Purpose: To evaluate the acceptability, retention, and efficacy of face-to-face intervention, incorporating education and Motivational Interviewing (MI) to support persons with relapsing-remitting multiple sclerosis (PwRRMS) and increase self-reported medication adherence.
Patients And Methods: PwRRMS (N = 60) prescribed Disease Modifying Treatment (DMT), who were identified as non-adherent and consented to participate in an intervention, received verbal education and counseling from their treating physician, a tailored MI counseling and a booster session via telephone with a health psychologist, and a concluding MI counseling six months later. Each PwRRMS filled a battery of patient-reported outcomes (PROs) at baseline, six and 12 months later. The design was a quasi-experimental pre-test post-test across a year.
Results: Of the sixty identified persons who consented to enroll, 52 completed the intervention and 46 completed the follow-up. At six months following the baseline, adherence scores increased (median = 12.0) and were significantly different than at baseline (median=10.0, p = 0.030). Still, at 12 months follow-up there was no significant difference from baseline in reported adherence (median = 11.0, p = 0.106).
Conclusion: This study demonstrated reasonable retention and initial efficacy of a combined psycho-education and MI protocol for PwRRMS to enhance medication adherence to DMT. To maintain the change, a more sustained intervention is required.
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http://dx.doi.org/10.2147/PPA.S455518 | DOI Listing |
Alzheimers Dement
December 2024
Senior Doc, Orange, CA, USA.
Background: Measuring the effectiveness of dementia care programs is essential for ensuring quality care and aligning with value-based care principles, especially in practical, real-world clinical settings. A Delphi method, a consensus-building approach among experts, was used to identify practical metrics for evaluating dementia programs. The expert panel comprised a clinical psychologist, two healthcare executives, and a physician experienced in person-centered care for older adults in residential and facility settings.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Michigan State University, East Lansing, MI, USA.
Background: Confabulation, the fabrication of details with short lucid intervals, hinders the diagnosis of Alzheimer's and other dementias. This case report explores the complexities of diagnosing and managing Alzheimer's dementia in a culturally diverse patient exhibiting fluctuating memory and confabulation, emphasizing challenges heightened by cultural and linguistic factors.
Case: An 84-year-old African descent man resided with his family in the United States, independent in his basic daily activities but struggling with instrumental tasks due to memory impairment.
Alzheimers Dement
December 2024
University of Waterloo, Waterloo, ON, Canada.
Background: The Medication Review in Cognitive Impairment and Dementia (MedRevCiD) checklist is a new tool designed to assist health care professionals in optimizing medication use in individuals with Mild Cognitive Impairment (MCI) or dementia. It consists of 6 domains, each of which addresses a specific medication use issue such as medication management and adherence. The primary objective of this study was to compare the mean number of drug-related problems (DRPs) identified with MedRevCiD Checklist to the Medication Appropriateness Index (MAI) in older adults attending a primary care-based memory clinic.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
University of Waterloo, Waterloo, ON, Canada.
Background: Up to 30% of hospitalizations in older adults living with Mild Cognitive Impairment (MCI) and dementia are attributed to drug-related problems (DRPs), including adverse drug reactions, drug interactions, potentially inappropriate medication (PIM) use, and medication non-adherence. This study categorizes the identified DRPs according to the Pharmaceutical Care Network Europe (PCNE) Classification for DRPs version 9.1.
View Article and Find Full Text PDFClin Kidney J
January 2025
Pharmacoepidemiology Unit, Department of Clinical Pharmacology, Amiens-Picardie University Medical Center, Amiens, France.
Background: We sought to comprehensively describe drug-related components associated with acute kidney injury (AKI) in patients with chronic kidney disease (CKD), describing the incidence of drug-related AKI, the proportion of preventable AKI, identified the various drugs potentially associated with it, explored the risk factors, and assessed the 1-year incidences of the recurrence of drug-related AKI, kidney failure, and death.
Methods: CKD-REIN is a French national prospective cohort of 3033 nephrology outpatients with a confirmed diagnosis of CKD (eGFR <60 ml/min/1.73 m²).
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