerning recommended radiotherapy in breast cancer. Association with recurrence, age, and hormonal therapy

International Nuclear Information System (INIS)

Winzer, K.J.; Gruber, C.; Badakhshi, H.; Charite Universitaetsmedizin Berlin; Hinkelbein, M.; Denkert, C.

2012-01-01

Background and purpose: In this study, we investigated how often guidelines for radiation therapy in patients with breast cancer are not complied with, which patient group is mostly affected, and how this influences local recurrence. Patients and methods: All patients (n = 1,903) diagnosed between November 2003 and December 2008 with primary invasive or intraductal breast cancer in the interdisciplinary breast center of the Charite Hospital Berlin were included and followed for a median 2.18 years. Results: Patients who, in contrast to the recommendation of the interdisciplinary tumor board, did not undergo postoperative radiation experienced a fivefold higher local recurrence rate (p < 0.0005), corresponding to a 5-year locoregional recurrence-free survival of 74.5% in this group. The 5-year locoregional recurrence-free survival of patients following the recommendations was 93.3%. Guideline compliance was dependent on age of patients, acceptance of adjuvant hormonal treatment or chemotherapy, and increased diameter of the primary tumor. Multiple logistic regression analysis showed an association between compliance and age or hormonal therapy. Conclusion: In order to avoid local recurrence patients should be motivated to comply with guideline driven therapy. Since a higher number of local recurrences is observed in health services research compared to clinical research, studies on the value of adjuvant treatment following local recurrence should be performed. (orig.)

Compliance with CPAP therapy in patients with the sleep apnoea/hypopnoea syndrome.

OpenAIRE

Engleman, H. M.; Martin, S. E.; Douglas, N. J.

1994-01-01

BACKGROUND--Continuous positive airway pressure (CPAP) therapy is the treatment of choice for the sleep apnoea/hypopnoea syndrome. Compliance with this relatively obtrusive therapy has not been well studied. METHODS--Usage of CPAP was investigated in 54 patients with sleep apnoea/hypopnoea syndrome (median 36 (range 7-129) apnoeas + hypopnoeas/hour slept) over the first 1-3 months after starting CPAP therapy. In all cases CPAP usage was monitored by hidden time clocks that indicated for how l...

Impaired fasting pyloric compliance in gastroparesis and the therapeutic response to pyloric dilatation.

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Gourcerol, G; Tissier, F; Melchior, C; Touchais, J Y; Huet, E; Prevost, G; Leroi, A M; Ducrotte, P

2015-02-01

Pyloric pressure and compliance have never been investigated in health nor gastroparesis. We hypothesised that pyloric pressure and/or compliance may be altered in gastroparesis. Fasting pyloric pressure and compliance were investigated in 21 healthy volunteers (HV), 27 gastroparetic patients (GP) and 5 patients who had undergone oesophagectomy without pyloroplasty as positive controls. Under videofluoroscopic control, pyloric compliance and pressure were measured by the EndoFLIP technique. Gastric emptying half time (T1/2 ) using (13) C-octanoic acid breath test, as well as symptoms and quality of life (GIQLI score) were also monitored. Mean fasting pyloric compliance was measured at 25.2 ± 2.4 mm²/mmHg in HV, and was lower both in GP (16.9 ± 2.1 mm²/mmHg; P fasting pyloric pressure was not different among groups. Fasting pyloric compliance and pressure correlated with T1/2 in GP (R = -0.43; P = 0.04). Fasting pyloric compliance, but not pressure, correlated with symptoms and GIQLI score. Pyloric dilation in 10 GP with low fasting pyloric compliance (fasting pyloric compliance is decreased in gastroparetic patients and is associated with T1/2 , symptoms and quality of life. This suggests that pyloric compliance may be a new relevant metric in gastroparetic patients, and may be useful to target patients for pyloric dilation or botulinum toxin injection. © 2014 John Wiley & Sons Ltd.

Pilot study: Assessing the effect of continual position monitoring technology on compliance with patient turning protocols

OpenAIRE

Schutt, Suann Cirigliano; Tarver, Christine; Pezzani, Michelle

2017-01-01

Abstract Aim The study aim was to evaluate if continual patient position monitoring, taking into account self‐turns and clinician‐assisted turns, would increase the percentage of time a patient's position changed at least every 2 hr. Background While patient turning has clinical benefits, current models to help staff remember to turn patients, such as “turn clocks” and timers, have not resulted in high compliance with turning protocols. In addition, reminders are based on arbitrary 2‐hr windo...

Myopia and misrecognition : the impact of managerialism on the management of compliance

OpenAIRE

Phillips, Jake

2016-01-01

This article explores the construction of a particular form of compliance in probation practice during a period in which policy shifted from enforcement towards compliance. The article uses four concepts from Bourdieu's field theory (habitus, field, misrecognition and symbolic violence) to highlight the way in which the shift in policy was attuned to the subjective structure of probation practitioners' habitus but resulted in a form of compliance which was myopic in nature and thus did not ad...

Upper gastrointestinal endoscopy for dyspepsia: Εxploratory study of factors influencing patient compliance in Greece

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Kouroumalis Elias

2011-02-01

Full Text Available Abstract Background Upper gastrointestinal endoscopy is the most preferable diagnostic examination for patients over fifty when upper gastrointestinal symptoms appear. However, limited knowledge exists in concerns to the compliance of primary care patients' to the doctors' recommendations for endoscopy. Methods Patients who visited primary care practices in Greece and experienced upper gastrointestinal symptoms within a 10 days screening study, were referred for an upper endoscopy exam. The patients which refused to complete the endoscopy exam, were interviewed by the use of an open- ended translated and validated questionnaire, the Identification of Dyspepsia in General Population (IDGP questionnaire. A qualitative thematic analysis grounded on the theory of planned behavior was performed to reveal the reasons for patients' refusal, while socio-demographic predictors were also assessed. Results Nine hundred and ninety two patients were recorded, 159 of them (16% were found positive for dyspepsia and gastro-esophageal reflux disease according to the IDGP questionnaire. Out of the above, 131 (83.6% patients refused further investigation with endoscopy. Patients who refused upper endoscopy were predominantly female (87.8% (p = 0.036 and over the age of 50. The lack of severe symptoms, fear of pain, concerns of sedation, comorbidity and competing life demands were reported by patients as barriers to performing an endoscopic investigation. Conclusions Patients with dyspepsia in rural Greece tend to avoid upper gastrointestinal endoscopy, with two major axons considered to be the causes of patients' refusal: their beliefs towards endoscopy and their personal capability to cope with it. Future research examining reasons of low compliance should be carried out in combination with modern behavioral theories so as to investigate into the above.

The impact of cost recovery on electric utilities' Clean Air Act compliance strategies

International Nuclear Information System (INIS)

Bensinger, D.L.

1993-01-01

By 1995, over 200 electric power plant units in twenty one states must comply with Phase I of the acid rain requirements in Title IV of the 1990 Clean Air Act Amendments (CAAA). By the year 2000, an additional 2200 units must comply with the Title IV. Compliance costs are expected to necessitate significant electricity rate increases. In order to recover their compliance costs, utilities must file rate increase requests with state public utility commissions (PUC's), and undergo a rate proceeding involving public heatings. Because of the magnitude of cost and the complexity of compliance options, including interaction with Titles I and III of the CAAA, extensive PUC reviews of compliance strategies are likely. These reviews could become as adversarial as the nuclear prudence reviews of the 1980's. A lack of understanding of air pollution and the CAA by much of the general public and the flexibility of compliance options creates an environment conducive to adverse public reaction to the cost of complying with the Clean Air Act. Public attitudes toward pollution control technologies will be greatly affected by these hearings, and the early plant hearings will shape the utility rate making process under the Clean Air Act. Inadequate cost recovery due to constrained compliance strategies or adverse hearings could significantly inhibit industry willingness to invest in certain control technologies or advanced combustion technologies. There are already signs that Clean Air Act compliance will be the prudence issue of the 1990's for utilities, even where state statutes mandate particular compliance approaches. Specific actions should be undertaken now by the utility industry to improve the probability of sound cost recovery decisions, preserve compliance options, including multimedia strategies, and avoid the social- and cost-acceptance problems of nuclear power

Premedication with melatonin vs midazolam: efficacy on anxiety and compliance in paediatric surgical patients.

Science.gov (United States)

Impellizzeri, Pietro; Vinci, Enrica; Gugliandolo, Maria Cristina; Cuzzocrea, Francesca; Larcan, Rosalba; Russo, Tiziana; Gravina, Maria Rosaria; Arena, Salvatore; D'Angelo, Gabriella; Gitto, Eloisa; Montalto, Angela Simona; Alibrandi, Angela; Marseglia, Lucia; Romeo, Carmelo

2017-07-01

Preoperative anxiety is a major problem in paediatric surgical patients. Melatonin has been used as a premedicant agent and data regarding effectiveness are controversial. The primary outcome of this randomized clinical trial was to evaluate the effectiveness of oral melatonin premedication, in comparison to midazolam, in reducing preoperative anxiety in children undergoing elective surgery. As secondary outcome, compliance to intravenous induction anaesthesia was assessed. There were 80 children undergoing surgery randomly assigned, 40 per group, to receive oral midazolam (0.5 mg/kg, max 20 mg) or oral melatonin (0.5 mg/kg, max 20 mg). Trait anxiety of children and their mothers (State-Trait Anxiety Inventory) at admission, preoperative anxiety and during anaesthesia induction (Modified Yale Pre-operative Anxiety Scale), and children's compliance with anaesthesia induction (Induction Compliance Checklist) were all assessed. Children premedicated with melatonin and midazolam did not show significant differences in preoperative anxiety levels, either in the preoperative room or during anaesthesia induction. Moreover, compliance during anaesthesia induction was similar in both groups. This study adds new encouraging data, further supporting the potential use of melatonin premedication in reducing anxiety and improving compliance to induction of anaesthesia in children undergoing surgery. Nevertheless, further larger controlled clinical trials are needed to confirm the real effectiveness of melatonin as a premedicant agent in paediatric population. What is Known: • Although midazolam represents the preferred treatment as a premedication for children before induction of anaesthesia, it has several side effects. • Melatonin has been successfully used as a premedicant agent in adults, while data regarding effectiveness in children are controversial. What is New: • In this study, melatonin was as effective as midazolam in reducing children's anxiety in both

ADAPTIF CONSERVATION (ACM MODEL IN INCREASING FAMILY SUPPORT AND COMPLIANCE TREATMENT IN PATIENT WITH PULONARY TUBERCULOSIS IN SURABAYA CITY REGION

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Siti Nur Kholifah

2017-04-01

Full Text Available Introduction: Tuberculosis (TB in Indonesia is still health problem and the prevalence rate is high. Discontinuing medication and lack of family support are the causalities. Numbers of strategies to overcome are seemingly not succeeded. Roles and responsibilities of family nursing are crucial to improve participation, motivation of individual, family and community in prevention, including pulmonary tuberculosis. Unfortunately, models of pulmonary tuberculosis currently unavailable. The combination of adaptation and conservation in complementarily improving family support and compliance in medication is introduced in this study. Method: This research intended to analyze Adaptive Conservation Model (ACM in extending family support and treatment compliance. Modeling steps including model analysis, expert validation, field trial, implementation and recommending the output model. Research subject involves 15 families who implement family Assistance and supervision in Medication (ASM and other 15 families with ACM. Result: The study revealed ACM is better than ASM on the case of family support and medication compliances. It supports the role of environment as influential factor on individual health belief, values and decision making. Therefore, it is advised to apply ACM in enhancing family support and compliance of pulmonary TB patients. Discussion: Social and family supports to ACM group obtained by developing interaction through communication. Family interaction necessary to improve family support to pulmonary tuberculosis patients. And social support plays as motivator to maintain compliance on medication

SMEs’ corporate income tax compliance in Tanzania

OpenAIRE

Mahangila, Deogratius Ng'winula

2014-01-01

Many governments are struggling with inadequate tax revenue and increasing tax gaps. Consequently, changing behaviour of non-compliant taxpayers as small and medium enterprises (SMEs) because of their tax revenue potential and non-compliance behaviour is essential. This thesis examined the impact of corporate income tax penalty incidence, retributive justice, procedural justice, the interaction between retributive and procedural justice on corporate income tax compliance behaviour. Also, the ...

Impact of sink location on hand hygiene compliance for Clostridium difficile infection.

Science.gov (United States)

Zellmer, Caroline; Blakney, Rebekah; Van Hoof, Sarah; Safdar, Nasia

2015-04-01

Hand hygiene with soap and water after the care of a patient with Clostridium difficile infection is essential to reduce nosocomial transmission in an outbreak situation. Factors that may pose barriers to user completion of infection prevention measures, such as hand hygiene, are of interest. We undertook a quantitative study to evaluate the relationship between sink location and compliance with handwashing among health care workers and visitors in a surgical transplant unit. We found that placement of 2 more easily visible sinks in a surgical transplant unit was associated with improved adherence to handwashing. Published by Elsevier Inc.

Patients' information-seeking activity is associated with treatment compliance in inflammatory bowel disease patients.

Science.gov (United States)

Pittet, Valérie; Rogler, Gerhard; Mottet, Christian; Froehlich, Florian; Michetti, Pierre; de Saussure, Philippe; Burnand, Bernard; Vader, John-Paul

2014-06-01

Despite the chronic and relapsing nature of inflammatory bowel diseases (IBD), at least 30% to 45% of the patients are noncompliant to treatment. IBD patients often seek information about their disease. To examine the association between information-seeking activity and treatment compliance among IBD patients. To compare information sources and concerns between compliant and noncompliant patients. We used data from the Swiss IBD cohort study, and from a qualitative survey conducted to assess information sources and concerns. Crude and adjusted odds ratios (OR) for noncompliance were calculated. Differences in the proportions of information sources and concerns were compared between compliant and noncompliant patients. A total of 512 patients were included. About 18% (n = 99) of patients were reported to be noncompliant to drug treatment and two-thirds (n = 353) were information seekers. The OR for noncompliance among information seekers was 2.44 (95%CI: 1.34-4.41) after adjustment for confounders and major risk factors. General practitioners were 15.2% more often consulted (p = 0.019) among compliant patients, as were books and television (+13.1%; p = 0.048), whereas no difference in proportions was observed for sources such as internet or gastroenterologists. Information on tips for disease management were 14.2% more often sought among noncompliant patients (p = 0.028). No difference was observed for concerns on research and development on IBD or therapies. In Switzerland, IBD patients noncompliant to treatment were more often seeking disease-related information than compliant patients. Daily management of symptoms and disease seemed to be an important concern of those patients.

Barriers to compliance with evidence-based care in trauma.

Science.gov (United States)

Rayan, Nadine; Barnes, Sunni; Fleming, Neil; Kudyakov, Rustam; Ballard, David; Gentilello, Larry M; Shafi, Shahid

2012-03-01

We have preciously demonstrated that trauma patients receive less than two-thirds of the care recommended by evidence-based medicine. The purpose of this study was to identify patients least likely to receive optimal care. Records of a random sample of 774 patients admitted to a Level I trauma center (2006-2008) with moderate to severe injuries (Abbreviated Injury Scale score ≥3) were reviewed for compliance with 25 trauma-specific processes of care (T-POC) endorsed by Advanced Trauma Life Support, Eastern Association for the Surgery of Trauma, the Brain Trauma Foundation, Surgical Care Improvement Project, and the Glue Grant Consortium based on evidence or consensus. These encompassed all aspects of trauma care, including initial evaluation, resuscitation, operative care, critical care, rehabilitation, and injury prevention. Multivariate logistic regression was used to identify patients likely to receive recommended care. Study patients were eligible for a total of 2,603 T-POC, of which only 1,515 (58%) were provided to the patient. Compliance was highest for T-POC involving resuscitation (83%) and was lowest for neurosurgical interventions (17%). Increasing severity of head injuries was associated with lower compliance, while intensive care unit stay was associated with higher compliance. There was no relationship between compliance and patient demographics, socioeconomic status, overall injury severity, or daily volume of trauma admissions. Little over half of recommended care was delivered to trauma patients with moderate to severe injuries. Patients with increasing severity of traumatic brain injuries were least likely to receive optimal care. However, differences among patient subgroups are small in relation to the overall gap between observed and recommended care. II.

COMPLIANCY AS A MEDICO-SOCIAL AND ETHIC PROBLEM OF PEDIATRICS

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G. L. Mikirtichan

2012-01-01

Full Text Available The article represents the clinic-sociological analysis of the compliancy among pediatric patients and the estimation of various factors influence on the patients’ and their surroundings’ adherence to the treatment regimen. For the compliance assessment physicians, children with allergic dermatosis at the age of 13–18 years old (n =295 and their parents (n =270 were interrogated with the special questionnaires. Received data confirms that there is decrease in compliance among the pediatric patients and their patients. It is more significant in older girls than in boys.

Compliance with follow-up after cataract surgery in rural China.

Science.gov (United States)

Huang, Guofu; Crooms, Rita; Chen, Qianyun; Congdon, Nathan; He, Mingguang

2012-04-01

To evaluate reasons for non-compliance with post-cataract surgical follow-up in rural China, and assess the impact of incentives on improving compliance. Patients having undergone cataract surgery more than 3 months previously at cataract surgery training hospitals in Guangdong were invited by telephone and advertisements to a hospital-based study examination, with compensation for travel costs (US$7). Information on prior post-surgical follow up was collected by questionnaire at the hospital or by telephone. Logistic regression was used to assess predictors of post-operative attendance with or without compensation. Among 518 eligible patients, 426 (82.2%) underwent interviews and 342 (66.0%) attended the compensated study examination. Ninety nine participants (23.2%) reported previously returning for uncompensated follow-up ≥ 3 months post-operatively, and 225 (52.8%) had returned for any prior post-operative examination. Uncompensated follow-up at ≥ 3 months was associated with higher income (P = 0.037), and recalling instruction by a doctor to follow-up (P = 0.001), while age, gender, travel cost, and post-operative satisfaction and vision were not associated. Younger (P = 0.002) patients and those reporting being instructed to follow up (P = 0.008) were more likely to return for the compensated research examination. Among all interviewed subjects, only 170 (39.9%) reported knowing they were to return to hospital. Modest compensation, advertisements and telephone contact can increase medium-term follow-up rates after cataract surgery by three-fold. Better communication of specific targets for follow-up may improve follow-up compliance.

Social, Economic, and Medical Factors Associated With Solifenacin Therapy Compliance Among Workers Who Suffer From Lower Urinary Tract Symptoms.

Science.gov (United States)

Kosilov, Kirill Vladimirovich; Alexandrovich, Loparev Sergay; Gennadyevna, Kuzina Irina; Viktorovna, Shakirova Olga; Sergeevna, Zhuravskaya Natalia; Ivanovich, Ankudinov Ivan

2016-09-01

The prevalence of hyperactive-type lower urinary tract symptoms is 45.2%, with shares of overactive bladder (OAB) and urge incontinence (UI) symptoms of 10.7% and 8.2%, respectively. We investigated the possible impact of a wide range of social, economic, and medical factors on compliance with solifenacin treatment in the working population. Social, economic, and medical factors as well as the Overactive Bladder questionnaire - the OAB-q Short Form (OAB-q SF), bladder diaries, and uroflowmetry of 1,038 people who were administered solifenacin for a year were gathered from employer documentation. Among the subjects, 32% maintained their compliance with solifenacin treatment throughout the year. Only 65% of the patients had compliance exceeding 80%, and 17% of patients had compliance of ≥50%, yet less than 80% were still taking solifenacin 12 months after the beginning of this experiment. Working people whose compliance level was, at least, 80% had reliably higher (P≤0.01) average age, annual salary, and treatment efficacy, and a greater treatment satisfaction level, as well as a lack of satisfaction with other antimuscarinic treatments and higher rate of urge UI diagnosis. The same cohort also featured a lower level (P≤0.01) of caffeine abuse and lower share of salary spent purchasing solifenacin. This study has shown that compliance with solifenacin treatment is associated with a number of significant medical, social, and economic factors. The medical factors included the type of urination disorder, severity of incontinence symptoms, presence of side effects, treatment efficacy and patients' satisfaction with it, and experience using other antimuscarinic treatments. Among the social and economic factors, those with the strongest correlation to compliance were patient age, employment in medicine and education, annual income level, percentage of solifenacin purchase expenditures, and caffeine abuse. Factors with a weaker, but still significant, association were

Long-term Compliance and Satisfaction With Percutaneous Bone Conduction Devices in Patients With Congenital Unilateral Conductive Hearing Loss.

Science.gov (United States)

Nelissen, Rik C; Mylanus, Emmanuel A M; Cremers, Cor W R J; Hol, Myrthe K S; Snik, Ad F M

2015-06-01

Patients with congenital unilateral conductive hearing loss (UCHL) can either be watchful monitored or treated surgically through the fitting of a percutaneous bone conduction device (BCD) or, in some cases, atresia repair. The current study evaluated the long-term compliance and satisfaction with a percutaneous BCD in this specific population. Fifty-three consecutive patients with congenital UCHL treated with a percutaneous BCD in our tertiary referral center between 1998 and 2011 were identified. Clinical and audiological data were retrospectively gathered from the patients' files. The patients were interviewed by telephone about their current device usage status and were asked to complete the Speech, Spatial and Qualities of Hearing Scale (SSQ). Compliance with the BCD was 56.6% after a mean follow-up of 7 years. The mean age at implantation of the users (22 years) was significantly higher than that of the nonusers (10 years). The mean time of device usage before the patients stopped using the BCD was 5 years. The primary reasons mentioned for quitting the BCD were experiencing excess background noise and/or subjectively not receiving enough benefit. Objectively measured features of binaural processing affected by the BCD were found to correlate with long-term BCD usage. The SSQ revealed significant improvement in the aided condition compared with the nonaided condition in the users, in contrast to the nonusers. The current disappointing long-term compliance figures indicate the need for an even more careful and individualized approach with life-long follow-up when fitting BCDs in this specific population, especially in children.

36. The relationship between compliance and quality of life among ...

African Journals Online (AJOL)

Esem

Department of Psychology, University of Zambia. ABSTRACT ... Main outcomes: Compliance to treatment, impact about ... adolescents and also influenced positive behaviour .... Diabetes can affect an adolescent's emotions both directly ... increased risk of depression and anxiety, which may be ... Importance of compliance.

Compliance to antihypertensive drugs, salt restriction, exercise and control of systemic hypertension in hypertensive patients at abbottabad

International Nuclear Information System (INIS)

Ahmed, N.; Waqas, A.; Khaliq, M.A.

