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Insulin therapy in type 2 diabetes: Insights into clinical efficacy, patient-reported outcomes, and adherence challenges

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World Journal of Diabetes 2024年第5期15卷 828-852页

作者： Mahmoud Emad-Eldin Gehan F Balata Eman A Elshorbagy Mona S Hamed Mohamed S Attia Department of Pharmacy Practice Faculty of PharmacyZagazig UniversityZagazig HFQM+872Al-Sharqia GovernorateEgypt Department of Pharmacy Practice Faculty of PharmacyHeliopolis UniversityCairo 44519Egypt Department of Pharmaceutics Faculty of PharmacyZagazig UniversityZagazig 44519Al-Sharqia GovernorateEgypt Department of Internal Medicine Faculty of MedicineZagazig UniversityZagazig 44519Al-Sharqia GovernorateEgypt Department of Community at Faculty of Medicine Zagazig UniversityZagazig 44519Al-Sharqia GovernorateEgypt

Insulin therapy plays a crucial role in the management of type 2 diabetes as the disease *** the past century,insulin formulations have undergone significant modifications and bioengineering,resulting in a diverse range of available insulin *** products show distinct pharmacokinetic and pharmacodynamic ***,various insulin regimens have em-erged for the management of type 2 diabetes,including premixed formulations and combinations of basal and bolus *** utilization of different insulin regimens yields disparate clinical outcomes,adverse events,and,notably,patient-reported outcomes(PROs).PROs provide valuable insights from the patient’s perspective,serving as a valuable mine of information for enhancing healthcare and informing clinical *** to insulin therapy,a critical patient-reported outcome,significantly affects clinical outcomes and is influenced by multiple *** review provides insights into the clinical effectiveness of various insulin preparations,PROs,and factors impacting insulin therapy adherence,with the aim of enhancing healthcare practices and informing clinical decisions for individuals with type 2 diabetes.

关键词： adherence Diabetes Insulin Patient-reported outcomes Pharmacokinetic Pharmacodynamic

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Scale offers the possibility of identifying adherence to lifestyle interventions in patients with non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2024年第25期30卷 3179-3181页

作者： Cen-Qin Liu Bing Hu Department of Gastroenterology and Hepatology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Gastroenterology and Hepatology/Medical Engineering Integration Laboratory of Digestive Endoscopy West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disorder,and dietary and lifestyle interventions remain the mainstays of NAFLD *** et al established a prediction system to evaluate adherence to lifestyle interventions in patients with NAFLD and choose optimal ***,we discuss the application scenarios of the scale and the areas warranting further attention,aiming to provide a possible reference for clinical recommend-ations.

关键词： Nonalcoholic fatty liver disease Dietary and lifestyle interventions Scale adherence Exercise

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adherence to Pharmacotherapy in Post-Menopausal Women with Hypertension or Metabolic Syndrome: Real World Experience

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International Journal of Clinical Medicine 2024年第3期15卷 145-154页

作者： Maria Maiello Francesca Amati Vincenzo Ezio Santobuono Andrea Igoren Guaricci Cinzia Forleo Marco Matteo Ciccone Pasquale Palmiero Department of Cardiology ASL BR SSN3 Brindisi Italy Cardiovascular Diseases Section Interdisciplinary Department of Medicine (DIM) University of Bari “Aldo Moro” Bari Italy

Background: adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, interactions with health care providers, and medication complexity. Even though several studies were conducted to test intervention strategies, results are uncertain. Aim: The aim of the study is to assess if a tailored combined intervention strategy improves medication adherence in a large population of post-menopausal women affected by hypertension or metabolic syndrome. Methods: We enrolled 6833 patients aged 50 to 69 years, 85.7% with hypertension, and 14.3% with metabolic syndrome. A network between patients, general practitioners, and cardiologists was established. Interventions included education, adequate information to patients, a simplified scheme of treatment, and periodic adherence assessment. These were either delivered as healthcare provider supports or using modern technology. Medication adherence was estimated by the proportion of days covered for all classes of drugs after the index date. Results: Non-adherent hypertensive women were 297 (5%), and those with metabolic syndrome were 73 (7.4%) (p Conclusions: The rate of non-adherence in both settings of postmenopausal women was 7.7%, much lower than that described in the literature. This rate was increased in patients with metabolic syndrome;probably it is related to the complexity of the therapeutic scheme or to a poor consciousness of the disease. Therefore, implementing a tailored combined intervention can improve significantly patients’ adherence to medical therapy.

