Search

Aims: Tyrosine kinase inhibitors (TKIs) have been successful in changing the course of chronic myeloid leukaemia (CML) due to their high efficacy. However, their effectiveness is conditioned by adherence to treatment. The aim of this study was to analyse the adherence of CML patients treated with TKIs and to evaluate the impact of pharmaceutical care on adherence in a prospective and interventional manner., Methods: Multicentre, prospective study including CML patients on treatment with TKIs attending the outpatient units of the Pharmacy Services. Adherence was assessed using a combination of two methods: the Simplified Adherence Problems Scale and the treatment dispensing register (a patient with a percentage <90% being considered "non-adherent"); patients who demonstrated a non-adherence in either of these two methods were classified as "non-adherent patients". In individuals with inadequate adherence, PC was reinforced for 8 months by means of a specific programme., Results: A total of 130 patients were included, 56.9% had optimal adherence to treatment. Pharmaceutical care in the oncohaematology-specific outpatient units of the Pharmacy Services improved adherence (from 67.1% to 90.9%; p < 0.001) while the generalist outpatient units kept it constant (from 70.2% to 72.4%; p = 0.509)., Conclusions: Adherence is one of the most relevant parameters in the effectiveness of chronic treatments. Approximately half of our CML patients showed inadequate adherence to TKIs. This is the first prospective study to determine that the pharmacist's actions in oncohaematology-specific outpatient units of the Pharmacy Services are capable of influencing adherence and improving it., (Copyright © 2024. Publicado por Elsevier España, S.L.U.)

Background: The Maastricht V Consensus recommends quadruple therapies as first-line Helicobacter pylori treatment in high clarithromycin (CLA) resistance areas., Aims: To compare efficacy, side effects and compliance between quadruple concomitant non-bismuth vs bismuth quadruple therapy., Method: Prospective study enrolling H. pylori-positive patients. Omeprazol and a three-in-one formulation of bismuth-metronidazol-tetracycline (OBMT-3/1) for 10 days, or combination of omeprazol-clarithromycin-amoxicillin-metronidazol (OCAM) for 14 days, were prescribed. Eradication outcome was assessed by urea breath test or histology. Side effects and compliance were recorded during the treatment period with specific questionnaires., Results: 404 patients were recruited (median age 53 years; 62.87% women). In 382 (183 with OCAM, 199 with OBMT-3/1) the post-treatment test result was available. The eradication rates were 85.94% (CI95%: 80.20-90.52) with OCAM and 88.21% (CI95%: 83.09-92.22) with OBMT-3/1 (p=0.595) in intention-to-treat analysis, whilst in per protocol analysis they were 91.12% (CI95%: 85.78-94.95) and 96.17% (CI95%: 92.28-98.45) respectively (p=0.083). Compliance over 90% was 91.35% with OCAM and 92.04% with OBMT-3/1 (p=0.951). Some side effect was present in 94.02% with OCAM and in 88.89% with OBMT-3/1 (p=0.109), being longer (12 vs 7 days, p<0.0001) and more severe (p<0.0001) with OCAM., Conclusions: In a high CLA-resistance area, there are no differences between OBMT-3/1 and OCAM in H. pylori eradication and compliance rates, but OBMT-3/1 achieves a higher safety profile., (Copyright © 2020 Elsevier España, S.L.U. All rights reserved.)

Objective: To test the effectiveness of a program to improve treatment adherence in new onset hypertensive patients., Design: This is a quasi-experimental study., Location: Four health centers in Almeria., Participants: A total of 120 subjects between 18 and 65 years, diagnosed with hypertension within the previous 12 months., Main Measurements: The participants were divided into three groups: intervention group A, which received educational instruction, intervention group B, educational instruction and feedback process, and the control group C, received usual care. Adherence was determined by lifestyle (diet, physical activity, smoking, alcohol) and drug treatment., Results: As regards diet and physical activity, there were significant differences between performance groups after intervention (p<0,05), with better adherence levels being found in group B subjects for these variables. Better adherence to pharmacological treatment was also observed in these patients. No significant results were found regarding alcohol and smoking., Conclusions: In the study population, patients undergoing educational instruction and feedback had better adherence levels than those who received only instruction or usual treatment., (Copyright © 2013 Elsevier España, S.L.U. All rights reserved.)

Therapeutic adherence is defined as the extent to which a person's behavior (taking medications, following a diet and changes in lifestyle) coincides with health recommendations (WHO, 2004). We can deduce that is a multiple, complex and changing phenomenon, that there can be total or partial adherence to a treatment, and depending on timing and circumstances. Lack of adherence is a worrying problem; due to its great magnitude and complexity (over two hundred factors) it is responsible for the increased morbid-mortality, complications, hospital admissions, health costs, and dissatisfaction of the user and health professionals. In this paper we develop effective interventions in changing habits and improving adherence: cognitive (education and improved communication), behavior and motivation. Interventions areas include pharmacological treatments, habits and life style, as well as social and family support. The most effective model emphasizes self-care and self-responsibility of the user to manage their disease and increase adherence., (Copyright © 2013 Elsevier España, S.L. All rights reserved.)