2008-01-01

Hypertension is one of the most important cardiovascular risk factor but its control is still a challenge for physicians all around the world. Control of blood pressure can reduce cardiovascular morbidity and mortality, so the compliance to antihypertensive drugs and life style modification play an important role for the control of hypertension. This analytical (cross-sectional) study was conducted to assess prevalence of control of hypertension among hypertensive patients and to assess the relationship of control of hypertension with factors like compliance to antihypertensive drugs, salt restriction and exercise among the hypertensive patients. This study was conducted at outpatient clinic of medicine at Shahina Jamil Hospital Abbottabad from April 2007 to September 2007. Eighty-nine patients seen in the outpatient clinic of medicine were enrolled in the study. All the patients with age 15 years or above, diagnosed as a case of systemic hypertension were included. Among eighty nine patients, 67 were female and 22 were male with mean age of 55.8+-13.4 years, mean systolic and diastolic blood pressure of 160+-28.6 and 97.8+-14.1 mm Hg respectively, and pulse rate of 85.9+-11.4 per minutes. Out of 89 patients, 25.8% were having controlled hypertension, 48.3% were compliant and 51.7% were not compliant to antihypertensive drugs, 55.1% were having salt restriction and 44.9% were having no salt restriction and 23.6% were used to do physical activity while 76.4% were not used to do physical activity. In group A consisted of patients with controlled hypertension, 95.7% patients were compliant to antihypertensive patients, 95.7% were having salt restriction and 43.5% were used to do physical activity. In group B consisted of patients with uncontrolled hypertension, only 31.8% were compliant to antihypertensive drugs, 40.9% were having salt restriction, 16.7% were used to do physical activity. Hypertension can be controlled if the hypertensive patients have good compliance

Compliance to antihypertensive therapy

International Nuclear Information System (INIS)

Almas, A.; Hameed, A.; Ahmed, B.; Islam, M.

2006-01-01

Objective: To determine compliance, factors affecting compliance to antihypertensive therapy and to compare compliant and non-compliant groups, in a tertiary care setting. Study Design: Analytical (cross-sectional) study. Place and Duration of Study: The outpatient clinics at the Aga Khan University from May 2004 to February 2005. Patients and Methods: Two hundred patients presenting to the outpatients clinic were included. All patients 18 years and above, who had stage 1 and 2 hypertension, had one clinic visit to a medicine clinic, 6 months prior to presentation and started on antihypertensive medicines, were included. Results: Sixty-six percent were males and 33.5 % were females. Mean age was 58.1 ( +- 12) years and mean duration of hypertension was 7.2 (+- 6.7) years. Fifty-seven percent were compliant and 43% were noncompliant. In the noncompliant group, 53.4 % had mild noncompliance, 24.4 % had severe non-compliance, while 22% had moderate noncompliance. Factors of noncompliance were 56.8% missed doses due to forgetfulness, 12.7% deliberately missed their doses, 11.6% could not take the medicine due to side effects, 10.4% did not take the dose due to increased number of tablets, 4.6% were not properly counseled by the physician and 3.48% did not take medicines due to cost issues. The mean systolic blood pressure was 126 +- 19.2 mmHg in the compliant group while it was 133 +- 16.5 mmHg in the noncompliant group (p-value 0.004). The mean diastolic blood pressure in the compliant group was 76 +- 11.9 mmHg, while in the noncompliant group it was 81.9 +- 10.9 mmHg (p-value 0.001). Conclusion: Compliance to antihypertensive therapy in a tertiary care center is significantly good. Forgetfulness was the major reason for noncompliance. The mean blood pressure control was better in the compliant group. (author)

Application of transtheoretical model to assess the compliance of chronic periodontitis patients to periodontal therapy

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Shilpa Emani

2016-01-01

Full Text Available Background: The present cross-sectional survey study was conducted to assess whether the transtheoretical model for oral hygiene behavior was interrelated in theoretically consistent directions in chronic periodontitis patients and its applicability to assess the compliance of the chronic periodontitis patients to the treatment suggested. Materials and Methods: A total of 150 chronic periodontitis patients were selected for the proposed study. The selected patients were given four questionnaires that were constructed based on transtheoretical model (TTM, and the patients were divided subsequently into five different groups (precontemplation, contemplation, preparation, action, and maintenance groups based on their answers to the questionnaires. Then, each patient was given four appointments for their periodontal treatment spaced with a time gap of 10 days. The patients visit for each appointments scheduled to them was documented. The results obtained were assessed using TTM. Results: Higher mean pro scores of decisional balance, self-efficacy, and process of change scores was recorded in maintenance group followed by action group, preparation group, contemplation group, and precontemplation group, respectively, whereas higher mean cons score was recorded in precontemplation group followed by contemplation group, preparation group, action group, and maintenance group, respectively. The difference scores of TTM constructs were statistically highly significant between all the five groups. Furthermore, the number of appointment attended in were significantly more than maintenance group followed by action group, preparation group, contemplation group, and precontemplation group. Conclusion: Within the limitations of this study, it can be concluded that transtheoretical model can be successfully applied to chronic periodontitis patients to assess their compliance to the suggested periodontal treatment.

Personal hand gel for improved hand hygiene compliance on the regional anesthesia team.

Science.gov (United States)

Parks, Colby L; Schroeder, Kristopher M; Galgon, Richard E

2015-12-01

Hand hygiene reduces healthcare-associated infections, and several recent publications have examined hand hygiene in the perioperative period. Our institution's policy is to perform hand hygiene before and after patient contact. However, observation suggests poor compliance. This is a retrospective review of a quality improvement database showing the effect of personal gel dispensers on perioperative hand hygiene compliance on a regional anesthesia team. Healthcare providers assigned to the Acute Pain Service were observed for compliance with hand hygiene policy during a quality improvement initiative. Provider type and compliance were prospectively recorded in a database. Team members were then given a personal gel dispensing device and again observed for compliance. We have retrospectively reviewed this database to determine the effects of this intervention. Of the 307 encounters observed, 146 were prior to implementing personal gel dispensers. Compliance was 34%. Pre- and post-patient contact compliances were 23 and 43%, respectively. For 161 encounters after individual gel dispensers were provided, compliance was 63%. Pre- and post-patient contact compliances were 53 and 72%, respectively. Improvement in overall compliance from 34 to 63% was significant. On the Acute Pain Service, compliance with hand hygiene policy improves when individual sanitation gel dispensing devices are worn on the person.

Adjuvant chemotherapy compliance is not superior after thoracoscopic lobectomy

DEFF Research Database (Denmark)

Licht, Peter B; Schytte, Tine; Jakobsen, Erik

2014-01-01

BACKGROUND: It is generally assumed that patient compliance with adjuvant chemotherapy is superior after video-assisted thoracoscopic surgery compared with open lobectomy for non-small cell lung cancer (NSCLC). The level of evidence for this assumption, however, is limited to single-institution, ......BACKGROUND: It is generally assumed that patient compliance with adjuvant chemotherapy is superior after video-assisted thoracoscopic surgery compared with open lobectomy for non-small cell lung cancer (NSCLC). The level of evidence for this assumption, however, is limited to single...... adjuvant chemotherapy and 121 (38.7%) completed all four cycles. Ordinal logistic regression revealed that chemotherapy compliance (none, partial, and full chemotherapy) was significantly reduced by the patient's age (p....02). No significant difference between video-assisted thoracoscopic surgery and thoracotomy was seen regarding chemotherapy compliance (p=0.17), number of chemotherapy cycles (p=0.60), or time from surgery to chemotherapy (p = 0.41). CONCLUSIONS: Complete national data do not support the widespread assumption...

A Process Improvement Evaluation of Sequential Compression Device Compliance and Effects of Provider Intervention.

Science.gov (United States)

Beachler, Jason A; Krueger, Chad A; Johnson, Anthony E

This process improvement study sought to evaluate the compliance in orthopaedic patients with sequential compression devices and to monitor any improvement in compliance following an educational intervention. All non-intensive care unit orthopaedic primary patients were evaluated at random times and their compliance with sequential compression devices was monitored and recorded. Following a 2-week period of data collection, an educational flyer was displayed in every patient's room and nursing staff held an in-service training event focusing on the importance of sequential compression device use in the surgical patient. Patients were then monitored, again at random, and compliance was recorded. With the addition of a simple flyer and a single in-service on the importance of mechanical compression in the surgical patient, a significant improvement in compliance was documented at the authors' institution from 28% to 59% (p < .0001).

Long-term Compliance with Oral 5-aminosalicylic Acid Therapy and Risk of Disease Recurrence in Patients with Ulcerative Colitis

DEFF Research Database (Denmark)

Prosberg, Michelle V; Vester-Andersen, Marianne K; Andersson, Mikael

2016-01-01

BACKGROUND: Noncompliance to long-term medical therapy is a well-known problem among patients treated for ulcerative colitis, but studies of long-term consequences in unselected patients are lacking. The authors aimed to determine the risk of recurrence according to long-term compliance with oral 5...

Decreased respiratory system compliance on the sixth day of mechanical ventilation is a predictor of death in patients with established acute lung injury

Directory of Open Access Journals (Sweden)

Matthay Michael A

2011-04-01

Full Text Available Abstract Background Multiple studies have identified single variables or composite scores that help risk stratify patients at the time of acute lung injury (ALI diagnosis. However, few studies have addressed the important question of how changes in pulmonary physiologic variables might predict mortality in patients during the subacute or chronic phases of ALI. We studied pulmonary physiologic variables, including respiratory system compliance, P/F ratio and oxygenation index, in a cohort of patients with ALI who survived more than 6 days of mechanical ventilation to see if changes in these variables were predictive of death and whether they are informative about the pathophysiology of subacute ALI. Methods Ninety-three patients with ALI who were mechanically ventilated for more than 6 days were enrolled in this prospective cohort study. Patients were enrolled at two medical centers in the US, a county hospital and a large academic center. Bivariate analyses were used to identify pulmonary physiologic predictors of death during the first 6 days of mechanical ventilation. Predictors on day 1, day 6 and the changes between day 1 and day 6 were compared in a multivariate logistic regression model. Results The overall mortality was 35%. In multivariate analysis, the PaO2/FiO2 (OR 2.09, p th day of acute lung injury. In addition, a decrease in respiratory system compliance between days 1 and days 6 (OR 2.14, p Conclusions A low respiratory system compliance on day 6 or a decrease in the respiratory system compliance between the 1st and 6th day of mechanical ventilation were associated with increased mortality in multivariate analysis of this cohort of patients with ALI. We suggest that decreased respiratory system compliance may identify a subset of patients who have persistent pulmonary edema, atelectasis or the fibroproliferative sequelae of ALI and thus are less likely to survive their hospitalization.

Compliance with the gluten-free diet: the role of locus of control in celiac disease.

Science.gov (United States)

Bellini, Anna; Zanchi, Chiara; Martelossi, Stefano; Di Leo, Grazia; Not, Tarcisio; Ventura, Alessandro

2011-03-01

To verify whether subjects with celiac disease (CD) have a different locus of control (LoC) compared with healthy subjects, and to evaluate the relationship between LoC and compliance with a prescribed gluten-free diet (GFD) and quality of life (QoL). We studied 156 subjects on a GFD (mean age, 10 years) and 353 healthy controls (mean age, 12 years). All subjects completed tests on the Nowicki-Strickland Locus of Control Scale; the subjects with CD also completed a questionnaire to measure compliance with dietary treatment and the disease's impact on QoL. There was no difference in LoC values between patients with CD and controls. Subjects with CD with good dietary compliance had a more internal LoC compared with those who were not compliant (P = .01). Patients who reported a satisfactory QoL had a more internal LoC compared with those who reported negative affects on QoL due to CD (P = .01). Our study confirms the usefulness of the LoC concept for identifying those patients who might be at risk for dietary transgression. Given the enhanced, psychological, and social well being that can result from adherence to a GFD, educational and psychological support can help internalize the LoC in those patients at risk for dietary transgression. Copyright © 2011 Mosby, Inc. All rights reserved.

Non-compliance with growth hormone treatment in children is common and impairs linear growth.

Directory of Open Access Journals (Sweden)

Wayne S Cutfield

Full Text Available BACKGROUND: GH therapy requires daily injections over many years and compliance can be difficult to sustain. As growth hormone (GH is expensive, non-compliance is likely to lead to suboptimal growth, at considerable cost. Thus, we aimed to assess the compliance rate of children and adolescents with GH treatment in New Zealand. METHODS: This was a national survey of GH compliance, in which all children receiving government-funded GH for a four-month interval were included. Compliance was defined as ≥ 85% adherence (no more than one missed dose a week on average to prescribed treatment. Compliance was determined based on two parameters: either the number of GH vials requested (GHreq by the family or the number of empty GH vials returned (GHret. Data are presented as mean ± SEM. FINDINGS: 177 patients were receiving GH in the study period, aged 12.1 ± 0.6 years. The rate of returned vials, but not number of vials requested, was positively associated with HVSDS (p < 0.05, such that patients with good compliance had significantly greater linear growth over the study period (p<0.05. GHret was therefore used for subsequent analyses. 66% of patients were non-compliant, and this outcome was not affected by sex, age or clinical diagnosis. However, Maori ethnicity was associated with a lower rate of compliance. INTERPRETATION: An objective assessment of compliance such as returned vials is much more reliable than compliance based on parental or patient based information. Non-compliance with GH treatment is common, and associated with reduced linear growth. Non-compliance should be considered in all patients with apparently suboptimal response to GH treatment.

The importance of clinical monitoring for compliance with Continuous Positive Airway Pressure.

Science.gov (United States)

Pelosi, Lucas B; Silveira, Mariana L C; Eckeli, Alan L; Chayamiti, Emilia M P C; Almeida, Leila A; Sander, Heidi H; Küpper, Daniel S; Valera, Fabiana C P

Obstructive sleep apnea syndrome is currently a public health problem of great importance. When misdiagnosed or improperly treated, it can lead to serious consequences on patients' quality of life. The gold standard treatment for cases of obstructive sleep apnea syndrome, especially in mild to severe and symptomatic cases, is continuous positive airway pressure therapy. Compliance with continuous positive airway pressure therapy is directly dependent on the active participation of the patient, which can be influenced by several factors. The objective of this study is to describe the factors related to compliance with continuous positive airway pressure therapy, and to analyze which associated factors directly influence the efficiency of the treatment. Patients who received continuous positive airway pressure therapy through the Municipal Health Department of the city of Ribeirão Preto were recruited. A structured questionnaire was administered to the patients. Compliance with continuous positive airway pressure therapy was assessed by average hours of continuous positive airway pressure therapy usage per night. Patients with good compliance (patients using continuous positive airway pressure therapy ≥4h/night) were compared to those with poor compliance (patients using <4h/night). 138 patients were analyzed: 77 (55.8%) were considered compliant while 61 (44.2%) were non-compliant. The comparison between the two groups showed that regular monitoring by a specialist considerably improved compliance with continuous positive airway pressure therapy (odds ratio, OR=2.62). Compliance with continuous positive airway pressure therapy is related to educational components, which can be enhanced with continuous and individualized care to patients with obstructive sleep apnea syndrome. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Quality of life, compliance, safety and effectiveness in fit older metastatic colorectal patients with cancer treated in first-line with chemotherapy plus cetuximab: A restrospective analysis from the ObservEr study.

Science.gov (United States)

Rosati, Gerardo; Pinto, Carmine; Di Fabio, Francesca; Chiara, Silvana; Lolli, Ivan R; Ruggeri, Enzo M; Ciuffreda, Libero; Ferrara, Raimondo; Antonuzzo, Lorenzo; Adua, Daniela; Racca, Patrizia; Bilancia, Domenico; Benincasa, Elena; Stroppolo, Maria Elena; Di Costanzo, Francesco

2018-05-01

The influence of age (<70 years and ≥70 years) was retrospectively studied on the quality of life (QoL), incidence of side effects (including skin reactions) and efficacy of chemotherapy plus cetuximab in patients with KRAS wild type (WT) metastatic colorectal cancer (mCRC). 225 patients of the Observed study (PS 0-1) were retrieved based on age (< 70 and ≥70 years) and evaluated through EORTC QLQ-C30 and DLQI questionnaires. The two patient groups (141 < 70 and 84 ≥ 70 years, respectively) were balanced with no differences in any of the clinical and pathological characteristics considered. Both groups underwent similar type of first-line chemotherapy plus cetuximab, treatment duration and compliance. Cetuximab therapy caused similar incidence of side effects and impact on QoL in older and younger patients. No difference was observed in progression free survival (PFS) and in disease control rates between the two patient populations. Median overall survival (OS) was higher in patients <70 (27 months, 95% CI: 22.7-31.27) than in patients ≥70 (19 months, 95% CI: 14.65-23.35) (p = 0.002), which is likely due to higher proportions of metastatic resection (27.0% vs 8.3%; p = 0.001) and utilization of second-line therapy in younger group (58.9% vs 42.9%; p = 0.028). The current data suggest that fit older patients with mCRC can be safely treated with a cetuximab-based therapy, as QoL and safety profile do not seem to be affected by age. In addition, age did not impact the choice of chemotherapy to be associated to cetuximab and treatment compliance. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Compliance with Antimalaria Chemoprophylaxis in a Combat Zone

Science.gov (United States)

Brisson, Michael; Brisson, Paul

2012-01-01

Compliance with malaria chemoprophylaxis by military service members (MSMs) is notoriously low, ranging from 30% to 56%. Our objective was to determine the rate of compliance and reasons for non-compliance with malaria chemoprophylaxis among healthy US MSMs in Afghanistan. An eight-question, anonymous online survey was used to collect data regarding the compliance of healthy MSMs with malaria chemoprophylaxis. E-mail surveys were sent to 1,200 MSMs; 528 (44%) MSMs completed the survey. One-time daily doxycycline was the most commonly prescribed chemoprophylaxis (90%); 60% (N = 318) responded that they were compliant with their chemoprophylaxis as prescribed, whereas 40% (N = 221) indicated that they were not compliant. Compliance with daily dosing was 61% and weekly dosing was 38%. The most common reasons for non-compliance were gastrointestinal effects (39%), forgetfulness (31%), and low perception of risk (24%). Malaria chemoprophylaxis compliance by healthy MSMs in Afghanistan is poor. Side effects, forgetfulness, and lack of education are contributing factors. Commanders bear the primary responsibility for the health of their soldiers, and the individual MSM bears personal responsibility; however, additional public health interventions could possibly have a positive impact on prevention. PMID:22492140

The role of patient isolation and compliance with isolation practices in the control of nosocomial MRSA in acute care.

Science.gov (United States)

Halcomb, Elizabeth J; Griffiths, Rhonda; Fernandez, Ritin

2008-06-01

Background  Nosocomial infection remains the most common complication of hospitalisation. Despite infection control efforts, nosocomial methicillin resistant Staphylococcus aureus (MRSA) transmission continues to rise. Various isolation practices are used to minimise MRSA transmission in acute care. However, the effectiveness of these practices has seldom been evaluated. Objectives  This review sought to evaluate the efficacy of isolation practices in minimising MRSA transmission in the acute hospital setting and explore staff, visitor and patient compliance with isolation practices. This review updates a review published in 2002. Search strategy  A systematic search for relevant published or unpublished English language literature was undertaken using electronic databases, the reference lists of retrieved papers and the Internet. This extended the search published in the original review. Databases searched included: Medline, CINAHL, EMBASE, Cochrane Library and Joanna Briggs Institute Evidence Library. Selection criteria  All English language research reports published between 1990 and August 2005 that focused on the role of isolation practices on the nosocomial transmission of MRSA in adult, paediatric or neonatal acute care settings were eligible for inclusion in the review. Studies that evaluated multiple infection control strategies or control of MRSA outbreaks were excluded. The main outcome of interest was the incidence of new cases of MRSA. The secondary outcome was staff, visitor and patient compliance with the isolation practices. Data collection and analysis  Two reviewers assessed each paper against the inclusion criteria and a validated quality scale. Data extraction was undertaken using a tool designed specifically for this review. Statistical comparisons of findings were not possible, so findings are presented in a narrative form. Results  Seven studies met the inclusion criteria. Given the small number of included studies and variable

Patient satisfaction with psychotropic drugs: sensitivity to change and relationship to clinical status, quality-of-life, compliance and effectiveness of treatment. Results from a nation-wide 6-month prospective study.

Science.gov (United States)

Gasquet, Isabelle; Tcherny-Lessenot, Stéphanie; Lépine, Jean-Pierre; Falissard, Bruno

2006-12-01

To see if patient satisfaction with psychotropics (PSP) could be used as a patient-oriented outcome variable in the evaluation of PSP drugs in clinical epidemiological studies, relationships between PSP, clinical status, QoL, compliance and the type of antipsychotic were analyzed. Elements of validation of PSP were also assessed. In a 6-month prospective study, 933 schizophrenic outpatients with initiation or change to their antipsychotic treatment were enrolled. Psychiatrists completed five CGI-SCH scales (positive, negative, cognitive, depressive and global), hospitalization, compliance, and prescription variables. Patients completed PSP, EuroQoL scales, sexual function and compliance variables. A satisfactory structural equation model was obtained showing significant relationships PSP/compliance (coef.=0.16), QoL/PSP (coef.=0.37), clinical status/QoL (coef.=0.61), clinical status/compliance (coef.=0.09). Patients receiving olanzapine were more satisfied than patients receiving other atypicals (coef.=012) and had better clinical status than patients treated with typicals (coef.=0.08). Evolution of PSP was related to clinical status, QoL, and continuation of treatment (all Pmeasure was not sufficiently sensitive to change. Multi-item questionnaires evaluating different dimensions are needed.

Difficulties related to compliance with gluten-free diet by patients with coeliac disease living in Upper Silesia

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Magdalena Ferster

2015-12-01

Full Text Available Compliance with gluten-free diet is the basic method for controlling coeliac disease in patients regardless of their age. It may be, however, challenging to follow in daily life. The prevalence of the disease (approx. 1% of European population is affected makes it an important public health problem. Aim of the study: Investigating the difficulties and obstacles related to compliance with gluten-free diet by children and adult patients living in Upper Silesia region. Material and method: The study included 30 mothers of children with coeliac disease (Group I and 30 adult coeliac disease patients (Group II. The patients kept a gluten-free diet. Data were obtained in an anonymous survey drawn up for the purpose of this study, conducted in 2010. Results: The respondents reported a very limited access to gluten-free meals in mass-catering establishments (76.7% of the participants in Group II, and 70% children at nurseries, kindergartens and schools, lack of adequate food product labelling (93% in both groups, difficulties experienced in social life (60% in Group II, difficulties experienced when travelling within Poland (76.7% in Group II and abroad (83.3% in Group II, and no existing reimbursement plan for the high diet costs (16.7% in Group I vs. 26.7% in Group II. Conclusions: 1 The necessity of compliance with gluten-free diet causes a lot of difficulties in everyday life to patients with coeliac disease and parents of children suffering from coeliac disease. Proper treatment requires their identification by the attending physician. 2 Improved food labelling as regards gluten content as well as inclusion of gluten-free meals in the menu of food-serving establishments will contribute to improved quality of life of children and adults suffering from coeliac disease. 3 Associations of patients on a gluten-free diet should continue their efforts to have high costs of this diet refunded.

Effect of Safety Education on Knowledge of and Compliance with ...

