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Objectives: Historically, nonadherence to medication has been a major problem faced by health care workers while treating chronic illnesses. Nonadherence to psychotropic medications is known to be associated with poorer treatment outcomes, remarkable risk, and cost to the medical system in managing psychiatric illness. For care providers, partial compliance or discontinuation of medications represents the difficulty of maintaining treatment successes over time. In this study, we intended to assess medication adherence and to understand the reasons for nonadherence in patients with major psychiatric disorders in southern India. Methods: This is a cross-sectional observational study, done from January to June 2023. With the International Classification of Diseases 10th Revision diagnosis, we assessed patients with psychotic disorders, bipolar affective disorders, and major depressive disorder. The Medication Adherence Rating Scale (MARS) was used to assess medication adherence. The patients also completed copies of semi-structured questionnaire on their sociodemographic characteristics, their medications, and reasons for nonadherence. Results: A total of 147 subjects were assessed. We found that 68.0% of subjects were poorly adherent to the treatment based on MARS, and that only 32.0% of them were strictly adherent to the treatment. The reasons for poor adherences to the medication treatment were carelessness or forgetfulness (21.8%), adverse effects of the medications (16.3%), and the perception of the subject of feeling better (15.6%). Conclusion: More than two thirds of the subjects was found to be non-adherent to the medications. Assessing various reasons for medication adherence will help find strategies to improve medication adherence and thus outcome of the treatment. [ABSTRACT FROM AUTHOR]

Background: Schizophrenic patients' adherence to medication regimens can determine clinical outcome success. This study focuses on medication adherence and its correlation with the efficacy of anti-psychotics. The study's goal is to (1) assess the efficacy of anti-psychotics and adherence using the Self-evaluation of Negative Symptoms (SNS) tool and Medication Adherence Rating Scale (MARS), and (2) examine the demographic and clinical factors that could impact both outcomes (SNS and MARS). Materials and Methods: Between November 2021 and February 2022, a cross-sectional study was carried out. Only 45 of 100 schizophrenia patients screened were included in the sample. MARS and SNS self-assessment questionnaires that took approximately 15 min to complete were administered to patients in a scheduled clinic interview. Other patients' demographic, physical, and clinical information was gathered from their electronic medical records via a Redcap designed data collection sheet. Results: Almost 53.3% of the current schizophrenic patients had perceived mild negative symptoms (scored 1 to <20 out of 40 on SNS). Surprisingly, 64.4% were either poor adherent (n=13 scored 5 to 6) or non-adherent (n=16 scored <5). There was a notable negative correlation between the total MARS score and both total SNS (r = -0.325, p=0.03) and social withdrawal scores (r = -0.436, p=0.003). Non-adherence was significantly associated with lower education levels (p=0.028) and unemployment (p=0.008), whereas SNS total score and anhedonia were both markedly associated with different marital status (p=0.046, and p=0.016, respectively). Conclusion: According to the study, medication schizophrenia nonadherence correlates negatively with the efficacy of anti-psychotics as perceived by patients, which reflects patient quality and perception of life. These findings strongly emphasize the importance of developing adherence interventions to enhance compliance with anti-psychotic regimens and improve patients' perceived self-evaluation of negative symptoms. [ABSTRACT FROM AUTHOR]

Objectives: Historically, nonadherence to medication has been a major problem faced by health care workers while treating chronic illnesses. Nonadherence to psychotropic medications is known to be associated with poorer treatment outcomes, remarkable risk, and cost to the medical system in managing psychiatric illness. For care providers, partial compliance or discontinuation of medications represents the difficulty of maintaining treatment successes over time. In this study, we intended to assess medication adherence and to understand the reasons for nonadherence in patients with major psychiatric disorders in southern India. Methods: This is a cross-sectional observational study, done from January to June 2023. With the International Classification of Diseases 10th Revision diagnosis, we assessed patients with psychotic disorders, bipolar affective disorders, and major depressive disorder. The Medication Adherence Rating Scale (MARS) was used to assess medication adherence. The patients also completed copies of semi-structured questionnaire on their sociodemographic characteristics, their medications, and reasons for nonadherence. Results: A total of 147 subjects were assessed. We found that 68.0% of subjects were poorly adherent to the treatment based on MARS, and that only 32.0% of them were strictly adherent to the treatment. The reasons for poor adherences to the medication treatment were carelessness or forgetfulness (21.8%), adverse effects of the medications (16.3%), and the perception of the subject of feeling better (15.6%). Conclusion: More than two thirds of the subjects was found to be non-adherent to the medications. Assessing various reasons for medication adherence will help find strategies to improve medication adherence and thus outcome of the treatment.