关键词： adherence Cardiovascular Prevention Postmenopausal Women Hypertensive Metabolic Syndrome

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Effectiveness of Short Message Service Support on adherence to Chemotherapy Treatment among Patients Attending Cancer Treatment Facilities in Kenya

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Open Journal of Nursing 2024年第3期14卷 93-113页

作者： Nebert Kiguhe Mchidi John P. Oyore Gordon Ogweno Department of Specialized Surgery . Kenyatta National Hospital Nairobi Kenya Department of Community Health and Epidemiology School of Public Health Kenyatta University Nairobi Kenya Department of Medical Physiology School of Medicine Kenyatta University Nairobi Kenya

Introduction: Cancer is a chronic debilitating disease that unnerves patients, communities, and nations. At some point in cancer patient’s disease experience, chemotherapy is used, and the patient is expected to adhere to treatment to improve survival and quality of life. Methods: This multisite Cluster Randomized Trial (CRT) evaluated the effectiveness of mobile phone Short Message Service (SMS) support on the adherence to treatment schedules among adult cancer patients in Kenya. Data was collected using questionnaires. Ethical approvals were obtained from relevant Ethical Review Boards (ERBs). Results: The mean adherence was 83%. There was a significant difference between treatment arms in relation to the adherence. The intervention arm had a higher mean adherence difference, M = 3.913, 95% CI 2.632-5.193, t (402) = 6.006, p ≤ 0.001), with Cohen’s d = 0.60. Although not significant, (χ2dd = 0.151, df = 1, p = 2.064), more women were perfect adheres than males. Perfect adherers were satisfied with SMS support (χ2dd = 7.620, df = 1, p = 0.06), were in the intervention arm (χ2dd = 22.942, df = 1, p ≤ 0.001), and had trust in the care provider (χ2dd = 10.591 p ≤ 0.001). SMS support was not significant in the multivariate analysis but had an estimated effect size of 0.958 (z = 1.424, p = 0.154, CI = 0.242-3.781), indicating that mean adherence was slightly better in the presence of the intervention. Conclusions: SMS-support intervention has demonstrated superiority in influencing adherence. Further, health system-related factors have a significant influence on the adherence to chemotherapy treatment. Interventions to re-design health systems that are responsive to unmet care needs of cancer patients must be explored. .

关键词： adherence Cancer Symptom Distress Quality of Life Medication Posses-sion Ratio Short Message Service Survivorship

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adherence and invasion of mouse-adapted H pylori in different epithelial cell lines

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World Journal of Gastroenterology 2007年第6期13卷 845-850页

作者： Mao-Jun Zhang Fan-Liang Meng Xiao-Yun Ji Li-Hua He Jian-Zhong Zhang Department of Diagnostics National Institute for Communicable Disease Control and Prevention Chinese Center for Disease Control and Prevention Beijing 102206 China Supported by the National Natural Science Foundation of China No. 30370078

AIM： To assess the adhesion and invasion abilities of different mouse adapted H py/or/strains in different cell lines in vitro and investigate their effects on the virulence factors cagA and vacA. METHODS： The adherence and invasion abilities of different N pylori strains in different epithelial cell lines were examined by the gentamycin protection assay. The null mutants of cagA and vacA were processed by direct PCR mutation method. The morphologic changes of different cell lines after N pylori attachment were examined by microscopy. RESULTS： The densities of adherence to and invasion into cells in vitro were different from those in the mouse infection experiments. 88-3887 strain could invade and adhere to cells stronger than SS1 and X47. All tested strains had better adhering and invasive abilities in SCG-7901 cell. CagA and vacA minus mutants had the same invasion and adherent abilities as their wild types. In all strains and cell lines tested, only AGS cell had the significant hummingbird phenotype after inoculation with the 88-3887 wild-type. CONCLUSION： Both the host cells and the bacteria play important parts in the invasion and adhesion abilities of Hpylori. CagA and VacA are not related to the ability of invasion and adhesion of Hpylori in different cell lines in vitro.

关键词： Hpylori adherence Invasion Cell line

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adherence to pharmacological and non-pharmacological treatment of frail hypertensive patients

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Journal of Geriatric Cardiology 2018年第2期15卷 153-161页

作者： Beata Jankowska-Polanska Karolina Zameta Izabella Uchmanowicz Anna Szymanska-Chabowska Donald Morisky Grzegorz Mazur Department of Clinical Nursing Wroclaw Medical University Wroclaw Poland Department of lnternal Medicine Occupational Diseases Hypertension and Oncology Wroclaw Medical University Wroclaw Poland Department of Community Health Sciences UCLA Fielding School of Public Health Los Angeles USA