African Journals Online (AJOL)

Objective: Compliance with road safety signs is important in the reduction of motorcycle accidents. The aim of this study was to implement health education intervention and assess its impact on the knowledge of and compliance with road safety signs among commercial motorcyclists in Uyo, Southern Nigeria. Method: This ...

Estimation of the compliance of the human capacitance vessels using radionuclide plethysmography. Comparison of the compliance with the NYHA functional classification

Energy Technology Data Exchange (ETDEWEB)

Takatsu, Hisato; Gotoh, Kohshi; Suzuki, Takahiko and others

1988-01-01

Radionuclide (RN) plethysmography with Tc-99m RBC was performed in 32 patients with heart disease with the purpose of obtaining compliance of human capacitance vessels. When equilibrium was achieved, RN counts of the region of interest and venous pressure in the forearm were sequentially recorded when the vein of the upper arm was occluded with a cuff inflator. Based on the RN count-venous pressure curve, the specific compliance of the forearm vein and compliance of systemic venous system (SVS) were estimated. In the group of the NYHA functional classification I, which is recognized as hemodynamically ''normal'', the compliance of SVS was 129.8 +- 25.9 ml center dot mmHg/sup -1/ (mean +- SD; n = 9). In comparing the NYHA functional classification and the compliance of SVS, the compliance of SVS was significantly decreased for severer heart failure. Tongue administration of nitroglycerin (0.6 mg) significantly increased the compliance of SVS (p < 0.01). (Namekawa, K.).

A multifaceted hospital-wide intervention increases hand hygiene compliance.

Science.gov (United States)

Patel, B; Engelbrecht, H; McDonald, H; Morris, V; Smythe, W

2016-03-07

Hand hygiene is an important and basic practice that should be used by all healthcare staff to protect both themselves and their patients against infection. Unfortunately hand hygiene compliance remains poor. To show an improvement in hand hygiene compliance using a multifaceted approach. This was a quasiexperimental pre-post intervention study design with a number of standardised interventions to promote hand hygiene. The World Health Organization hand hygiene multimodal (five-step) intervention approach was used. The study ran from June 2015 to August 2015 in 11 selected wards of a 975-bed tertiary and quaternary care public hospital (Groote Schuur Hospital, Cape Town, South Africa). The outcome was to assess improvement in hand hygiene compliance monthly over the 3 months, compared with non-intervention wards and compared with the wards' own performance measured in 2014. The study included both descriptive and analytical components. Post intervention, hand hygiene compliance showed a statistically significant improvement for before patient contact from 34% in 2014 to 76% in 2015 (p<0.05) and for after patient contact from 47% in 2014 to 82% in 2015 (p<0.05). The intervention improved hand hygiene compliance and can easily be replicated in other wards, resulting in sustaining a culture of hand hygiene improvement and behavioural change throughout the hospital.

Perception on justice, trust and tax compliance behavior in Malaysia

Directory of Open Access Journals (Sweden)

Sellywati Mohd Faizal

2017-09-01

Full Text Available The relationship between justice and trust with tax compliance behavior in Malaysia was studied. Previous studies have acknowledged the perception that justice does have an impact on tax compliance. This study distinguishes justice into procedural justice, distributive justice, and retributive justice. Therefore, this study examined the effect of these three types of justice on tax compliance. Trust also influences the act of tax compliance and it also has a relationship to the element of justice. Perceptions from individual taxpayers were gathered using questionnaires from previous studies. The findings suggest only procedural justice and trust affect tax compliance and procedural justice was positively and significantly correlated to trust. However, trust does not mediate the relationship between justice and compliance. This research will contribute to the tax literature with widened scope on justice in Malaysia.

Higher Education IT Compliance through the Prism of Risk Controls

Science.gov (United States)

Feehan, Patrick J.

2013-01-01

In 2013, compliance issues march, unceasingly, through every aspect of higher education. Yet the intricacies of privacy, information security, data governance, and IT policy as compliance and risk areas within the IT organization can reverberate and impact every other department within the higher education institution. The primary focus is always…

Compliance to consensus recommendations, surgeon's experience, and introduction of a quality assurance and management program: influence on therapy of early-stage ovarian carcinoma.

Science.gov (United States)

Kommoss, Stefan; Harter, Philipp; Traut, Alexander; Strutas, Deivis; Riegler, Nina; Buhrmann, Christine; Gomez, Ruth; du Bois, Andreas

2009-05-01

State-of-the-art surgical staging and adjuvant chemotherapy in early-stage ovarian carcinoma have an impact on patient's outcome, but compliance to guidelines and consensus recommendations is still poor. This article reports on our results before and after introduction of a quality assurance and management program in our clinic in 2001. Patients with ovarian carcinoma limited to the pelvis who underwent primary surgery in our hospital from 1997 to October 2007 were eligible for this study. Univariate and multivariate logistic regression analyses were performed to evaluate the impact of compliance with our management program and physician's experience in ovarian carcinoma surgery on achieving both standards of surgery and chemotherapy. In a total of 117 women, a significant impact on adherence to guideline-defined comprehensive surgical staging was found for poor Eastern Cooperative Oncology Group performance status (odds ratio [OR], 22.16; confidence interval [CI] 3.2-152.0; P = 0.002) and year of surgery before 2001 (OR, 47.60; CI, 9.20-245.22; P grading less than G3 (OR, 4.14; CI, 1.20-14.22; P = 0.02) was a statistically significant predictor for receiving standard adjuvant chemotherapy. Survival analyses showed a trend toward improved survival for patients having received guideline-adopted therapy, but event numbers were too low for adequate analyses. The introduction of a quality assurance program for treatment of ovarian carcinoma represents a major improvement of patient care. It led to a higher compliance with consensus recommendations and showed already a trend toward improved outcome. Further outcome research should focus on methods for implementation of guidelines in daily practice in institutions caring for patients with ovarian carcinoma.

Drainage of pleural effusion in mechanically ventilated patients: time to measure chest wall compliance?

Science.gov (United States)

Formenti, Paolo; Umbrello, Michele; Piva, Ilaria R; Mistraletti, Giovanni; Zaniboni, Matteo; Spanu, Paolo; Noto, Andrea; Marini, John J; Iapichino, Gaetano

2014-10-01

Pleural effusion (PE) is commonly encountered in mechanically ventilated, critically ill patients and is generally addressed with evacuation or by fluid displacement using increased airway pressure (P(AW)). However, except when massive or infected, clear evidence is lacking to guide its management. The aim of this study was to investigate the effect of recruitment maneuvers and drainage of unilateral PE on respiratory mechanics, gas exchange, and lung volume. Fifteen critically ill and mechanically ventilated patients with unilateral PE were enrolled. A 3-step protocol (baseline, recruitment, and effusion drainage) was applied to patients with more than 400 mL of PE, as estimated by chest ultrasound. Predefined subgroup analysis compared patients with normal vs reduced chest wall compliance (C(CW)). Esophageal and P(AW)s, respiratory system, lung and C(CW)s, arterial blood gases, and end-expiratory lung volumes were recorded. In the whole case mix, neither recruitment nor drainage improved gas exchange, lung volume, or tidal mechanics. When C(CW) was normal, recruitment improved lung compliance (81.9 [64.8-104.1] vs 103.7 [91.5-111.7] mL/cm H2O, P drainage had no significant effect on total respiratory system mechanics or gas exchange, although it measurably increased lung volume (1717 vs 2150 mL, P drainage improved respiratory system and C(CW)s as well as lung volume (42.7 [38.9-50.0] vs 47.0 [43.8-63.3], P Drainage of a moderate-sized effusion should not be routinely performed in unselected population of critically ill patients. We suggest that measurement of C(CW) may help in the decision-making process. Copyright © 2014 Elsevier Inc. All rights reserved.

Specific efficacy expectations mediate exercise compliance in patients with COPD.

Science.gov (United States)

Kaplan, R M; Atkins, C J; Reinsch, S

1984-01-01

Social learning theory has generated two different approaches for the assessment of expectancies. Bandura argues that expectancies are specific and do not generalize. Therefore, he prefers measures of specific efficacy expectations. Others endorse the role of generalized expectancies measured by locus of control scales. The present study examines specific versus generalized expectancies as mediators of changes in exercise behavior among 60 older adult patients with Chronic Obstructive Pulmonary Disease. The patients were given a prescription to increase exercise and randomly assigned to experimental groups or control groups. All groups received attention but only experimental groups received training to increase their exercise. After 3 months, groups given specific training for compliance with walking significantly increased their activity in comparison to the control group receiving only attention. These changes were mediated by changes in perceived efficacy for walking, with efficacy expectations for other behaviors changing as a function of their similarity to walking. A generalized health locus of control expectancy measure was less clearly associated with behavior change. The results are interpreted as supporting Bandura's version of social theory.

The demand for statin: the effect of copay on utilization and compliance.

Science.gov (United States)

Thiebaud, Patrick; Patel, Bimal V; Nichol, Michael B

2008-01-01

Increasing drug costs in the US have prompted employers and insurers alike to turn to higher drug copays for cost containment. The effect of rising copays on compliance with statins (HMG-CoA reductase inhibitors) treatment has received surprisingly little attention in the applied literature. This paper uses pharmacy claims data from a commercially insured adult population to determine the effect of copay change on compliance at the individual level. Fixed effect logit and Poisson regressions estimate the effect of copays on monthly likelihood of high compliance and average monthly days of supply respectively. Higher copays reduce compliance among statin users, with less compliant patients responding more strongly to copay change than compliant patients. These results suggest that specific financial incentives given to less compliant patients could improve compliance with statin treatment at a relatively low cost. Copyright (c) 2007 John Wiley & Sons, Ltd.

Updated ozone absorption cross section will reduce air quality compliance

Directory of Open Access Journals (Sweden)

E. D. Sofen

2015-12-01

et al. (2015 as 1.8 % smaller than the accepted value (Hearn, 1961 used for the preceding 50 years. Thus, ozone measurements that applied the older cross section systematically underestimate the amount of ozone in air. We correct the reported historical surface data from North America and Europe and find that this modest change in cross section has a significant impact on the number of locations that are out of compliance with air quality regulations if the air quality standards remain the same. We find 18, 23, and 20 % increases in the number of sites that are out of compliance with current US, Canadian, and European ozone air quality health standards for the year 2012. Should the new cross-section value be applied, it would impact attainment of air quality standards and compliance with relevant clean air acts, unless the air quality target values themselves were also changed proportionately. We draw attention to how a small change in gas metrology has a global impact on attainment and compliance with legal air quality standards. We suggest that further laboratory work to evaluate the new cross section is needed and suggest three possible technical and policy responses should the new cross section be adopted.

Impacts and Compliance Implementation Plans and Required Deviations for Toxic Substance Control Act (TSCA) Regulation of Double Shell Tanks (DST)

International Nuclear Information System (INIS)

MULKEY, C.H.

2000-01-01

In May 2000, the U.S. Department of Energy, Office of River Protection (DOE-ORP) and the U.S. Environmental Protection Agency (EPA) held meetings regarding the management of polychlorinated biphenyls (PCBs) in the Hanford tank waste. It was decided that the radioactive waste currently stored in the double-shell tanks (DSTs) contain waste which will become subject to the Toxic Substance Control Act (TSCA) (40 CFR 761). As a result, DOE-ORP directed the River Protection Project tank farm contractor (TFC) to prepare plans for managing the PCB inventory in the DSTs. Two components of the PCB management plans are this assessment of the operational impacts of TSCA regulation and the identifications of deviations from TSCA that are required to accommodate tank farm unique limitations. This plan provides ORP and CH2M HILL Hanford Group, Inc. (CHG) with an outline of TSCA PCB requirements and their applicability to tank farm activities, and recommends a compliance/implementation approach. Where strict compliance is not possible, the need for deviations from TSCA PCB requirements is identified. The purpose of assembling this information is to enhance the understanding of PCB management requirements, identify operational impacts and select impact mitigation strategies. This information should be useful in developing formal agreements with EPA where required

Impact of smoke-free housing policy lease exemptions on compliance, enforcement and smoking behavior: A qualitative study

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Pamela Kaufman

2018-06-01

Full Text Available This paper investigates the impacts of smoke-free housing policies on compliance, enforcement and smoking behavior. From 2012 to 2014, we studied two affordable housing providers in Canada with comprehensive smoke-free policies: Waterloo Regional Housing that required new leases to be non-smoking and exempted existing leases, and Yukon Housing Corporation that required all leases (existing and new to be non-smoking. Focus groups and key informant interviews were conducted with 31 housing and public health staff involved in policy development and implementation, and qualitative interviews with 56 tenants. Both types of smoke-free policies helped tenants to reduce and quit smoking. However, exempting existing tenants from the policy created challenges for monitoring compliance and enforcing the policy, and resulted in ongoing tobacco smoke exposure. Moreover, some new tenants were smoking in exempted units, which undermined the policy and maintained smoking behavior. Our findings support the implementation of complete smoke-free housing policies that do not exempt existing leases to avoid many of the problems experienced by staff and tenants. In jurisdictions where exempting existing leases is still required by law, adequate staff resources for monitoring and enforcement, along with consistent and clear communication (particularly regarding balconies, patios and outdoor spaces will encourage compliance. Keywords: Smoke-free policy, Housing, Tobacco smoke pollution, Smoking cessation, Qualitative research

Assessing Compliance With Mercaptopurine Treatment in Younger Patients With Acute Lymphoblastic Leukemia in First Remission | Division of Cancer Prevention

Science.gov (United States)

This randomized phase III trial studies compliance to a mercaptopurine treatment intervention compared to standard of care in younger patients with acute lymphoblastic leukemia in remission. Assessing ways to help patients who have acute lymphoblastic leukemia to take their medications as prescribed may help them in taking their medications more consistently and may improve

28 CFR 73.4 - Partial compliance not deemed compliance.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Partial compliance not deemed compliance. 73.4 Section 73.4 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) NOTIFICATIONS TO THE ATTORNEY GENERAL BY AGENTS OF FOREIGN GOVERNMENTS § 73.4 Partial compliance not deemed compliance. The fact...

Increased arterial compliance in decompensated cirrhosis

DEFF Research Database (Denmark)

Henriksen, Jens Henrik Sahl; Møller, Søren; Schifter, S

1999-01-01

of the vasodilator, calcitonin gene-related peptide (CGRP) and mean arterial blood pressure (MAP). METHODS: Arterial compliance (COMPart=deltaV/deltaP) was determined as the stroke volume relative to pulse pressure (i.e. systolic minus diastolic blood pressure) during a haemodynamic evaluation of portal hypertension......BACKGROUND/AIMS: In patients with cirrhosis, the systemic circulation is hyperdynamic with low arterial blood pressure and reduced systemic vascular resistance. The present study was undertaken to estimate the compliance of the arterial tree in relation to severity of cirrhosis, circulating level...... of CGRP (r=0.34, parterial compliance in cirrhosis is directly related to the severity of the disease and to the elevated level of circulating vasodilator peptide CGRP, and inversely related...

GPs' Perceptions of Cardiovascular Risk and Views on Patient Compliance

DEFF Research Database (Denmark)

Barfoed, Benedicte Marie Lind; Jarbøl, Dorte Ejg; Paulsen, Maja Skov

2015-01-01

Objective. General practitioners' (GPs') perception of risk is a cornerstone of preventive care. The aims of this interview study were to explore GPs' professional and personal attitudes and experiences regarding treatment with lipid-lowering drugs and their views on patient compliance. Methods....... The material was drawn from semistructured qualitative interviews. We sampled GPs purposively from ten selected practices, ensuring diversity of demographic, professional, and personal characteristics. The GPs were encouraged to describe examples from their own practices and reflect on them and were informed...... that the focus was their personal attitudes and experiences. Systematic text condensation was applied for analysis in order to uncover the concepts and themes. Results. The analysis revealed the following 3 main themes: (1) use of cardiovascular guidelines and risk assessment tools, (2) strategies for managing...

Tax Compliance Inventory: TAX-I Voluntary tax compliance, enforced tax compliance, tax avoidance, and tax evasion

Science.gov (United States)

Kirchler, Erich; Wahl, Ingrid

2010-01-01

Surveys on tax compliance and non-compliance often rely on ad hoc formulated items which lack standardization and empirical validation. We present an inventory to assess tax compliance and distinguish between different forms of compliance and non-compliance: voluntary versus enforced compliance, tax avoidance, and tax evasion. First, items to measure voluntary and enforced compliance, avoidance, and evasion were drawn up (collected from past research and newly developed), and tested empirically with the aim of producing four validated scales with a clear factorial structure. Second, findings from the first analyses were replicated and extended to validation on the basis of motivational postures. A standardized inventory is provided which can be used in surveys in order to collect data which are comparable across research focusing on self-reports. The inventory can be used in either of two ways: either in its entirety, or by applying the single scales independently, allowing an economical and fast assessment of different facets of tax compliance. PMID:20502612

Tax Compliance Inventory: TAX-I Voluntary tax compliance, enforced tax compliance, tax avoidance, and tax evasion.

Science.gov (United States)

Kirchler, Erich; Wahl, Ingrid

2010-06-01

Surveys on tax compliance and non-compliance often rely on ad hoc formulated items which lack standardization and empirical validation. We present an inventory to assess tax compliance and distinguish between different forms of compliance and non-compliance: voluntary versus enforced compliance, tax avoidance, and tax evasion. First, items to measure voluntary and enforced compliance, avoidance, and evasion were drawn up (collected from past research and newly developed), and tested empirically with the aim of producing four validated scales with a clear factorial structure. Second, findings from the first analyses were replicated and extended to validation on the basis of motivational postures. A standardized inventory is provided which can be used in surveys in order to collect data which are comparable across research focusing on self-reports. The inventory can be used in either of two ways: either in its entirety, or by applying the single scales independently, allowing an economical and fast assessment of different facets of tax compliance.

CROSS COMPLIANCE AND COMPETITIVENESS OF THE EUROPEAN BEEF AND PIG SECTOR

OpenAIRE

de Roest, Kees; Jongeneel, Roelof A.; Dillen, Koen; Winsten, Jonathan R.

2008-01-01

Beef and pig production are important sectors affected by the cross-compliance policy. Full compliance with SMRs and GAECs generates costs and benefits which may have an impact on the competitiveness of these sectors on the world market. Compliance with the Nitrate Directive, animal identification and registration requirements and animal welfare standards can give rise to non-negligible cost of production increases at individual farm level and at sector level. Additional costs can be relevant...

Compliance and Noncompliance in Anxious, Aggressive, and Socially Competent Children: The Impact of the Child's Game on Child and Maternal Behavior

Science.gov (United States)

Kotler, Julie S.; McMahon, Robert J.

2004-01-01

The present study examined the impact of the Child's Game parenting intervention (Forehand & McMahon, 1981; McMahon & Forehand, 2003) on child compliance, noncompliance, and aversive behavior in 3 groups of 20 nonreferred preschool children identified as high on dimensions of anxiety/withdrawal, anger/aggression, or social competence. The impact…

42 CFR 35.2 - Compliance with hospital rules.

Science.gov (United States)

2010-10-01

... EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.2 Compliance with hospital rules. All patients and visitors in stations and hospitals of the Service are expected to comply with the rules and instructions... 42 Public Health 1 2010-10-01 2010-10-01 false Compliance with hospital rules. 35.2 Section 35.2...

Understanding how to maintain compliance in the current regulatory climate

International Nuclear Information System (INIS)

Bignell, D.T.; Burns, R.

1995-01-01

High level radioactive waste facilities must maintain compliance with all regulatory requirements, even those requirements that have been promulgated after the facility was placed into operation. Facilities must aggressively pursue compliance because environmental laws often impose strict liability for violations; therefore, an honest mistake is no defense. Radioactive waste management is constantly under the public microscope, particularly those facilities that handle high-level radioactive waste. The Savannah River Site has effectively met the challenges of regulatory compliance in its HLRW facilities and plans are being formulated to meet future regulatory requirements as well. Understanding, aggressively achieving, and clearly demonstrating compliance is essential for the continued operations of radioactive waste management facilities. This paper examines how HLRW facilities are impacted by regulatory requirements and how compliance in this difficult area is achieved and maintained

Protocol compliance and time management in blunt trauma resuscitation.

Science.gov (United States)

Spanjersberg, W R; Bergs, E A; Mushkudiani, N; Klimek, M; Schipper, I B

2009-01-01

To study advanced trauma life support (ATLS) protocol adherence prospectively in trauma resuscitation and to analyse time management of daily multidisciplinary trauma resuscitation at a level 1 trauma centre, for both moderately and severely injured patients. All victims of severe blunt trauma were consecutively included. Patients with a revised trauma score (RTS) of 12 were resuscitated by a "minor trauma" team and patients with an RTS of less than 12 were resuscitated by a "severe trauma" team. Digital video recordings were used to analyse protocol compliance and time management during initial assessment. From 1 May to 1 September 2003, 193 resuscitations were included. The "minor trauma" team assessed 119 patients, with a mean injury severity score (ISS) of 7 (range 1-45). Overall protocol compliance was 42%, ranging from 0% for thoracic percussion to 93% for thoracic auscultation. The median resuscitation time was 45.9 minutes (range 39.7-55.9). The "severe team" assessed 74 patients, with a mean ISS of 22 (range 1-59). Overall protocol compliance was 53%, ranging from 4% for thoracic percussion to 95% for thoracic auscultation. Resuscitation took 34.8 minutes median (range 21.6-44.1). Results showed the current trauma resuscitation to be ATLS-like, with sometimes very low protocol compliance rates. Timing of secondary survey and radiology and thus time efficiency remains a challenge in all trauma patients. To assess the effect of trauma resuscitation protocols on outcome, protocol adherence needs to be improved.

Hierarchical Compliance Control of a Soft Ankle Rehabilitation Robot Actuated by Pneumatic Muscles.

Science.gov (United States)

Liu, Quan; Liu, Aiming; Meng, Wei; Ai, Qingsong; Xie, Sheng Q

2017-01-01

Traditional compliance control of a rehabilitation robot is implemented in task space by using impedance or admittance control algorithms. The soft robot actuated by pneumatic muscle actuators (PMAs) is becoming prominent for patients as it enables the compliance being adjusted in each active link, which, however, has not been reported in the literature. This paper proposes a new compliance control method of a soft ankle rehabilitation robot that is driven by four PMAs configured in parallel to enable three degrees of freedom movement of the ankle joint. A new hierarchical compliance control structure, including a low-level compliance adjustment controller in joint space and a high-level admittance controller in task space, is designed. An adaptive compliance control paradigm is further developed by taking into account patient's active contribution and movement ability during a previous period of time, in order to provide robot assistance only when it is necessarily required. Experiments on healthy and impaired human subjects were conducted to verify the adaptive hierarchical compliance control scheme. The results show that the robot hierarchical compliance can be online adjusted according to the participant's assessment. The robot reduces its assistance output when participants contribute more and vice versa , thus providing a potentially feasible solution to the patient-in-loop cooperative training strategy.

Compliance with carbapenem guidelines in a university hospital.