Background: Chronic headache greatly affects the quality of life and also constitutes a significant burden on the health system. Objective: The objective of this study was to evaluate the feasibility of telephone-based follow-up in a cohort of headache patients in India. Materials and Methods: This was a longitudinal cohort study of patients with episodic headache with one physical visit in the neurology outpatient services in the last year. Two neurologists conducted the telephone follow up (TFU) of included patients 12 weeks apart. We evaluated the following: (1) objective characterization of headache, (2) coexistent depression and anxiety, (3) patient satisfaction, (4) treatment adherence, and (5) changes in medications. Results: A total of 214 out of 274 eligible patients were included in the cohort. The mean age was 31.74 ± 7.77 years (18–45), and 164 (77%) were females. Migraine without aura was the most common diagnosis in 159 (74%). The mean disease duration was 78.01 ± 70.15 months (8–360). Concurrent depression and anxiety were noted in 87 (40.6%) and 45 (21%) of the patients, respectively. There was a significant improvement in the headache frequency (23.82 vs. 1.06, P < 0.001), severity (7.21 vs. 2.62, P = 0.032), and Headache Impact 6-item score (58.12 vs. 38.01, P = 0.014) at baseline and second follow-up. The satisfaction level to TFU in the first and second interviews was 94.4% and 97.2%, respectively. Conclusion: Telephone-based follow-up is a feasible alternative for repeat outpatient consultation of headache patients.

Introduction: The Medication Adherence Rating Scale (MARS) is a self-rated questionnaire that assesses medication compliance., Aim: This study aimed to validate the Malaysian language translation of the MARS (MARS-M)., Method: The original scale was translated to Malay via forward and backward translation process. The psychometric properties of the MARS-M were validated on clinical samples (N = 54)., Results: The MARS-M was filled by 54 participants. Exploratory factor analysis supported a two-factor model. Factor 1 of the MARS-M consisted of four items (α = 0.84), while factor 2 consisted of three items (α = 0.78).Kaiser-Meyer-Olkin measure of sampling adequacy was 0.60, and Bartlett's test of sphericity was significant (X 2 (28) = 66.4, p <0.001)., Conclusion: The MARS-M is reliable and valid., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Tan et al.)

Regular use of inhaled corticosteroids (ICS) is the standard of care for patients with persistent asthma and chronic obstructive pulmonary disease (COPD). Adherence to ICS is measured using the 10-item Medication Adherence Report Scale (MARS), a self-reported medication adherence assessment. However, data on the validity of this measure are limited. Data were obtained from two cohort studies that examined the association of health literacy with self-management behaviors among adults ages 65 and older with asthma and adults ages 40 and older with COPD. ICS adherence was objectively measured over a 4-week period using electronic monitoring devices. Adequate adherence by MARS assessment was defined as a score ≥4.5, and by electronic monitoring as ≥80% of doses prescribed. We assessed the criterion validity using correlations between self-reported adherence and electronic adherence. Receiver Operating Characteristic (ROC) curve analysis was performed between the two measures. Among patients with asthma, the continuous values for adherence measured by self-report and electronically were weakly correlated (r = 0.33, p < 0.001); similarly, the agreement between the dichotomized measures was weak (kappa 0.30, p=.49). Findings were similar for COPD patients: r = 0.26, p = 0.003; kappa 0.19, p =.60. Area under curve (AUC) values generated from ROC analysis was 0.69 and 0.61, for asthma and COPD patients, respectively. Commonly used measure for adherence performed weakly compared to electronic monitoring in separate populations of patients with asthma and COPD. Investigators measuring self-reported medication adherence among patients with these pulmonary diseases should consider using alternative instruments or using objective measures exclusively. [ABSTRACT FROM AUTHOR]

Diabetes Mellitus (DM) has emerged as a major global healthcare problem. The risk of diabetes can be reduced by maintaining blood glycaemic levels, which can be achieved by stringent adherence to the treatment regime. Therefore, there is a continuing need to assess the level of adherence to medication/self-care activities and the factors that are related to non-adherence to medication and self-care. This would facilitate healthcare professionals to identify subjects with low medication adherence and thereby aid them in planning interventions to improve medication and self-care adherence. In this study, we aimed to estimate the proportion of medication adherence among diabetic patients above 60 years of age attending a tertiary care hospital in Southern India. We found that 72% of type 2 diabetes patients were adherent to the medications prescribed to them and there was a discernible effect of gender and literacy on medication adherence. However, more such regional studies need to be conducted with a larger sample size from diverse hospital setups to obtain a clear and unbiased picture of the drug adherence scenario in India., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Udupa et al.)

• The Medication Adherence Rating Scale's (MARS) factor structure is understudied. • Confirmatory factor analysis supported a three-factor structure. • Lower insight, higher stigma, higher loss and grief predicted lower adherence. • Lower adherence was significantly associated with lower quality of life. • The MARS is a useful research tool to examine adherence in different languages. The present study examined the factor structure of the Hungarian version of the Medication Adherence Rating Scale (MARS) and analyzed its association with socio-demographics, insight, internalized stigma, and the experience of loss and grief as a result of the mental illness diagnosis, using confirmatory factor analysis (CFA) with a series of one covariates at a time. Mentally ill patients (N=200) completed self-report questionnaires. CFA supported the original three-factor structure although one item was moved from its original factor to another. Lower insight, higher internalized stigma, loss, and grief were significant predictors of lower treatment adherence. Lower adherence was found to be significantly associated with lower quality of life. No difference in adherence was found between different diagnostic groups, which stresses the need to examine non-adherence in the wider spectrum of mental diagnosis. The study also stresses the importance of patients' subjective experience in promoting better adherence, and raises the need to address the experience of stigma but also of less studied experiences, such as patients' feelings of loss and grief. Integrating these experiences in intervention programs might have meaningful implications for the improvement of treatment adherence and patients' quality of life. [ABSTRACT FROM AUTHOR]