Objective To investigate the relationship between frailty syndrome （FS） and adherence to pharmacological and non-pharmacological treatment for hypertension. Methods The study included 100 patients diagnosed with hypertension and treated with one or more hypotensive drugs. Results Frail patients obtained low scores （4.1 ± 2.0） for adherence to pharmaceutical treatment of hypertension, while non-frail patients obtained moderate scores （6.1 ± 2.1）. Non-frail patients had higher scores in two out of four domains of the Health Behavior Inventory （HBI）： positive mental attitudes （3.6 ± 0.4 vs. 3.2 ± 0.5; P = 0.006） and health practices （3.6 ± 0.5 vs. 3.2 ± 0.5; P 〈 0.03）; as well as higher global scores （HBI raw score）： 83.3 ±10.6 vs. 77.3 ± 9.5; P 〈 0.03. Multiple regression analysis showed that frailty syndrome （FS） was a statistically significant independent determinant of worse adherence to pharmacological treatment （β= -0.27; P 〈 0.001） and health behaviors （β = -0.10; P = 0.036）. Education was a statistically significant independent determinant of better adherence to pharmacological treatment （β = 0.82; P = 0.012）, while net income positively affected health behaviors as measured by the HBI （β = 0.39; P = 0.046）. Conclusions FS is a significant independent factor contributing to worse adherence to pharmacological and non-pharmacological treatment of hypertension. Better education significantly improves patients＇ adherence to the prescribed pharmacological treatment, while a good financial standing evidenced by high net income is a determinant of better adherence to health-related behaviors recommended in hypertension treatment.

关键词： adherence Elderly Frailty syndrome Non-pharmacological treatment

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adherence to self-care practices, glycemic status and influencing factors in diabetes patients in a tertiary care hospital in Delhi

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World Journal of Diabetes 2018年第5期9卷 72-79页

作者： Saurav Basu Suneela Garg Nandini Sharma M Meghachandra Singh Sandeep Garg Department of Community Medicine Maulana Azad Medical College Department of Medicine Maulana Azad Medical College

AIM To assess the adherence to self-care practices,glycemic status and influencing factors in diabetes *** This was a cross-sectional observational analysis of baseline data from a quasi-experimental study conducted among 375 diabetic patients aged between 18 to 65years at a major public tertiary care centre in New Delhi,India during February-September’*** Summary of Diabetes Self-care activities measure was used to assess medical adherence in diabetic *** ended questions were used to identify facilitators and inhibitors of medical *** Mean age of the study subjects was 49.7±10.2 years.A total of 201 men and 174 women were enrolled in the *** hundred nine(82.4%)subjects were adherent to their intake of anti-diabetic *** binary logistic regression,education level below primary school completion and absence of hypertensioncomorbidity were found to be independent predictors of medication *** resistance was an important factor impeding outdoor exercise among younger *** of diabetes in the study subjects was low with mean score of 3.1±2(maximum score=10).Suboptimal glycemic control was found in259(69%)subjects which was significantly more likely in patients on Insulin therapy compared to those on Oral Hypoglycemic agents alone(Padherence and glycemic *** suggests the need for enhanced physician focus for diabetic patient management.

关键词： Diabetes adherence Glycemic control Insulin India

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adherence to surveillance endoscopy following hospitalization for index esophageal variceal hemorrhage

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World Journal of Gastrointestinal Surgery 2018年第4期10卷 40-48页

作者： Brendan T Everett Steven D Lidofsky Gastroenterology and Hepatology Unit University of Vermont Medical Center

AIM To investigate patient adherence to surveillance endoscopy after index esophageal variceal hemorrhage and the extent to which adherence influences *** We reviewed the records of patients with cirrhosis admitted to the medical intensive care unit between 2000 and 2014 for first time esophageal variceal hemorrhage treated with endoscopic variceal ligation who were subsequently discharged and scheduled for surveillance endoscopy at our medical center. Demographic and clinical data were obtained through the medical records, including etiology of cirrhosis, completion of variceal obliteration, attendance at surveillance endoscopy, zip code of primary residence, distance from home to hospital, insurance status, rehospitalization for variceal hemorrhage, beta-blocker at discharge, pharmacologically treated psychiatric disorder, and transplant free survival. RESULTS Of 99 consecutive survivors of esophageal variceal bleeding, the minority(33) completed variceal obliteration and fewer(12) adhered to annual surveillance. Completion of variceal obliteration was associated with fewer rehospitalizations for variceal rebleeding(27% vs 56%, P = 0.0099) and when rehospitalizations occurred, they occurred later in those who had completed obliteration(median 259 d vs 207 d, P = 0.0083). Incomplete adherence to endoscopic surveillance was associated with more rehospitalizations for variceal rebleeding compared to those fully adherent to annual endoscopic surveillance(51% vs 17%, P = 0.0328). Those adherent to annual surveillance were more likely to be insured privately or through Medicare compared to those who did not attend post-hospital discharge endoscopy(100% vs 63%, P = 0.0119).CONCLUSION Most patients do not complete variceal obliteration after index esophageal variceal hemorrhage and fewer adhere to endoscopic surveillance, particularly the uninsured and those insured with Medicaid.