Science.gov (United States)

Van Hollebeke, M; Chapuis, C; Bernard, S; Foroni, L; Stahl, J P; Bedouch, P; Pavese, P

2016-03-01

We aimed to evaluate carbapenem prescription compliance with guidelines for nosocomial and community-acquired infections. We conducted a prospective study over a four-month period at our university hospital. We included all adult and pediatric hospitalized patients who had received at least one dose of carbapenem. Data was collected from patients' medical records (hard copy and computerized data; CristalLink software). Compliance with guidelines was assessed by two infectious disease specialists. Assessment criteria included indication, antibiotic choice, dosage, and treatment duration. We included 152 patients in the study (65.4% of men). Carbapenem prescription was appropriate for 76.3% of prescriptions. The use of carbapenems was considered appropriate for 73.9% of empirical prescriptions and for 77.8% of documented prescriptions. Non-compliance with guidelines was mainly due to prescriptions for community-acquired infections. Antibiotic de-escalation could not be initiated in 40.3% of patients and was only initiated in 51.7% of patients for whom it could be considered. Although the average treatment duration was 7.5 days, 23.7% of patients received carbapenems for more than 10 days. These results highlight the need for a strong carbapenem stewardship program in our hospital. Copyright © 2016. Published by Elsevier SAS.

Topical nasal steroid treatment does not improve CPAP compliance in unselected patients with OSAS.

Science.gov (United States)

Strobel, Werner; Schlageter, Manuel; Andersson, Morgan; Miedinger, David; Chhajed, Prashant N; Tamm, Michael; Leuppi, Jörg D

2011-02-01

Continuous positive airways pressure (CPAP) for treatment of obstructive sleep apnea (OSA) can produce troublesome nasal symptoms (i.e. congestion, rhinorrhea) that may reduce the compliance of CPAP. Topical nasal steroids are often prescribed to reduce these side effects, although scientific data are scarce supporting any benefits of this treatment for CPAP-induced nasal side effects. To study whether a topical nasal steroid can reduce CPAP-induced nasal symptoms and improve CPAP adherence during the initial phase of OSA treatment. A randomized, double-blinded, placebo-controlled study with fluticasone propionate 100 μg/nasal cavity twice daily Treatment was started 10 days prior to and continued throughout the first 4 weeks of CPAP. 63 patients who were selected for CPAP treatment participated. Nasal symptoms were recorded, nasal patency was assessed and lung function was measured with a peak flow meter. The patients' adherence to CPAP was recorded by the CPAP device. Total nasal symptoms increased from baseline to 4 wks after CPAP use for both nasal treatments (p < 0.05). No differences in total nasal symptoms between treatments were seen (p = 1), and no differences in nasal peak flow values after treatment were seen (p = 0.11). Moreover, there were no differences in CPAP use between the treatments. Fluticasone propionate as a nasal topical steroid does not reduce CPAP-induced unwanted nasal side effects, and has no beneficial effect on CPAP compliance during the first four weeks of treatment in unselected patients with OSAS. Copyright © 2010 Elsevier Ltd. All rights reserved.

Compliance to the prescribed dose and overall treatment time in five randomized clinical trials of altered fractionation in radiotherapy for head-and-neck carcinomas

International Nuclear Information System (INIS)

Khalil, Azza A.; Bentzen, Soeren M.; Bernier, Jacques; Saunders, Michele I.; Horiot, Jean-Claude; Bogaert, Walter van den; Cummings, Bernard J.; Dische, Stanley

2003-01-01

Purpose: To investigate compliance to the prescribed dose-fractionation schedule in five randomized controlled trials of altered fractionation in radiotherapy for head-and-neck carcinoma. Methods and Materials: Individual patient data from 2566 patients participating in the European Organization for Research and Treatment of Cancer (EORTC) 22791, EORTC 22811, EORTC 22851, Princess Margaret Hospital (PMH), and continuous hyperfractionated accelerated radiotherapy (CHART) head-and-neck trials were merged in the fractionation IMPACT (Intergroup Merger of Patient data from Altered or Conventional Treatment schedules) study database. The ideal treatment time was defined as the minimum time required to deliver a prescribed schedule. Compliance to the prescribed overall treatment time was quantified as the difference between the actual and the ideal overall time. An overall measure of compliance in an individual patient, the total dose lost (TDL), was calculated as the dose lost due to prolongation of therapy (assuming a D prolif of 0.64 Gy/day) plus the difference between the prescribed and the actual dose given. Results: The time in excess of the ideal ranged up to 97 days (average 3.9 days), and 25% of the patients had delays of 6 days or more. World Health Organization (WHO) performance status and nodal stage had a significant effect on TDL. TDL was significantly higher in the conventional than in the altered arm of the EORTC 22851 and CHART trials. In the PMH trial, TDL was significantly higher in the hyperfractionation than in the conventional arm. Centers participating in the three EORTC trials varied significantly in their compliance. There was a significant improvement in compliance in patients treated more recently. Conclusions: Even in randomized controlled trials, compliance to the prescribed radiation therapy schedule may be relatively poor, especially after conventional fractionation. This affects the interpretation of the outcome of these trials

Compliance with and short-term adverse events from clarithromycin versus placebo in patients with stable coronary heart disease: the CLARICOR trial

DEFF Research Database (Denmark)

Jespersen, C M; Kolmos, H J; Frydendall, N

2009-01-01

mg of clarithromycin daily versus 2200 patients to matching placebo for 14 days. This paper presents protocol-specified analysis of the patient-reported information regarding their compliance and non-serious adverse events during the 14 days of treatment as well as serious adverse events (mortality...

Predictors of CPAP compliance in different clinical settings: primary care versus sleep unit.

Science.gov (United States)

Nadal, Núria; de Batlle, Jordi; Barbé, Ferran; Marsal, Josep Ramon; Sánchez-de-la-Torre, Alicia; Tarraubella, Nuria; Lavega, Merce; Sánchez-de-la-Torre, Manuel

2018-03-01

Good adherence to continuous positive airway pressure (CPAP) treatment improves the patient's quality of life and decreases the risk of cardiovascular disease. Previous studies that have analyzed the adherence to CPAP were performed in a sleep unit (SU) setting. The involvement of primary care (PC) in the management of obstructive sleep apnea (OSA) patients receiving CPAP treatment could introduce factors related to the adherence to treatment. The objective was to compare the baseline predictors of CPAP compliance in SU and PC settings. OSA patients treated with CPAP were followed for 6 months in SU or PC setting. We included baseline clinical and anthropometrical variables, the Epworth Sleep Scale (ESS) score, the quality of life index, and the Charlson index. A logistic regression was performed for each group to determine the CPAP compliance predictors. Discrimination and calibration were performed using the area under the curve and Hosmer-Lemeshow tests. We included 191 patients: 91 in the PC group and 100 in the SU group. In 74.9% of the patients, the compliance was ≥ 4 h per day, with 80% compliance in the SU setting and 69.2% compliance in the PC setting (p = 0.087). The predictors of CPAP compliance were different between SU and PC settings. Body mass index, ESS, and CPAP pressure were predictors in the SU setting, and ESS, gender, and waist circumference were predictors in the PC setting. The predictors of adequate CPAP compliance vary between SU and PC settings. Detecting compliance predictors could help in the planning of early interventions to improve CPAP adherence.

Narratives of empowerment and compliance

DEFF Research Database (Denmark)

Wentzer, Helle; Bygholm, Ann

2013-01-01

Purpose: New technologies enable new forms of patient participation in health care. Thearticle discusses whether communication in online patient support groups is a source ofindividual as well as collective empowerment or to be understood within the tradition ofcompliance. The discussion is based...... of empowerment and compliance in patient care. On a collective level, the site isempowering the individual users to comply with ‘doctor’s recommendations’ as a group....

CROSS-COMPLIANCE Facilitating the CAP reform: Compliance and competitiveness of European agriculture : Specific Targeted Research or Innovation Project (STREP) Integrating and Strengthening the European Research Area

NARCIS (Netherlands)

Jongeneel, R.A.; Bezlepkina, I.; Winsten, J.; Fox, G.

2008-01-01

The prime aim or the project was on assessing the impacts of compliance with standards, more specifically those part of cross-compliance, on EU’s external competitiveness. This is why in several deliverables and also in the main text of this Deliverable 13 a lot of attention is given to the EU and

Compliance as factor for prevent complications of using of contact lenses

Directory of Open Access Journals (Sweden)

E. Y. Markova

2015-01-01

Full Text Available The main goal of this study is to identify the role of compliance in the prevention of complications while wearing soft contact lenses (SCL. 2257 patients in the «Center of vision correction contact» were examined. The age of patients was from12 till 46 years. 58 % female, 42 % male. 47.5 % patients were using daily disposable lenses, 52.5 % — lenses of planned replacement: 23.4 % — 2 weeks, 25.1 % — 1 month, 4 % — 3 months. All patients were using SCL for at least 1 year. The benefits of contact lens are compared with the glasses by different authors. However, any contact lens are a foreign body for the eye, which requires special care, and in case of non-compliance with the doctor’s recommendations may cause the complications. This study has shown that compliance among patients using contact lenses is below 50 %. The main reason for noncompliance of patients is the lack of time and attention to the health of patients. For achievement of compliance and prevention of complications of contact lens is recommended to regularly take the following necessary measures: patient education, explaining to him the need for each stage of lens care, which increases motivation. At the same time, the learning process can be demonstrated to have complications arise in the case of disturbances. Optimization of individual therapeutic program, which is the correct selection of contact lenses and care products tailored to the individual needs of the patient, his lifestyle and personal finance. However, the risk of complications depends not only on the doctor or the manufacturer, but to a greater extent on the patient. In other words, compliance — a necessary condition for ensuring the effectiveness of contact lens and avoiding the occurrence of complications.

The Role of Mediators in the Indirect Effects of Religiosity on Therapeutic Compliance in African Migrant HIV-Positive Patients.

Science.gov (United States)

Mambet Doue, Constance; Roussiau, Nicolas

2016-12-01

This research investigates the indirect effects of religiosity (practice and belief) on therapeutic compliance in 81 HIV-positive patients who are migrants from sub-Saharan Africa (23 men and 58 women). Using analyses of mediation and standard multiple regression, including a resampling procedure by bootstrapping, the role of these mediators (magical-religious beliefs and nonuse of toxic substances) was tested. The results show that, through magical-religious beliefs, religiosity has a negative indirect effect, while with the nonuse of toxic substances, religious practice has a positive indirect effect. Beyond religiosity, the role of mediators is highlighted in the interaction with therapeutic compliance.

Practice organisational characteristics can impact on compliance with the BTS/SIGN asthma guideline: Qualitative comparative case study in primary care

Directory of Open Access Journals (Sweden)

Gillies John

2008-06-01

Full Text Available Abstract Background Although the BTS-SIGN asthma guideline is one of the most well known and widely respected guidelines in the world, implementation in UK primary care remains patchy. Building on extensive earlier descriptive work, we sought to explore the way teamwork and inter-professional relationships impact on the implementation of the BTS-SIGN guideline on asthma in general practice. Methods Qualitative comparative case study using nine in-depth interviews and 2 focus groups with general practitioners and practice nurses, involved in delivering asthma care. Participants were purposively recruited from practices in a Scottish health board with high and low compliance with the BTS-SIGN asthma guideline. Results There was a marked difference in the way respondents from practices with high compliance and respondents from practices with low compliance spoke about the value of guidelines and the challenges of implementing them. On both accounts, the former were more positive than the latter and were able to be more specific about the strategies they used to overcome barriers to implementation. We explored the reason for this difference in response and identified practice organisation, centring on delegation of work to nurses, as a factor mediating the practice's level of compliance. Effective delegation was underpinned by organisation of asthma work among practice members who have the appropriate level of skills and knowledge, know and understand each others' work and responsibilities, communicate well among themselves and trust each others' skills. It was the combination of these factors which made for successful delegation and guideline implementation, not any one factor in isolation. Conclusion In our sample of practices, teamwork and organisation of care within practices appeared to impact on guideline implementation and further larger studies are needed to explore this issue further. Isolated interventions such as measures to improve staff

Practice organisational characteristics can impact on compliance with the BTS/SIGN asthma guideline: qualitative comparative case study in primary care.

Science.gov (United States)

Wiener-Ogilvie, Sharon; Huby, Guro; Pinnock, Hilary; Gillies, John; Sheikh, Aziz

2008-06-04

Although the BTS-SIGN asthma guideline is one of the most well known and widely respected guidelines in the world, implementation in UK primary care remains patchy. Building on extensive earlier descriptive work, we sought to explore the way teamwork and inter-professional relationships impact on the implementation of the BTS-SIGN guideline on asthma in general practice. Qualitative comparative case study using nine in-depth interviews and 2 focus groups with general practitioners and practice nurses, involved in delivering asthma care. Participants were purposively recruited from practices in a Scottish health board with high and low compliance with the BTS-SIGN asthma guideline. There was a marked difference in the way respondents from practices with high compliance and respondents from practices with low compliance spoke about the value of guidelines and the challenges of implementing them. On both accounts, the former were more positive than the latter and were able to be more specific about the strategies they used to overcome barriers to implementation. We explored the reason for this difference in response and identified practice organisation, centring on delegation of work to nurses, as a factor mediating the practice's level of compliance. Effective delegation was underpinned by organisation of asthma work among practice members who have the appropriate level of skills and knowledge, know and understand each others' work and responsibilities, communicate well among themselves and trust each others' skills. It was the combination of these factors which made for successful delegation and guideline implementation, not any one factor in isolation. In our sample of practices, teamwork and organisation of care within practices appeared to impact on guideline implementation and further larger studies are needed to explore this issue further. Isolated interventions such as measures to improve staff's knowledge or increased clinical resource and time, which are

Blood glucose control and compliance of diabetic children

Directory of Open Access Journals (Sweden)

F. P. R. de Villiers

1997-03-01

Full Text Available Non-compliance is an important factor hindering good control in diabetics. The aim of this study was to identify areas of poor compliance with the diabetes management regimen in the children attending our clinic. A questionnaire was administered to 57 patients who attend the Paediatric Diabetes Clinic. It was designed to elicit socio-demographic data and information about the diabetic regimen. Prior to the administration of the questionnaire, patients were classified as being well, satisfactorily or poorly controlled, based on their average glycosylated Haemoglobin results over the past year.

Treatment compliance and challenges among tuberculosis patients across selected health facilities in Osun State Nigeria.

Science.gov (United States)

Ajao, K O; Ogundun, O A; Afolabi, O T; Ojo, T O; Atiba, B P; Oguntunase, D O

2014-12-01

Tuberculosis (TB) is a major public health problem in the world and Africa has approximately one quarter of the world's cases. One of the greatest challenges facing most TB programmes is the non-compliance to TB treatment among TB patients. This study aimed at determining the challenges of management of tuberculosis (TB) across selected Osun State health facilities. The study employed a descriptive cross-sectional design. A semi-structured questionnaire was used to collect data from 102 TB patients in the health facilities. The instrument measured socio-demographic variables, patient related factors, socio-economic variables, health care system related factors to TB disease and treatment. Data were analysed and summarized using descriptive and inferential statistics. Statistical significance was placed at p facilities (χ2 = 21.761, p facility and patient-related factors were largely responsible.

Education as Prescription for Patients with Type 2 Diabetes Mellitus: Compliance and Efficacy in Clinical Practice

Directory of Open Access Journals (Sweden)

Mi Yeon Kim

2012-12-01

Full Text Available BackgroundDiabetes self-management education has an important role in diabetes management. The efficacy of education has been proven in several randomized trials. However, the status of diabetes education programs in real Korean clinical practice has not yet been evaluated in terms of patient compliance with the education prescription.MethodsWe retrospectively analyzed clinical and laboratory data from all patients who were ordered to undergo diabetes education during 2009 at Samsung Medical Center, Seoul, Korea (n=2,291. After excluding ineligible subjects, 588 patients were included in the analysis.ResultsAmong the 588 patients, 433 received education. The overall compliance rate was 73.6%, which was significantly higher in the subjects with a short duration or living in a rural area compared to those with a long duration (85.0% vs. 65.1%, respectively; P<0.001 or living in an urban area (78.2% vs. 70.4%, respectively; P=0.037. The hemoglobin A1c decreased greater in the compliant group (from 7.84±1.54 at baseline to 6.79±1.06 at 3 months and 6.97±1.20 at 12 months after prescription in the compliant group vs. from 7.74±1.25 to 7.14±1.02 and 7.24±1.24 in the non-compliant group; P=0.001. The decrease in hemoglobin A1c was greater in the subjects with a short duration (P=0.032.ConclusionIn our study a large percent of patients refuse to get education despite having a prescription from their physician. This refusal rate was higher in the patients with long-standing diabetes or in urban residence. Furthermore, education was more effective in patients with a short duration of diabetes in clinical practice.

Impact of spatial differentiation of nitrogen taxes on french farms’ compliance costs

OpenAIRE

Lungarska, Anna; Jayet, Pierre-Alain

2016-01-01

The spatial differentiation of input-based pollution fees should in theory decrease compliance costs in the case of nitrate pollution of water bodies from agriculture because both the damage and the compliance costs vary over space. However, the empirical evidence in the literature does not agree on the extent of the potential savings from differentiation. We address this issue in the case of France, using a mathematical programming model of agricultural supply (AROPAj). The modeling approach...

Optimizing urine drug testing for monitoring medication compliance in pain management.

Science.gov (United States)

Melanson, Stacy E F; Ptolemy, Adam S; Wasan, Ajay D

2013-12-01

It can be challenging to successfully monitor medication compliance in pain management. Clinicians and laboratorians need to collaborate to optimize patient care and maximize operational efficiency. The test menu, assay cutoffs, and testing algorithms utilized in the urine drug testing panels should be periodically reviewed and tailored to the patient population to effectively assess compliance and avoid unnecessary testing and cost to the patient. Pain management and pathology collaborated on an important quality improvement initiative to optimize urine drug testing for monitoring medication compliance in pain management. We retrospectively reviewed 18 months of data from our pain management center. We gathered data on test volumes, positivity rates, and the frequency of false positive results. We also reviewed the clinical utility of our testing algorithms, assay cutoffs, and adulterant panel. In addition, the cost of each component was calculated. The positivity rate for ethanol and 3,4-methylenedioxymethamphetamine were us to optimize our testing panel for monitoring medication compliance in pain management and reduce cost. Wiley Periodicals, Inc.

Social, Economic, and Medical Factors Associated With Solifenacin Therapy Compliance Among Workers Who Suffer From Lower Urinary Tract Symptoms

Directory of Open Access Journals (Sweden)

Kirill Vladimirovich Kosilov

2016-09-01

Full Text Available Purpose The prevalence of hyperactive-type lower urinary tract symptoms is 45.2%, with shares of overactive bladder (OAB and urge incontinence (UI symptoms of 10.7% and 8.2%, respectively. We investigated the possible impact of a wide range of social, economic, and medical factors on compliance with solifenacin treatment in the working population. Methods Social, economic, and medical factors as well as the Overactive Bladder questionnaire – the OAB-q Short Form (OAB-q SF, bladder diaries, and uroflowmetry of 1,038 people who were administered solifenacin for a year were gathered from employer documentation. Results Among the subjects, 32% maintained their compliance with solifenacin treatment throughout the year. Only 65% of the patients had compliance exceeding 80%, and 17% of patients had compliance of ≥50%, yet less than 80% were still taking solifenacin 12 months after the beginning of this experiment. Working people whose compliance level was, at least, 80% had reliably higher (P≤0.01 average age, annual salary, and treatment efficacy, and a greater treatment satisfaction level, as well as a lack of satisfaction with other antimuscarinic treatments and higher rate of urge UI diagnosis. The same cohort also featured a lower level (P≤0.01 of caffeine abuse and lower share of salary spent purchasing solifenacin. Conclusions This study has shown that compliance with solifenacin treatment is associated with a number of significant medical, social, and economic factors. The medical factors included the type of urination disorder, severity of incontinence symptoms, presence of side effects, treatment efficacy and patients’ satisfaction with it, and experience using other antimuscarinic treatments. Among the social and economic factors, those with the strongest correlation to compliance were patient age, employment in medicine and education, annual income level, percentage of solifenacin purchase expenditures, and caffeine abuse. Factors

If you can't comply with dialysis, how do you expect me to trust you with transplantation? Australian nephrologists' views on indigenous Australians' 'non-compliance' and their suitability for kidney transplantation

Directory of Open Access Journals (Sweden)

Anderson Kate

2012-04-01

Full Text Available Abstract Introduction Indigenous Australians suffer markedly higher rates of end-stage kidney disease (ESKD but are less likely than their non-Indigenous counterparts to receive a transplant. This difference is not fully explained by measurable clinical differences. Previous work suggests that Indigenous Australian patients may be regarded by treating specialists as 'non-compliers', which may negatively impact on referral for a transplant. However, this decision-making is not well understood. The objectives of this study were to investigate: whether Indigenous patients are commonly characterised as 'non-compliers'; how estimations of patient compliance factor into Australian nephrologists' decision-making about transplant referral; and whether this may pose a particular barrier for Indigenous patients accessing transplants. Methods Nineteen nephrologists, from eight renal units treating the majority of Indigenous Australian renal patients, were interviewed in 2005-06 as part of a larger study. Thematic analysis was undertaken to investigate how compliance factors in specialists' decision-making, and its implications for Indigenous patients' likelihood of obtaining transplants. Results Specialists commonly identified Indigenous patients as both non-compliers and high-risk transplant candidates. Definition and assessment of 'compliance' was neither formal nor systematic. There was uncertainty about the value of compliance status in predicting post-transplant outcomes and the issue of organ scarcity permeated participants' responses. Overall, there was marked variation in how specialists weighed perceptions of compliance and risk in their decision-making. Conclusion Reliance on notions of patient 'compliance' in decision-making for transplant referral is likely to result in continuing disadvantage for Indigenous Australian ESKD patients. In the absence of robust evidence on predictors of post-transplant outcomes, referral decision-making processes

Compliance with pharmacological treatment in outpatients from a Brazilian cardiology referral center

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Paulo Roberto Chizzola

Full Text Available To evaluate the degree of compliance with pharmacological therapy, and to identify predictors of non-compliance in outpatients from a cardiology referral center in São Paulo, Brazil, we studied 485 outpatients, 230 (47.4 percent males and 255 (52.6 percent females, through an interview guided by a questionnaire during medical consultation. The ages ranged between 17 and 86 (mean 54, standard deviation 15 years. Heart disease and socioeconomic factors (residence, means of transport, educational level and professional status were studied. In addition, we examined the drugs prescribed including: difficulties in taking them; the source of supply; and the patient's knowledge of the drugs. Assessment of compliance was based on the patients' response. The patients' answers were compared with the prescription and progress notes. Errors were recorded if the patient reported using one or more nonprescribed medicines. Compliance with therapy was recorded if the patient said the prescription was taken correctly without interruption and without error. The variables with significant differences in univariate analysis were further analyzed by multivariate log-linear regression analysis. Noncompliance occurred in 286 (59 percent of the patients, and was predicted by the reported difficulty in taking medication (P<0.001, and by the lack of knowledge of medication names (P<0.001.Thus, noncompliance with medical therapy was common. The main predictors of non-compliance were the reported difficulty in taking medication and inability to identify medicines' names.

Compliance and Caregiver Satisfaction in Alzheimer’s Disease: Results from the AXEPT Study

Directory of Open Access Journals (Sweden)

Roberto Bernabei

2012-10-01

Full Text Available Background/Aims: According to experimental data, a transdermal application is preferred by caregivers of Alzheimer’s disease (AD patients compared with oral medications. The AXEPT study compared compliance to treatment among community-dwelling patients with mild-to-moderate AD treated with transdermal application compared to oral medications and caregiver satisfaction in a real clinical setting. Methods: Data from 45 memory clinics in Italy were collected between September 8, 2010 and January 31, 2011. Compliance to treatment and caregiver satisfaction were measured using the Caregiver Medication Interview. Results: A total of 855 AD patients and their caregivers participated in the study. Nearly 80% of caregivers of patients on patch were not concerned about adherence to treatment compared with 64% of caregivers of patients on oral drugs. Among caregivers of patients on patch, 94% did not report any difficulties in remembering to administer treatment compared with 73% of caregivers of patients on oral medications. The highest level of compliance and satisfaction was reported by caregivers of patients on transdermal application. Conclusion: Caregivers of patients treated with a transdermal application appeared to be more satisfied and reported a higher level of compliance than caregivers of patients receiving anti-AD oral medications.

Usefulness of an app in improving oral hygiene compliance in adolescent orthodontic patients.

Science.gov (United States)

Zotti, Francesca; Dalessandri, Domenico; Salgarello, Stefano; Piancino, Mariagrazia; Bonetti, Stefano; Visconti, Luca; Paganelli, Corrado

2016-01-01

To evaluate the influence of an app-based approach in a protocol for domestic oral hygiene maintenance in a group of adolescent patients wearing fixed multibracket appliances. Eighty adolescent patients scheduled to start an orthodontic multibracket treatment were randomly divided into two groups of 40. Plaque index (PI), gingival index (GI), white spots (WS), and caries presence were recorded in all patients, and they were instructed regarding domestic oral hygiene maintenance on the day of braces application (t0) and every 3 months (t1, t2, t3, t4) during the first year of treatment. Study group (SG) patients were enrolled in a WhatsApp chat room-based competition and instructed to share monthly with the other participants two self-photographs (selfies) showing their oral hygiene status. SG patient participation in the chat room was regular and active throughout the observation period. At t2, t3, and t4, SG patients had significantly lower values of both PI and GI and a lower incidence of new WS and caries, compared with the control group. Integration of new "social" technologies in a standard oral hygiene motivation protocol is effective in improving compliance of adolescent patients and in improving their oral health status during orthodontic multibracket treatment.

Awareness and compliance to anti-smoking law in South Bengaluru, India

Directory of Open Access Journals (Sweden)

Pradeep S. Banandur

2017-09-01

This is the first representative survey of awareness and compliance of COTPA in Bengaluru City. Low compliance, coupled with the lack of appropriate awareness among PRCs and AOs about COTPA, demands a comprehensive strategy to enhance awareness. Comprehensive efforts towards making all stakeholders understand the health impacts of smoking, and strict enforcement, might facilitate effective implementation of COTPA.

Comparison of in-and outpatients protocols for providence night time only bracing in AIS patients -- compliance and satisfaction

DEFF Research Database (Denmark)

Al-Aubaidi, Zaid Tj; Tropp, Hans; Pedersen, Niels W

2013-01-01

BACKGROUND: Skeletally immature patients diagnosed with adolescent idiopathic scoliosis (AIS) and a Cobb angle above 25degrees is usually treated with a brace. Standard protocols in many centers include hospitalisation for a few days for the purpose of brace adaptation and fitting. The aim...... of this study is to compare compliance and satisfaction in hospitalization and out patient clinic protocols, at the initiation phase of brace treatment.Materials and methodsTwenty-four consecutive patients with AIS were initiated with the Providence night time only brace at our department between October 2008...

Managing quality and compliance.

Science.gov (United States)

McNeil, Alice; Koppel, Carl

2015-01-01

Critical care nurses assume vital roles in maintaining patient care quality. There are distinct facets to the process including standard setting, regulatory compliance, and completion of reports associated with these endeavors. Typically, multiple niche software applications are required and user interfaces are varied and complex. Although there are distinct quality indicators that must be tracked as well as a list of serious or sentinel events that must be documented and reported, nurses may not know the precise steps to ensure that information is properly documented and actually reaches the proper authorities for further investigation and follow-up actions. Technology advances have permitted the evolution of a singular software platform, capable of monitoring quality indicators and managing all facets of reporting associated with regulatory compliance.

Title IV compliance strategies and the incidence of co-pollutants and synergistic pollution controls

International Nuclear Information System (INIS)

South, D.W.; Bailey, K.A.

1993-01-01

Title 4 of the Clean Air Act Amendments (CAAA) of 1990 (Pub.L. 101-549) authorizes a system of tradeable SO 2 allowances in order to reduce Utility SO 2 emissions in a cost-effective manner. The CAAA also expanded and strengthened regulation of urban ozone nonattainment (Title 1), air toxics (Title 3) and utility NO x emissions (Title 4). Implementation of the requirements of each of these titles will force the utility industry to incur additional control expenditures. Utilities also face the potential for regulation of CO 2 emissions within the next decade, and increased regulation and reclassification of high volume combustion wastes, i.e., scrubber sludge, fly ash and bottom ash. Unfortunately for the utility industry, many of the issues in Titles 1, 3, 4 and other regulations have not been resolved, even though utility Phase 1 compliance planning has begun. This paper will examine compliance conflicts and synergies resulting from utility compliance with Title IV SO 2 requirements. The fundamental question addressed is: what multi-media effects are introduced and what opportunities exist through utility compliance with Title 4-SO 2 . Several issues will be addressed including: (1) the potential impact of non-SO 2 regulation on utility compliance and compliance costs, (2) the flexibility of utility SO 2 compliance options, (3) the synergies and co-pollutant effects associated with particular compliance options, (4) the impact of the timing and uncertainty of the various rules on utility compliance choice

Compliance with occlusion therapy for childhood amblyopia.

Science.gov (United States)

Wallace, Michael P; Stewart, Catherine E; Moseley, Merrick J; Stephens, David A; Fielder, Alistair R

2013-09-17

Explore compliance with occlusion treatment of amblyopia in the Monitored and Randomized Occlusion Treatment of Amblyopia Studies (MOTAS and ROTAS), using objective monitoring. Both studies had a three-phase protocol: initial assessment, refractive adaptation, and occlusion. In the occlusion phase, participants were instructed to dose for 6 hours/day (MOTAS) or randomized to 6 or 12 hour/day (ROTAS). Dose was monitored continuously using an occlusion dose monitor (ODM). One hundred and fifty-two patients (71 male, 81 female; 122 Caucasian, 30 non-Caucasian) of mean ± SD age 68 ± 18 months participated. Amblyopia was defined as an interocular acuity difference of at least 0.1 logMAR and was associated with anisometropia in 50, strabismus in 44, and both (mixed) in 58. Median duration of occlusion was 99 days (interquartile range 72 days). Mean compliance was 44%, mean proportion of days with no patch worn was 42%. Compliance was lower (39%) on weekends compared with weekdays (46%, P = 0.04), as was the likelihood of dosing at all (52% vs. 60%, P = 0.028). Compliance was lower when attendance was less frequent (P amblyopia type, and severity were not associated with compliance. Mixture modeling suggested three subpopulations of patch day doses: less than 30 minutes; doses that achieve 30% to 80% compliance; and doses that achieve around 100% compliance. This study shows that compliance with patching treatment averages less than 50% and is influenced by several factors. A greater understanding of these influences should improve treatment outcome. (ClinicalTrials.gov number, NCT00274664).

Alcohol consumption, blood alcohol concentration level and guideline compliance in hospital referred patients with minimal, mild and moderate head injuries

DEFF Research Database (Denmark)

Harr, Marianne Efskind; Heskestad, Ben; Ingebrigtsen, Tor

2011-01-01

In 2000 the Scandinavian Neurotrauma Committee published guidelines for safe and cost-effective management of minimal, mild and moderate head injured patients.The aims of this study were to investigate to what extent the head injury population is under the influence of alcohol, and to evaluate...... whether the physicians' compliance to the guidelines is affected when patients are influenced by alcohol....

Assessment of Compliance to Treatment of Diabetes and Hypertension amongst Previously Diagnosed Patients from Rural Community of Raigad District of Maharashtra.

Science.gov (United States)

Kakumani, Kiranmayi Venkata; Waingankar, Prasad

2016-12-01

Substantial burden of diabetes and hypertension is on rise in India, leading to a twin epidemic. India, being a rural country, has unique problems regarding the treatment compliance which is a serious risk for morbidity and mortality. To assess the compliance to treatment of hypertension and diabetes amongst the diagnosed patients from rural area and to study reasons of non-compliance and knowledge and attitude. Community based, cross sectional, observational study conducted in the rural communities of Tara and Barapada villages of Raigad district of Maharashtra. Survey was conducted covering population of 2115 across 360 families, 250 at Barapada and 110 at Tara. All the cases of diabetes and hypertension diagnosed for more than one year were included. A structured and pre-tested questionnaire was administered including details on demography, medical documentation, treatment details and factors assessing the compliance, knowledge and attitude towards the diseases. When reviewed the treatment adherence pattern based on documentary evidence and interview of the patient, on history of taking medication strictly since the detection illness, it was found that more than 70% of the Diabetics and more than 75% of the Hypertensive have discontinued the treatment in between. The most common reasons of non-compliance is the lack of sufficient motivation for treatment adherence as many mentioned (61.4% diabetics, 55.8% hypertensives) difficulty to remember to take daily medication due to work or forgetfulness. This is followed by lack of money (50%diabetics, 55.8% hypertensives) and living far away from doctor in city (43% diabetics and 46% hypertensives). The study findings are only tip of iceberg and the non-adherence to the treatment of diabetes and hypertension in rural population is at alarmingly high. Illiteracy, lack of faith in treatment and motivation, unawareness and self-neglect as well as financial constraints and lack of specialist care in rural area is playing

DEVELOPMENT OF THE QUESTIONNAIRE ON COMPLIANCE TO MEDICAL NUTRITION THERAPY FOR TYPE 2 DIABETIC PATIENTS AND ASSESSMENT OF ITS POTENTIAL USE

Directory of Open Access Journals (Sweden)

E. G. Starostina

2016-01-01

Full Text Available Background: А  specific questionnaire is necessary to perform quantitative assessment of compliance to medical nutrition therapy in patients with type 2 diabetes mellitus (DM.Aim: Тo develop a questionnaire to assess how type 2 diabetic patients adhere with the principles of medical nutrition therapy and to identify factors associated with good dietary compliance.Materials and methods: We proposed a questionnaire "Dietary adherence test" (DAT and validated it in 300 inand out-patients with type 2 DM. DAT was validated against the diabetes-related behavior score, diabetes-related knowledge score, and HbA1c level; the internal consistency coefficient (Cronbach's alfa was also calculated.Results: Cronbach's alfa for primary raw and standardized data were 0.7444 and 0.7413, respectively, thus meeting the required range of 0.7–0.8. The score on DAT item 1 (the title item and total score (the sum of scores of item 2 to 10 correlated with the diabetes-related behavior score (r=0.21, р=0.0006 and r=0.34, р<0.0001, respectively. Patients with poor dietary compliance (average DAT score≤2 had a significantly lower score on the subscale "Nutrition" of the diabetes knowledge test, than those with good dietary compliance (average DAT score≥2 (44.9±15.6 vs 60.2±16.2, р<0.0001. Patients who perceived their diet as the most burdensome element of life with diabetes, had lower total DAT score (24.1±4.6 than those who did not see their diet as a problem (25.9±5.1, р=0.001. There was a  significant difference in average DAT score between patients on insulin therapy and patients on oral treatment (2.8±0.6 vs 2.9±0.6, respectively, р=0.019. Patients with poor and good dietary adherence, according to DAT, differed in their duration of diabetes, social status and diabetes-related behavior score. There was a  weak correlation between the DAT score and duration of diabetes (r=0.16, р=0.009, and weak inverse correlation between the DAT score and

The impact of farmers’ participation in field trials in creating awareness and stimulating compliance with the World Health Organization’s farm-based multiple-barrier approach

DEFF Research Database (Denmark)

Amponsah, Owusu; Vigre, Håkan; Schou, Torben Wilde

2016-01-01

-barrier approach field trials. The results of the study show that participation in the field trials has statistically significant effects on farmers’ awareness of the farm-based multiple-barrier approach. Compliance has, however, been undermined by the farmers’ perception that the cost of compliance is more......The results of a study aimed as assessing the extent to which urban vegetable farmers’ participation in field trials can impact on their awareness and engender compliance with the World Health Organization’s farm-based multiple-barrier approach are presented in this paper. Both qualitative...... and quantitative approaches have been used in this paper. One hundred vegetable farmers and four vegetable farmers’ associations in the Kumasi Metropolis in Ghana were covered. The individual farmers were grouped into two, namely: (1) participants and (2) non-participants of the farm-based multiple...

Effects of Quizzing Methodology on Student Outcomes: Reading Compliance, Retention, and Perceptions

Science.gov (United States)

Dowling, Carey Bernini

2017-01-01

This study set out to replicate and extend research on students' reading compliance and examine the impact of daily quizzing methodology on students' reading compliance and retention. 98 students in two sections of Abnormal Psychology participated (mean age = 21.5, SD = 3.35; 72.4% Caucasian). Using a multiple baseline quasi-experimental design…

Acid rain compliance planning using decision analysis

International Nuclear Information System (INIS)

Norris, C.; Sweet, T.; Borison, A.

1991-01-01

Illinois Power Company (IP) is an investor-owned electric and natural gas utility serving portions of downstate Illinois. In addition to one nuclear unit and several small gas and/or oil-fired units, IP has ten coal-fired units. It is easy to understand the impact the Clean Air Act Amendments of 1990 (CAAA) could have on IP. Prior to passage of the CAAA, IP formed several teams to evaluate the specific compliance options at each of the high sulfur coal units. Following that effort, numerous economic analyses of compliance strategies were conducted. The CAAA have introduced a new dimension to planning under uncertainty. Not only are many of the familiar variables uncertain, but the specific form of regulation, and indeed, the compliance goal itself is hard to define. For IP, this led them to use techniques not widely used within their corporation. This paper summarizes the analytical methods used in these analyses and the preliminary results as of July, 1991. The analysis used three approaches to examine the acid rain compliance decision. These approaches were: (1) the 'most-likely,' or single-path scenario approach; (2) a multi-path strategy analysis using the strategies defined in the single-scenario analysis; and (3) a less constrained multi-path option analysis which selects the least cost compliance option for each unit

Effectiveness of an electronic hand hygiene monitoring system on healthcare workers' compliance to guidelines.

Science.gov (United States)

Al Salman, J M; Hani, S; de Marcellis-Warin, N; Isa, Sister Fatima

2015-01-01

Hand hygiene is a growing concern among populations and is a crucial element in ensuring patient safety in a healthcare environment. Numerous management efforts have been conducted in that regard, including education, awareness and observations. To better evaluate the possible impact of technology on a healthcare setting, we observed the impact of a particular niche technology developed as an answer to the growing hand hygiene concerns. A study was conducted at Salmaniya Medical Complex (SMC) in Bahrain on a total of 16 Coronary Care Unit (CCU) beds where the system was installed, and the hand hygiene activity of healthcare workers (HCWs) in this area was monitored for a total period of 28 days. Comments, remarks and suggestions were noted, and improvements were made to the technology during the course of the trial. While resistance to change was significant, overall results were satisfactory. Compliance with hand hygiene techniques went from 38-42% to 60% at the beginning of the trial and then increased to an average of 75% at the end of the 28-day trial. In some cases, compliance peaked at 85% or even at 100%. Our case study demonstrates that technology can be used effectively in promoting and improving hand hygiene compliance in hospitals, which is one way to prevent cross-infections, especially in critical care areas. Copyright © 2014 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

review of compliance to anti tuberculosis treatment and risk factors ...

African Journals Online (AJOL)

Background: The aim of this study is to assess anti TB treatment compliance and the factors predictive for poor adherence in Sub-Saharan Africa in the last 10 years. Methods: We searched Medline for articles written in English using the terms: "Patient Compliance"[Mesh] OR "Medication Adherence"[Mesh])) AND ...

The effect of 3 different exercise approaches on neck muscle endurance, kinesiophobia, exercise compliance, and patient satisfaction in chronic whiplash.

Science.gov (United States)

Peterson, Gunnel E; Landén Ludvigsson, Maria H; O'Leary, Shaun P; Dedering, Åsa M; Wallman, Thorne; Jönsson, Margaretha I N; Peolsson, Anneli L C

2015-09-01

The purpose of this study was to compare the effects of 3 different exercise approaches on neck muscle endurance (NME), kinesiophobia, exercise compliance, and patient satisfaction in patients with chronic whiplash. This prospective randomized clinical trial included 216 individuals with chronic whiplash. Participants were randomized to 1 of 3 exercise interventions: neck-specific exercise (NSE), NSE combined with a behavioral approach (NSEB), or prescribed physical activity (PPA). Measures of ventral and dorsal NME (endurance time in seconds), perceived pain after NME testing, kinesiophobia, exercise compliance, and patient satisfaction were recorded at baseline and at the 3- and 6-month follow-ups. Compared with individuals in the prescribed physical activity group, participants in the NSE and NSEB groups exhibited greater gains in dorsal NME (P = .003), greater reductions in pain after NME testing (P = .03), and more satisfaction with treatment (P .07). Among patients with chronic whiplash, a neck-specific exercise intervention (with or without a behavioral approach) appears to improve NME. Participants were more satisfied with intervention including neck-specific exercises than with the prescription of general exercise. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Compliance with therapy in children with respiratory diseases.

Science.gov (United States)

Schöni, M H; Horak, E; Nikolaizik, W H

1995-01-01

Compliance with medical treatment was evaluated in 89 children and adolescents with respiratory diseases using two methods of assessment: a double blinded covert recording of the use of an air compressor for nebulization of drugs and the determination of theophylline levels in serum. In the covert monitoring of inhalation the overall compliance with the prescribed medication was 47.6%. In the open randomized theophylline trial, 56%-71% of the patients (according to uncontrolled or controlled intake of the drug) received a dosage of theophylline which was too low to achieve a sufficient serum level in the range of 10-20 mg/l. This, however, was also due to the fact that in 72% of the cases physicians prescribed doses which were substantially below the recommended amount of drug according to age and weight. It is, therefore, concluded that compliance of medication is based on the patients adherence to the medication, to the efficacy of the drug itself and the attitude of the physician.

Ecological Monitoring and Compliance Program 2007 Report

Energy Technology Data Exchange (ETDEWEB)

Hansen, Dennis; Anderson, David; Derek, Hall; Greger, Paul; Ostler, W. Kent

2008-03-01

In accordance with U.S. Department of Energy (DOE) Order 450.1, 'Environmental Protection Program', the Office of the Assistant Manager for Environmental Management of the DOE, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) requires ecological monitoring and biological compliance support for activities and programs conducted at the Nevada Test Site (NTS). National Security Technologies, LLC (NSTec), Ecological Services has implemented the Ecological Monitoring and Compliance (EMAC) Program to provide this support. EMAC is designed to ensure compliance with applicable laws and regulations, delineate and define NTS ecosystems, and provide ecological information that can be used to predict and evaluate the potential impacts of proposed projects and programs on those ecosystems. This report summarizes the EMAC activities conducted by NSTec during calendar year 2007. Monitoring tasks during 2007 included eight program areas: (a) biological surveys, (b) desert tortoise compliance, (c) ecosystem mapping and data management, (d) sensitive plant monitoring, (e) sensitive and protected/regulated animal monitoring, (f) habitat monitoring, (g) habitat restoration monitoring, and (h) biological monitoring at the Nonproliferation Test and Evaluation Complex (NPTEC). The following sections of this report describe work performed under these eight areas.

Scrubbers: A popular Phase I compliance strategy

International Nuclear Information System (INIS)

Fink, C.E.; Bissell, P.E.; Koch, B.J.; Rutledge, G.D.

1992-01-01

As utilities commit to compliance plans to meet the Phase I requirements of the Clean Air Act Amendments of 1990, there are indications that scrubbing may account for up to 50 percent of the total SO 2 reductions in Phase I. This paper presents and analyzes the critical reasons that explain how and why scrubber-based compliance strategies have developed into the least-cost option in Phase I for many utilities. A hypothetical utility system was simulated to study the impacts of various technological, legislative, and regulatory issues on compliance decisions and costs. Issues evaluated using the hypothetical system include the emissions cap, Clean Air Act and state incentives to scrub, improvements in scrubber technology and costs, and the integration of Phase I and II compliance strategies by the phased installation of scrubbers. In combination, these considerations increase the attractiveness of scrubbers during the 1995-1999 Phase I period. Other considerations that will ultimately influence the amount of Phase I scrubbing capacity include the additional power generation costs associated with fuel switching, the uncertainty of low-sulfur coal price projections, fuel supply flexibility, scrubber market aspects, and socioeconomic considerations

Diabetes Support Groups Improve Patient’s Compliance and Control Blood Glucose Levels

Directory of Open Access Journals (Sweden)

Zamrotul Izzah

2013-09-01

Full Text Available Providing information is not enough to improve diabetic patient’s compliance and achieve goals of therapy. Patient’s good awareness as well as emotional and social supports from family and community may play an important role to improve their compliance and clinical outcomes. Therefore, diabetes support groups were developed and each support group consisted of two pharmacists, two nurses, diabetic patients and their family members. A total of 70 type 2 diabetic patient’s were enrolled and randomized into support group 1 and support group 2. Patients in the group 1 received information leaflets only, while patient in the group 2 received pharmacist counselling and information leaflets at each meeting. Patient’s awareness of diabetes and compliance with medications were assessed by a short questionnaire at baseline and final follow-up. Blood glucose and cholesterol levels were also evaluated in both groups. At the end of study, the overall patient’s awareness and compliance improved by 61.5%. The random and fasting blood glucose levels decreased over than 30% in the group 2 and around 14% in the group 1. This study reveals that collaboration between health care professionals and community in the diabetes support group might help diabetic patients to increase their knowledge and compliance with the diabetes therapy as well as glycaemic control.

Job Burnout Reduces Hand Hygiene Compliance Among Nursing Staff.