关键词： Liver cirrhosis Endoscopy Esophageal varices Secondary prevention Patient adherence

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Prevalence,predictors,and clinical consequences of medical adherence in IBD:How to improve it?

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World Journal of Gastroenterology 2009年第34期15卷 4234-4239页

作者： Peter Laszlo Lakatos 1st Department of Medicine Semmelweis University

Inflammatory bowel diseases(IBD)are chronic diseases with a relapsing-remitting disease course necessitating lifelong ***,non-adherence has been reported in over 40%of patients,especially those in remission taking maintenance therapies for IBD. The economical impact of non-adherence to medical therapy including absenteeism,hospitalization risk, and the health care costs in chronic conditions,is *** causes of medication non-adherence are complex,where the patient-doctor relationship, treatment regimen,and other disease-related factors play key ***,subjective assessment might underestimate *** adherence may result in more frequent relapses,a disabling disease course, in ulcerative colitis,and an increased risk for colorectal *** medication adherence in patients is an important challenge for *** the different patient types,the reasons given by patients for non-adherence,simpler and more convenient dosage regimens,dynamic communication within the health care team,a self-management package incorporating enhanced patient education and physician-patient interaction,and identifying the predictors of nonadherence will help devise suitable plans to optimize patient *** editorial summarizes the available literature on frequency,predictors,clinical consequences,and strategies for improving medical adherence in patients with IBD.

关键词： Inflammatory bowel disease Crohn's disease Ulcerative colitis Therapy adherence Compliance 5-aminosalicylate Mesalazine Azathioprine

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Patient education improves adherence to peg-interferon and ribavirin in chronic genotype 2 or 3 hepatitis C virus infection:A prospective,real-life,observational study

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World Journal of Gastroenterology 2008年第40期14卷 6195-6203页

作者： Patrice Cacoub Denis Ouzan Pascal Melin Jean-Philippe Lang Michel Rotily Thierry Fontanges Marina Varastet Michel Chousterman Patrick Marcellin Department of Internal Medicine Pitié-Salpêtrière Hospital Pierre and Marie Curie (Paris 6) University Department of Hepato-Gastroenterology Arnault Tzanck Institute Department of Polyvalent Medicine Hospital of Saint Dizier Department of Psychiatry and Addiction Hospital of Erstein ClinSearch Bagneux 92220France Department of Hepato-Gastroenterology General Hospital of Bourgoin Department of Hepato-Gastroentrology Hospital of Créteil (CHIC) Department of Hepatology Beaujon Hospital INSERM U 773 CRB3University of Paris VⅡBeaujon Hospital

AIM： To evaluate the impact of therapeutic education on adherence to antiviral treatment and sustained virological response （SVR） in a real-life setting in genotype 2/3 hepatitis C, as there are few adherence data in genotype 2/3 infection, even from randomized trials. METHODS： This prospective survey included genotype 2/3 patients who received peg-interferon alfa-2b and ribavirin. There was no intervention. adherence wasself-reported over the past 4 wk （peg-interferon） or 7 d （ribavirin）. adherence to bitherapy was defined as adherence to the two drugs for ≥ 20 wk. SVR was defined as undetectable RNA ≥ 12 wk after the end of treatment. RESULTS： 370/674 patients received education during the first 3 mo of treatment. After 6 too, adherence to bitherapy was higher in educated patients （61% vs 47%, P = 0.01）. adherence to peg-interferon was 78% vs 69% （P=0.06）. adherence to ribavirin was 70% vs 56% （P = 0.006）. The SVR （77% vs 70%, P = 0.05） and relapse （10% vs 16%, P = 0.09） rates tended to be improved. After adjustment for baseline differences, education improved adherence [Odds ratio （OR） 1.58, P = 0.04] but not the SVR （OR 1.54, P = 0.06）. CONCLUSION： In genotype 2/3 patients, therapeutic education helped maintain real-life adherence to bitherapy.

关键词： Viral hepatitis adherence Therapeutic education Real life Peg-interferon Ribavirin

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