Science.gov (United States)

Manomenidis, Georgios; Panagopoulou, Efharis; Montgomery, Anthony

2017-10-13

Health professional burnout has been associated with suboptimal care and reduced patient safety. However, the extent to which burnout influences hand hygiene compliance among health professionals has yet to be explored. The aim of the study was to examine whether job burnout reduces hand washing compliance among nursing staff. A diary study was conducted. Forty registered nurses working in a general city hospital in Thessaloniki, Greece, completed a questionnaire, while they were monitored for hand hygiene compliance following the World Health Organization protocol for hand hygiene assessment. Burnout was measured using validated items from the Maslach Burnout Inventory. Data were collected from September to October 2015. Multiple regression analysis showed that controlling for years in practice, burnout was negatively associated with hand hygiene compliance (R = 0.322, F(3,36) = 5.704, P compliance to hand hygiene among nurses. Given the crucial role of hand hygiene compliance for the prevention of in-hospital infections, this study highlights the need for interventions targeting the prevention of burnout among nursing staff.

Utilizing Forced Vital Capacity to Predict Low Lung Compliance and Select Intraoperative Tidal Volume During Thoracic Surgery.

Science.gov (United States)

Hoftman, Nir; Eikermann, Eric; Shin, John; Buckley, Jack; Navab, Kaveh; Abtin, Fereidoun; Grogan, Tristan; Cannesson, Maxime; Mahajan, Aman

2017-12-01

Tidal volume selection during mechanical ventilation utilizes dogmatic formulas that only consider a patient's predicted body weight (PBW). In this study, we investigate whether forced vital capacity (FVC) (1) correlates better to total lung capacity (TLC) than PBW, (2) predicts low pulmonary compliance, and (3) provides an alternative method for tidal volume selection. One hundred thirty thoracic surgery patients had their preoperative TLC calculated via 2 methods: (1) pulmonary function test (PFT; TLCPFT) and (2) computed tomography 3D reconstruction (TLCCT). We compared the correlation between TLC and PBW with the correlation between TLC and FVC to determine which was stronger. Dynamic pulmonary compliance was then calculated from intraoperative ventilator data and logistic regression models constructed to determine which clinical measure best predicted low compliance. Ratios of tidal volume/FVC plotted against peak inspiratory pressure were utilized to construct a new model for tidal volume selection. Calculated tidal volumes generated by this model were then compared with those generated by the standard lung-protective formula Vt = 7 cc/kg. The correlation between FVC and TLC (0.82 for TLCPFT and 0.76 for TLCCT) was stronger than the correlation between PBW and TLC (0.65 for TLCPFT and 0.58 for TLCCT). Patients with very low compliance had significantly smaller lung volumes (forced expiratory volume at 1 second, FVC, TLC) and lower diffusion capacity of the lungs for carbon monoxide when compared with patients with normal compliance. An FVC cutoff of 3470 cc was 100% sensitive and 51% specific for predicting low compliance. The proposed equation Vt = FVC/8 significantly reduced calculated tidal volume by a mean of 22.5% in patients with low pulmonary compliance without affecting the mean tidal volume in patients with normal compliance (mean difference 0.9%). FVC is more strongly correlated to TLC than PBW and a cutoff of about 3.5 L can be utilized to predict

Comprehensive Assessment of Compliance with Antimuscarinic Drug Treatment in the Case of Urge Urinary Incontinence of Older Patients.

Science.gov (United States)

Kosilov, Kirill V; Loparev, Sergey A; Kuzina, Irina G; Shakirova, Olga V; Zhuravskaya, Natalya S; Lobodenko, Alexandra

2017-01-01

To investigate the heterogeneous factors affecting the stability of patients older than 60 years in the UI treatment with Antimuscarinics. The prevalence of Urge Incontinence (UI) in older persons reaches 29.3%. The symptoms of urinary incontinence in older people reduce the health related life quality. In 1257 patients over 60 years (857 (68.2%) women - average age 67.8, 400 (31.8%) men - 71.4), who received AM for one year, demographic, socio-economic and health parameters were studied. OABq-SF questionnaires, MOS SF-36, urination diaries, uroflowmetry, income information from the tax offices and outpatient records were used. The compliance to AM treatment within 6 months was retained in 44.2%, and within the year - 26.8% of older patients. At least 40% of the total number of patients refused to continue the treatment for medical reasons. The persons taking Solifenacin (p≤ 0.01), Trospium (p≤ 0.05), or Darifenacin (p≤ 0.05), suffering from severe UI symptoms (p≤ 0.01), and experiencing minor side effects (p≤ 0.01), well-informed about UI treatment methods (p≤ 0.01) prevailed among the treatment compliant patients. At least 20.4% of the patients discontinued their treatment due to economic reasons. The persons with significantly larger annual income (p≤ 0.05) and annual medical cost (p≤ 0.01) prevailed among the treatment compliant patients. About 12.2% of the patients stopped their treatment for reasons related to the social background and psychological status. In this experiment, we found that AM treatment compliance in older patients, in addition to medical parameters and health conditions, is largely affected by the economic as well as social, demographic and psychological factors. The study results can be claimed by practitioners involved in correcting UI symptoms in older people. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Treatment Compliance with Fixed-Dose Combination of Vildagliptin/Metformin in Patients with Type 2 Diabetes Mellitus Inadequately Controlled with Metformin Monotherapy: A 24-Week Observational Study

Directory of Open Access Journals (Sweden)

Grigorios Rombopoulos

2015-01-01

Full Text Available Objective. To evaluate the differences in treatment compliance with vildagliptin/metformin fixed-dose versus free-dose combination therapy in patients with type 2 diabetes mellitus (T2DM in Greece. Design. Adult patients with T2DM, inadequately controlled with metformin monotherapy, (850 mg bid, participated in this 24-week, multicenter, observational study. Patients were enrolled in two cohorts: vildagliptin/metformin fixed-dose combination (group A and vildagliptin metformin free-dose combination (group B. Results. 659 patients were enrolled, 360 were male, with mean BMI 30.1, mean T2DM duration 59.6 months, and mean HbA1c at baseline 8%; 366 patients were assigned to group A and 293 to group B; data for 3 patients was missing. In group A, 98.9% of patients were compliant with their treatment compared to 84.6% of group B. The odds ratio for compliance in group A versus B was (OR 18.9 (95% CI: 6.2, 57.7; P<0.001. In group A mean HbA1c decreased from 8.1% at baseline to 6.9% (P<0.001 at the study end and from 7.9% to 6.8% (P<0.001 in group B. Conclusions. Patients in group A were more compliant than patients in group B. These results are in accordance with international literature suggesting that fixed-dose combination therapies lead to increased compliance to treatment.

The Amsterdam Hip Protector Study: Compliance and determinants of compliance

NARCIS (Netherlands)

van Schoor, N.M.; Asma, G.; Smit, J.H.; Bouter, L.M.; Lips, P.T.A.M.

2003-01-01

Hip protectors appear to be effective in reducing the incidence of hip fractures. However, compliance is often poor. Therefore, the objective of this study was to examine the compliance and determinants of compliance with external hip protectors. A prospective study was performed in residents from

Environmental factors and their association with emergency department hand hygiene compliance: an observational study.

Science.gov (United States)

Carter, Eileen J; Wyer, Peter; Giglio, James; Jia, Haomiao; Nelson, Germaine; Kauari, Vepuka E; Larson, Elaine L

2016-05-01

Hand hygiene is effective in preventing healthcare-associated infections. Environmental conditions in the emergency department (ED), including crowding and the use of non-traditional patient care areas (ie, hallways), may pose barriers to hand hygiene compliance. We examined the relationship between these environmental conditions and proper hand hygiene. This was a single-site, observational study. From October 2013 to January 2014, trained observers recorded hand hygiene compliance among staff in the ED according to the World Health Organization 'My 5 Moments for Hand Hygiene'. Multivariable logistic regression was used to analyse the relationship between environmental conditions and hand hygiene compliance, while controlling for important covariates (eg, hand hygiene indication, glove use, shift, etc). A total of 1673 hand hygiene opportunities were observed. In multivariable analyses, hand hygiene compliance was significantly lower when the ED was at its highest level of crowding than when the ED was not crowded and lower among hallway care areas than semiprivate care areas (OR=0.39, 95% CI 0.28 to 0.55; OR=0.73, 95% CI 0.55 to 0.97). Unique environmental conditions pose barriers to hand hygiene compliance in the ED setting and should be considered by ED hand hygiene improvement efforts. Further study is needed to evaluate the impact of these environmental conditions on actual rates of infection transmission. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

RCR audit of compliance with UK guidelines for the prevention and detection of acute kidney injury in adult patients undergoing iodinated contrast media injections for CT.

Science.gov (United States)

Cope, L H; Drinkwater, K J; Howlett, D C

2017-12-01

To determine radiology departmental compliance with current UK guidance on contrast-induced acute kidney injury (CI-AKI) and to provide data on the incidence of clinically significant post-contrast AKI (PC-AKI) in computed tomography (CT) practice. A questionnaire was sent to all UK acute National Health Service (NHS) providers (NHS boards in Scotland, local health boards in Wales, NHS trusts in England and health and social care trusts in Northern Ireland) to assess compliance of provider protocols with current UK guidelines for the prevention, recognition, and management of CI-AKI. Audit data were collected for 40 consecutive fit outpatients and 40 consecutive acutely unwell patients/inpatients from hospitals within each participating provider to assess clinical compliance. Eighty-nine of 172 (52%) health service providers responded, and data on 7,159 contrast-enhanced CT examinations were provided. Compliance with guidelines was poor with wide variation in clinical practice. The observed incidence of clinically significant (requiring treatment or resulting in death) PC-AKI was zero in 3,590 outpatients, although two patients developed AKI due to other causes (sepsis and progressive malignancy). Fourteen out of 3,569 (0.4%) patients in the inpatient group developed clinically significant PC-AKI, and a further 17 patients were identified who met the Kidney Disease Improving Global Outcomes (KDIGO) definition of AKI (Electronic Supplementary Material Appendix S1), but did not require active treatment, giving an overall incidence of AKI of 0.9%. In patients at high risk due to impaired renal function prior to the scan, there was no difference in the median serum creatinine (SCr) before and after contrast medium administration in either group. Health service provider protocols and clinical practice demonstrate poor compliance with current UK guidance on CI-AKI. A very low incidence of PC- AKI was demonstrated. Copyright © 2017 The Royal College of Radiologists

An investigation of the factors which influence and deter the compliance behaviour of Australian individual taxpayers

OpenAIRE

Devos, Ken Neil Harry

2017-01-01

The tax compliance literature indicates that many factors, including economic, social, psychological and demographic factors, have an impact on the compliance behaviour of taxpayers. Of the two main compliance theories, the economic deterrence theory model and social/fiscal psychology theory model, this study has adopted the latter. The aim of this study was to examine whether or not a relationship exists between selected tax compliance variables (both economic and non-economic) and the attit...

Mapping Tax Compliance

DEFF Research Database (Denmark)

Boll, Karen

2014-01-01

Tax compliance denotes the act of reporting and paying taxes in accordance with the tax laws. Current social science scholarship on tax compliance can almost entirely be divided into behavioural psychology analyses and critical tax studies. This article, which presents two cases of how tax...... compliance is constructed, challenges the explanatory reaches of today's social science approaches, arguing that an alternative approach to understanding tax compliance is worthwhile exploring. This other choice of approach, inspired by actor–network theory (ANT), adopts a more practice-oriented focus...... that studies tax compliance where it takes place as well as what it is made of. Consequently, this article argues that tax compliance is a socio-material assemblage and that complying is a distributed action. The article concludes by highlighting how an ANT approach contributes to the further theoretical...

TAX ADMINISTRATION: Impact of Compliance and Collection Program Declines on Taxpayers

National Research Council Canada - National Science Library

2002-01-01

...) compliance and collection programs. Many view these programs-such as audits to determine whether taxpayers have accurately reported the amount of taxes that they owe and collection follow-up with taxpayers who have not...

Assessment of public perception and environmental compliance at a pulp and paper facility: a Canadian case study.

Science.gov (United States)

Hoffman, Emma; Bernier, Meagan; Blotnicky, Brenden; Golden, Peter G; Janes, Jeffrey; Kader, Allison; Kovacs-Da Costa, Rachel; Pettipas, Shauna; Vermeulen, Sarah; Walker, Tony R

2015-12-01

Communities across Canada rely heavily on natural resources for their livelihoods. One such community in Pictou County, Nova Scotia, has both benefited and suffered, because of its proximity to a pulp and paper mill (currently owned by Northern Pulp). Since production began in 1967, there have been increasing impacts to the local environment and human health. Environmental reports funded by the mill were reviewed and compared against provincial and federal regulatory compliance standards. Reports contrasted starkly to societal perceptions of local impacts and independent studies. Most environmental monitoring reports funded by the mill indicate some levels of compliance in atmospheric and effluent emissions, but when compliance targets were not met, there was a lack of regulatory enforcement. After decades of local pollution impacts and lack of environmental compliance, corporate social responsibility initiatives need implementing for the mill to maintain its social licence to operate.

Patching compliance with full-time vs. part-time occlusion therapy.

Science.gov (United States)

Kane, Jessica; Biernacki, Ron; Fraine, Lisa; Fukuda, Neva; Haskins, Kelsie; Morrison, David G

2013-01-01

Amblyopia is commonly treated with part-time occlusion (PTO) therapy. We have made two anecdotal observations regarding this therapy. First, children undergoing full-time occlusion seem to have better success and compliance rates. Secondly, a subset of children exists that fail PTO but can improve with more aggressive therapy. A retrospective review where treatment, visual outcome, and compliance scores were recorded. Compliance was graded on percent adherence reported by family. Patients scored “1” (for no compliance), “2” (for 1–25% of prescribed treatment performed), “3” (for 26–50%), “4” (for 51–75%), or “5” (for 76–100%). Seventy-six children were enrolled in the study: forty-five were treated with part-time occlusion, twenty-two were treated with full time occlusion (FTO), and nine had a history of failed PTO and were subsequently treated with FTO. Visual outcomes for FTO versus PTO were not statistically significant (P = 0.82). However, compliance rates in FTO were significantly better (P = 0.02). Of the nine patients that failed PTO, four improved an average of three lines with full-time occlusion, and five had no change with more aggressive patching. This study confirms previous reports of similar visual outcomes between PTO and FTO. However, compliance rates for FTO seem to be higher and some children who have failed PTO may improve with FTO.

EWTD compliance amongst Anaesthesia trainees in Ireland.

Science.gov (United States)

Brohan, J; Moore, D

2017-02-01

The implications of the EWTD include a limit of 48 h working week and 11 consecutive hours rest every 24 h. This survey was designed to assess EWTD compliance over designated 1-week and 1-month periods amongst College of Anaesthesetists of Ireland (CAI) trainees and non-training Anaesthesia NCHDs. The two key elements of EWTD compliance were assessed; the compliance to a 48 h working week, and a minimizing of shift duration to 24 h. Existence of protected training time and teaching time were also assessed. This survey was completed by 191 Anaesthesia NCHDs, including 151 responses from CAI trainees; 75 % response rate from CAI trainees. 71 % of respondents worked in excess of 48 h. 37 % of respondents reported to have worked a shift >24 h duration. The average hours worked was 66 h (range 48.5-103 h). Our figures are a contrast to the reported figures in the HSE "Performance Assurance Report". 49 % of respondents reported a change in their working patterns to facilitate EWTD compliance. There appears to be a negative impact on training however, with 68 % respondents missing departmental teaching sessions and 30 % not receiving protected training time. 33 % of respondents were not in favour of full EWTD compliance. As work patterns change, it is vital to ensure that training is not compromised. Previous reports have recommended an increase in consultant numbers, which has yet to be achieved. This may provide a solution to allow service provision, NCHD training and EWTD compliance amongst NCHDs.

Compliance, clinical outcome, and quality of life of patients with stable angina pectoris receiving once-daily betaxolol versus twice daily metoprolol: a randomized controlled trial

Directory of Open Access Journals (Sweden)

Przemyslaw Kardas

2007-05-01

Full Text Available Przemyslaw KardasThe First Department of Family Medicine, Medical University of LodzBackground: A randomized, controlled trial was conducted in an outpatient setting to examine the effect of beta-blocker dosing frequency on patient compliance, clinical outcome, and health-related quality of life in patients with stable angina pectoris.Methods: One hundred and twelve beta-blockers-naive outpatients with stable angina pectoris were randomized to receive betaxolol, 20 mg once daily or metoprolol tartrate, 50 mg twice daily for 8 weeks. The principal outcome measure was overall compliance measured electronically, whereas secondary outcome measures were drug effectiveness and health-related quality of life.Results: The overall compliance was 86.5 ± 21.3% in the betaxolol group versus 76.1 ± 26.3% in the metoprolol group (p < 0.01, and the correct number of doses was taken on 84.4 ± 21.6% and 64.0 ± 31.7% of treatment days, respectively (p < 0.0001. The percentage of missed doses was 14.5 ± 21.5% in the once-daily group and 24.8 ± 26.4% in the twice-daily group (p < 0.01. The percentage of doses taken in the correct time window (58.6% vs 42.0%, p = 0.01, correct interdose intervals (77.4% v 53.1%, p < 0.0001, and therapeutic coverage (85.6% vs 73.7%, p < 0.001 were significantly higher in the once-daily group. Both studied drugs had similar antianginal effectiveness. Health-related quality of life improved in both groups, but this increase was more pronounced in the betaxolol arm in some dimensions.Conclusions: The study demonstrates that patient compliance with once-daily betaxolol is significantly better than with twice daily metoprolol. Similarly, this treatment provides better quality of life. These results demonstrate possible therapeutic advantages of once-daily over twice-daily beta-blockers in the treatment of stable angina pectoris.Keywords: patient compliance, quality of life, stable angina pectoris, randomized controlled trial

Compliance Groundwater Monitoring of Nonpoint Sources - Emerging Approaches

Science.gov (United States)

Harter, T.

2008-12-01

Groundwater monitoring networks are typically designed for regulatory compliance of discharges from industrial sites. There, the quality of first encountered (shallow-most) groundwater is of key importance. Network design criteria have been developed for purposes of determining whether an actual or potential, permitted or incidental waste discharge has had or will have a degrading effect on groundwater quality. The fundamental underlying paradigm is that such discharge (if it occurs) will form a distinct contamination plume. Networks that guide (post-contamination) mitigation efforts are designed to capture the shape and dynamics of existing, finite-scale plumes. In general, these networks extend over areas less than one to ten hectare. In recent years, regulatory programs such as the EU Nitrate Directive and the U.S. Clean Water Act have forced regulatory agencies to also control groundwater contamination from non-incidental, recharging, non-point sources, particularly agricultural sources (fertilizer, pesticides, animal waste application, biosolids application). Sources and contamination from these sources can stretch over several tens, hundreds, or even thousands of square kilometers with no distinct plumes. A key question in implementing monitoring programs at the local, regional, and national level is, whether groundwater monitoring can be effectively used as a landowner compliance tool, as is currently done at point-source sites. We compare the efficiency of such traditional site-specific compliance networks in nonpoint source regulation with various designs of regional nonpoint source monitoring networks that could be used for compliance monitoring. We discuss advantages and disadvantages of the site vs. regional monitoring approaches with respect to effectively protecting groundwater resources impacted by nonpoint sources: Site-networks provide a tool to enforce compliance by an individual landowner. But the nonpoint source character of the contamination

Environmental Compliance Mechanisms

NARCIS (Netherlands)

Merkouris, Panagiotis; Fitzmaurice, Malgosia

2017-01-01

Compliance mechanisms can be found in treaties regulating such diverse issues as human rights, disarmament law, and environmental law. In this bibliography, the focus will be on compliance mechanisms of multilateral environmental agreements (MEAs). Compliance with norms of international

Healthcare professionals' perceptions on the emotional impact of having an inadequate response to antidepressant medications: survey and prospective patient audit.

Science.gov (United States)

Mago, Rajnish; Fagiolini, Andrea; Weiller, Emmanuelle; Weiss, Catherine

2018-01-01

Despite the availability of effective antidepressants, about half of patients with major depressive disorder (MDD) display an inadequate response to their initial treatment. A large patient survey recently reported that 29.8% of MDD patients experiencing an inadequate treatment response felt frustrated about their medication and 19.2% were frustrated with their healthcare provider. This survey and chart audit evaluated healthcare professionals' (HCP) views on the emotional impact of having an inadequate response to antidepressant medication. HCPs who frequently treat patients with MDD completed a survey and chart audit of their MDD patients currently experiencing an inadequate response to antidepressant treatment. 287 HCPs completed 1336 chart audits. HCPs reported that 38% of their patients were trusting/accepting of their MDD medications and 41% of their patients trusted/felt confident with their healthcare provision. Conversely, HCPs reported that 11% of their patients were frustrated with their medication and 5% with their healthcare benefits. HCPs cited impact on daily life (53%) and treatment issues (lack of efficacy and side effects; 50%) as the main drivers for their patients' feelings of frustration. When HCPs recognized patients' feelings of frustration, the top concerns of the HCPs were worsening of symptoms (43%) and non-compliance (41%). This survey and chart audit highlights the emotional burden associated with inadequate responses to MDD treatment in addition to persistent symptoms. Differences between the views of the HCPs and patients are highlighted and suggest that HCPs may underestimate the full impact that having to try numerous medications has on their patients.

Hierarchical Compliance Control of a Soft Ankle Rehabilitation Robot Actuated by Pneumatic Muscles

Directory of Open Access Journals (Sweden)

Quan Liu

2017-12-01

Full Text Available Traditional compliance control of a rehabilitation robot is implemented in task space by using impedance or admittance control algorithms. The soft robot actuated by pneumatic muscle actuators (PMAs is becoming prominent for patients as it enables the compliance being adjusted in each active link, which, however, has not been reported in the literature. This paper proposes a new compliance control method of a soft ankle rehabilitation robot that is driven by four PMAs configured in parallel to enable three degrees of freedom movement of the ankle joint. A new hierarchical compliance control structure, including a low-level compliance adjustment controller in joint space and a high-level admittance controller in task space, is designed. An adaptive compliance control paradigm is further developed by taking into account patient’s active contribution and movement ability during a previous period of time, in order to provide robot assistance only when it is necessarily required. Experiments on healthy and impaired human subjects were conducted to verify the adaptive hierarchical compliance control scheme. The results show that the robot hierarchical compliance can be online adjusted according to the participant’s assessment. The robot reduces its assistance output when participants contribute more and vice versa, thus providing a potentially feasible solution to the patient-in-loop cooperative training strategy.

[The TPE nurse improving the patient's quality of life].

Science.gov (United States)

Mira, Thierry

The impact of interventions by therapeutic education nurses on compliance and the quality of life of patients with chronic diseases has been proven. These different perspectives of caregivers and patients highlight the specific case of the treatment of HIV. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

The impacts of migraine and anxiety disorders on painful physical symptoms among patients with major depressive disorder.

Science.gov (United States)

Hung, Ching-I; Liu, Chia-Yih; Chen, Ching-Yen; Yang, Ching-Hui; Wang, Shuu-Jiun

2014-11-10

No study has simultaneously investigated the impacts of migraine and anxiety disorders on painful physical symptoms (PPS) among patients with major depressive disorder (MDD). The study aimed to investigate this issue. This open-label study enrolled 155 outpatients with MDD, who were then treated with venlafaxine 75 mg per day for four weeks. Eighty-five participants with good compliance completed the treatment. Migraine was diagnosed according to the International Classification of Headache Disorders. MDD and anxiety disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR. The visual analog scale (VAS) was used to evaluate the severity of eight PPS. Multiple linear and logistic regressions were used to investigate the impacts of migraine and anxiety disorders on PPS. Compared with patients without migraine, patients with migraine had a greater severity of PPS at baseline and post-treatment. After controlling for demographic variables and depressive severity, migraine independently predicted the intensities of eight PPS at baseline and four PPS post-treatment. Moreover, migraine independently predicted poorer treatment responses of chest pain and full remission of pains in the head, chest, neck and/or shoulder. Anxiety disorders predicted less full remission of pains in the abdomen and limbs. Migraine and anxiety disorders have negative impacts on PPS among patients with MDD. Integrating the treatment of migraine and anxiety disorders into the management of depression might help to improve PPS and the prognosis of MDD.

National Environmental Policy Act (NEPA) compliance at Sandia National Laboratories/New Mexico (SNL/NM)

International Nuclear Information System (INIS)

Wolff, T.A.

1998-08-01

This report on National Environmental Policy Act (NEPA) compliance at Sandia National Laboratories/New Mexico (SNL/NM) chronicles past and current compliance activities and includes a recommended strategy that can be implemented for continued improvement. This report provides a list of important references. Attachment 1 contains the table of contents for SAND95-1648, National Environmental Policy Act (NEPA) Compliance Guide Sandia National Laboratories (Hansen, 1995). Attachment 2 contains a list of published environmental assessments (EAs) and environmental impact statements (EISs) prepared by SNL/NM. Attachment 3 contains abstracts of NEPA compliance papers authored by SNL/NM and its contractors

National Environmental Policy Act (NEPA) compliance at Sandia National Laboratories/New Mexico (SNL/NM)

Energy Technology Data Exchange (ETDEWEB)

Wolff, T.A. [Sandia National Labs., Albuquerque, NM (United States). Community Involvement and Issues Management Dept.; Hansen, R.P. [Hansen Environmental Consultants, Englewood, CO (United States)

1998-08-01

This report on National Environmental Policy Act (NEPA) compliance at Sandia National Laboratories/New Mexico (SNL/NM) chronicles past and current compliance activities and includes a recommended strategy that can be implemented for continued improvement. This report provides a list of important references. Attachment 1 contains the table of contents for SAND95-1648, National Environmental Policy Act (NEPA) Compliance Guide Sandia National Laboratories (Hansen, 1995). Attachment 2 contains a list of published environmental assessments (EAs) and environmental impact statements (EISs) prepared by SNL/NM. Attachment 3 contains abstracts of NEPA compliance papers authored by SNL/NM and its contractors.

Improving physician hand hygiene compliance using behavioural theories: a study protocol

Directory of Open Access Journals (Sweden)

Squires Janet E

2013-02-01

Full Text Available Abstract Background Healthcare-associated infections affect 10% of patients in Canadian acute-care hospitals and are significant and preventable causes of morbidity and mortality among hospitalized patients. Hand hygiene is among the simplest and most effective preventive measures to reduce these infections. However, compliance with hand hygiene among healthcare workers, specifically among physicians, is consistently suboptimal. We aim to first identify the barriers and enablers to physician hand hygiene compliance, and then to develop and pilot a theory-based knowledge translation intervention to increase physicians’ compliance with best hand hygiene practice. Design The study consists of three phases. In Phase 1, we will identify barriers and enablers to hand hygiene compliance by physicians. This will include: key informant interviews with physicians and residents using a structured interview guide, informed by the Theoretical Domains Framework; nonparticipant observation of physician/resident hand hygiene audit sessions; and focus groups with hand hygiene experts. In Phase 2, we will conduct intervention mapping to develop a theory-based knowledge translation intervention to improve physician hand hygiene compliance. Finally, in Phase 3, we will pilot the knowledge translation intervention in four patient care units. Discussion In this study, we will use a behavioural theory approach to obtain a better understanding of the barriers and enablers to physician hand hygiene compliance. This will provide a comprehensive framework on which to develop knowledge translation interventions that may be more successful in improving hand hygiene practice. Upon completion of this study, we will refine the piloted knowledge translation intervention so it can be tested in a multi-site cluster randomized controlled trial.

The role of pouch compliance measurement in the management of pouch dysfunction

DEFF Research Database (Denmark)

Maeda, Yasuko; Molina, María Elena; Norton, Christine

2010-01-01

PURPOSE: Ileal pouch anal anastomosis is an established option for patients who require total proctocolectomy and restoration of bowel continuity. However, the functional results are not always good and low pouch compliance has been suggested as one possible cause. We aimed to review the results...... of pouch compliance tests over 11 years to assess whether measuring pouch compliance is a useful diagnostic tool to guide management of pouch dysfunction. METHODS: The results of pouch compliance tests performed between 1996 and 2007 together with the details of symptoms, treatments and outcome were...... reviewed. RESULTS: One hundred and forty-one pouch compliance tests were performed. There was no difference in pouch compliance between those with overt pathology (pouchitis, pelvic sepsis or anastomotic stricture) and those with idiopathic pouch dysfunction. In this second group, there was no difference...

PATIENT WEB PORTALS AND PATIENT-PROVIDER RELATIONSHIPS: A SUMMARY PERSPECTIVE.

Science.gov (United States)

Caldwell, Hannah D; Minkoff, Neil B; Murthy, Kalyani

2017-01-01

Patient Web portals (PWPs) have been gaining traction as a means to collect patient-reported outcomes and maintain quality patient care between office visits. PWPs have the potential to impact patient-provider relationships by rendering additional channels for communication outside of clinic visits and could help in the management of common chronic medical conditions. Studies documenting their effect in primary care settings are limited. This perspective aims to summarize the benefits and drawbacks of using PWPs in the management of chronic conditions, such as diabetes mellitus, hypertension, and asthma, focusing on communication, disease management, compliance, potential barriers, and the impact on patient-provider dynamic. After a review of these topics, we present potential future directions. We conducted an exploratory PubMed search of the literature published from inception through December 2015, and focused our subsequent searches specifically to assess benefits and drawbacks of using PWPs in the management of diabetes mellitus, hypertension, and asthma. Our search revealed several potential benefits of PWP implementation in the management of chronic conditions with regards to patient-provider relationships, such as improved communication, disease management, and compliance. We also noted drawbacks such as potentially unreliable reporting, barriers to use, and increased workload. PWPs offer opportunities for patients to report symptoms and outcomes in a timely manner and allow for secure online communication with providers. Despite the drawbacks noted, the overall benefits from successful PWP implementation could improve patient-provider relationships and help in the management of chronic conditions, such as diabetes mellitus, hypertension, and asthma.

ENHANCING VOLUNTARY COMPLIANCE BY REDUCING COMPLIANCE COSTS: A TAXPAYER SERVICE APPROACH

OpenAIRE

Glenn Jenkins; EDWIN FORLEMU

1993-01-01

In this paper an overview is made of the determinants of voluntary tax compliance. Unlike previous treatments of this subject, the cost of taxpayer compliance is considered as an important determinant of overall level of voluntary compliance in a country. A number of ways that tax authorities reduce compliance are discussed, and the most common uses of information technology in providing taxpayer service is described. Finally, the paper considers some of the ways that such activities might be...

Estimation of the clinical and economic consequences of non-compliance with antimicrobial treatment of canine skin infections.

Science.gov (United States)

Van Vlaenderen, Ilse; Nautrup, Barbara Poulsen; Gasper, Sabina M

2011-05-01

The goal of this study was to estimate the health and economic consequences of non-compliance with oral antimicrobial treatment in dogs with superficial pyoderma, wounds or abscesses in the US. A mathematical model (Markov model) which simulated treatment with long-term injectable cefovecin versus oral amoxicillin/clavulanic acid was developed and accounted for the effect of non-compliance on clinical outcomes and mean total treatment costs per patient. Efficacy parameters considered in the model were derived from clinical studies. Treatment failure due to oral antimicrobial treatment non-compliance was approximated from published data at 13.6%. US cost data for 2009 were derived from public sources. When non-compliance was considered as a cause of treatment failure with oral medication, the long-term injectable antibiotic was more effective than oral comparator (162 versus 158 days without clinical signs). Mean total treatment costs were lower with cefovecin (USD 376.74) versus amoxicillin/clavulanic acid (USD 382.34) in dogs of 25 kg; and cefovecin remained cost-saving up to a body weight of 31 kg. In large dogs, cefovecin was more costly; however, total therapy costs were less than 6% greater than with amoxicillin/clavulanic acid. Accordingly the higher drug and administration costs of the long-term injectable antibiotic were totally or substantially offset when non-compliance was considered as reason for treatment failure with oral medication. The model also allowed for the estimation of the impact of various non-compliance scenarios. Copyright © 2011 Elsevier B.V. All rights reserved.

PCI Compliance Understand and Implement Effective PCI Data Security Standard Compliance

CERN Document Server

Chuvakin, Anton

2010-01-01

Identity theft and other confidential information theft have now topped the charts as the #1 cybercrime. In particular, credit card data is preferred by cybercriminals. Is your payment processing secure and compliant?. Now in its second edition, PCI Compliance has been revised to follow the new PCI DSS standard 1.2.1. Also new to this edition: Each chapter has how-to guidance to walk you through implementing concepts, and real-world scenarios to help you relate to the information and better grasp how it impacts your data. This book provides the information that you need to understand the curre

Dietary compliance among diabetes patients attending clinic at new ...

African Journals Online (AJOL)

Background: Diabetes Mellitus is a major public health issue. It is one of the most prevalent medical conditions affecting people and is responsible for high mortality and large amount of potential years of life lost. Diet is the cornerstone of diabetes management, without which its control is impossible. However, compliance to ...

Perspectives on compliance: non-compliance with environmental licenses in the Netherlands

NARCIS (Netherlands)

van Snellenberg, A.H.L.M.; van de Peppel, R.A.

2002-01-01

Compliance with environmental law is not self-evident. In many instances enforcement of environmental regulations is a necessary means for achieving compliance. Assuming that an enforcement strategy, in order to be effective, has to fit the type of non-compliance, we integrate six different

Public Health Impact and Economic Costs of Volkswagen’s Lack of Compliance with the United States’ Emission Standards

Directory of Open Access Journals (Sweden)

Lifang Hou

2016-09-01

Full Text Available The U.S. Environmental Protection Agency (EPA recently issued a notice of violation against Volkswagen (VW for installing a defective device in certain models of diesel cars to circumvent emission tests for nitrogen oxides (NOx. We quantified the health and economic impacts of extra NOx emissions attributable to non-compliant vehicles in the U.S. using the EPA’s Co-Benefits Risk Assessment model. We estimated that the total extra NOx emitted over one year of operation would result in 5 to 50 premature deaths, 687 to 17,526 work days with restricted activity, and economic costs of $43,479,189 to $423,268,502, based on various assumptions regarding emission scenarios and risks. This study highlights the potential impacts of VW vehicles’ lack of compliance on the health and well-being of the U.S. population.

Color fading of the blue compliance indicator encapsulated in removable clear Invisalign Teen® aligners.

Science.gov (United States)

Schott, Timm Cornelius; Göz, Gernot

2011-03-01

To evaluate the color fading in aqueous solutions of the blue dot wear-compliance indicators of the Invisalign Teen® System outside the oral cavity. The compliance indicators in the Invisalign Teen aligners were tested for color resistance in various aqueous models with no saliva involved. Color fading was observed as a function of time, pH, and temperature while compliance indicators were stored in drinking water or sour soft drinks and in conjunction with the use of cleaning tablets and a dishwasher. The findings of color fading were consistent with the color changes observed when the aligners were being worn by patients. Color fading, notably as observed in connection with acidic soft drinks and cleaning techniques, introduces uncertainty into the assessment of actual patient compliance, as reflected by the fading colors of compliance indicators. Compliance indicators are not immune to simple intentional or unintentional manipulations. Therefore, they can best show an estimate of wear time but cannot be recommended as objective wear-time indicators.

Criminal Compliance

Directory of Open Access Journals (Sweden)

Cristina Antonella Andretta

2015-10-01

The article discusses the concepts of both compliance and criminal compliance, its main components and structure as well as the main rules relating to its global application, and finally his emergence in the Ecuadorian legal system.

The role of pouch compliance measurement in the management of pouch dysfunction

DEFF Research Database (Denmark)

Maeda, Yasuko; Molina, Maria E; Norton, Christine

2010-01-01

in pouch compliance between patients with and without each of the symptoms of increased defaecatory frequency, incontinence and evacuation difficulties. The results of the compliance testing did not influence the clinical decision making on idiopathic pouch dysfunction (p=0.77) nor diverted pouches (p=0...

National Environmental Policy Act (NEPA) Compliance Guide, Sandia National Laboratories

Energy Technology Data Exchange (ETDEWEB)

Hansen, R.P. [Hansen Environmental Consultants, Englewood, CO (United States)

1995-08-01

This report contains a comprehensive National Environmental Policy Act (NEPA) Compliance Guide for the Sandia National Laboratories. It is based on the Council on Environmental Quality (CEQ) NEPA regulations in 40 CFR Parts 1500 through 1508; the US Department of Energy (DOE) N-EPA implementing procedures in 10 CFR Part 102 1; DOE Order 5440.1E; the DOE ``Secretarial Policy Statement on the National Environmental Policy Act`` of June 1994- Sandia NEPA compliance procedures-, and other CEQ and DOE guidance. The Guide includes step-by-step procedures for preparation of Environmental Checklists/Action Descriptions Memoranda (ECL/ADMs), Environmental Assessments (EAs), and Environmental Impact Statements (EISs). It also includes sections on ``Dealing With NEPA Documentation Problems`` and ``Special N-EPA Compliance Issues.``

Team care to cure adolescents with braces (avoiding low quality of life, pain and bad compliance): a case–control retrospective study. 2011 SOSORT Award winner

OpenAIRE

Tavernaro, Marta; Pellegrini, Anna; Tessadri, Fabrizio; Zaina, Fabio; Zonta, Andrea; Negrini, Stefano

2012-01-01

Abstract Background Bracing could be efficacious, given good compliance and quality of braces. Recently the SOSORT Brace Treatment Management Guidelines (SBTMG) have highlighted the perceived importance of the professional teams surrounding braced patients. Purpose To verify the impact of a complete rehabilitation team in the adolescent patient with bracing. Materials and methods Design. Initial cross-sectional study, followed by a retrospective case–control study. Population: Thirty-eight pa...

Using Social Cognitive Theory to Predict Medication Compliance Behavior in Patients with Depression in Southern United States in 2016 in a Cross-Sectional Study.

Science.gov (United States)

Bennett, Britney; Sharma, Manoj; Bennett, Russell; Mawson, Anthony R; Buxbaum, Sarah G; Sung, Jung Hye

2018-03-01

Introduction: Depression is a major public health issue. One of the concerns in depression research and practice pertains to non-compliance to prescribed medications. The purpose of the study was to predict compliance with medication use for patients with depression using social cognitive theory (SCT). Based on this study it was envisaged that recommendations for interventions to enhance compliance for medication use could be developed for patients with depression. Methods: The study was conducted using cross sectional design (n=148) in southern United States with a convenience sample of clinic-based depression patients with a 37-item valid and reliable questionnaire. Sample size was calculated to be 148 using G*Power (five predictors with a 0.80 power at the 0.05 alpha level and an estimated effect size of 0.10 with an inflation by 10% for missing data). Social cognitive theory constructs of expectations, self-efficacy and self-efficacy in overcoming barriers, self-control, and environment were reified. Data were analyzed using multiple linear regression and multiple logistic regression analyses. Results: Self-control for taking medication for depression (P=0.04), expectations for taking medication for depression (P=0.025), age (P<0.0001) and race (P=0.04) were significantly related to intent for taking medication for depression (Adjusted R 2 = 0.183). In race, Blacks had lower intent to take medication for depression. Conclusion: Social cognitive theory is weakly predictive with low explained variance for taking medication for depression. It needs to be bolstered by newer theories like integrative model or multi-theory model of health behavior change for designing educational interventions aimed at enhancing compliance to medication for depression.

Using Social Cognitive Theory to Predict Medication Compliance Behavior in Patients with Depression in Southern United States in 2016 in a Cross-Sectional Study

Directory of Open Access Journals (Sweden)

Britney Bennett

2018-03-01

Full Text Available Introduction: Depression is a major public health issue. One of the concerns in depression research and practice pertains to non-compliance to prescribed medications. The purpose of the study was to predict compliance with medication use for patients with depression using social cognitive theory (SCT. Based on this study it was envisaged that recommendations for interventions to enhance compliance for medication use could be developed for patients with depression. Methods: The study was conducted using cross sectional design (n=148 in southern United States with a convenience sample of clinic-based depression patients with a 37-item valid and reliable questionnaire. Sample size was calculated to be 148 using G*Power (five predictors with a 0.80 power at the 0.05 alpha level and an estimated effect size of 0.10 with an inflation by 10% for missing data. Social cognitive theory constructs of expectations, self-efficacy and self-efficacy in overcoming barriers, self-control, and environment were reified. Data were analyzed using multiple linear regression and multiple logistic regression analyses. Results: Self-control for taking medication for depression (P=0.04, expectations for taking medication for depression (P=0.025, age (P<0.0001 and race (P=0.04 were significantly related to intent for taking medication for depression (Adjusted R2 = 0.183. In race, Blacks had lower intent to take medication for depression. Conclusion: Social cognitive theory is weakly predictive with low explained variance for taking medication for depression. It needs to be bolstered by newer theories like integrative model or multi-theory model of health behavior change for designing educational interventions aimed at enhancing compliance to medication for depression.

Estimation of the compliance of the human capacitance vessels using radionuclide plethysmography

International Nuclear Information System (INIS)

Takatsu, Hisato; Gotoh, Kohshi; Suzuki, Takahiko

1988-01-01

Radionuclide (RN) plethysmography with Tc-99m RBC was performed in 32 patients with heart disease with the purpose of obtaining compliance of human capacitance vessels. When equilibrium was achieved, RN counts of the region of interest and venous pressure in the forearm were sequentially recorded when the vein of the upper arm was occluded with a cuff inflator. Based on the RN count-venous pressure curve, the specific compliance of the forearm vein and compliance of systemic venous system (SVS) were estimated. In the group of the NYHA functional classification I, which is recognized as hemodynamically ''normal'', the compliance of SVS was 129.8 +- 25.9 ml · mmHg -1 (mean +- SD; n = 9). In comparing the NYHA functional classification and the compliance of SVS, the compliance of SVS was significantly decreased for severer heart failure. Tongue administration of nitroglycerin (0.6 mg) significantly increased the compliance of SVS (p < 0.01). (Namekawa, K.)

Esophageal Sensorimotor Function and Psychological Factors Each Contribute to Symptom Severity in Globus Patients.

Science.gov (United States)

Rommel, Nathalie; Van Oudenhove, Lukas; Arts, Joris; Caenepeel, Philip; Tack, Jan; Pauwels, Ans

2016-10-01

Altered upper esophageal sphincter (UES) and esophageal body (EB) sensorimotor function and psychosocial factors may both be involved in symptom generation in globus, but their common impact is not yet assessed. The aim of the study is (1) to compare UES and EB sensitivity and compliance of globus patients with healthy controls (HC); (2) to study the association of globus symptom severity (GSS) with UES and EB sensitivity and compliance, UES motor function and psychosocial factors. In 58 globus patients, GSS, somatization, and anxiety disorders were determined using validated questionnaires. In 26 HC and 42/58 patients, UES and EB sensitivity and compliance were assessed twice using barostat measurements. UES function of 27 globus patients was evaluated using high-resolution manometry. Bivariate correlations and a general linear model tested the association of these factors with GSS. UES and EB compliance did not differ between globus patients and HC. Upon repeated distension, UES habituation was seen in both groups, whereas EB sensitization (23.3±1.3 vs. 19.5±1.5 mm Hg, Pdisorder (t=3.04, P=0.004), and post-traumatic stress severity (ρ=0.40, P=0.005) were associated with GSS. UES compliance and somatization were independently associated with GSS. A trend (P=0.061) was found for the association of GSS with change in EB compliance. UES compliance, change in EB compliance, and somatization explain 40% of the variance in GSS. This indicates that globus is a complex disorder of the brain-gut axis rather than a "psychosomatic" disorder or a peripheral esophageal disorder.

Social Support of Patients with Type 2 Diabetes in Marginalized Contexts in Mexico and Its Relation to Compliance with Treatment: A Sociocultural Approach

Science.gov (United States)

Juárez-Ramírez, Clara; Théodore, Florence L.; Villalobos, Aremis; Jiménez-Corona, Aida; Lerin, Sergio; Nigenda, Gustavo; Lewis, Sarah

2015-01-01

Objective This study aimed to describe the ways social support works in the daily life of patients with type 2 diabetes living in conditions of social and economic marginality, in order to understand how that support relates to treatment compliance. Methods Sequential mixed methods research was used. The sample of patients was obtained from primary health care units and selected considering regional representativeness, and levels of morbidity and mortality for type 2 diabetes. Results Results point to the nuclear family as the main source of support. Regardless of the area of residence, four main dimensions of support were identified: economic support, help with treatment compliance, emotional support, and material aid. Conclusions We conclude that the support network assists the patient in different ways and helps cope with the disease, but in conditions of social and economic marginality, does not guarantee the quality of attention nor enable the self-management of treatment. PMID:26545122

Does educating nurses with ventilator-associated pneumonia prevention guidelines improve their compliance?

Science.gov (United States)

Aloush, Sami M

2017-09-01

This study aimed to compare the compliance with ventilator-associated pneumonia (VAP)-prevention guidelines between nurses who underwent an intensive educational program and those who did not, and to investigate other factors that influence nurses' compliance. A 2-group posttest design was used to examine the effect of the VAP-prevention guidelines education on nurses' compliance. Participants were randomly assigned to experimental and control groups. The overall nurses' compliance scores were moderate. There was no statistically significant difference in compliance between the nurses who received VAP education and those who did not (t[100] = -1.43; P = .15). The number of beds in the unit and the nurse-patient ratio were found to influence nurses' compliance. Education in VAP-prevention guidelines will not improve nurses' compliance unless other confounding factors, such as their workload, are controlled. It is imperative to reduce nurses' workload to improve their compliance and enhance the effectiveness of education. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Frequency Dependence of Damping and Compliance in Loudspeaker Suspensions

DEFF Research Database (Denmark)

Thorborg, Knud; Tinggaard, Carsten; Agerkvist, Finn T.

2010-01-01

]. It is an empirical model mathematically describing the effects of visco-elasticity in loudspeaker suspensions. The evaluation is to a high degree based on test loudspeakers with rubber surrounds with a high content of plasticizer combining high compliance and high damping. This is very effective to reduce rim...... resonances, but less used in high quality loudspeakers today – where “Low Loss Rubber Surround” is currently seen as a marketing feature, as it is expected to have positive impact on sound quality. The plasticized type of surround shows significant creep, followed by compliance and damping increasing towards...... - with the additives normally used to adjust stiffness and damping - neither frequency dependency of compliance nor creep are significant problems. Despite this, experience shows that frequency dependent mechanical damping nevertheless might be present. In this paper some modifications to the LOG-model are proposed...

Feasibility and Acceptability of Utilizing a Smartphone Based Application to Monitor Outpatient Discharge Instruction Compliance in Cardiac Disease Patients around Discharge from Hospitalization

Directory of Open Access Journals (Sweden)

Aimee M. Layton

2014-01-01

Full Text Available The purpose of this study was to determine the feasibility and acceptability of utilizing a smartphone based application to monitor compliance in patients with cardiac disease around discharge. For 60 days after discharge, patients’ medication compliance, physical activity, follow-up care, symptoms, and reading of education material were monitored daily with the application. 16 patients were enrolled in the study (12 males, 4 females, age 55 ± 18 years during their hospital stay. Five participants were rehospitalized during the study and did not use the application once discharged. Seven participants completed 1–30 days and four patients completed >31 days. For those 11 patients, medication reminders were utilized 37% (1–30-day group and 53% (>31-day group of the time, education material was read 44% (1–30 and 53% (>31 of the time, and physical activity was reported 25% (1–30 and 42% (>31 of the time. Findings demonstrated that patients with stable health utilized the application, even if only minimally. Patients with decreased breath sounds by physical exam and who reported their health as fair to poor on the day of discharge were less likely to utilize the application. Acceptability of the application to report health status varied among the stable patients.

Interventions for enhancing medication compliance/adherence with benefits in treatment outcomes

Directory of Open Access Journals (Sweden)

Hagen, Anja

2007-01-01

Full Text Available Scientific background: Poor compliance or adherence in drug therapy can cause increased morbidity, mortality and enormous costs in the healthcare system (in Germany annually approximately 10 billion euros. Different methods are used for enhancing the compliance or adherence. Research questions: The evaluation addresses the questions about existence, efficacy, cost-benefit relation as well as ethical-social and juridical implications of strategies for enhancing compliance or adherence in drug therapy with concomitant improvements in treatment outcomes. Methods: A systematic literature search was conducted in the medical, also health economic relevant, literature databases in January 2007, beginning from 2002. Systematic reviews on the basis of (randomised controlled trials (RCT concerning interventions to enhance compliance or adherence with regard to treatment outcomes as well as systematic reviews of health economic analyses were included in the evaluation. Additionally, it was also searched for publications which primarily considered ethical-social and juridical aspects of these interventions for the German context. Results: One systematic review with data for 57 RCT was included in the medical evaluation and one systematic review with data for six studies into the health economic evaluation. No publication primary concerning ethical-social or juridical implications could be identified. A significant positive effect on the treatment outcome was reported for 22 evaluated interventions. For many interventions the results can be classified as reliable: counseling with providing an information leaflet and compliance diary chart followed by phone consultation for helicobacter pylori positive patients, repeated counseling for patients with acute asthma symptoms, telephone calls to establish the level of compliance and to make recommendations based on that for the therapy of cardiovascular diseases, calls of an automated telephone system with phone

The monitoring of relative changes in compartmental compliances of brain

International Nuclear Information System (INIS)

Kim, Dong-Joo; Carrera, Emmanuel; Castellani, Gianluca; Zweifel, Christian; Smielewski, Peter; Pickard, John D; Czosnyka, Marek; Kasprowicz, Magdalena; Lavinio, Andrea; Sutcliffe, Michael P F

2009-01-01

The study aimed to develop a computational method for assessing relative changes in compartmental compliances within the brain: the arterial bed and the cerebrospinal space. The method utilizes the relationship between pulsatile components in the arterial blood volume, arterial blood pressure (ABP) and intracranial pressure (ICP). It was verified by using clinical recordings of intracranial pressure plateau waves, when massive vasodilatation accompanying plateau waves produces changes in brain compliances of the arterial bed (C a ) and compliance of the cerebrospinal space (C i ). Ten patients admitted after head injury with a median Glasgow Coma Score of 6 were studied retrospectively. ABP was directly monitored from the radial artery. Changes in the cerebral arterial blood volume were assessed using Transcranial Doppler (TCD) ultrasonography by digital integration of inflow blood velocity. During plateau waves, ICP increased (P = 0.001), CPP decreased (P = 0.001), ABP remained constant (P = 0.532), blood flow velocity decreased (P = 0.001). Calculated compliance of the arterial bed C a increased significantly (P = 0.001); compliance of the CSF space C i decreased (P = 0.001). We concluded that the method allows for continuous monitoring of relative changes in brain compartmental compliances. Plateau waves affect the balance between vascular and CSF compartments, which is reflected by the inverse change of compliance of the cerebral arterial bed and global compliance of the CSF space

The roles of safety and compliance in determining effectiveness of topical therapy for psoriasis.

Science.gov (United States)

Stein Gold, Linda; Corvari, Linda

2007-01-01

Topical therapies are the mainstays of treatment for most patients with psoriasis because they relieve symptoms and reduce the size and severity of lesions. The effectiveness of a therapeutic intervention is a function of drug efficacy (determined by randomized clinical trial results) and patient safety and compliance. Alterations in any parameter can have a substantial influence on clinical outcomes. However, topical agents can be associated with unwanted and potentially toxic side effects that make physicians reluctant to prescribe them, and patients intentionally discontinue treatment with these topical agents. To maximize effectiveness and improve patient safety, physicians may prescribe medications in combination, sequential, or rotational therapeutic regimens. This treatment strategy has the potential to improve the overall efficacy and safety of topical therapy; however, the effectiveness of this method may be compromised because the complexity of the therapeutic regimen may decrease patient compliance. Newer topical therapies that have a convenient once-daily dosing schedule are needed and will have important implications for patient compliance.

Increased arterial compliance in decompensated cirrhosis

DEFF Research Database (Denmark)

Henriksen, Jens Henrik; Møller, Søren; Schifter, S

1999-01-01

BACKGROUND/AIMS: In patients with cirrhosis, the systemic circulation is hyperdynamic with low arterial blood pressure and reduced systemic vascular resistance. The present study was undertaken to estimate the compliance of the arterial tree in relation to severity of cirrhosis, circulating level...... of the vasodilator, calcitonin gene-related peptide (CGRP) and mean arterial blood pressure (MAP). METHODS: Arterial compliance (COMPart=deltaV/deltaP) was determined as the stroke volume relative to pulse pressure (i.e. systolic minus diastolic blood pressure) during a haemodynamic evaluation of portal hypertension...... of CGRP (r=0.34, pcompliance in cirrhosis is directly related to the severity of the disease and to the elevated level of circulating vasodilator peptide CGRP, and inversely related...

[The role of the nurse in encouraging compliance in dialysis patients].

Science.gov (United States)

Lethuillier, Valérie

2010-05-01

The impact of starting dialysis on patients with renal failure requires nurses to draw on their educational, pedagogical and interpersonal skills. It is important to monitor the patients in their daily lives to support them and encourage them to comply with their prescribed therapy.

Effects of Heated Humidification and Topical Steroids on Compliance, Nasal Symptoms, and Quality of Life in Patients with Obstructive Sleep Apnea Syndrome Using Nasal Continuous Positive Airway Pressure

Science.gov (United States)

Ryan, Silke; Doherty, Liam S.; Nolan, Geraldine M.; McNicholas, Walter T.

2009-01-01

Background: Nasal side effects are common in patients with obstructive sleep apnea syndrome (OSAS) starting on nasal continuous positive airway pressure (CPAP) therapy. We tested the hypothesis that heated humidification or nasal topical steroids improve compliance, nasal side effects and quality of life in this patient group. Methods: 125 patients with the established diagnosis of OSAS (apnea/hypopnea index ≥ 10/h), who tolerated CPAP via a nasal mask, and who had a successful CPAP titration were randomized to 4 weeks of dry CPAP, humidified CPAP or CPAP with additional topical nasal steroid application (fluticasone, GlaxoWellcome). Groups were similar in all demographic variables and in frequency of nasal symptoms at baseline. Outcome measures were objective compliance, quality of life (short form 36), subjective sleepiness (Epworth Sleepiness Scale score) and nasal symptoms such as runny, dry or blocked nose, sneezing and headaches; all variables assessed using a validated questionnaire and by direct interview. Results: There was no difference in compliance between groups after 4 weeks (dry: 5.21 ± 1.66 h/night, fluticasone: 5.66 ± 1.68, humidifier: 5.21 ± 1.84; p = 0.444). Quality of life and subjective sleepiness improved in all groups, but there were no differences in the extent of improvement. Nasal Symptoms were less frequently reported in the humidifier group (28%) than in the remaining groups (dry: 70%, fluticasone: 53%, p = 0.002). However, the addition of fluticasone resulted in increased frequency of sneezing. Conclusion: The addition of a humidifier, but not nasal steroids decreases the frequency of nasal symptoms in unselected OSAS patients initiating CPAP therapy; however compliance and quality of life remain unaltered. Citation: Ryan S; Doherty LS; Nolan GM; McNicholas WT. Effects of heated humidification and topical steroids on compliance, nasal symptoms, and quality of life in patients with obstructive sleep apnea syndrome using nasal

Auditory training and challenges associated with participation and compliance.

Science.gov (United States)

Sweetow, Robert W; Sabes, Jennifer Henderson

2010-10-01

When individuals have hearing loss, physiological changes in their brain interact with relearning of sound patterns. Some individuals utilize compensatory strategies that may result in successful hearing aid use. Others, however, are not so fortunate. Modern hearing aids can provide audibility but may not rectify spectral and temporal resolution, susceptibility to noise interference, or degradation of cognitive skills, such as declining auditory memory and slower speed of processing associated with aging. Frequently, these deficits are not identified during a typical "hearing aid evaluation." Aural rehabilitation has long been advocated to enhance communication but has not been considered time or cost-effective. Home-based, interactive adaptive computer therapy programs are available that are designed to engage the adult hearing-impaired listener in the hearing aid fitting process, provide listening strategies, build confidence, and address cognitive changes. Despite the availability of these programs, many patients and professionals are reluctant to engage in and complete therapy. The purposes of this article are to discuss the need for identifying auditory and nonauditory factors that may adversely affect the overall audiological rehabilitation process, to discuss important features that should be incorporated into training, and to examine reasons for the lack of compliance with therapeutic options. Possible solutions to maximizing compliance are explored. Only a small portion of audiologists (fewer than 10%) offer auditory training to patients with hearing impairment, even though auditory training appears to lower the rate of hearing aid returns for credit. Patients to whom auditory training programs are recommended often do not complete the training, however. Compliance for a cohort of home-based auditory therapy trainees was less than 30%. Activities to increase patient compliance to auditory training protocols are proposed. American Academy of Audiology.

Factors associated with sun protection compliance: results from a nationwide cross-sectional evaluation of 2215 patients from a dermatological consultation.

Science.gov (United States)

Sattler, U; Thellier, S; Sibaud, V; Taïeb, C; Mery, S; Paul, C; Meyer, N

2014-06-01

Campaigns designed to promote sun protection often fail to induce long-term changes in behaviour. There is limited information on patients with low compliance to sun protection recommendations from dermatologists. To characterize dermatology patients at higher risk of low compliance to sun protection measures, and to investigate the relationship between sun protection behaviour, knowledge about accurate sun protection recommendations, ultraviolet (UV)-associated risks and level of UV exposure. An anonymous self-administered multiple-choice questionnaire was distributed by dermatologists to patients receiving a sunscreen prescription. Four domains were explored: sun protection behaviour, sun protection knowledge, level of UV exposure and knowledge about UV-associated risks. We modelled sun protection behaviour and determined factors associated with low compliance to sun protection measures. In total 2215 questionnaires were analysed. Patients stratified by risk who better complied with sun protection measures had a better knowledge of UV-associated risks (mean score 14·45 ± 3·20 vs. 12·75 ± 3·29 and 11·20 ± 3·80, P protection measures (mean score 12·08 ± 2·79 vs. 10·68 ± 3·11 and 9·00 ± 3·63, P protection measures also reported higher levels of sun exposure (mean score 4·24 ± 2·26 vs. 4·02 ± 2·05 and 3·34 ± 2·14, P protection behaviour were age below 20 or over 64 years, male sex, lower knowledge about accurate sun protection recommendations and UV-associated risks, and low UV exposure. This study shows the complex relationship between UV exposure, knowledge about UV-associated risks, and knowledge about sun protection recommendations and behaviour. Future skin cancer prevention programmes should focus on specific populations with low sun protection behaviour and high UV exposure. © 2014 British Association of Dermatologists.

Uncontrolled chronic disease: patient non-compliance or clinical mismanagement?

Science.gov (United States)

Javors, Jonathan R; Bramble, Judith E

2003-01-01

A study group of 30 individuals was randomly chosen from 1,379 beneficiaries predicted to be at risk for health care complications at a large, Midwest, industrial company currently experiencing increased health care costs. All 30 individuals had one or more chronic illness, primarily diabetes, cardiovascular disease, or asthma. Through analysis of medical records, a self-reporting health risk assessment survey, and personal contact with both patients and clinicians, each study individual was assessed as to whether his disease(s) was under control, the individual was compliant with his treatment protocol, and whether the supervising clinician was following nationally accepted standards of care. Fewer than 50% of the individuals in the study group had their chronic illness(es) under control. Those individuals whose treatment adhered to national guidelines were significantly more likely to have their disease under control (p Behavioral (external) barriers were most often cited as the reason a clinical practitioner did not follow the appropriate national standard of care. Most clinicians were aware of and familiar with the guidelines; a few either did not agree with or misunderstood the guidelines. The results of this study suggest that changing clinical practice behaviors to better ensure compliance to national standards of care may make a substantial difference in chronic disease control.

Continuous assessment of carotid intima-media thickness applied to estimate a volumetric compliance using B-mode ultrasound sequences

International Nuclear Information System (INIS)

Pascaner, A F; Craiem, D; Casciaro, M E; Graf, S; Danielo, R; Guevara, E

2015-01-01

Recent reports have shown that the carotid artery wall had significant movements not only in the radial but also in the longitudinal direction during the cardiac cycle. Accordingly, the idea that longitudinal elongations could be systematically neglected for compliance estimations became controversial. Assuming a dynamic change in vessel length, the standard measurement of cross-sectional compliance can be revised. In this work, we propose to estimate a volumetric compliance based on continuous measurements of carotid diameter and intima-media thickness (IMT) from B-mode ultrasound sequences. Assuming the principle of conservation of the mass of wall volume (compressibility equals zero), a temporal longitudinal elongation can be calculated to estimate a volumetric compliance. Moreover, elongations can also be estimated allowing small compressibility factors to model some wall leakage. The cross-sectional and the volumetric compliance were estimated in 45 healthy volunteers and 19 asymptomatic patients. The standard measurement underestimated the volumetric compliance by 25% for young volunteers (p < 0.01) and 17% for patients (p < 0.05). When compressibility factors different from zero were allowed, volunteers and patients reached values of 9% and 4%, respectively. We conclude that a simultaneous assessment of carotid diameter and IMT can be employed to estimate a volumetric compliance incorporating a longitudinal elongation. The cross-sectional compliance, that neglects the change in vessel length, underestimates the volumetric compliance. (paper)

Formalizing and appling compliance patterns for business process compliance

NARCIS (Netherlands)

Elgammal, A.; Turetken, O.; van den Heuvel, W.; Papazoglou, M.

2016-01-01

Today’s enterprises demand a high degree of compliance of business processes to meet diverse regulations and legislations. Several industrial studies have shown that compliance management is a daunting task, and organizations are still struggling and spending billions of dollars annually to ensure

Formalizing and applying compliance patterns for business process compliance

NARCIS (Netherlands)

Elgammal, A.F.S.A.; Türetken, O.; van den Heuvel, W.J.A.M.; Papazoglou, M.

Today’s enterprises demand a high degree of compliance of business processes to meet diverse regulations and legislations. Several industrial studies have shown that compliance management is a daunting task, and organizations are still struggling and spending billions of dollars annually to ensure

Diagnostic information for compliance checking of temporal compliance requirements

NARCIS (Netherlands)

Ramezani Taghiabadi, E.; Fahland, D.; Dongen, van B.F.; Aalst, van der W.M.P.; Salinesi, C.; Norrie, M.C.; Pastor, O.

2013-01-01

Compliance checking is gaining importance as today’s organizations need to show that operational processes are executed in a controlled manner while satisfying predefined (legal) requirements or service level agreements. Deviations may be costly and expose an organization to severe risks. Compliance

The "physician on call patient engagement trial" (POPET): measuring the impact of a mobile patient engagement application on health outcomes and quality of life in allergic rhinitis and asthma patients.

Science.gov (United States)

Cingi, Cemal; Yorgancioglu, Arzu; Cingi, Can Cemal; Oguzulgen, Kıvılcım; Muluk, Nuray Bayar; Ulusoy, Seçkin; Orhon, Nezih; Yumru, Cengiz; Gokdag, Dursun; Karakaya, Gul; Çelebi, Şaban; Çobanoglu, H Bengü; Unlu, Halis; Aksoy, Mehmet Akif

2015-06-01

In this prospective, multicenter, randomized, controlled, double-blind study, we investigated the impact of a mobile patient engagement application on health outcomes and quality of life in allergic rhinitis (AR) and asthma patients. In total, 327 patients with diagnoses of persistent AR or mild-to-severe persistent asthma were randomized into 2 intervention groups and 2 control groups upon their admission at outpatient clinics. The intervention groups (POPET-AR and POPET-Asthma) received a mobile phone application ("physician on call patient engagement trial" [POPET]), enabling them to communicate with their physician, and record their health status and medication compliance. The AR groups completed the Rhinitis Quality of Life Questionnaire (RQLQ) at initiation and at the first month of the study. The asthma groups completed the Asthma Control Test (ACT) at initiation and at the third month of the study. The POPET-AR group showed better clinical improvement than the control group in terms of the overall RQLQ score as well in measures of general problems, activity, symptoms other than nose/eye, and emotion domains (p 19) compared with the control group (27%); this was statistically significant (p mobile engagement platform, such as POPET, can have a significant impact on health outcomes and quality of life in both AR and asthma, potentially decreasing the number of hospital admissions, repeat doctor visits, and losses in productivity. Improvements were seen in domains related to activity, productivity, perception of disease, and emotion. © 2015 ARS-AAOA, LLC.

A systematic review of compliance with palivizumab administration for RSV immunoprophylaxis.

Science.gov (United States)

Frogel, Michael P; Stewart, Dan L; Hoopes, Michael; Fernandes, Ancilla W; Mahadevia, Parthiv J

2010-01-01

;and an abstract database, Medical Intelligence Solution, for citations through April 2008. Specific search terms used were palivizumab with patient compliance, patient adherence, or patient persistence. Twenty-five articles and abstracts met the inclusion criteria. Available studies were mostly retrospective or observational prospective.Compliance, defined in various ways across the studies, varied between 25% and 100%, and 12 studies identified some of the factors related to noncompliance. Compliance generally was lower among Medicaid patients,African American patients, and other minorities. Ten studies (3 manuscripts and 7 abstracts) investigated the association of administration of prophylaxis through monthly home visits by a health professional with parental compliance with therapy. Most of the home-based programs were associated with higher compliance rates compared with clinic or office programs.Rates as high as 94% and 64% were achieved when Medicaid infants and infants of minority descent, respectively, received their doses through a home health program. When these infants received their doses at a clinic or office, depending on the definition of compliance, rates were 61%-100% for Medicaid infants and 44% for infants of minority descent. Reminder telephone calls to parents or caregivers, comprehensive multidisciplinary programs that included extensive counseling of parents, calendars with sticker reminders, and education in the language native to parents also were associated with increased compliance, although statistical significance was reported in only 1 study. Several studies recommended educating parents on the benefits of RSV prophylaxis, alleviating transportation and language difficulties, recognizing cultural differences and biases, and clarifying misperception of RSV illness severity. Home health programs had lower rates of RSV hospitalizations than office-based programs in 3 analyses conducted in 2 studies. In 4 other abstracts, the rates of RSV

Development, Implementation and Compliance of Treatment Pathways in Radiation Medicine

Directory of Open Access Journals (Sweden)

Louis ePotters

2013-05-01

Full Text Available INTRODUCTION: While much emphasis on safety in the radiation oncology clinic is placed on process, there remains considerable opportunity to increase safety, enhance outcomes and avoid ad-hoc care by instituting detailed treatment pathways. The purpose of this study was to review the process of developing evidence and consensus-based, outcomes-oriented treatment pathways that standardize treatment and patient management in a large multicenter radiation oncology practice. Further, we reviewed our compliance in incorporating these directives into our day-to-day clinical practice. METHODS: Using the Institute of Medicine guideline for developing treatment pathways, 87 disease specific pathways were developed and incorporated into the electronic medical system in our multi-facility radiation oncology department. Compliance in incorporating treatment pathways was assessed by mining our EMR data from January 1, 2010 through February 2012 for patients with breast and prostate cancer. RESULTS: This retrospective analysis of data from electronic medical records found overall compliance to breast and prostate cancer treatment pathways to be 97% and 99%, respectively. The reason for non-compliance proved to be either a failure to complete the prescribed care based on grade II or III toxicity (n=1 breast, 3 prostate or patient elected discontinuance of care (n=1 prostate or the physician chose a higher dose for positive/close margins (n=3 breast. CONCLUSION: This study demonstrates that consensus and evidence-based treatment pathways can be developed and implemented in a multi-center department of radiation oncology. And that for prostate and breast cancer there was a high degree of compliance using these directives. The development and implementation of these pathways serve as a key component of our safety program, most notably in our effort to facilitate consistent decision-making and reducing variation between physicians.

Compliance and toxicity of the hypoxic radiosensitizer nimorazole in the treatment of patients with head and neck squamous cell carcinoma (HNSCC)

DEFF Research Database (Denmark)

Metwally, Mohamed Ahmed Hassan; Frederiksen, Katrine Diemer; Overgaard, Jens

2014-01-01

Abstract Purpose. To evaluate the compliance and toxicity of the hypoxic radiosensitizer nimorazole in head and neck cancer patients. Methods. A retrospective study of patients with head and neck squamous cell carcinoma (HNSCC), treated in Denmark between 1990 and 2013. All patients treated...... with radical radiotherapy (± chemotherapy) [66-70 Gy; 33-35 fractions; 2 Gy/fraction; 5-6 fractions/week] concomitant with the hypoxic radiosensitizer nimorazole. Nimorazole was administered as oral tablets in doses of approximately 1.2 g/m(2) body surface area in connection with the first of each daily...

[Effect of compliance with an antibiotic prophylaxis protocol in surgical site infections in appendectomies. Prospective cohort study].